I am a therapist in a group practice in NH. A group practice is when several therapists in private practice share the expenses of space, employees who handle the billing, and so on.
Recently we lost one of the three clinicians who can accept medicare clients, so now there is only myself as a MSW and one of the partners who is a psychologist who can do so. The upshot of this is that all the recent referrals I have gotten have been medicare clients, all of which also have medicaid.
Without having medicaid too few of these folks would be seeking therapy because the copay w/out any other coverage is about 35$ per session. My concern is that I know the teabaggers who were elected in 2010 are trying to slash medicaid in this state, so when these cuts hit I could lose a large proportion of my caseload virtually over night. Part of the challenge of private practice is building a stable case load which took me about 9 months to do, so this would be devastating to my ability to keep eating.
On the other hand I am wondering if having all these medicare cases might insulate me because messing with medicare is so toxic, which might spill over into who gets effected by the cuts. In other words, perhaps there will be a reluctance on the part of the Repugs in this state to cut or eliminate medicaid benefits to those who are also on medicare for fear of a backlash from the elderly who vote more often than anyone else.
My other problem is that I am a little fuzzy on the details in this state because I tend to focus more on the national level. I always vote in the mid terms, but that is about as far as it goes.
Any thoughts, especially from those who are more familiar with what's going on in NH would be greatly appreciated.