In 2018, long-term care advocates got New Hampshire legislators to overwhelmingly vote against putting Medicaid long-term care in the hands of out-of-state Big Insurers. But now Big Insurers are trying again.
According to the federal Medicare Payment Advisory Commission, the all-payer margin for freestanding nursing homes averaged only .4% nationally in 2023, with almost half of nursing homes in the red. Medicaid isn't paying costs like a 36% increase in wages for non-supervisory employees since February 2020, or inflation-driven costs for food and supplies.
There is no room within negative margins for Big Insurers to siphon off funds as middlemen.
And Big Insurers are in the business of delaying and denying lifesaving care. As one article reported, "The nation’s largest health insurance company pressured its medical staff to cut off payments for seriously ill patients in lockstep with a computer algorithm’s calculations, denying rehabilitation care for older and disabled Americans as profits soared, a STAT investigation has found."
To illustrate this cruelty, as another article reported: "Robby Martin got an unsettling call from his father, Jackie. The 82-year-old told his son that a representative of the insurance giant UnitedHealth Group had barged into his nursing home room at 2.30 in the morning, announcing that he was going to be checked out at the end of the week."
Jackie Martin died alone in his bathroom at home, just 5 days after his life-preserving nursing home coverage was cancelled. Is that the sort of cruel profiteering we want for the most vulnerable Granite Staters?
Furthermore, allowing insurers to run Medicaid for seniors would jeopardize federal funding unique to New Hampshire nursing home care, which could only be made up for through massive property tax increases. Indiana, the most recent state to turn over Medicaid long-term care to insurers, has experienced severe cost overruns in the hundreds of millions of dollars. As the Indianapolis Star reported in September 2025:
"More than a year into the state's endeavor to shift care management for Hoosier seniors on Medicaid from the state to private insurance companies, just about no one is happy. What was intended to make things simpler for Medicaid recipients and cheaper for the state has instead been universally described by families, care providers and even the head of the Family and Social Services Administration as the opposite: a more painful, bureaucratic mess in which paperwork falls through the cracks, call centers don't have the right answers and assisted living facilities are constantly chasing down reimbursements to keep their doors open."
TELL YOUR LEGISLATORS TO PUT SENIORS, NOT BIG INSURERS, FIRST!