Senate budget writers hear arguments on Medicaid expansion, other state issues

Last modified: 5/15/2013 7:37:07 AM
The Senate’s budget writers heard six hours of public testimony yesterday about a wide range of state programs and spending, including arguments for and against expanding New Hampshire’s Medicaid program under the 2010 health care reform law championed by President Obama.

“It seems to make sense for the state, for our residents, for our budget and for our economy,” Deb Fournier, policy analyst for the liberal-leaning New Hampshire Fiscal Policy Institute, told the Senate Finance Committee during the state budget hearing.

Fournier and other supporters said Medicaid expansion will provide health coverage to tens of thousands of residents and would be fully funded by the federal government for the first three years. Federal money would cover 90 percent or more of the cost in subsequent years.

But Greg Moore, state director for the conservative group Americans for Prosperity, said expanding the Medicaid program would swell the state government’s size and spending, and increase utilization of services without necessarily improving health outcomes for people who lack insurance now.

He pointed out New Hampshire has relatively low Medicaid reimbursement rates for providers.

“When hospitals are losing money on Medicaid, to increase utilization means they’re going to lose even more money,” Moore said.

Gov. Maggie Hassan, a Democrat, and the Democratic-led House both support expanding the Medicaid program, as do groups including the New Hampshire Hospital Association. The Republican-led Senate hasn’t yet voted on the issue.

Yesterday’s hearing lasted well into the night and came as the six-member Senate Finance Committee works on the next two-year state budget. The House passed its version last month and the Senate is expected to approve its version by June 6, with final negotiations on a compromise budget to follow.

The next biennium begins July 1.

The two-year, $11 billion budget passed by the House in early April was based on a proposal submitted in mid-February by Hassan.

Hassan’s budget increased state funding for public colleges and universities, the community college system, mental health services and services for adults with developmental disabilities and acquired brain injuries. The House reduced, but didn’t eliminate, the extra funding for the University System of New Hampshire, and cut funding for new charter schools and public school building aid, among other things. It didn’t cut the increased funding for community colleges, mental health services and the developmentally disabled.

The House budget includes a 12-cent hike in the gas tax (spread over three years for gasoline and six years for diesel fuel), a 30-cent hike in the cigarette tax and a handful of increased fees. It doesn’t include $80 million in casino license revenue that Hassan had included in her budget; the House, which has opposed past proposals for expanded gambling, hasn’t voted yet on a casino bill that passed the Senate earlier this year.

Much like the House Finance Committee’s public hearings on the budget earlier this year, yesterday saw dozens of activists, lobbyists and residents ask for increased – or at least, not reduced – funding for domestic violence programs, drug and alcohol addiction treatment services, New Hampshire Legal Assistance, services for adults with developmental disabilities, the Land and Community Heritage Investment Program, Family Resource Centers and other programs.

“Over the years, the state has balanced the budget on the backs of people with disabilities, who are among the state’s most vulnerable citizens. Why has that been allowed to happen?” asked Pete Eldredge of Somersworth, whose adult daughter is developmentally disabled. “It’s now time to correct this long-standing travesty.”

The Finance Committee won’t make any final decisions for a few more weeks. But Salem Republican Sen. Chuck Morse, the panel’s chairman, has predicted the Senate’s budget will look quite different from the version passed by the House.

Morse has said tax increases are a nonstarter and that the House overestimated revenue from the state’s Medicaid Enhancement Tax, which in turn affects uncompensated care payments to hospitals. In all, Morse said this week, he believes the House’s $11 billion budget has a $300 million hole that the Senate must fill.

(Ben Leubsdorf can be reached at 369-3307 or or on Twitter @BenLeubsdorf.)


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