Senate gives Sununu some, not all, he wanted with free care reform bill
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May 23—CONCORD — The state Senate voted to give Gov. Chris Sununu some of the funds, but not all, that he wanted to set aside for community health centers, mental health centers and substance abuse treatment programs under more than $300 million a year in federal grants the state receives to compensate for free health care.
The plan would earmark at least 7% of money that comes from imposing a Medicare Enhancement Tax on hospital revenues to be given to these community providers.
Sununu had proposed that these other providers get at least 9% of the money.
The New Hampshire Hospital Association strongly opposed Sununu's plan and officials said the amended proposal still would mean some acute care hospitals would lose money under the new arrangement.
Under the Senate plan, the agreement automatically terminates after four years, forcing a future Legislature to reauthorize it by July 2028.
Senate President Jeb Bradley, R-Wolfeboro, said the plan isn't the final answer and he's hopeful negotiations with House leaders over the next few weeks will provide a better deal.
"We all know more work needs to be done to have a settlement that both sides can agree to," Bradley said.
Sen. Lou D'Allesandro, D-Manchester, said it's critical lawmakers keep working to reach consensus.
"We know the hospitals are in trouble; it's clear," D'Allesandro said, noting Catholic Medical Center of Manchester in his district would receive less money.
"The critical access hospitals are in trouble under the current proposal that is on the table."
The Senate adopted its plan on a voice vote, adding it to a House-passed bill (HB 1593) to restore benefits for people with disabilities so they are reimbursed for receiving services.
Since 1991, New Hampshire has had a legal scheme that helps the state collect additional federal Medicaid reimbursements.
The state levies a Medicaid enhancement tax on the hospitals at 5.4% of net patient services revenue and quickly repays the hospitals for much of the levy, which generates matching grants from the federal government.
Sununu said hospitals are not the only entities that perform free or uncompensated care in the state, yet they end up getting the lion's share of this money.
Since 2020 under the current law, the hospitals each year receive at least 86% of what they pay into the Medicaid enhancement tax and 5% goes to Medicaid providers that perform services at the hospitals.
The Senate was working into the night Thursday to finalize work making significant changes to House-passed bills that would legalize recreational use of marijuana by adults 21 and older (HB 1633) and to alter a 2019 bail reform law to require those arrested for serious felonies to have to appear before a judge prior to release pending trial (SB 318).
Earlier, the Senate essentially killed two House-passed bills to provide $20 million more a year for school building aid (HB 546) and $130 million for the next two years of increased per pupil grants for public schools (HB 1583).
D'Allesandro said there wasn't a big enough state budget surplus to afford these increases and they should not be acted on while two education finance lawsuits are pending before the New Hampshire Supreme Court.
Zach Sheehan, executive director of the New Hampshire School Funding Fairness Project, condemned the Senate action.
"I'm disappointed because this would have been such an easy way for the Legislature to show they were doing something to address the state's school funding issues and would have made a real impact in communities that are struggling the most" Sheehan said. "We don't need more studies of this issue, we need action."
