NHDP - ICYMI: Republican lawmakers bungled N.H. budget

Key Point: House and Senate Republicans "bungled" the budget with their "new tax on hospitals, many of which slashed jobs in response to losing revenue" and "the ill-conceived 10-cent per pack tax cut on cigarettes that was questionably enacted, led by Speaker O'Brien."

Portsmouth Herald: Republican lawmakers bungled N.H. budget

[Link: http://www.seacoastonline.com/apps/pbcs.dll/article?aid=/20111220/OPINION/112200375&template=printart]

The Republican-controlled New Hampshire Legislature hailed its $10.3 billion budget as lean, balanced and responsible. But after only six months, it can be said that the devil is in the details.

The worst devil is the crushing impact of the GOP's doomed decision to end the policy that returned the 5.5 percent tax on net patient service revenue on hospitals via the Medicaid Enhancement Tax to the hospitals through the Disproportionate Share program. The short story is that the affected hospitals switched guidelines for determining the tax, which resulted in New Hampshire getting $50 million less than expected in November revenues.

Reports indicate the shortfall will double by the end of the two-year budget.

GOP leaders are challenging the switch and acted shocked by the shortfall. Hospital executives, however, said they warned legislative budget writers that federal tax guidelines on such Medicaid taxes didn't encompass as large a revenue base as the state had been using. "Reports of a potential shortfall in the New Hampshire Medicaid Enhancement Tax should come as no surprise to anyone," said Steven Ahnen, president of the New Hampshire Hospital Association.

Ironically, the state GOP regularly criticized Democrats for increasing taxes and fees, and Republicans touted that their budget plan did not do so. Gutting the Disproportionate Share program resulted in a new tax on hospitals, many of which slashed jobs in response to losing revenue. And now the impact to the state budget is even worse, as the GOP's lean spending plan offers little opportunity for spending reductions.

GOP leaders indicated they will try anyway. Senate Finance Chairman Chuck Morse suggested that if the hospitals' decision to follow federal guidelines instead of state guidelines stands, Gov. John Lynch might need to make cuts to keep the budget in balance. It's irresponsible to push the GOP's mismanagement to the governor, who spoke against the Republicans' MET decision.

Some Republican leaders seem gleeful in their calls to further cut spending. It could be interesting next month, when the Legislature reconvenes based on House Speaker William O'Brien's reaction to an earlier ruling that New Hampshire will have to pay back $35 million in federal Medicaid funds. Following that ruling, which put the budget out of balance, O'Brien broke out the standard, tired rhetoric: "We are going to need to do what the working families across New Hampshire are doing right now: tightening their belts to live within their means."

Given that it was the GOP's decision on the MET that created the $50 million, and growing, shortfall, it makes sense for their leadership to find a reasonable solution. Cutting from a lean and "responsible" budget doesn't seem a viable option. But one option that should be considered first next month is to repeal the ill-conceived 10-cent per pack tax cut on cigarettes that was questionably enacted, led by Speaker O'Brien.

This was the worst devil in the details of the GOP budget until the MET disaster. The theory that dropping cigarette the tax would increase revenues has proven a failure. In November alone, tobacco receipts were $3.5 million below the projected level and $4.3 million below November 2010.

Shock and finger-pointing are not going to absolve Republican leaders from their responsibility for creating their own budget mess.

DNC - Alliance for Retired Americans, NH State Rep. React to Mitt Romney’s Out of Touch Medicaid Comments

Washington, D.C. - ARA Executive Director Ed Coyle and Rep. Cindy Rosenwald (D-Nashua) called Mitt Romney out of touch for telling an Iowa audience today that he didn’t know the difference between Medicaid and Medicare.  Romney also said, “And by the way, I’m concerned about the poor,” which just goes to show that he considers working American families an afterthought. All of this is coming from a candidate who supports policies that would toss 36 million Americans off of Medicaid.

Ed Coyle, Executive Director of the ARA, said that Romney’s record indicates he cannot capably represent the 31,000 ARA members in Iowa and the 12,000 members in New Hampshire.

“The Alliance for Retired Americans are committed to keeping America as a nation where we still lend a helping hand to the young and to the old and to the sick and to the poor,” said Coyle. “While Romney could have taken just one moment to learn the difference between these vital programs that millions of older Americans and the poor rely onto make ends meet, he instead spent the majority of his career prior to government as a corporate buyout specialist laying off American workers, shipping jobs overseas, and bankrupting companies for his own profit.”

New Hampshire State Representative Cindy Rosenwald said that Medicare and Medicaid are important issues for the people of New Hampshire.

“Medicaid is counter-cyclical. When the economy is down, more people rely on it. Low income children make up 60% of the recipients,” said Rep. Rosenwald. “Mr. Romney supports turning Medicaid into a block grant that would shift costs to the states already struggling.”

DNC Communications Director Brad Woodhouse added, “I think if I had a dollar for every out of touch comment or policy of Mitt Romney’s I could perhaps buy Bain Capital.”

Listen to the call here: http://my.democrats.org/page/-/audio/calls/20111216_CC.mp3

Smith For Governor - Lynch Administration Passes Bulk of $35 Million in Lost Medicaid Funds to Next Governor

Smith says Lynch simply passing buck to next Adminitration

Concord, NH – As state Republicans have worked to close the $900 million budget deficit left by Governor Lynch and Democrats, the legislative leaders’ task got more complicated by the fact that the Lynch Administration failed to fight the federal government’s efforts to take back $35 million in Medicaid funds.  As reported in this week's NH Union Leader and Nashua Telegraph, the Lynch Administration agreed to a settlement with the federal government in which the state gave up its right to sue to recover the Medicaid funds and didn’t even receive a guarantee that the federal government wouldn’t audit other years, which could cost the state tens of millions of additional funds.

Commenting on the settlement was Republican gubernatorial candidate, Kevin Smith:

“Make no doubt, the Lynch Administration gave away the store to the federal government,” said Smith.  “The taxpayers are now left both holding the bag for the $35 million hole, with no right to appeal the decision, as well as potentially on the hook for huge new costs if the federal government decides to audit further years.”

Smith added, “This ‘settlement’ appears to be part of Lynch’s Lame Duck Strategy to push as many of his problems off to the next administration just get them off his desk.  As governor, I will put the best interests of the state and the taxpayers first, not political expediency just to get through the next election cycle.”

ALG Praises Senate Republicans for Blocking Berwick for head of Center for Medicare and Medicaid Services

Nov. 23, 2011, Fairfax, VA—Americans for Limited Government President Bill Wilson today in a statement praised Senate Republicans for blocking the confirmation of the recess-appointed Donald Berwick for head of the Center for Medicare and Medicaid Services, leading to him stepping down:

"As government continues to struggle to find a way to add 30 million people to the taxpayer-funded health care rolls thanks to ObamaCare in the midst of a sovereign debt crisis, Senate Republicans are to be praised for blocking the confirmation of Berwick, an official who believes rationing health care is inevitable. In 2009 he said, 'The decision is not whether or not we will ration care — the decision is whether we will ration with our eyes open.'

"Berwick also was a radical redistributionist, who believed the only way to have a 'just, equitable, civilized, and humane' health plan was to 'redistribute wealth from the richer among us to the poorer and the less fortunate'. His doctrines were pure Marxism, and the only reason he even was allowed to serve was because he was recess-appointed by Barack Obama.

"Now Senate Republicans must be vigilant that whosoever Obama selects to replace Berwick is not just another radical extremist.  The nation does not need anybody who believes it is just to take health care away from one person and give it to another as government sees fit."

Attachments:

Donald Berwick Nominee Alert, May 2010, Americans for Limited Government at http://www.getliberty.org/files/NomineeAlert%20-%20Donald%20%20Berwick%20-%20Administrator%20-%20CMMS%2005_04_10.pdf .

Interview Availability: Please contact Rebekah Rast at (703) 383-0880 or at rrast@getliberty.org to arrange an interview with ALG President Bill Wilson.

NH DHHS Releases Medicaid Care Management Services RFP

Concord, NH – The New Hampshire Department of Health and Human Services

(DHHS) is announcing the procurement process is underway for the State’s

Care Management Program. DHHS is now seeking proposals from Managed Care

Organizations (MCO) that will be responsible for coordinating health

benefits for New Hampshire’s Medicaid population. The release of the

Medicaid Care Management Services Request for Proposals follows the passage

of SB 147, legislation that requires DHHS to transition from its current

Medicaid fee-for-service system to a Care Management Program.



“We are pleased to have entered this phase in the process of transforming

the State’s Medicaid program,” said DHHS Commissioner Nicholas Toumpas.

“Moving to a managed care model will be challenging but we are determined

to make this truly work for the betterment of the health and well-being of

the people we serve. While there is much work ahead, we eagerly anticipate

the responses from entities that want to partner with us to achieve our

goals.” The goals, as articulated in SB 147, include obtaining the best

value, quality assurance and efficiency for the program while at the same

time maximizing the potential for savings.



Prior to releasing the RFP, DHHS held a series of forums and focus groups

around the State. The sessions were an opportunity for people to comment

and provide input about their expectations of a Care Management Program. In

addition, DHHS also gathered feedback through an online survey and accepted

written comments. The Department will continue to engage stakeholders in

the implementation of the new program.



The full RFP can be found at http://www.dhhs.nh.gov/business/rfp/index.htm