The Union Leader published a misleading op-ed written by Greg Moore, state director of the Koch-funded Americans for Prosperity (AFP), which promoted tired conservative myths surrounding Medicaid expansion in New Hampshire.

Moore's op-ed in the September 30 Union Leader attempted to discredit Medicaid expansion currently being debated by a panel of state lawmakers who are expected to make a final recommendation by October 15. The piece pushed previously debunked claims that Medicaid expansion would force people off private health care and onto Medicaid, would create long wait times to see doctors, and that the government will be unable to pay for expansion:

According to a report commissioned for the state Department of Health and Human Services by the Lewin Group, expansion would result in 20,500 people being dropped from their high-quality private health insurance into a substandard Medicaid program.

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With expansion, we will also need to be prepared to wait longer to see our doctors. A study of Oregon's expansion published in May's New England Journal of Medicine showed that under Medicaid, with its lack of deductibles and minimalist co-payments, health care utilization of those covered exploded. With a major new demand in doctors' time and no new supply of doctors, it means that under expansion doctors will be stretched thin and we should all be prepared to wait more to get an appointment or a referral.

Then there's the question of money. Obamacare supporters claim that the federal government will pay for the entirety of expansion for three years and the vast majority as far as the eye can see, and that the federal government will “always” keep its promise.

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With a nation that's $17 trillion in debt, it's just a matter of time until the federal government steps away from the high cost of expansion, which starts at more than $350 million each year in New Hampshire and then grows. If state taxpayers have to pick that up, it's hello to a state income tax.

Moore's first point concerning the 20,500 people expected to move from private health care to Medicaid, according to the Lewin Group study, fails to explain the whole story. While denying Medicaid expansion would keep the estimated 20,500 on private insurance, it would also deny 58,000 people any sort of coverage. According to the Lewin Group, failing to expand Medicaid would also result in a need to provide higher uncompensated care:

Although health systems would see more of an improvement in their bottom line, they would need to provide a greater volume of uncompensated care without the Medicaid expansion.

Uncompensated care costs hospitals millions of dollars each year, and with recent cuts to state reimbursement, this could cancel out savings that hospital systems see from denying Medicaid expansion. According to New Hampshire Public Radio:

 “Uncompensated care cost our members a little over $300 million this past year,” Steve Ahnen, president of the New Hampshire Hospital Association, says, “and obviously the state did not pay out anywhere close to that to hospitals.”

Furthermore, the Lewin Group study estimated health systems  -- which include hospitals, physician groups, skilled nursing facilities, freestanding surgical centers, and home health agencies - would “see an increase in net income of about $113.1 million” under expansion.

Moore's second point dismissed benefits of giving the uninsured access to health care, claiming that when Oregon expanded care to those in need, “health care utilization of those covered exploded.” He continued, making the case that the newly covered would create backlogs in the health care system that would mean limited access to doctors. However, according to The Washington Post, a survey in Michigan found that doctors were willing to take on more patients in the event of Medicaid expansion. Furthermore, New Hampshire has more doctors per capita than Michigan, meaning there are more doctors available for each person.

Finally, Moore suggests that the federal government may not be able to pay for its share of the Medicaid expansion, thus shifting costs to the state; however, this myth has been previously debunked. According to The Washington Post, “there just isn't a history of the federal government 'dumping' new spending on the state.”

Moore's organization, Americans for Prosperity, is a notorious media manipulator that is funded by the conservative billionaire Koch brothers.  The Union Leader's op-ed page continues a pattern of support for AFP by repeatedly publishing its misleading talking points.