Shaheen warns proposed cuts to Medicaid could impact addiction treament

Feb. 29--WASHINGTON -- In a budget hearing this week, Sen. Jeanne Shaheen warned that proposed cuts to Medicaid could block thousands of Granite Staters from getting addiction treatment.

Daisy Pierce, executive director of Navigating Recovery of the Lakes Region, said about 80% of her clients have Medicaid, the health insurance for low income and disabled people funded jointly by states and the federal government.

"Without that, we wouldn't be able to get them into treatment beds," Pierce said.

Pierce was not sure how many of her patients became newly eligible for Medicaid when the program was expanded in 2014 -- but state Department of Health and Human Services data show that more than one in four people with Medicaid insurance in New Hampshire are covered through the expansion.

Over the past five years, 23,000 people in New Hampshire have used Medicaid insurance to get treatment, according to an estimate from health policy advocacy group New Futures.

When Health and Human Services Secretary Alex Azar presented the Trump administration's proposed budget for his department, Shaheen drew Azar's attention to the budget's impact on drug treatment.

"Medicaid spending will grow at a more sustainable rate by ending the financial bias that currently favors able-bodied working-age adults over the truly vulnerable," the White House budget document states.

In the budget document and during the hearing Tuesday, Azar and other administration officials framed the change as remedying a bias that resulted in more federal funding going toward health insurance for people who are not disabled or pregnant, and for adults over children.

"Trying to justify this cut by saying this is about 'regularizing' Medicaid funding is grossly Orwellian," Shaheen said in a statement, "when the truth is it would simply kick Granite Staters off their health care and treatment."

Azar told Shaheen that meant reducing the federal reimbursement rate for people who got health insurance through Medicaid expansion -- the piece of the Affordable Care Act that raised the income level to qualify for Medicaid.

The federal-state split varies by state, but right now, New Hampshire covers half the cost of standard Medicaid patients' care, and 10% of Medicaid expansion -- known in New Hampshire as the Granite Advantage Health Care Program. The federal government pays for the rest.

In a hearing Tuesday, Azar said the budget proposal would make the federal reimbursement rate the same for Medicaid and Medicaid expansion programs like Granite Advantage.

This would either put New Hampshire on the hook for a greater portion of the cost of Medicaid expansion or reduce the funds available to care for those people.

"That reduction in funding would make it impossible for states to make up the difference without ending Medicaid expansion," said Shaheen spokesperson Sarah Weinstein.

Shaheen said the Trump administration's proposal would seriously hurt New Hampshire's ability to fight addiction

"There is no alternative in states like New Hampshire providing treatment," Shaheen said to Azar. "I hope that is something you will think about."

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