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May 31, 2013

Posted: May 30, 2013

Senate Finance Committee Submits HB1 and 2 to Senate Floor For June 6 Vote

On Tuesday, May 28, by a party line vote of 4-2 the Senate Finance Committee sent HB 1 and HB 2 to the Senate floor for a June 6 vote, but this is not the end for the Senate process.  It is anticipated that additional floor amendments will be introduced, when the budget is debated on the Senate floor next week, making various changes to the committee’s recommendations.

 

Who Spent More?

Both chambers of the Legislature, the Governor, and political parties have issued press releases taking differing positions about budget expenses. Based on Legislative Budget Office information, the Senate budget “spends less than the House.” However, the “spend less” definition is of “total funds (i.e. funds from all sources: State, Federal, County and others such as fees.) In terms of General Fund or state spending, the Senate actually spends more than the House.

 

No New Taxes

The Senate removed four tax/fee increases from the budget as proposed by the House. There were two fee increases, one to the Salt Water Fishing License and one to the Marriage License; both were deleted. In addition, the committee removed tobacco and gasoline tax increases. The Senate did predict that the State of NH will bring in over $100 million in additional revenue from existing fees and taxes based on economic growth. This growth in revenue allowed for increased spending.

 

What about the DHHS budget?

When looking at DHHS, the Senate spends more than the House (nearly $24 million more). However, the DHHS Commissioner has said that because of low budget estimates for caseloads and other “back of the budget cuts” made by the Senate, the DHHS budget has a $40 million deficit. There was never an official amendment drafted to cut many of the programs that are in jeopardy because of this “deficit.” The Commissioner verbally told the committee that the following programs are at risk with the Senate’s version of the budget: DD/ABD waitlists, CHINS, mental health, community health centers, family planning clinics and payments to counties. At this point in the budget process, the “deficit” in DHHS remains and will be discussed during the June House/Senate Committee of Conference on the budget.

 

Medicaid Expansion Update

The Senate Finance committee removed Medicaid expansion from HB 1 and HB 2 in favor of studying the issue. It is interesting to note that DHHS contracted with the Lewin Group several months ago to provide the state with an analysis that would assist with informed decision making. The Lewin study reached many conclusions that strongly favor NH choosing Medicaid expansion, but the Senate has elected to further continue study of this issue.

 

Innovation in Medicaid Delivery – I-MD Commission

HB 2 now calls for an “Innovation in Medicaid Delivery” or an “I-MD” Commission. This commission will work to create a new Medicaid waiver application, an 1115 Medicaid waiver. According to the proposal, the waiver’s goal is to “Obtain federal matching funds for so-called costs not otherwise match-able to improve access and quality of care for Medicaid-dependent patients.”

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Consumer Assistance Grant

The Senate Finance committee did not include any federal funding for the Health Benefit Marketplace that will soon be created as part of the Affordable Care Act. NH has been approved for a federal grant to set up a consumer assistance program. There was a proposal by Senator Larsen to accept $5 million in federal funds in HB 1; this did not happen. The money would be used for training to assist people — many of whom have never had insurance coverage — in navigating the new marketplace. With the grant New Hampshire will be able to launch a program designed in NH. Without the grant, NH would cede control of this to the Federal government.

 

The House has now responded to the Senate’s inaction on this issue by tacking on the federal funding for this program on to another bill, SB 129, relative to court-ordered placements in shelter care facilities and at the Sununu Youth Services Center, relative to the children in need of services (CHINS) program, and establishing a committee to study programs for children in need. That bill, like the budget, will likely end up in a Committee of Conference.

 

What next?

It isn’t over yet. We still have a month to go in this budget process. Steps to come are: the full Senate vote, the appointment of the Committee of Conference (by 6/13), votes in both houses to accept their report, action by the Governor, and then back to the House and Senate if it does not get her approval, for another try. Stay tuned for further developments.

 

 

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