An Evaluation of the Impact of Medicaid Expansion in New Hampshire
Health Strategies of New Hampshire
Lewin contact: Randy Haught
As a result of the June 2012 Supreme Court ruling that the federal government cannot require individual states to expand their Medicaid programs for adults, as under the Affordable Care Act (ACA), The Lewin Group is working with the New Hampshire Department of Health and Human Services (DHHS) to explore the potential financial impacts of expanding or not expanding the state’s Medicaid program. This report provides estimates on Medicaid enrollment and costs under the option of not expanding Medicaid compared to the option of expanding the program under various program design options. We find that if the state does not expand Medicaid, it could reduce state Medicaid spending by $66 to $114 million over the 2014-2020 period. However, expanding Medicaid would (1) reduce the number of uninsured in the state by an additional 22,300 people, (2) provide subsidized coverage for low income adults in the state, who would not have access without the expansion, and (3) increase federal revenues in the state by $1.8 to $2.7 billion over the 2014-2020 period.
In Phase II of the study, to be released in December 2012, Lewin will estimate the secondary effects of expanding versus not expanding Medicaid in the state. This will include the impact of additional federal revenues on the state economy if the state expands Medicaid, the impact on spending for other state programs, the impact on Medicaid Disproportionate Hospital Share (DSH) payments and provider uncompensated care, the financial impact on health care providers, and the potential impact on cost shifting and its effect on commercial premiums.