New Hampshire has introduced legislation that essentially requires all licensed and actively practicing “health care practitioners and facilities” to accept as many uninsured and Medicaid patients as everyone else or pay a penalty, reports the Association of American Physicians and Surgeons (AAPS). The bill, HB 693-FN, requires the commissioner to conduct an annual audit of health care practitioners and facilities, including outpatient facilities. “Based on the audited data the commissioner shall calculate the ratio of Medicaid and uninsured procedures to other compensated procedures.”Penalties shall be assessed for those who are outside the acceptable range.

A practitioner can pay a fee of $10,000, or a facility can pay $10,000 per full-time professional staff equivalent to opt out of the requirement. “It’s reminiscent of the provision in some parts of the antebellum South that allowed slaves to buy their freedom,” stated AAPS executive director Jane Orient, M.D.“The $10,000 annual fee is likely to be less than the revenue lost by accepting Medicaid payment rates,” stated AAPS president Marilyn Singleton, M.D., J.D. “What if everybody opts out? The state would have money but no facilities to treat patients.”The law does not define “health care practitioner” or set the penalty, Dr. Orient noted. It also apparently assumes that “uninsured” means non-paying.

“New Hampshire seems to be anticipating the problem that arises when politicians promise free health care for all,” Dr Orient suggested. “Who will do the work?”The Association of American Physicians and Surgeons (AAPS) is a national organization representing physicians in all specialties, founded in 1943. Its motto is “omnia pro aegroto,” or “all for the patient.”