This story was originally produced by the New Hampshire Bulletin, an independent local newsroom that allows NHPR and other outlets to republish its reporting.
Some lawmakers are exploring an 11th hour attempt to settle a showdown between Gov. Chris Sununu and the state’s hospitals over Sununu’s plan to cut their state Medicaid payments by nearly $35 million a year.
Senate President Jeb Bradley said earlier this month that Sununu’s plan would take so much Medicaid funding away from hospitals, “the viability of hospitals is at stake.” Steve Ahnen, the president of the New Hampshire Hospital Association, has called Sununu’s plan a “direct threat” to hospitals.
At a Joint Legislative Fiscal Committee meeting Thursday, Sen. Tim Lang, a Sanbornton Republican, proposed that both chambers bring forward new legislation this fall on “veto day,” typically lawmakers’ final meeting of the session. Such an effort will almost certainly face significant hurdles.
Bringing a bill forward that late would require a two-thirds vote among lawmakers to suspend legislative rules, and Sununu, who has long been at odds with hospitals, would have to sign on.
That seemed unlikely based on a statement his office sent to the Bulletin Friday.
“The Senate had their chance but they refused to find common ground with the House,” Sununu said, referring to the chambers’ inability to agree on legislation earlier this month.
Still, Lang thinks taking another pass at legislation is critical.
“I know my community’s hospital will have a problem if we don’t get something done and that’s going to affect my constituents and their access to health care,” Lang said in an interview Friday. “The reality is if there is the will between the House and the Senate to come to a resolution on this issue, there is a process in place to get it resolved this year.”
At issue is the Medicaid Enhancement Tax (MET) hospitals pay annually, which totaled about $320 million this year. The state receives a federal match on that money and returns 91 percent of it to hospitals to help them cover primarily uncompensated medical care costs.
Sununu’s directive to DHHS would reduce that to 80 percent and redirect some of the money that currently goes to hospitals to community mental health centers, federally qualified health centers, and substance use disorder providers, which do not pay the tax.
“This (new) process has been finalized and the new positively adjusted rates going into effect will ensure community mental health agencies and local health centers have more resources for their critical services, while fairly compensating the hospitals,” Sununu said in his statement Friday. “We are moving our health care into the 21st century and that’s a big win for New Hampshire.”
The current arrangement that returns 91 percent of the tax hospitals, which was reached in 2018 as part of a lawsuit filed by the hospitals, expires at the end of June. Hoping to avoid another lawsuit from the hospitals, Bradley began negotiating late last year with hospitals, the governor, and other stakeholders on a legislative fix.
By the time the Senate passed that proposed legislation in May, there was no time for the House to study it and hold public hearings. Bradley’s bill fizzled this month in a committee of conference when House negotiators rejected it.
During the Joint Legislative Fiscal Committee meeting Thursday, Sen. Lou D’Allesandro, a Manchester Democrat, blasted Sununu’s decision to resolve the dispute by directing DHHS to implement his own plan.
“That is totally disregarding the Legislature, and we all represent hospitals,” he said. “There are critical access hospitals that will be impacted severely and there will be hospitals that will be impacted significantly. That is the public we are talking about. The public is served by these hospitals.”
It was unclear how hospitals will respond if the $35 million reduction in Medicaid payments holds or whether they will sue the state again. The New Hampshire Hospital Association said it is considering all options.
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