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By Clay Wirestone April 15, 2016

Republican state Rep. cites higher than average Medicaid enrollment in two NH counties

At a news conference last month, U.S. House candidate and state Rep. Jack Flanagan explained his vote to continue the state’s expanded Medicaid program.

Flanagan, a Republican, supported the legislation because those in the second congressional district were relying on the expanded plan, he told reporters.

"When I looked at the actual layout -- Coos County, Sullivan County, there was a significant number of people -- I think it’s almost 5 percent if not more -- in those counties. So, looking ahead and knowing those people could use the support, that’s why I voted" for the program, he said.

Flanagan’s assertion caught our eye. While the overall number of those on the expanded program has been stated repeatedly – about 48,000 individuals – less has been said about who those people are and where they live.

So we decided to check out Flanagan's statement.

Let’s start with the district boundaries. New Hampshire’s second congressional district stretches from the very top of the state to the very bottom, and generally covers the western half. It’s currently represented by U.S. Rep. Annie Kuster, a Democrat.

As Flanagan noted, the district encompasses all of Coos and Sullivan counties. It also includes all of Cheshire County. Much of Grafton, Merrimack and Hillsborough counties are in the district, too, along with a slice of Rockingham.

That’s a lot of space, and as you might expect, use of the expanded Medicaid, which offers subsidized health care to people making less than $16,000 a year, isn’t uniform across the district. Towns and cities in sparse Coos and populated Merrimack counties face very different economic challenges, after all.

The next piece of the puzzle is the actual usage of the program. The state’s Health and Human Services department has produced a number of maps through its division of Public Health Services that show, as of January, how many residents across the state use expanded Medicaid.According to this information, Coos County saw the greatest use of the expanded Medicaid program, with 5.38 percent participating. Sullivan County, the second one named by Flanagan, had 4.28 percent of its residents enrolled in the program. These figures include just the expanded program, not all Medicaid enrollees.

As expected, numbers vary in the other counties included in the district. Only 3.77 percent of the population of Cheshire County is enrolled. Merrimack County has 3.75 percent of residents participating, while Hillsborough has 3.58 percent.

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Grafton County is broken up in an unusual way on the map -- Hanover and Lebanon are broken out. Between them, the communities have only 1.72 percent of their residents in the program. The rest of the county has a 4.19 percent enrollment.

While the numbers can be sliced and diced further -- the state also issued a town-by-town breakdown of enrollments -- Flanagan was speaking about county numbers, so this rough breakdown should be sufficient.

The two counties Flanagan specified, Coos and Sullivan, indeed have the highest participation rate in the expanded Medicaid program. Only the former is over 5 percent, though.

Bolstering his argument, both have higher enrollments than the state as a whole, which stands at about 3.5 percent.

When reached for comment, the representative pointed to the same set of data from the state.

"I was considering Coos when I made that statement, however Grafton and Sullivan counties are still high, percentage wise," Flanagan wrote in an email.

Our ruling

U.S. House candidate and State Rep. Jack Flanagan said that "almost 5 percent if not more" of the population of Coos and Sullivan counties were enrolled in the state’s expanded Medicaid program.

In the second congressional district, one county has more than 5 percent enrollment in the state’s expanded Medicaid program and another is pretty close. Coos county indeed breaks the 5 percent mark. Sullivan, at 4.28 percent, which have the first and second-highest participation rates in the state, respectively.

We rate Flanagan’s statement True.

Our Sources

N.H. Rep. Jack Flanagan press conference, March 10, 2016

E-mail correspondence with N.H. Rep. Jack Flanagan, April 8-9, 2016

"State Rep. Jack Flanagan to target independents, Democrats in 2nd District race," Concord Monitor, March 10, 2016

New Hampshire information, Medicaid.gov, 2016

"NH Health Protection Program Demographic Profile, 1/15/16," New Hampshire Department of Health and Human Services, January 2016

"Percent of Individuals Enrolled in the New Hampshire Health Protection Program by County as of January 15, 2016," NH Division of Public Health Services, January 2016

"Percent of Individuals Enrolled in the New Hampshire Health Protection Program by Town as of January 15, 2016," NH Division of Public Health Services, January 2016

"New Hampshire Congressional Districts," Congressional Districts - 113th Congress, U.S. Geological Service

"2012 New Hampshire Congressional district maps," WMUR-TV, Oct. 21, 2012

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More by Clay Wirestone

Republican state Rep. cites higher than average Medicaid enrollment in two NH counties

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