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As the bipartisan bill to reauthorize New Hampshire’s Medicaid expansion program, Granite Advantage, moves through the legislature, backers are making a conservative case for the expansion.

Senate President Jeb Bradley (R-Wolfeboro) is one of the bill’s prime sponsors. He says expanding Medicaid has lowered healthcare costs, improved healthcare for Granite Staters, and helped get more people into the workforce.

“The program has worked as intended,” Bradley said.

The Granite Advantage bill, SB 263, won unanimous support in the Senate last month. It’s scheduled for an executive session discussion on Wednesday before the House Health, Human Services and Elderly Affairs Committee. If approved, the bill will then head to the full House for a vote.

Granite Advantage was last reauthorized in 2018 and is set to expire at the end of the year without SB 263’s passage. Enrollment in the program was around 94,000 residents at the start of the year, though the national COVID-19 emergency inflated those numbers. Those figures are expected to return to around 60,000 residents in the coming months.

SB 263 would reauthorize the program and remove the requirement that the legislature pass legislation to reauthorize it every few years, instead relying on a study commission to send an annual report to the legislature reporting on the effectiveness of the program. Even if SB 263 were to pass, the legislature could sunset this program at any time by a vote of the legislature.

According to Bradley, providing coverage through Granite Advantage is taking a bite out of healthcare costs. The program is driving down the cost of uncompensated care hospitals are required to provide to people without insurance. That protects people with private insurance from being stuck picking up the tab when someone without insurance goes to an emergency room for treatment, he said.

“[Uncompensated care] is a hidden tax on any individual or any business with private insurance,” Bradley said.

According to the New Hampshire Hospital Association, Granite Advantage has led to a 63 percent decrease in the number of uninsured people going to emergency rooms. There has also been a 57 percent drop in uninsured people being admitted to hospitals and another 41 percent reduction in the number of outpatient visits by the uninsured.

In 2014, hospitals reported $174 million in uncompensated care costs before Granite Advantage went into effect. In 2021, that figure dropped to $69 million, according to the NHHA.

Sen. Lou D’Allesandro (D-Manchester) said permanently expanding Granite Advantage makes sense beyond the numbers.

“I just feel it’s the right thing to do,” D’Allesandro said. “We take care of a lot of people.

And, he pointed out, the bill does not use any money from the state’s General Fund.

The bill’s costs are 90 percent covered by the federal government. In 2022, Granite Advantage cost $558 million, but the federal government covered $502 million. According to Bradley, the remaining $56 million was paid through healthcare taxes and fees, with money from the state liquor fund also available to cover costs.

New Hampshire Business and Industry Association (BIA) President and CEO Michael Skelton said abandoning Medicaid expansion would hurt both the state’s economy and the people who make New Hampshire’s growing economy possible.

“We benefit from an overall healthier population,” Skelton said. “Hospitals and other caregivers avoid catastrophic loss of revenue, and employers and employees across the state will benefit from individuals being healthy enough to work.”

In addition to the BIA, numerous other NH-based business organizations including the NH Retail Association and several chambers of commerce have advocated for the reauthorization of Medicaid expansion.

A new ship that will function as an at-sea headquarters for the workers maintaining some 200 wind turbines off the New England coast is nearing completion, part of an Eversource project to expand the reach of renewable energy in the region.

The Eco Edison, a 262-foot-long service operations vessel, is more than halfway built at the Edison Chouest Offshore shipyard on the Gulf of Mexico in Louisiana. Once launched, the ship will be a floating, year-round home base for 60 of the first American offshore wind turbine technicians. They will work at sea over the life of the wind farms, servicing and maintaining the wind turbines. 

It’s a big step toward Eversource’s renewable energy goals, according to Mike Ausere, Vice President of Business Development at Eversource.

“Offshore wind is a key driver of economic growth, creating well-paying jobs in states across the country and forging a new, domestic supply chain that, together, will position our nation as a global leader in the industries of tomorrow, today,” Ausere said.

The Eco Edison, built by Edison Chouest, is a first-of-its-kind vessel to serve the crews who work on and maintain wind farms. 

The ship will be crewed by around five dozen workers drawn from the northeast region to which it will be providing power. The onboard technicians, who the company says will work two weeks on/two weeks off schedules, will have access to on-ship entertainment and recreation facilities, including a gym and a movie theater.

Eversource partners with Ørsted, a leading offshore power supplier, to bring power from several Northeast wind farms. The two companies are investing hundreds of millions into the new shipbuilding venture to service those projects.

Ausere said the Eco Edison is, as long as the Superdome is tall, able to host 60 wind turbine technicians–all of whom will benefit from the vessel’s state-of-the-art accommodations to keep them safe and well-cared for while at sea; and ready to support the long-term operations and maintenance of Eversource and Ørsted’s portfolio of offshore wind farms.

Eversource’s current lease with Ørsted is for 4,000 megawatts, with the option to double that amount. That means the Ørsted partnership can power up to 2 million homes in New England. Ørsted’s wind farms are currently located in New Jersey, Rhode Island, New York, Maryland, and Connecticut.

Eversource is also working with Sunrise Wind and Revolution Wind on wind farm projects off the Massachusetts coast that will generate more power for customers.

The large-scale renewable energy projects represent significant investments and new jobs in a readily growing industry, said David Hardy, the executive vice president, and CEO for America at Ørsted.

“This first American service operations vessel represents the ingenuity of businesses like Edison Chouest to build upon their legacy in offshore energy and to supply a cutting-edge vessel that will allow workers to safely and effectively operate offshore,” Hardy said. “The offshore wind energy industry is utilizing the talented and expert Gulf Coast workforce, and we’re proud that this first-of-its-kind vessel will support the production of more American energy, strengthening our national security and powering millions of American homes.” 

Renewable energy currently comprises just over one-fifth of all electricity generation sources in the U.S., according to data from the Department of Energy. Fossil fuels—overwhelmingly coal and natural gas—make up 60 percent of the U.S. energy profile.

Wind, meanwhile, represents nearly half of the total U.S. renewable electricity capture, with 10.2 percent of renewable energy coming from wind farms. Hydroelectric comes in second at 6.2 percent.

Baseball fans love to argue who has the strongest team, the best pitching, and fiercest lineup. And they make their case by using stats: winning record, ERA, batting average.

At the State House, many of the players say they’ll support legislation that promotes a healthy climate for job creation and a strong New Hampshire economy. Because businesses are the number one payer of state taxes, legislators often say they’ll get behind efforts that help businesses thrive. But when they finally get their turn at the plate, some just leave the bat on their shoulder and watch pitches go by.

BIA recently published its fourteenth annual Legislative Scorecard and fifth annual Victories & Defeats for New Hampshire Businesses. (Access the publication on our website, BIAofNH.com.) The companion pieces track how all Senators and House members voted on legislation of keen interest to the business community and summarizes the outcome of a wide variety of bills in a mix of policy areas.

The Scorecard section is easy to follow. Individual scores are based on roll call votes only (those in which lawmakers’ votes are recorded by the clerk), not up-or-down voice votes in which a Senator’s or Representative’s position is difficult, if not impossible, to identify. Selected legislation (ten bills for the Senate, eleven bills in the House) covers a variety of issue areas.

BIA is a nonpartisan advocate for our members – leading employers in every corner of the state. Business-friendly legislation sometimes falls on the political left and sometimes falls on the political right. Not everyone agrees with BIA on every vote; however, 141 Senators and Representatives – both democrats and republicans – scored high enough to warrant special recognition.

Those scoring between 86-100% on selected legislation received the honor, “Champion of Business.” Those who scored between 70-85% are recognized as “Friend of Business.” If you meet a state legislator running for re-election over the next few weeks, ask them what their BIA Scorecard percentage was (or look it up yourself online).

While the Scorecard is intended to hold legislators accountable for their response to business issues, the Victories & Defeats portion of the publication reports on the legislature’s efforts to enhance New Hampshire’s climate for job creation. By extension, the publication is a reflection of BIA’s efforts to influence public policy. As New Hampshire’s leading business advocate, our members expect us to communicate their concerns to elected officials. No one bats a thousand, but looking back at the 2018 session, BIA did well.

For example, in the area of employment law, we flashed some Gold Glove-caliber defense on a flurry of bills that would have allowed state government to intrude on private business decisions in everything from hiring practices to scheduling to benefits administration. We think employers know better than politicians how to run their businesses. Most lawmakers agreed with us, and all bills of this type, which are listed in the document, were defeated.

Another area where legislators heard us was on environmental policy. Most thoughtful business leaders agree the issue of emerging contaminants, such as PFOS and PFOA, should be taken seriously and thoughtfully addressed. Throughout the 2018 session however, we saw an overreaction to this issue. Although modern technology can now detect the presence of chemicals at increasingly smaller concentrations (parts-per-trillion), science around health impacts of smaller concentrations is lagging.

We saw lawmakers attempt to address this conundrum by tasking the state to do something the federal government’s Environmental Protection Agency, academia, and industry scientists have yet to do: establish new standards for a cornucopia of compounds in the air, groundwater, and surface water. Then legislators proposed taking existing standards and unilaterally change them to arbitrary levels – levels not based on science, just numbers that would show their constituents they’re “doing something.” After articulating the folly of this approach, these bills were defeated.

We had a mixture of wins and losses in the areas of tax policy, economic development, health care, and education. For example, the House and Senate missed opportunities to put downward pressure on New Hampshire electricity prices, which are already 50-60% higher than the national average year-round. They instead listened to special interests that wanted ratepayer subsidies for unprofitable power generators.

The season at the State House is over and we spectators are already thinking about the next season coming up in January. BIA’s Legislative Scorecard and Victories & Defeats publication is a stat sheet for voters to evaluate their elected officials and determine who’s an MVP and who should ride the bench.

Is there a trade war on the way?  Or is these announced sanctions, as President Trump’s new top economic advisor Larry Kudlow says, merely “first proposals” in a broader trade negotiation?

Either way, New Hampshire should be OK.  Why? Because the good news (and bad) for New Hampshire business is that foreign trade is just 18 percent of the state’s economic activity. So even if the US and China are serious about the tit-for-tat sanctions currently under discussion, the impact on the Granite State should be relatively small.

According to data from the US Census Bureau, New Hampshire exported a total of $5.1 billion worth of goods in 2017, accounting for just 0.3 percent of all US exports. As the New Hampshire Employment Security, Economic and Labor Market Information Bureau put it, “the total value of exports from New Hampshire is relatively small, ranking 43rd when compared to the other states and the District of Columbia.”

New Hampshire’s number one export? Civilian aviation equipment, though overall telecom and related tech dominate New Hampshire’s export sector.

And if a China/US trade war should ignite, New Hampshire will benefit from the fact that its largest export recipients are in North America, not Asia. Canada and Mexico are the top of the list of nations receiving New Hampshire exports. In fact, when it comes to goods (as opposed to services), New Hampshire exports more to the United Arab Emirates than to China.

If these numbers seem surprisingly low, it’s probably because—like most Americans—you overestimate the role of trade in the overall economy.  While the US exported a robust $1.454 trillion worth of goods and services in 2016, the nation’s GDP that year was $18.6 trillion. That’s more than a drop in the bucket, but it’s still a modest-sized bucket.

The states that rely most on foreign trade tend to be in the South, states like South Carolina, Louisiana and Tennessee. What do they have in common? Agriculture and relatively low-skill manufacturing. New Hampshire ranks 48th in the dollar value of agricultural output by state. Granite State manufacturing is more high skill and tech related.

If New Hampshire’s political and economic leaders really want to impact the state’s manufacturing sector, their priority wouldn’t be exports abroad. It would be lowering energy costs here at home.