Shaheen meets with health care officials to discuss potential Medicaid funding cuts
CLAREMONT, N.H. — Medicaid cuts of nearly $900 million could be on the horizon, and U.S. Senator Jeanne Shaheen has been meeting with health care officials this week to get first-hand accounts about what this would do to the services they provide patients.
On Wednesday, Shaheen visited Valley Regional Hospital in Claremont, where one in three residents are enrolled in Medicaid. Valley Regional Hospital CEO Matt Foster said in the discussion that the uncertainty of what may or may not happen at the federal level is challenging.
“It is hard to plan for the future,” Foster said, ”when you think about things like Medicare and Medicaid, which are so impactful to critical access hospitals.”
He noted that 62% of families in Claremont are headed by single family households, and 20% of them live below the poverty level. It becomes concerning because they want to have service for their residents, but everything comes with a cost.
“What we don’t want to do is be forced to reduce services, or quite frankly, reduce the number of employees here,” Foster said. “We’re about as efficient as we can be.”
Shaheen, who had already visited Berlin and Laconia and was visiting Concord and Manchester on Thursday, said hearing from people like Foster is exactly why she set up her Medicaid Impact Tour.
The tour comes as Congress is working to advance legislation that would lead to cuts to Medicaid funding that would impact millions of people across the country. On April 10, House Republicans approved a budget resolution by a 216-214 vote that would lead to increasing immigration enforcement and other aspects highlighted by the Trump Administration, while making massive cuts in other areas. Top official have spoken of a goal of about $1.5 trillion in cuts, and the fear by many is that much of this will be through Medicaid.
She believes Medicaid will be the focus of the cut, as the bill includes a hole between $800 and 900 billion.
“The only place you can get those kinds of dollars is the Medicaid program,” she explained.
The proposal could lead to more than 59,000 residents of New Hampshire losing coverage, which includes 7,600 patients receiving treatment for substance use disorders.
She noted that statewide one in seven people, or about 180,000 people, are enrolled in Medicaid in some form. That number is even more staggering in Claremont at a third of the population.
“You talked about the uncertainty, and one of the challenges we have in Washington is uncertainty,” Shaheen said. “It’s been very hard to get information that was being planned, particularly around health care.”
Co-Interim Chief Medical Officer & Physician Practice Medical Director Juliann Barrett told Shaheen that a major impact will be people showing up for non-acute appointments like preventatives, routine follow-ups and routine surveillance. This would also have a drastic impact on the amount of preventative services that cost money but are far less costly if they wait to show up when the situation gets dire.
“We just won’t see them come because they have to prioritize that versus food, or taking care of their kids,” Barrett said. “Inevitably, I’ve seen in this community, health will always unfortunately come last for them.”
Barrett also said there is a significant impact on children, and she hopes that any bill with cuts to Medicaid would not touch their “vulnerable population of children, but it certainly probably would.”
“There’s so much we pick up on as primary physicians when kids just come in for their preventative,” Barrett said.
There was discussion about the Granite Advantage Health Care Program, which provides low-income residents with medical coverage funded through Medicaid. If there are cuts it could cost about 60,000 patients to lose coverage, and without a Plan B to fill the gap, it has health care officials concerned.
“People will just not have care and go to the emergency room,” Shaheen pointed out.
Director of Revenue Cycle and Health Information Management Amy Lavertue said Medicaid is going to impact nursing homes, as well. There will be a struggle to find a disposition source for patients, and they will end up taking up a bed at the hospital, which will be detrimental to others needing treatment.
“I think that’s going to end up being a big driver for us, as well,” Lavertue said.
Shaheen was surprised about one factor she learned in the session, and she plans to bring back information she gathered throughout the week to her colleagues in Washington.
“I hadn’t thought about the extent to which Medicaid covers medical transport, so that is interesting,” Shaheen said. “One of the interesting things about these discussions, and one of the reasons we wanted to do this, is that a lot of people don’t realize what Medicaid covers.”
Shaheen said when she was in Berlin, she met two mothers with adult children with disabilities. The adult children work part-time because they can get paid by Medicaid as care providers. This is a small stipend, she said, but it is enough to have their adult children able to work.
“They are able to support them, driving them to and from the jobs, and that sort of thing that they would not be able to do without that stipend,” Shaheen said. “That means not only the mothers, but the children would be at home without the ability to work or the ability to contribute and pay taxes.”
It is stories like these that turn the situation into more than a numbers game, putting faces to the figures that will be affected.
Foster said there are headlines about hospitals closing their doors, but he said, “I think Valley is not going to do that, thankfully.” He said they have a mission to this community and people are going to need health care, but the prospect is still concerning him and Shaheen alike.
“As you said, this hospital is not going to close, but we have some other smaller hospitals that really are in danger if Medicaid funding goes away,” Shaheen said. “What would that mean, at what point is the breaking point for some of those hospitals and what does that mean for those of you who continue to be able to operate.”
Foster said they will need to focus on what they can do and do it well. With less than 360 employees providing care to 13,000 patients per year, it is a small group.
“At what point do you say, what are the services we’re not going to provide?” Foster said.