The cost of health care has been a historically harsh reality for families across the United States, and it's not only an issue for the uninsured. We all pay into the health care system through monthly insurance premiums or co-pays, but hospitals remain obligated to treat patients regardless of their actual ability to pay. When uninsured patients are unable to pay out of pocket, the cost of their uncompensated care has to be made up by the insured population, leading to higher insurance premiums for Granite Staters. Our state was in desperate need of a way to help provide care to low-income families without passing on the costs to taxpayers, leading to the evolution of the Granite Advantage Health Care Program.

Medicaid expansion has been a controversial topic in New Hampshire for the past decade, and for good reason. Fiscal conservatives were concerned about signing up for a program based on the promises of Washington, D.C., only to have federal funding dry up down the line. Using federal Medicaid funds to help Granite Staters who didn't qualify for existing support made sense, but only if we could find a New Hampshire way to deliver.

Over several years, lawmakers built Granite Advantage, using a federal contribution of 90%, and insuring that if that federal share ever went away, New Hampshire's program would end. We have also found a way to fund the state's 10% share without hurting New Hampshire families, using a combination of health care industry fees and dedicated funds to protect taxpayers. These guardrails make Granite Advantage both financially responsible and advantageous to every New Hampshire resident.

Since the start of this program, we've witnessed a 63% reduction in the number of uninsured patients seeking emergency care. We've also seen a 57% drop in uninsured patient admissions, along with a 41% reduction in uninsured outpatient admissions. Financially speaking, the cost of uncompensated care attributable to uninsured patients plummeted from $173 million in 2014 to $69 million in 2021 in New Hampshire hospitals. The program was working as anticipated, and the benefits were exponential.

We're lowering costs for everyone and expanding health care access in the process. Instead of pushing the cost of unpaid care onto the insured, we're providing low-income families with Medicaid access. The difference between what we've done in New Hampshire, as opposed to other states, is that we set standards to ensure our taxpayers will not be left with the bill. This program was built with the same commonsense financial directive as past successful state budgets. New Hampshire Republicans have your back; we're always fighting to protect your hard-earned income.

The letters of support we received for this program from over 70 businesses and organizations are further proof of its success. The Seacoast Chamber Alliance (2,500 businesses), Business & Industry Association (400 companies), NH Municipal Association, and the NH Commerce Corridor (which includes the Greater Manchester, Greater Concord, Greater Nashua, Greater Salem, Greater Hudson, and Greater Merrimack-Souhegan Chambers of Commerce), among others, all support making the Granite Advantage program permanent. New Hampshire companies are eager to confirm the effectiveness of this program and the positive impact it brings to our state's workers and overall business climate.

The solid financial benefit to our Granite State communities has been the inspiring factor for many fellow Republicans, including myself, to rally support for this program. We've taken what may have been another expensive Washington D.C. mandate and turned it into a New Hampshire success story.

As the Chair of the Senate Finance Committee, I'm always considering the financial health of our state with the utmost seriousness. After deep discussion and vetting, I can sincerely report that the Granite Advantage program is worth our continued investment and is delivering positive long-term returns.

Sen. Jim Gray, R-Rochester, represents District 6 and chairs the Senate Finance Committee.