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Hospitals and Medicaid Expansion

September 10, 2013 Common Cents

Hospitals in New Hampshire would do better financially if Medicaid is expanded to more low-income families, according to the Lewin Group report that looked at New Hampshire’s situation.

“We estimate that health systems would see an increase in net income of about $113.1 million under the Medicaid expansion assuming full implementation in 2014, which would represent a 28 percent increase from their current net income,” the report concludes

This is in direct contradiction to an online Forbes article by commentator Avik Roy who suggested incorrectly that New Hampshire hospitals will lose money under the Medicaid expansion.

The state of New Hampshire, through the Department of Health and Human Services, commissioned the Lewin Group, a national consulting firm, to analyze what would happen to New Hampshire’s budget and economy if it went forward with the Medicaid expansion.  Lewin found that the Medicaid expansion would improve both.  To wit:

“The ACA boosts NH’s economy and revenues, and Medicaid expansion maximizes these economic and fiscal impacts,” the report reads.

Roy concludes hospital will lose money by relying on a comparison of the impact on hospitals if Medicaid expansion went forward against what would happen if the expansion did not.

But in both scenarios, hospitals benefit, according to Lewin.

“Overall, health systems would see an increase in net income of $113 million under expansion, compared to $158 million under no expansion.”  That is to say, under either scenario, hospitals will see an increase in net income under the Affordable  Care Act.

Furthermore, the New Hampshire Hospital Association remains firmly in support of expanding Medicaid.

In a recent news release, the association observed that “[the online Forbes article] misinterprets the Lewin Group analysis on the impact of expanding Medicaid to New Hampshire’s hospitals and greatly misses the mark on what Medicaid expansion is all about… In the end, this is about getting patients the right care, at the right time, in the right place.”

The Forbes article also suggests the Medicaid expansion will cause more people to lose their private insurance than will gain it under Medicaid.

To the contrary, the Lewin report actually says that 38,000 uninsured people will be covered by the Medicaid expansion and that 20,000 people who are currently privately insured may choose to leave that private coverage for public coverage. The number of people with coverage, private or public, increases; it does not fall.

Critics who use the Forbes article as justification for not moving forward with the Medicaid expansion should review both the Lewin Group reports and consider the testimony from hospitals, community health centers, community mental health centers, doctors, nurses and citizens – all of whom cite compelling reasons for New Hampshire to accept the federal funds to get more people covered.

For more information, including copies of the Lewin Report and public testimony, visit our Resource Page.


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Interactive Maps of Municipal Economic Disparities and Fiscal Capacities

30 Aug 2018

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New Hampshire’s economy continues to grow overall, but significant disparities in economic conditions and service needs exist within the boundaries of the Granite State. Differences between the southeastern part of the state and the more rural northern and western regions can be identified broadly and are present across many different indicators. However, experiences in local communities can vary widely even within regions. NHFPI’s new Issue Brief, Measuring New Hampshire’s Municipalities: Economic Disparities and Fiscal Capacities, explores measures indicating the differing experiences of these communities. Interactive maps showing many of these measures are available through NHFPI’s Data Viz posts.