After millions of dollars of aid for low-income families has ended, including pandemic-era rental assistance and increased food stamp benefits, the House of Representatives will vote on a budget Thursday that looks to continue support for the state’s lowest earners and their families.

The $15.8 billion budget, which adds to Gov. Chris Sununu’s initial proposal, includes increased Medicaid reimbursements, childcare funding and expanded free and reduced lunch eligibility for students.

But at a time when housing is an ongoing crisis throughout the state – with low rental vacancies accompanying a high cost of living – state representatives also voted to cut affordable housing funding.

Here are four ways the House Finance Committee budget addresses low-income individuals and families across the state.

Medicaid reimbursement rates

Medicaid, a federal and state health insurance program, has provided health care coverage for people who are low-income or have disabilities since 1965. In New Hampshire, 250,000 residents are enrolled, as of February 2023.

The proposed budget from the House Finance Committee increases the reimbursement rate for Medicaid, with $24 million for general state rate increases and $70 million for targeted rate increases.

Medicaid works like private insurance, where health care providers are reimbursed for services for individuals who are enrolled. But these rates aren’t adjusted for inflation or rising costs, and have fallen behind in the state, according to research from the New Hampshire Fiscal Policy Institute.

“The Medicaid reimbursement rate is effectively what a service provider or a health care professional is paid to provide these services to people who otherwise would likely not be able to pay for this service typically,” said Phil Sletten, the research director for the fiscal policy institute. “Adding to those reimbursement rates, means that you are paying health providers more to provide the service to a Medicaid enrollee.”

And with rising costs of services and a workforce shortage in the health care industry, these increased rates could direct more resources to providers.

Targeted services are specific types of care, most of which have seen increases in their rates. These services include community mental health services, developmental services for individuals with disabilities or acquired brain disorders, home health and personal care aides, and residential care – like nursing homes or assisted care facilities.

With the federal and state partnership of the Medicaid program, these state funds will be matched by federal dollars, as well.

The budget also proposes expanding coverage for Medicaid to include postpartum health coverage for 12 months following a birth. The current period is 60 days.

Finally, the House Finance Committee also proposed extending the Granite Advantage Program, which is the state Medicaid expansion program. The current expansion covers people who earn 133 percent of the federal poverty guidelines – $19,391 per year for a household of one, or $39,900 for a household of four.

Of the 250,000 people enrolled in Medicaid in the state, just over 95,000 have access to healthcare as a result of the expansion program. The budget includes a two-year extension to the program, as it is currently set to expire at the end of 2023.

Childcare funding

With long waiting lists and rising costs, childcare is a financial burden for many families across the state or a barrier for parents returning to work if they can’t find available providers.

Child care comes with a price tag – estimates say the average price of child care for an infant is $14,000 and a toddler is $13,000.

But many New Hampshire families don’t have many options. Research at the University of New Hampshire surveyed parents statewide, and found that 74 percent of respondents said they used outside care for their young children. Of this group, 80 percent also said that their arraignment is not ideal, due to the cost.

The state provides childcare scholarship assistance, which helps share costs for families. The House budget proposes raising eligibility for assistance to 85 percent of the state median income, which is an annual household income of $102,698 for a family of four.

“This would be expanding eligibility for all family sizes,” said Sletten.

The budget also proposes increasing reimbursement rates to childcare providers. Similar to Medicaid reimbursement, these rates set the amount that providers are paid for participating in the childcare scholarship program. Currently, the state pays 55 percent for children over three, and 60 percent for children younger.

The House Finance Committee proposes expanding reimbursement to 75 percent of the market rate for the cost of care.

Free and reduced lunch

Throughout the pandemic, free and reduced lunch was available for all students across the state. And at home, low-income families saw better access to food as well, with expanded benefits for the Supplemental Nutrition Assistance Program, commonly known as food stamps.

While the state budget does not include extending these expanded SNAP benefits, despite neighboring states continuing on this program, it does focus on increasing enrollment for free and reduced lunch in school.

“It isn’t a replacement to the Supplemental Nutrition Assistance Program being rolled back, but it is food assistance targeted at children,” said Sletten.

At the beginning of this school year, policy shifted back to pre-pandemic, where students were required to enroll for free and reduced lunch. Currently, if a family’s income is at 185 percent or below of the federal poverty guidelines – which translates to $45,991 for a family of three – children qualify for free and reduce priced meals at school.

The House Finance budget proposes expanding eligibility to 300 percent of the poverty guideline – meaning families who make $74,580 a year, or less, for a family of three, would also have access to free meals in school.

House lawmakers are also suggesting eliminating administrative barriers to enrollment, by automatically enrolling students who are enrolled in Medicaid and income eligible. This mirror SNAP enrollment, where students automatically receive free lunch, if their families have food stamps.

Affordable housing

But at a time when housing has been identified as a statewide crisis – with vacancy rates at a historic low and a shortage of thousands of units – the House Finance budget cut proposed funding for affordable housing.

Sununu’s initial budget proposal contained over $50 million for affordable housing by adding to the state’s Affordable Housing Fund, InvestNH program and creating a historic home tax credit to promote renovating old infrastructure into homes.

Yet, House Finance Committee members stripped back this funding, hoping that the Senate would pass similar proposals in Senate Bill 231, which instead is laid on the table.

Lawmakers approved a $25 million funding cut, including removing $15 million from InvestNH and $10 million from the Affordable Housing Fund. They also suggested limiting the InvestNH funding to only support municipal grants, not proposed projects from developers.

The House will vote on the Finance Committee’s proposed budget in session tomorrow.

]]>