Tom Blonski is the president and CEO of Catholic Charities NH.
Since 1948, Catholic Charities New Hampshire has stood by our most vulnerable neighbors, providing compassionate nursing home care to the elderly and sick, regardless of their economic means. But today, that commitment – a focal part of our mission – faces one of its greatest threats.
Over half of the older adults we care for are on Medicaid, and Medicaid payments fall well below the actual cost of their care. Yet the New Hampshire House has adopted a budget trailer bill that would, among 195 other things, “reduce all Medicaid provider rates by 3 percent effective January 1, 2026.”
A funding cut would not be sustainable for nursing home care, especially at a time when costs such as wages and benefits, food, medical equipment and supplies have increased by over 6% annually. Rising tariffs will drive many of these costs even higher.
Even when Medicaid funding has increased, as it did in the current two-year budget, it has not kept pace with the cost of care. A cut to nursing home care rates would betray our duty to care for the most vulnerable among us – the sick and the elderly. They are a generation that cared for us, and we need to be there for them.
Pope Francis wrote that too often we “lose sight of the value of each individual and people are then judged in terms of their cost, which is in some cases considered too high to pay.” The Pope also decried the fact that “we are accustomed to throwing people away. But people are never to be thrown out. The disadvantaged cannot be thrown away. Every person is a sacred and unique gift, no matter what their age or condition is. Let us always respect life and not throw it away.”
At the national level, we often hear unsupported allegations that Medicaid funding is fraught with waste, fraud and abuse, yet nursing homes can document through state-audited cost reports that they lose money on each Medicaid beneficiary. In fact, we currently lose in excess of $75 per patient, per day, for every Medicaid resident. In effect, by not getting paid in full, nursing homes have long been subsidizing the state budget. Isn’t expecting someone else to bear the costs of their own obligations a form of taxation?
In that sense, a 3% cut simply adds insult to injury. Worse, for a mission-driven organization like ours, the growing losses from providing nursing home care at a funding deficit can jeopardize other critical parts of our mission — whether it’s the New Hampshire Food Bank; New Generation, which provides shelter for single mothers and children; or Liberty House, which supports veterans facing homelessness and other struggles.
We urge the New Hampshire Senate to reject the House’s efforts to cut nursing home care and instead rely upon Gov. Ayotte’s more compassionate proposed budget.
On another note, adding to our challenges even more, delays in Medicaid application processing can result in facilities not getting paid at all for care they provide. For our nonprofit organization alone, this has meant waiting for over $1.6 million in delayed payments for the care provided. This, in turn, constrains our ability to make vendor payments in the face of cash-flow challenges that these Medicaid payment delays create.
That’s why we support the New Hampshire Health Care Association’s efforts to find a solution to the problem of long-pending Medicaid applications. Sen. David Rochefort (R—Littleton), whose sprawling district includes our Berlin facility, has proposed Senate Bill 131, which would allow provisional payments while applications are sorted out. Providers would also be willing to pay a higher licensing fee to allow the Department of Health and Human Services to contract for help in processing applications.
Adversity, even the state budget adversity we’re seeing this year, can bring out the best in people. We’re counting on the New Hampshire Senate to make that happen.