It’s supposed to be a day devoted to New Hampshire’s response to a Supreme Court internet sales tax ruling, but Democrats are hoping to tack on another item to Wednesday’s special session: Medicaid reimbursement rates.
Lawmakers will return to Concord on Wednesday to vote on a bill drafted by Gov. Chris Sununu and a bipartisan task force last week aiming to dissuade states from requesting sales taxes from New Hampshire businesses. The session, approved by Sununu and the Executive Council earlier this month, was explicitly created for that bill; the Legislature has been adjourned for the summer since May.
Now, Sen. Dan Feltes, D-Concord, plans to use the opportunity to push for a $7.5 million appropriation to shore up the state Medicaid expansion bill.
“We can and should act now,” Feltes wrote in an email to state senators that was shared with the Monitor.
At issue is a provision of the state’s Medicaid expansion reauthorization, which extends the program for five years and makes a range of overhauls. As part of a transfer next year of the more than 50,000 participants from a private insurance model to a “managed care” model, substance abuse and mental health treatment centers are facing a cut in their reimbursement rates for Medicaid expansion patients.
Whereas private insurers paid under the current program shell out from $300 per patient per day, the new baseline Medicaid rates will be almost half that: $162. A piece of the bill seeks to guard against that scenario, mandating that the Department of Health and Human Services set “sufficient” rates for those providers. Commissioner Jeffrey Meyers has said that the department is working with an actuary to determine, and ultimately set, higher rates by the fall – in time for the law’s implementation date in January.
But Democrats and the providers themselves, who rallied in favor of expedited action last month, say that state legislators should set aside the money now. Doing so, they argue, would put at ease substance abuse and mental health treatment providers who are now worried about cutting staff and beds if the ultimate rate is not sufficient.
“We simply cannot afford to lose any provider capacity for any substance misuse or mental health service, including services for the Medicaid expansion population,” Feltes said. “Regardless of your overall view of Medicaid expansion, we ought to follow through on this new legal requirement and move forward on implementing the new law.”
For Feltes and other Democrats, the push has become a rallying cry in recent weeks. An effort by Democratic executive councilors to formally add the issue to the agenda during the group’s approval of the tax legislation special session was voted down earlier this month.
Feltes’s bill, titled Senate Bill 2, carries a hefty price tag: $7.5 million, or about a third of the state’s present $22 million budget surplus. But in his letter, the senator stipulated that the money is there only as a safeguard in case the department doesn’t have the cash to cover the rates it ultimately sets. Any or all unused amount would lapse back to the general fund, according to the bill.
Still, it’s unclear whether lawmakers will have an appetite for the proposed bill Wednesday, which would come in the midst of what is expected to be a bipartisan effort to pass a law directed at other states’ sales tax practices.
Senate President Chuck Morse, one of the architects of the new tax bill, was not immediately available to comment Tuesday.
(Ethan DeWitt can be reached at edewitt@cmonitor.com, or on Twitter at @edewittNH.)