SPEAKER_01: 0:00

You're listening to New Hampshire Has Issues and I never do this at the beginning. I usually have like a cold open of sorts where my guests or sometimes me, you know, we say something funny and then the music cuts in and then there's the intro music and then future list shows up. And that's me this time, right at the top. I'm recording this on Monday, January 5th, 2026. It is 9.45 at night. But I thought I would have a re-release of a really important episode, especially now that we're in 2026. Back in August, I had an episode with Christine Stoddard about Medicaid. She does such an excellent job of a tutorial of like what is Medicaid? It's health insurance. What does it actually mean? Who's covered? Why does it matter? Why do we need Medicaid? And that's really important in 2026 because between the state budget in New Hampshire and the federal budget, the changes are coming to Medicaid. Some of the changes are here already. And so going back to that episode, doing a little re-release, especially for new listeners who've joined since then and may not have gone back. Of course you should, go back and listen to all the episodes. But the Medicaid one is extremely timely right now. And I have some guests coming up in the next month or so that talk about healthcare costs. And so I think it's really important to go back to the Medicaid episode as like a refresher. Especially if you've already listened to it back when it came out. Think about how many lifetimes we've lived since August when it was light out at 4 p.m. Do you remember those days? I barely do. And a lot has changed since then. Health care, uh everybody needs it. And what does our state do to make sure that everyone is able to access the care that they need? The one resource I'm gonna point out right at the top as well is the Medicaid Matters website, New Hampshire Needs Medicaid, and the website is nhneedsmedicaid.com. And I'll have the link in the show notes. They have on there the upcoming changes to New Hampshire Medicaid. They talk about what is the current law, what are the expected changes, when are they expected to happen. I feel like I can't emphasize enough. Even if you are not covered by Medicaid, and Christine does such a great job of talking about this, we need to care about what happens to those who are covered and those who perhaps are going to lose their coverage. So it's a great website to find out what's going on, and if you want to get involved, that's the place to go. nhneedsmedicaid.com. Uh nobody asked me to talk about that at the top. It's just an incredible resource that we should all know about and be and be sharing around. All right. I'm gonna pass it back over to the incomparable, Christine Stoddard. I'm gonna be honest with you, Christine. I don't know a lot about Medicaid. I know it, but I don't know it.

SPEAKER_02: 3:03

It is very complicated, and there are so many parts of it that are influenced by different policies, whether at the state level or the federal level.

SPEAKER_01: 3:13

Yeah. It's like a spider web.

SPEAKER_02: 3:16

It is a spider web. Of course, speak in generalities without uh missing some piece of information. But that's unless you want like 10 hours of podcast, that's what we're gonna have to do.

SPEAKER_01: 3:31

Well, look, I'm happy to do a 10-part series just on Medicaid.

SPEAKER_02: 3:38

You might want another guess.

SPEAKER_01: 3:39

And welcome to New Hampshire Has Issues, the podcast that dares to ask, why does it appear that our lawmakers really don't like low-income people? Christine, let me hear your tagline. Welcome to New Hampshire Has Issues.

SPEAKER_02: 4:08

The podcast that dares to ask why everyone in New Hampshire should care whether or not their friends and neighbors have health insurance.

SPEAKER_01: 4:18

I cannot wait to get into this because I I'm just gonna be honest that I don't know why it's controversial that we should want everybody on health insurance. It feels like. I mean, Welcome to New Hampshire has issues. The podcast editors ask, why would we want people to go bankrupt from needing to go to the doctor? Why is that the position some people are taking? It makes no sense to me.

SPEAKER_02: 4:41

I've tried to explain it to my eight-year-old who also doesn't understand. Why do you have to pay to go to the doctor when everyone should have access to health care?

SPEAKER_01: 4:52

I mean, your eight-year-old sounds like they got it. Like that's that's correct. Why should you be paying to go to the doctor when you should just be able to go to the doctor? Right. Period.

SPEAKER_02: 5:02

But America has this thing called health insurance that you can have commercial health insurance.

SPEAKER_01: 5:08

Should I cheer? USA. USA. Is this the time where I do the is that the time to chant? No. Am I doing it right? Definitely not on this one. Okay. All right. Not this one. I am your host, Liz Canada. And joining me today is Christine Stoddard, who is a health care policy ultra nerd. And that is exactly who I need to help me understand Medicaid because I hear about it a lot. In my job, I hear about it. But out in the news, especially right now, with, you know, I had Phil Slutton on a few episodes ago talking about the budget. He alluded to changes to Medicaid, you know, the budget that was passed by the Trump administration. Like that has some impacts on Medicaid. But I gotta be honest with you, what the heck is Medicaid? So that is why, Christine, I've asked you to come on because I think there's some misconceptions about it. I think there are some like I hear the word and then I have a feeling, and I'm not sure how I'm supposed to feel about it. And I'm hoping you can help folks understand what it actually is and whether or not we need it. Do we need Medicaid?

SPEAKER_02: 6:19

We do.

SPEAKER_01: 6:19

We just okay.

SPEAKER_02: 6:21

Episode over.

SPEAKER_01: 6:21

Thank you. Great. I like to start every episode with a simple question. What the heck is Medicaid? What is it? And why is it even an issue in New Hampshire?

SPEAKER_02: 6:32

Medicaid is just health insurance. That's all it is. Medicaid is health insurance. For some reason, different groups have turned it into this bad thing that if you're on Medicaid, you're a bad person, you don't work hard enough, you're not worthy of our support or the government's aid. We've turned it into the boogeyman, and it's not. It was never meant to be that. It is simply health insurance. It's to help people access healthcare and particularly low-income children, elderly people who live in nursing homes, adults, low-income adults, and people in New Hampshire with complicated medical needs. They're not the boogeyman. Those people all sound great. Exactly. You want to help them. You want to help them be healthy. There are friends, there are neighbors, they're our constituents if we're elected officials.

SPEAKER_03: 7:29

Right.

SPEAKER_02: 7:30

These are the people that you interact with when you go get coffee in downtown Concord. These are the people that answer your questions when you go to the library. They're the people that hand you your coffee through a drive-thru window. These are people. They are granite staters and they deserve our support and our respect, not our animosity.

SPEAKER_01: 7:56

Some folks have health insurance through their jobs. Yes. I am married. Bragging. So I am married. My wife, she has the policy for our health insurance. So I am on her health insurance, even though I also have a job.

SPEAKER_02: 8:12

Yes.

SPEAKER_01: 8:13

There are some people who work jobs that do not offer health insurance.

SPEAKER_02: 8:19

Yes. There are a lot of industries in New Hampshire that do not offer health insurance. This could be the construction industry. This could be big box stores, Home Depot, Walmart. It could depend on how many hours you work. It could depend on whether or not you work for a sole proprietor. If you have a 1099, if you're a carpenter like my husband is, he doesn't have health insurance through his employer. He's a 1099. He contracts with other carpenters to do work for them. And he has health insurance through my job. And a little secret I will share with you: my husband has an autoimmune disease. Not through anything that he did wrong. He was born with an autoimmune disease that can be hereditary. We got legally married in our kitchen in Concord, New Hampshire, months before our wedding, because my husband's employer did not offer health insurance. And because he has an autoimmune disease, he has to take biologics. Biologics are very expensive. Oh, yeah. So we got married, didn't tell anyone so that he could get on my health insurance. And that's a reality that people face. And no, it was not fraud. We're still married. We have two kids. Um, I pay for his car, you know, whatever.

SPEAKER_01: 9:35

Let's get into the details of your marriage, Christine. Tell me more about what's happening, who's paying which bills, and so forth. This is what New Hampshire needs to know. We need to know everyone's actually that is what lawmakers are trying to do is to get into all of the details of everyone's personal lives, but we will set that one right aside.

SPEAKER_02: 9:56

So he could not work without health insurance. His he has psoriatic arthritis and which affects your joints. And if you're a carpenter who's on a roof, you need your joints to work properly so that you don't drop an impact um gun or something like that or a nail gun. I don't know the names of tools.

SPEAKER_01: 10:18

Let's get into the details of tools now. We got into the marriage, and now we're getting into the tools.

SPEAKER_02: 10:24

He literally could not work without this medicine because his knuckles were swelling, his joints and his feet were swelling. And my husband is like the epitome of health. He exercises every day. He's very, very healthy, with this one exception. And he could not work because he did not have access to a biologic. But we got married months before our actual ceremony so that he could access health insurance, access biologics, and continue to work. Otherwise, he would have been unemployed.

SPEAKER_01: 10:59

You've got the employer-sponsored health insurance. You have my spouse has employer-sponsored health insurance, has the health insurance through their job. And then you have individuals who aren't married to somebody who has a job with health insurance. And so what are their choices?

SPEAKER_02: 11:19

So if they can afford it, if they're lucky enough to afford it, they can go on the marketplace and buy their health insurance.

SPEAKER_01: 11:26

Not the Facebook marketplace. There's no health insurance on the field.

SPEAKER_02: 11:30

You could try.

SPEAKER_01: 11:31

You know what? I haven't checked actually. I don't know. So what is this marketplace?

SPEAKER_02: 11:37

So the Affordable Care Act created like a one-stop shop for health insurance. And on that health insurance website, you can go and choose what you need out of health insurance, how much you want to pay. And if you have certain incomes, then you get different benefits. So you might get subsidized health insurance or premium subsidized health insurance through the marketplace. It just depends on your income. If you cannot afford those marketplace plans because you do not make enough money, so say you work minimum wage in the state of New Hampshire, minimum wage in the state of New Hampshire is below the federal poverty level. So you would qualify for what is called Medicaid. And if you are my age, say 40, almost 46, you would qualify for Medicaid expansion, also known as granite advantage. New Hampshire, our minimum wage is$7.25. We are one of the few states, right?

SPEAKER_01: 12:43

$7.25. A$5 bill, two$1 bills and a quarter. Yes. That is how much money we're talking about for the minimum wage in New Hampshire.

SPEAKER_02: 12:57

So policymakers have said that it is okay to pay granite staters$7.25, regardless of your age, regardless of your work experience. It is acceptable to pay someone that little. And because of that, people can go without health insurance prior to the Affordable Care Act. They couldn't afford health insurance. Prior to the Affordable Care Act, if you had a pre-existing condition, insurance carriers didn't have to insure you. They could say no, or they could say, we'll insure you for these services, but not this service because you have a pre-existing condition. Like, say you have eczema or something random. We'll do all of your other dermatology appointments, but we're not going to cover anything related to eczema. That's why you need to go to the doctor because you have this condition that exists that you need treatment for. So the ACA comes into effect and says insurance carries, you can't kick people off anymore because you have pre-existing conditions. And so they made this marketplace where people can go and choose what they want from for health insurance. But if they can't afford that, states had the option to do what is called Medicaid expansion. So adults who are between the ages of 19 and 64 could access Medicaid. Again, it's just health insurance.

SPEAKER_01: 14:26

It's another type of health insurance.

SPEAKER_02: 14:28

Yes. So they could access Medicaid and most of their expenses would be paid for by a combination of state funding and the federal government because they do not have the money to pay for a$250 mammogram. They don't have the money to pay for a$35 prescription because, again, they make$7.25 an hour. You can't afford an apartment in New Hampshire. So this Medicaid expansion created an option to increase access to health insurance coverage for people who can otherwise not afford it. All Medicaid is, is health insurance. It's not a horrible thing. It's not a horrible thing to be on Medicaid.

SPEAKER_01: 15:23

And it's essentially for folks who, as you said earlier, cannot afford any other health insurance option. Like does not have anything else available to be able to have health insurance coverage.

SPEAKER_02: 15:39

Right. You cannot afford, based on your income levels, to buy health insurance or pay for those healthcare services.

SPEAKER_01: 15:47

So when I hear, I'm not going to name names, despite how badly I would like to name names. But there are some lawmakers who seem not super into Medicaid. What do they want people to do instead?

SPEAKER_02: 16:04

They want them to work for it and to prove that they're working for it. And in fact, most people on Medicaid are working. Yeah.

SPEAKER_01: 16:12

Again, let's just say$7.25 an hour.

SPEAKER_02: 16:17

Working full time, you still do not make enough money to pay for your health insurance. So combine that with having kids. A single dad with two kids, one kid, you're making minimum wage or$16 an hour at Home Depot. You can't afford your health insurance. So in that example, now, thank you to Medicaid expansion. The dad can access health insurance through, if he can't get it through his employer, he can access it through Medicaid, through what we call the granted advantage. And that his children can access Medicaid also because of his low income. Pre-Medicaid expansion in New Hampshire, he would have gone without health insurance. The kids would have been able to get health insurance, but the dad, who's responsible for these children, who wants to work so that he can put food on their table, who wants to go to their band concerts at school, who needs to be healthy to work, could not access health insurance. And policymakers at the time, it took many, many tries for us to get Medicaid expansion passed in New Hampshire. You would think it would just be a slam dunk. Here's a problem, here's a solution. And by the way, the feds are going to cover 90% of the costs. You'd think it would just be a slam dunk. But no, we had to argue about it like four times.

SPEAKER_01: 17:45

Okay, that's wild that it was even a debate.

SPEAKER_02: 17:48

Multiple times.

SPEAKER_01: 17:49

Prior to the Affordable Care Act, prior to Medicaid expansion, that dad would have had no health insurance and would have gone either to the doctor and had exorbitant costs associated for being able to go there. Or not gone at all because knowing that it would cost a lot of money.

SPEAKER_02: 18:07

So say he gets, I'm not a doctor, but say he gets sinus infection or a respiratory virus. Yep. And he can't afford to take time off because he makes$7.25 that he needs to pay for his kids' food.

SPEAKER_01: 18:21

Yep.

SPEAKER_02: 18:22

So he keeps going to work. He's sick. He tries to put aside the fact that he's sick. And he can't go to a traditional primary care doctor because he can't afford the bill. He's forced to wait to see a health care provider because he doesn't have health insurance and he can't afford it. So he ends up with pneumonia and it's so bad he can't breathe. So then he goes to the emergency room because at this point it's serious and he's unable to work. The hospitals have to see him. They have to treat his pneumonia because of federal laws that require that. But had he had health insurance, he could have gone to his primary care provider. He could have accessed prescription drugs because he had health insurance. So he could have accessed the antibiotics necessary to treat an infection and it would have never turned into pneumonia. And seeing a primary care provider is a hell of a lot cheaper than going to an emergency room.

SPEAKER_01: 19:19

Yeah, absolutely.

SPEAKER_02: 19:21

Even the copay for someone who has insurance, it's so expensive to go to an emergency room. The minute you walk in the door, you're spending hundreds of dollars, regardless. Why wouldn't we want to give the dad, other granite staters, the option to have health insurance, to stay healthy, to be able to work, to be able to support the economy by working, to be able to keep his employer on task, on target? Why wouldn't we want these things? Not only is it the right thing to do, like we want people to be healthy because that's important. That's being kind. That's being a good human. Right. Guess what? It Also saves us all money.

SPEAKER_01: 20:02

Okay. Now you're talking the language of people who like want to, I don't know, take things away, hold them for themselves, whatever it might be.

SPEAKER_02: 20:12

This is saying the quiet part out loud, I guess.

SPEAKER_01: 20:14

Oh, great. It's a podcast, so we can turn the volume up. Yes. Let's do it.

SPEAKER_02: 20:19

It saves money for people to be on Medicaid. So not only does it save the state money, it saves people who have insurance through their employer money. Wait a minute.

SPEAKER_01: 20:29

Yes. Wait a minute. You're telling me that if people have coverage under Medicaid, that saves me, Liz Canada, who has insurance in another form. That saves me and people like me money.

SPEAKER_02: 20:44

Yes. How? Because the the more people who are insured in a market. So in New Hampshire, our market is just the state. That's how health insurance works. It's not a national market, it's a state market. So the more people who have health insurance, the more adequate reimbursement is given to healthcare organizations, the more the risk of an insurer having to pay an astronomical amount of money out is spread amongst more people. The more people who have health insurance, the better access they have to health care. It doesn't necessarily equal they get access to health care, but it improves the likelihood that they will be able to access health care. So if you have access to health care because you have health insurance, it means that there will be less wait times. So if you have a heart attack, God forbid, Liz.

SPEAKER_01: 21:41

Look, there are plenty of reasons for me to have a heart attack. I don't need to get into them, but yes. I'm following this scenario very closely. Yes, go on.

SPEAKER_02: 21:50

If you have a heart attack, you have health insurance through your wife.

SPEAKER_01: 21:54

Yes.

SPEAKER_02: 21:54

Her employer-sponsored health insurance covers you and your kids.

SPEAKER_03: 21:59

Yes.

SPEAKER_02: 21:59

So if you go to the emergency room and granted Advantage, our Medicaid expansion program is intact. People who are eligible to access it can access it. Everything's working as it should. The wait times will be shorter because people won't be going to the emergency rooms who don't have emergencies. Ah so your heart attack is treated earlier, which means the insurance company reimburses the hospital for a less catastrophic event.

SPEAKER_01: 22:30

Okay.

SPEAKER_02: 22:31

Because your heart attack could cause all sorts of other things.

SPEAKER_01: 22:35

I love that you're calling it my heart attack. Like it's it's not just anyone's heart attack, it's my heart attack. I love it. Christine, you're gonna feel so badly if I have a heart attack sometime between now and you shouldn't say that. I I'm gonna laugh. I make I need to make sure this episode is published before it happens.

SPEAKER_02: 22:54

I would feel so awful.

SPEAKER_01: 22:55

But in this in this scenario, Liz's heart attack is trying to go to the ER. And that dad, who didn't have insurance, who wasn't able to see someone for a sinus infection, who had to wait to go get care, who then is getting sicker and sicker over the course of time because it is untreated, then has the only option essentially to go to the emergency room. And now you've got heart attack Liz and this dad going for the same spot when dad could have been treated months ago.

SPEAKER_02: 23:24

Right. And dad and all of his friends, right? If you look at Berlin, New Hampshire, Berlin has a high number of Medicaid enrollees. So imagine going to an emergency room in a town like Berlin and Franklin that have a high number of Medicaid enrollees now. Those Medicaid enrollees lose their insurance. So instead of having access to a primary care provider, Franklin residents or Berlin residents are forced to go to the emergency room to access care because they can't afford it otherwise. So the people that have heart attacks or diverticulitis or appendicitis or gallbladder issues, a gallbladder attack, those people get pushed down the line, right? Because there's so many people in front of them. So what ends up happening is your insurance company has to pay more money eventually. It drives insurance rates up. If they're paying more, they have to charge their beneficiaries more because they have to cover their cost, right? They have to cover their cost of reimbursing all of these healthcare providers. So they have to spread the burden amongst their consumers. And now there's fewer consumers to spread it amongst because there's fewer insured people. So the more people that have health insurance, the lower our costs are as people who have access through employer-sponsored insurance.

SPEAKER_01: 24:51

So why is there an argument about the costs of Medicaid?

SPEAKER_02: 24:58

Honestly, Liz, I don't know. I honestly do not understand why anyone would want to take someone's health insurance away from them. I understand that policymakers have all of these big decisions that they have to make, all of these considerations that they have to make, but the math just doesn't work. By reducing access to Medicaid insurance, by changing the eligibility for Medicaid insurance, you're pushing people off of their health insurance. Um, so the state looks like it's saving money, right? In those budget sheets that Phil talked about. It looks like the state is saving money, but guess who's paying for it? Everyone else. You're paying for my heart attack is paying for it.

SPEAKER_01: 25:42

Yeah.

SPEAKER_02: 25:43

Exactly. Your heart's paying for it. Your wife is paying for it. Everyone else now has to bear the burden because policymakers are kicking people off of health insurance. So what ends up happening is the costs get pushed down onto other health insurance consumers. It also gets pushed down onto property taxpayers, everyone else in New Hampshire, because towns in New Hampshire have welfare offices. When someone loses their health insurance, they can access help, hopefully, if everything's okay, I guess, they can access help through the town welfare office. Right. So who pays for the town welfare office, Liz?

SPEAKER_01: 26:25

The town.

SPEAKER_02: 26:26

Yes. Who gives the town money?

SPEAKER_01: 26:28

Liz's heart attack again is giving. Yes. Just Liz in that scenario. Yes.

SPEAKER_02: 26:32

You and your wife pay property taxes.

SPEAKER_01: 26:35

Which I will say, and I talked with folks from Families in Transition about homelessness and how I brought up the welfare office actually, because I serve on our town's budget recommendations committee. And one of my subcommittees is the welfare office. So I have learned a lot in the last few years serving in that subcommittee about the types of calls that they get and the types of you know support that our town is thankfully able to provide people who need it.

SPEAKER_02: 27:02

Yes.

SPEAKER_01: 27:03

But it is not an unlimited amount of money in a town to be able to do this. Like that's that's pushed all these costs all the way down to just our community, just our town as well.

SPEAKER_02: 27:14

But guess who people blame when their property taxes go up? They blame town officials because that's all they see. They see their property bill and they think, why are my property taxes going up?

SPEAKER_03: 27:27

Right.

SPEAKER_02: 27:27

Well, it's because policymakers at the state level are making policy choices that cost you money and you're going to pay for it through your property taxes and with your health.

SPEAKER_01: 27:41

And the issue as well is that when they make these decisions, they don't follow the rule of math class. They don't show their work to say They don't use their calculus. They don't use their calculus, but they don't show their work and say, okay, so we're gonna make this change. And because we've made this change at the state level, the towns are going to have to pick up that cost because we've done that. They don't show that work, but that's what's happening, regardless. Exactly.

SPEAKER_02: 28:09

Because they only have to balance the state budget, they don't have to worry about their the town budgets in their districts. They their responsibility is to balance the state budget. It's not their responsibility to decide what residents in Franklin are paying for and for how much. So all you see when you go to a state budget hearing is the savings that the state's generating and the funding that they're providing for programs. You don't see what else is happening. They do not have to show on their budget reconciliation documents what the consequences are.

SPEAKER_01: 28:47

I'm trying to think of an analogy. I love analogies. But it's it would kind of be like in our household, you know, if you got Molly and me, then you got the two boys. And if we make the analogy of like we are the state and the boys are the local level, it's like saying, like, well, we balance the budget. Uh, we didn't need to spend any money on school lunches this year. Great news for us, huh? And then the boys are like, wait, no, we still have to have school lunch. It's like, well, uh, it's not in the budget.

SPEAKER_03: 29:12

Yeah.

SPEAKER_01: 29:13

And then they're just gonna have to figure it out on their own. Like, there's still that needs to happen, even if we're just like, nope, cut that line at them saved, saved our expenses. Pretty great. Liz. Good for us.

SPEAKER_02: 29:23

Kids in New Hampshire aren't hungry. They don't need to eat. They just want more things. They always want things.

SPEAKER_01: 29:29

They always want money. Christine, I literally dropped the boys off at their friend's house and I fed them so many things. So I'm like, do not walk into their house and say, what's for dinner? as soon as you walk in. Because one that is rude, they're just hungry all the time. Yes. And my younger one was like, Liz, you know I'm gonna do it anyway. I'm like, I know you are, but please don't just walk into someone's house and be like, is there any food here? In this little silly analogy, if Molly and I are like, no, we we did our budget and uh school lunches didn't make the cut, the boys are still gonna need to eat. Like, are they just gonna have to scrounge for food? Like, what are they gonna have to do? Similarly to the state. Like the state can say, actually, we uh cut that line item, but the local level has to pick up the tab.

SPEAKER_02: 30:08

They have to figure it out.

SPEAKER_01: 30:09

Yeah.

SPEAKER_02: 30:09

And they figure it out by raising your property taxes. Or if they don't, if they can't raise property taxes, people go without. So, like you said, your welfare office has a very limited amount of money right now, right? Right. Because taxes can't go up and down by the day. Right. They're set at a certain time of year and they are what they are. So if the policymakers in Concord or DC change Medicaid eligibility today, there's nothing your town can do about it. But if today we change the eligibility so that people lose their Medicaid health insurance and they then can't go to work, which means they can't afford their food. So they go to the town welfare office. More people end up coming to the town welfare office. The town welfare office has a discrete amount of money. They can only pay for so much food for people. You can't just go raise taxes willy-nilly and decide to buy more food. It doesn't work that way. So they go without. Families go without. And in a state that is so wealthy and has just gobs of money, it doesn't make any sense to me or my moral compass to not want people to have health insurance because it's better for everyone.

SPEAKER_01: 31:30

I want to also be clear that town welfare offices are doing critical, such important work because I know that there are stories of individuals who are about to lose their homes or who have been staying in their car for weeks and months, and then it gets so cold and they're finally going into the welfare office. That is really, really important. And your point is so true that we can't just say, well, you know, we need to bring in more money to the welfare office to do this because there's only so much a local community can do. There's a lot more that a state can do, and a lot more that the country can do. And when they choose not to, it gets pushed down to us and our property taxes. It does.

SPEAKER_02: 32:16

Right. And towns and cities can only raise revenue from a very limited number of sources, especially in New Hampshire. They can't just go create a tax or create a source of revenue. We're very limited as to how towns and cities can generate revenue. Right. The state has more options and more choices.

SPEAKER_01: 32:36

Christine. Yes. I learned a lot from Phil.

SPEAKER_02: 32:39

Don't you always think about it?

SPEAKER_01: 32:41

I really always do. But that interest and dividends tax moment. I'm still thinking about it. I am still thinking about how people had millions and millions of dollars and it generated hundreds of thousands of dollars, and they were taxed ten thousand dollars, and that tax was cut for those people.

SPEAKER_02: 32:57

Yes. Policymakers chose to reduce the revenue coming into the state of New Hampshire by eliminating the interest in dividends tax, which, like you said, the bulk of it was paid for by very, very wealthy people. People who are not just surviving on their pension. It's people who have millions and millions of dollars in assets, people who earn hundreds of thousands of dollars on their interest and dividends.

SPEAKER_01: 33:25

Money that was just generating in an account that they've essentially done nothing. It's just generating passive income.

SPEAKER_02: 33:31

Right. And I'm not judging them. I mean, good for you for having that. But there are other people who have nothing. And honestly, like the state has an obligation to pay for basic services. And the interest in dividends tax and the business tax, that is how the state of New Hampshire raises revenue. And so if these are the ways you can raise revenue to pay for basic services like roads, like schools, like healthcare, why would you just say, oops, never mind, we don't need that revenue. You're creating a problem, which is exactly why we're in the situation that we are in. Over the last six years, policymakers have reduced, purposely reduced state revenue. And now it's like, well, now we can't fund Medicaid because we don't have any revenue. Look at us, there's no money. Well, of course there's no money. It's because you cut it. And that was a choice that the state of New Hampshire made, policymakers made.

SPEAKER_01: 34:34

A majority of policymakers made.

SPEAKER_02: 34:37

Not every single one who's there, but that's a very good point.

SPEAKER_01: 34:40

Enough. A majority of the folks did. Yeah.

SPEAKER_02: 34:43

Right. And their towns are going to be impacted. Their constituents are going to be impacted. You're going to be impacted, even if you don't live near them, because your insurer is going to have to pay more money. So you're going to have to pay more to have that insurance through Molly's employer. Right. That's just the way insurance works.

SPEAKER_01: 35:04

Let's talk about the folks who are covered by Medicaid. Because I know that a lot of them are kids, are younger people, right? And there's also a lot of folks who are maybe 65 and older, or you know, in their they're they're older folks who need uh health coverage as well.

SPEAKER_02: 35:24

Yeah. So the biggest group of people who have Medicaid in the state of New Hampshire are actually kids. There's about 90,000 children who are covered by Medicaid in the state of New Hampshire.

SPEAKER_01: 35:37

And does that mean that they all are in families that have lower incomes? No.

SPEAKER_02: 35:43

Some of these kids have severe disabilities. Some need in-home care. And we want people to stay in their home, right? That's we want people to be able to access care in their home. For one thing, it's less expensive. For another, it's better for everyone. Right. So there are children who have special needs that also access Medicaid. Yep. But children cost the least amount of money in the Medicaid program. We have elderly people and adults with disabilities who account for about 24,000 people. They are the highest spend in our Medicaid program because nursing home care is expensive. I don't know how old your parents are, but health care for geriatric patients is very, very expensive. And in-home care is very expensive. So if you have a child who needs a feeding tube or has an immune disorder that doesn't allow them to go to school, they can access healthcare services in their home with Medicaid. And it's literally life or death for some people. Without healthcare services, people who are medically complex die. And Medicaid is their lifeline. And that's not hyperbole. It's true. You also have kids whose parents, like you said, are what we consider low income, which means you live at a certain level, you make a certain amount of income. Their parents, again, could have health insurance through their employer, and they could save a little bit of money by having the kids on insurance through Medicaid. But again, they're still considered low income. So they need access to health insurance that they can't afford. They need access to healthcare services that they can't afford without Medicaid coverage.

SPEAKER_01: 37:35

So what changes are expected to happen because of the state budget or because of the federal budget? Or both? What happened with Medicaid this summer, essentially? Because it all happened in June and July across the state and the country.

SPEAKER_02: 37:52

Yes. And what happened in the state is different than what happened at the federal level in Congress. Right. So they're not in alignment because the great super duper terrorism. Those bill drafting processes are different. So in New Hampshire, our state budget passed. This is a budget year. And in this budget, because we had less revenue, because again, legislators chose to reduce sources of revenue.

SPEAKER_01: 38:21

They were like, you know what we don't need is money. So let's get rid of that revenue. And then they did the budget, and they're like, you know what we need is money. And so here we are.

SPEAKER_02: 38:30

So the legislature reduced the revenue coming into the state over the past six years. And that means that when the legislature decided to craft its budget, they had less money to work with, which means they are paying for less services. So the choices that they made to the Medicaid program include charging low-income parents who have children on Medicaid premiums so that their children have health insurance.

SPEAKER_01: 39:01

Christine, I love words like this because premium is like, ooh, it sounds so fancy. What does premium actually mean? What does that word really mean?

SPEAKER_02: 39:08

So healthcare is so full of jargon. I apologize.

SPEAKER_01: 39:11

No, I love it. But what does lower income families have to pay a premium? What does that mean?

SPEAKER_02: 39:18

So that is the monthly amount of money that they have to pay, the amount of money they pay each month for their kids to be insured. And so in New Hampshire, this policy change means if you have a family of three and you have kids on chip, which is um kids Medicaid, you have to earn just under$68,000. That's not a lot of money. So that that captures a lot of granite staters, right? So that family of three is going to have to pay$230 a month so that their child can access health insurance.

SPEAKER_01: 39:57

Wait, I'm gonna get my calculator, aka my. Smartphone. Let's just do a math thing really fast. How much did you say?$230 a month.$230 a month divided by, you know what I'm gonna do?$7.25. So they would need to work 31 hours to pay that premium on a$7.25 an hour job.

SPEAKER_02: 40:21

And that doesn't include 31 hours. Yeah. That doesn't include Social Security. That doesn't include the food that they have to buy. That doesn't include the rent that they have to pay.

SPEAKER_01: 40:32

For a cool 31 hours of work and just that you can pay for the health insurance you already have. Yes. True?

SPEAKER_02: 40:42

No one can pay that amount of money if you make$7.25 an hour. This isn't in a vacuum, right? There's so many other things happening in the state of New Hampshire. We don't have enough access to housing. So rent is very, very expensive here. The average for a studio is like$1,300. You have to pay$1,300 and you have to pay your health insurance premium. And if you do a comparison, I mean it truly depends on your employer and what kind of plan they offer. But families in some circumstances who have employer-sponsored insurance would be paying less than this parent trying to provide Medicaid coverage. And I make quite a bit more than$7.25 an hour. That's less of a burden on me than someone who makes minimum wage.

SPEAKER_01: 41:43

Where they talked about how they they wanted to do the premium the way that it passed it, because they didn't want it to be called an income tax. They're like, we don't want it to be called an income tax, so we're gonna do with this other thing instead. It's like, no, it's still you're it's still a a fee, a premium on the income. Yes. You can call it a banana, but it's still the same thing at the end of the day.

SPEAKER_02: 42:06

What is that phrase if it walks like a duck?

unknown: 42:08

Yeah.

SPEAKER_01: 42:08

And talks like a duck. It's an income tax, is what it is.

unknown: 42:12

Yes.

SPEAKER_01: 42:13

I don't know.

SPEAKER_02: 42:13

Or a fee that I know they wanted us to be.

SPEAKER_01: 42:17

What's the difference between a tax, a fee, a premium? Semantics. So$230 a month for a family of three, making around like$65,000 a year.

SPEAKER_02: 42:30

Yeah. So that's one of the great policy changes that was put in place in this budget. The other one was And this was at the state level.

SPEAKER_01: 42:39

The state law making. This is at the state level.

SPEAKER_02: 42:41

Yeah. So in addition to that, people who are on Medicaid expansion or what is called Granite Advantage will have to Why do we have all these secret code names?

SPEAKER_01: 42:52

Why are we calling it these? It's like, it's not Medicaid, it's Granite Advantage wink. It's not Medicaid, it's Chip Wink. It's not an income tax, it's a premium wink. Like that's how I feel that we're why are we doing this? It's not Medicaid, it's Katie Beckett.

SPEAKER_02: 43:07

It's Katie What? What is Katie Beckett? Katie Beckett is a Medicaid program in the state of New Hampshire. Because that's a person's name. Right. It's also a Medicaid program.

SPEAKER_01: 43:17

It's like Jeremy Barramy in a good place. Like it's the concept of time. It's Jeremy Barrame.

SPEAKER_02: 43:23

What? So states get to craft what their Medicaid programs look like. They get to decide which populations and which needs they cover. And so they name them after people. Katie Beckett is a real person. A and B is also a Medicaid program.

SPEAKER_01: 43:43

A and B. A and B. ANB.

SPEAKER_02: 43:47

And is in Nancy. Aid to the Needy Blind.

SPEAKER_01: 43:50

Okay. Yep.

SPEAKER_02: 43:52

APTD, aid to the permanently disabled, Medicaid for Employed Adults with Disabilities. In and Out Medicaid, home and community-based waivers. So here's a a category that also has four names that are included: in-home supports, DD, also known as developmental disabilities, acquired brain disorders, choices for independence.

SPEAKER_01: 44:20

Are these all names of programs that's actually just Medicaid?

SPEAKER_02: 44:24

Yes. They're all Medicaid.

SPEAKER_01: 44:27

That is so interesting.

SPEAKER_02: 44:30

It is, but you know what happens? Normal people who don't live in our policy world, who go about their days thinking. I wish I could turn that off in my brain. People don't know, and rightfully so, right? Like who would say Katie Beckett and think Medicaid? It's just a name.

SPEAKER_01: 44:51

I remember seeing polling that shows that people support the concepts of Medicaid, support things like chip. Yeah. Right? Like they support those things. And then if you say, What do you think about Medicaid? They're like, oh, I don't like that. It's like, no, you just said you liked it, but a different name of it.

SPEAKER_02: 45:06

It's because we've created this monster Medicaid. Stigma. Yeah. We've created a stigma where there shouldn't be one.

SPEAKER_01: 45:14

It's just health insurance, folks.

SPEAKER_02: 45:16

It's just health insurance. The only difference is who designs the program and how it's paid for. And you know, Liz, through Molly's health insurance, you're not paying the cost of all of that health insurance. No. It costs her employer a lot of money to insure your family. You're paying a fraction of the health.

SPEAKER_01: 45:35

Which is a good thing because I'm going to have a heart attack. But yes, right. Tomorrow. It's going to be the ultimate hilarious joke. It'll all be worth it. It'll all be worth it. We are as serious as a heart attack here on the podcast. We are not paying the full cost of the health insurance.

SPEAKER_02: 45:55

No. But now we're making people who have very, very little income pay for what they get. We're making another policy choice. We're making them demonstrate that they've worked for a hundred hours a month, or else we're going to take their health insurance away.

SPEAKER_01: 46:10

Okay, tell me about that. This is a new requirement, work requirements?

SPEAKER_02: 46:15

Yes. So Medicaid was created to provide better access to healthcare services. It is for the millionth time just health insurance. That is what it was designed to be. And in 2018, I believe, the state of New Hampshire asked Centers for Medicaid and Medicare to allow the state of New Hampshire to make people work in order to access their Medicaid. So, which is great, I mean, because people are already working, right? But now you have to go through this rigmal role to prove that you're working.

SPEAKER_01: 46:51

Yes. How does one prove that they are working? Do they have to take a video of themselves? Do they have to go to the Department of Health and Human Services and fill out what you think?

SPEAKER_02: 47:03

So imagine all of the paperwork that has to be done and all of the steps that have to be taken for a human to verify that they're employed. They have to get something from their employer. They have to find paperwork that demonstrates they're employed. They have to drive to the DHHS district office or mail it or upload it on internet. What if they don't have the internet? There are exceptions that were built into that program. So if you have substance use disorder and you're actively engaged in treatment, you have an exemption. But guess what? You can't just say, I have substance use disorder. The state can't just go look at all of the claims for your substance disorder treatment in their system because our system doesn't work that way. So they have to take this person battling substance use disorder with all of these other things going on, has to make an appointment with their health care provider that's weeks out, has to get the healthcare provider to sign a form. The healthcare provider has to make a determination. The other phrase that we used was medically frail. That's not a medical term. So we have to, as a healthcare provider, decide whether or not our patient is medically frail.

SPEAKER_01: 48:17

Medically frail?

SPEAKER_02: 48:18

Yeah, I don't even know what that means.

SPEAKER_01: 48:20

Like Tiny Tim from a Christmas carol?

SPEAKER_02: 48:22

I don't know.

SPEAKER_01: 48:23

I meant to read a passage from a Christmas carol because this is all of the debates against Medicaid and against supporting folks with lower incomes is just the opening scenes of a Christmas carol of Ebenezer Scrooge being like, then let them die. We really do like analogies. That's another good one. I'm sorry. Yes. That's a good one. It's the English teacher brain of like trying to find them. But that's how it feels. He's like, yes. Aren't there poor houses? Aren't there places workplaces to go?

SPEAKER_02: 48:54

That's how this feels. Right. So we're creating more barriers for people who are eligible for Medicaid. We're creating more barriers for them to access health insurance that they are legally eligible to access to save money. New Hampshire has tried a work requirement before and it didn't work. We had to stop it because it was costing the state so much money, and we weren't able to contact enough people who would be subject to the work requirement to get them to comply with the work requirement. So we paused it. It's stopped. It's actually current law and it's not in effect because it doesn't work.

SPEAKER_01: 49:36

The work requirement doesn't work, but they put it back in this time.

SPEAKER_02: 49:40

Yes.

SPEAKER_01: 49:41

So that we could talk about it, so that we can say, you know what didn't work the first time was the work requirements. And yet here we are again.

SPEAKER_02: 49:47

Right. It's like that Taylor Swift song.

SPEAKER_01: 49:50

Oh, which one?

SPEAKER_02: 49:54

I love that song. It doesn't work, New Hampshire. You're going to waste money. We shouldn't be doing it.

SPEAKER_01: 50:01

We shouldn't be doing it. And people will lose their health care if they don't do it.

SPEAKER_02: 50:05

They will.

SPEAKER_01: 50:06

How soon after? If they don't prove that they have worked for a hundred hours, what happens?

SPEAKER_02: 50:11

We don't know yet what it's going to look like because now federal law says states, if you want Medicaid dollars, you have to have a work requirement. So we don't know yet what will happen if you don't prove that you're working. But we do know that people are going to lose their health insurance. Clinicians are going to lose reimbursement for the services that they provide. And people are going to go without care. Your insurance costs are going to go up if you're commercially insured. We know all of these things, and we're still doing it.

SPEAKER_01: 50:45

Holding health insurance hostage. Yes. Fantastic. Really glad that's what we're spending our time on.

SPEAKER_02: 50:52

Such a good use of money.

SPEAKER_01: 50:54

Such a good use of money and time and resources.

SPEAKER_02: 50:57

Such a good use of our very limited revenue because people chose to eliminate gigantic sources of revenue.

SPEAKER_01: 51:04

Oh well, well. To save money really means that you're betting on people not doing it and therefore losing their health insurance. Like you're making a bet against people.

SPEAKER_02: 51:17

We are betting that granite staters don't want to work. We are choosing to see the worst in our friends and neighbors. We're choosing to see people as anything but human beings. And at the end of the day, it actually doesn't save anyone money. It doesn't save the state money. It doesn't save you money as a healthcare consumer. It doesn't save the healthcare provider money. It actually costs a ton of money for the state of New Hampshire to implement a work requirement. Like millions and millions of dollars. So we're actually spending money to do something that doesn't help anyone, that doesn't save any money for what? To prove a point?

SPEAKER_01: 52:05

I don't know. I mean, I I joke and not joke about Ebenezer Scrooge, but like, are they just hoping those people will die and not have to cover them? What are they trying to do?

SPEAKER_02: 52:18

Love to believe that they think they're trying to help people who are unemployed access work. But we know that's not the case. Most people on Medicaid are working. I always tell my kids not to assume the worst in people. Assume the best. But despite hours and hours of testimony from healthcare consumers, from healthcare providers, from their own Department of Health and Human Services telling them, policymakers, that they were that most people are working, that the people who aren't working, there's a legitimate reason. And that legitimate reason is already an exception that we built into the law in 2018.

SPEAKER_03: 53:02

Right.

SPEAKER_02: 53:02

So why are we going through these extra steps just to prove a point? In the first year of implementing a work requirement, it is going to cost the state of New Hampshire. So just the state, not healthcare providers, which we should also talk about, because the burden is going to be borne by them as well. Right. It's going to cost the state alone almost$4 million in the first year, almost um$3.8 million in the second year,$3.8 million in the third year. So we are wasting money to prove a point that we research already shows is not real.

SPEAKER_01: 53:41

We're spending money to justify cutting money.

SPEAKER_02: 53:46

So how can anyone assume that this is done to benefit people, people who aren't working to get them working when the only savings is generated by them losing their health insurance?

SPEAKER_03: 53:58

Yeah.

SPEAKER_02: 53:59

Hopefully my kids don't listen to this because this is me assuming the worst, but I don't see any other way the math works on this. It doesn't work. You're spending more money than you're saving, and so much harm is going to be done to actual people.

SPEAKER_01: 54:16

Let's talk about the healthcare providers. Because when I've been in doctors' offices, some have signs that say we do not accept Medicaid here. Medicaid is not accepted. And then there are other providers who do accept Medicaid. With these changes and what's happening at the state or federal level, like what's going to happen to the providers who do accept patients who have Medicaid coverage?

SPEAKER_02: 54:38

There are providers who are legally required to accept Medicaid. Those include hospitals. Hospitals have to accept Medicaid. It includes what are called federally qualified health centers, also known as community health centers. And those provider types exist across the country just like hospitals do.

SPEAKER_01: 54:59

Yep.

SPEAKER_02: 54:59

And they cannot turn away Medicaid patients. Community health centers cannot turn away a patient for their inability to pay. And so the way they make their math work, they do have to make their math work also because community health centers are small businesses. They have boards of directors who are members of their community who decide what types of services they provide, what the needs in their communities are, how they can meet those needs. So it's a very community-based organization.

SPEAKER_03: 55:34

Right.

SPEAKER_02: 55:34

Community health centers have to use different sources of revenue, just like the state, just like you and Molly, to make their ends meet. And so they have grants, they have federal grants, they have private grants, they accept commercial insurance, they accept Medicare, they accept Medicaid.

SPEAKER_01: 55:54

Medicaid reimbursement rates vary by state. So Vermont's reimbursement rates for their Medicaid programs are different than Maine's, which is different than New Hampshire's, because their lawmakers get to decide. Is that correct?

SPEAKER_02: 56:10

Policymakers get to decide traditionally, yes, how much Medicaid reimbursement rates are to a certain extent. So what they don't decide usually, they don't decide the dollar amount. They decide the the amount of the in the bucket. They decide how much money is in the Medicaid bucket.

SPEAKER_03: 56:29

Yep.

SPEAKER_02: 56:29

And then DHHS or whatever their health agency is called decides what the rates are. So if the state doesn't give them a lot of money, then they have to make the rates low in order to make the lines work.

SPEAKER_01: 56:43

There's a pool of money to be able to reimburse providers with. Right. Who accept Medicaid patients. Right. And so if our state lawmakers put less money in that pot of money for Medicaid, then providers will therefore have lower reimbursement rates because there is less money theoretically. Unless, of course, a whole bunch of health centers close and then there are just fewer providers in general. Is that what they're trying to do?

SPEAKER_02: 57:12

So this is again them not showing their work. This isn't in the budget reconciliation documents, but this is what happens. When you reduce the number of insured patients in a state, you reduce the revenue that healthcare providers earn by providing those services. And the provider earns less money, they have to cut services to make ends meet, they have to close sites to make ends meet, and wait times increase. So even if you're insured, your wait times are going to be longer at your primary care provider because they have less revenue, because there are less insured granite staters. So if you look at a community health center or a hospital, for example, they have to accept Medicaid. They have to treat community health centers have to treat you regardless of your ability to pay or insurance status. If their patient loses their health insurance, they can't turn them away. They still have to provide the$300 in primary care to their patient. They just have no source of revenue now for that patient. So they lose the$300. They still have to take care of their patients. They just don't get any revenue from that, those services. And so what ends up happening is they have to treat the patient. The patient can't afford to pay. So the health center has to decide where the income's coming and where it's not. And they cut the services that they earn less revenue on, for instance, substance use disorder treatment.

SPEAKER_01: 58:49

Let's be exceedingly clear here. All of these patients deserve health care. They are not doing anything wrong in this process. They deserve to be able to make an appointment, go to a health center, get treatment, do get the get the things that they need to get healthy in whatever healthy way needs to happen. And that should be the extent of their participation in this conversation. They should just be able to get the health care that they need. Yes. You shouldn't have to deserve it, you shouldn't have to like earn it. Prove it. Prove you need that health care.

SPEAKER_02: 59:26

Prove you have skin in the game. You're worthy of an insurance card to put in your pocket.

SPEAKER_01: 59:32

Right. And the providers who are providing this health care need to have the revenue coming in to be able to provide that health care for these people who need it.

SPEAKER_02: 59:42

Right. Because guess what, Liz? Your high cholesterol still needs to be.

SPEAKER_01: 59:48

Shout out to my high cholesterol. Your high cholesterol still needs to be. We are getting into why the heart attack is happening.

SPEAKER_02: 59:57

Can you tell I just had my blood tested?

SPEAKER_01: 1:00:01

That's good. You should you should be able to get the health care that you need and the blood tests that you need when you need them. Right. Yes.

SPEAKER_02: 1:00:08

Right. And I have health insurance. So I can access those services and not be out$800 that blood work costs. So then when they the providers lose revenue because their patients lose insurance, they have to let people go, which means they're fired.

SPEAKER_01: 1:00:28

Fewer providers.

SPEAKER_02: 1:00:29

Which means they have fewer providers, which means that provider just lost their job, lost their health insurance, lost their income that supports their family. And you have to wait longer to get your cholesterol levels checked because they have fewer providers. Right. Because policymakers chose to implement policies that are guaranteed to kick people off of Medicaid. So everyone, Liz, should care if granite staters retain their Medicaid because it will inevitably impact every single person in our state.

SPEAKER_03: 1:01:07

Yeah.

SPEAKER_02: 1:01:08

And that doesn't even get into what's happening at the federal level. Because that's fun.

SPEAKER_01: 1:01:13

You have an interesting definition of the word fun, is what I'm hearing. Mm-hmm. Let's hold on the federal piece. Yeah, it's a lot. No, this is incredible. So my last question for you is if folks are listening to this podcast and they're like, wow, I did not know all this stuff about Medicaid, and say they're pretty frustrated to find out that our lawmakers and our policymakers in New Hampshire have made the conscious decisions to negatively impact people who are covered by Medicaid or who could be and so forth. What should they do, Christine? What does one do with all the rage?

SPEAKER_02: 1:01:53

Scream very, very loud into the void.

SPEAKER_01: 1:01:58

Yes. Scream into the void. Check. I do that every day. It's a good part of my morning routine. Scream into the void.

SPEAKER_02: 1:02:04

Mountain bike before work. That helps me. I crossfit.

SPEAKER_01: 1:02:08

Yeah, I crossfit. Oh, yeah. It's one hour of my day that I know I cannot think about work because I am too busy doing too many wall balls.

SPEAKER_02: 1:02:17

Right. No time. If I think about work, I crash and I get bruises.

SPEAKER_01: 1:02:22

You mountain bike. I do mountain bike. I crossfit. So scream into the void, do something to maybe avoid anxiety attacks.

SPEAKER_02: 1:02:31

Yes, right. Panic attacks. So you gotta do that. And then talking to your friends and neighbors, because I bet you, Liz, you throw a rock, or maybe I don't know, a tennis ball is a better choice. Right. No, rocks are great. You throw a tennis ball from your front door and you hit someone, they probably have Medicaid. Because guess what? Almost 200,000 people in our state are covered by Medicaid. If you go to the Merrimack County nursing home, those residents are thankfully insured by Medicaid. So it will affect every aspect of your life, of your friends and neighbors' lives. So you have to learn, right? And then vote. Also vote.

SPEAKER_01: 1:03:17

Vote.

SPEAKER_02: 1:03:19

The other thing we need to do is write letters, make phone calls to your legislators. We have the most accessible lawmakers.

SPEAKER_01: 1:03:28

We really do.

SPEAKER_02: 1:03:29

There's 400 in the house. Yeah. One of your neighbors is probably a legislator.

SPEAKER_01: 1:03:34

They're everywhere.

SPEAKER_02: 1:03:35

So call them and talk to them about why you're concerned and how you don't want your health insurance rates to go up and what they can do to prevent that. Because guess what? There's already reports out there that say health insurance rates are going to go up.

SPEAKER_03: 1:03:52

Yeah.

SPEAKER_02: 1:03:52

Not just because of what happened at the federal level, it's also these choices that our state policymakers have made to reduce state revenue and to push the burden and the cost down onto residents.

SPEAKER_01: 1:04:04

Letting them know that health insurance costs and health insurance coverage matters a heck of a lot to you. That is a tangible next step that you can take after you scream into the void, after you mountain bike or do your reverse lunges like we've been doing at the gym. I don't know what that is. They're hard to. You're gonna vote, of course, but also you're gonna contact your lawmakers. You don't have to wait until election day. You can talk to them now.

SPEAKER_02: 1:04:31

Right. And it's actually better to talk to them now because they're less busy because they're not in the legislative session. And they're also drafting bills right now.

SPEAKER_00: 1:04:40

Yeah.

SPEAKER_02: 1:04:41

So if there's something they can do to help you or mitigate the consequences that are going to come because of this legislation, they can do it now.

SPEAKER_01: 1:04:49

You can talk to them now. You don't have to wait. Christine, thank you so much for your time. Thank you for coming on here and talking to me about Medicaid, which is health insurance.

SPEAKER_02: 1:05:00

That's all it is. That's all it is. Health insurance.

SPEAKER_01: 1:05:02

Medicaid, not scary. Not a scary thing. Just health insurance.

SPEAKER_02: 1:05:06

It's great.

SPEAKER_01: 1:05:24

What is a wall ball? You take a weighted ball and you squat and then you throw it up as you get up and it hits the wall and it comes back down and you keep doing those. It's, as you might say, fun.

SPEAKER_02: 1:05:35

What happens if it hits you on the head? Like, is that a punk? And then I gotta catch it.

SPEAKER_01: 1:05:39

You'll catch it. You you don't want to get hit.

SPEAKER_02: 1:05:41

I wear bifocals, Liz. You're asking a lot.