N.H.governor wants taxpayers to share charity care cost

Wednesday February 20, 2013

CONCORD, N.H. -- Gov. Maggie Hassan told a joint legislative panel Tuesday that taxpayers should help offset New Hampshire hospitals’ charity care costs to ensure the state’s poor citizens have access to the medical care they need.

The current budget, written by Republicans, cut state hospital aid for the care for all but a handful of critical access hospitals. Hassan’s proposal would restore about half of the $200 million cut in the last two years.

"We have had a long relationship with the hospitals in this state who provide an essential public function. We don’t have any public hospitals in New Hampshire unlike many other states. Our people need access to health care and we need to make sure we have a health care system that can provide affordable, accessible care particularly around preventable and primary care," Hassan told a joint meeting of the House and Senate Finance Committees in response to a question from State Rep. Dan McGuire, an Epsom Republican.

Hassan, a Democrat, said a state hospital tax is crippling some hospitals’ ability to provide care that citizens need. She said the state and federal government have historically shared the cost of uncompensated care with hospitals. She said the help should become less over time as the Obama administration’s health care overhaul is implemented.

Ten of the state’s largest hospitals sued the state last year in part over the elimination of payments they previously received from the state to offset what they spend on uninsured patients. Hassan’s budget would make more funding available for uncompensated care payments to those hospitals -- about $50 million in fiscal year 2014 and $60 million in 2015.

Her budget also counts on New Hampshire expanding Medicaid under the federal health care overhaul, but does not include the federal money to pay for it.

Health and Human Services Commissioner Nicholas Toumpas told the House Finance Committee later Tuesday that his proposed budget includes nearly $4 million to administer the expansion but the federal share is still being determined.

Toumpas said the expansion would be folded into the effort to implement a managed care system for existing Medicaid clients.

Toumpas acknowledged that the state’s managed Medicaid program has yet to be implemented due to gaps in the provider network. Those gaps include hospitals and community mental health centers that have not yet agreed to participate.

Besides the hospital lawsuit, the state is being sued by advocates for the mentally ill over the lack of services. Hassan’s budget includes $28 million in increased spending from state taxes on mental health programs.

Hassan says her budget is fiscally responsible and balanced, but House Republicans don’t think so. Hassan’s proposed $11 billion, two-year budget is a 10 percent increase over the current budget.

House Republican Leader Gene Chandler said Tuesday that Republicans want the budget to be built upon realistic revenue projections and Hassan’s plan is not.

State Rep. David Hess, a Republican on the House Ways and Means Committee, said Hassan’s estimates are almost $104 million too high from state taxes by GOP estimates. He said she is counting on money from a cigarette tax increase and a casino. Neither has been approved by lawmakers.

Hess and Chandler are particularly upset that Hassan included $80 million in revenues for licensing a single casino. The House has defeated dozens of attempts over the years to legalize video slots.

A Hassan-backed casino bill is expected to pass the Senate.


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