Daniel Lapidus

Chairman and Members of the Committee, My name is Dr. Daniel Lapidus. I am an emergency medicine physician practicing in Claremont, New Hampshire at Valley Regional Hospital. I care for patients every day who rely on Medicaid for their health care—many of whom are hardworking, low-income individuals, often juggling multiple jobs, family responsibilities, or health challenges. I’m here today to express my strong opposition to SB 134. As someone on the front lines, I want to be clear: this bill will harm my patients. It will create administrative barriers to care, increase preventable emergency room visits, and push more people into being uninsured—at the exact moment when we are finally seeing progress in public health outcomes. 1. Monthly Work Requirements Create Administrative Barriers. Even with exceptions for pregnancy, behavioral health, and substance use disorder, this bill requires patients to prove they qualify every month. That’s a bureaucratic hurdle that will trip up thousands of eligible patients. We’ve seen this in Georgia, where a similar system led to only 5% of eligible individuals successfully enrolling. That’s not a success—it’s a collapse of coverage. 2. The Cost of Implementation Will Hurt the Entire Medicaid Program. Implementing and tracking these work requirements will cost New Hampshire millions of dollars—none of which is currently in the state budget. That means cutting existing services or reducing provider reimbursement rates to pay for this unfunded mandate. As a physician already operating under thin margins, I ask: is this really worth another Medicaid rate cut? 3. This Risks Reversing Hard-Won Progress in the Opioid Crisis. We’ve finally begun turning the tide—overdose deaths were down 35% in 2024 compared to the previous year. This is the result of years of focused work, community investment, and expanded access to care. SB 134 threatens to unravel that progress. 4. We’ve Been Down This Road Before—and It Was Struck Down. When New Hampshire previously attempted to implement a work requirement, nearly one-third of Medicaid expansion enrollees would have lost coverage before the courts declared the policy unconstitutional. This bill is essentially a rerun of that failed attempt. 5. Uninsured Patients Don’t Disappear—They Just Show Up Sicker and in the ER. When patients lose coverage, they don’t stop needing care. They stop getting preventive care. They show up later, sicker, and in crisis—often in my emergency department. And then the hospital—and by extension, taxpayers and providers—are stuck covering 100% of the cost for care that could have been 90% federally funded through Medicaid expansion. This bill doesn't save money—it shifts cost, worsens outcomes, and punishes the working poor for being poor. As a physician, I urge you to reject SB 134. Let’s continue building a health care system that works for every Granite Stater—not tear it down in ways that we already know don’t work. Thank you for your time and consideration. Respectfully, Daniel Lapidus, MD Emergency Medicine Physician Claremont, New Hampshire