New Hampshire Legislative Session: Bipartisan Efforts Produce Results in Healthcare

State Capital Notes …

In the 2014 session, the second year of the biennium, not a budget-writing year, two issues that were holdovers from the first session, commanded the attention of the governor, lawmakers, attorney general, state healthcare agencies, hospitals and other healthcare providers.

Gov. Maggie Hassan and state lawmakers reached agreement on the Health Care Protection Program, New Hampshire’s plan to expand Medicaid and provide coverage to 50,000 uninsured residents who can now purchase private insurance through an exchange.

Lawmakers were also forced to take up the state’s Medicaid Enhancement Tax (MET) after two Superior Court judges acting on a suit brought by several New Hampshire hospitals, ruled the tax unconstitutional. The law violated the constitution’s equal protection clause because the tax does not apply to other healthcare providers performing the same services as the hospitals. Under the MET, the state taxed hospital revenue 5.5% on inpatient and outpatient services and sent back half of the money to hospitals for services rendered to uninsured and Medicaid patients. The federal government matched the state’s share and remaining funds were put into the state’s general fund.

The courts’ rulings prompted Standard & Poor’s to downgrade the outlook for the state from stable to negative given the looming possibility of a $375 million shortfall in the biennial budget. As a result, legislation was signed into law that will tentatively avert a fiscal crisis. SB 396 will suspend both state and federal litigation, stabilize the budget and give hospitals more money while reducing the tax rate. Some lawmakers predict a 10% increase in the state budget.

Lawmakers also increased funding for mental health community services, raised the gas tax by 4.2 cents a gallon, which will be dedicated to infrastructure improvements, and passed the Paycheck Fairness Act.

Legislation That Passed

An Act Relative to Health Insurance Coverage

Establishes the New Hampshire Health Protection Program and the New Hampshire Health Protection Trust fund which is to be administered by the commissioner of the Department of Health and Human Services to pay certain costs associated with the programs established in the bill and to accept any federal funds for such programs.

(The federal Affordable Care Act gives states the option of expanding their Medicaid programs to include adults ages 18 to 64 up to 138% of the federal poverty level. In exchange, the federal government would fund 100% of all medical costs associated with this new population for the first three years. Reimbursement would go down after that, ending at 90% of costs by 2020 and remaining at that level.)

An Act Relative to the Medicaid Enhancement Tax

Revises services taxable under the MET and clarifies that it is a healthcare-related tax. The bill removes the application of the MET to special hospitals for rehabilitation. The bill also changes the payment schedule for the tax and the method for collecting overdue tax payments and prescribes expenditures from the uncompensated care and Medicaid fund.

An Act Relative to Community Mental Health Programs and Making Appropriations Therefore and Relative to the Disposition of Funds Obtained by the Attorney General

Provides funds for the departments of Health and Human Services and Justice to pay costs related to mental health services in integrated community settings pursuant to a comprehensive settlement agreement with the U.S. Department of Justice. The legislation requires:

  • the fiscal committee of the General Court to approve the expenditure or distribution of monetary settlements received by the state;
  • the deposit of a portion of judgments over a specified amount in the revenue stabilization reserve account; and
  • the attorney general to submit a report to the fiscal committee of the General Court relative to all legal settlements received by the state.

An Act Establishing the Crime of Domestic Violence

Joshua’s Law designates domestic violence as a specific crime. Law enforcement officials will be better able to identify and respond to abusers. The law is named for Joshua Sayvon, a 9-year-old boy who was shot and killed by his father during a supervised visit.

An Act Relative to Paycheck Equity

Updates state law to eliminate loopholes, increase transparency in wages, and provides that all workers have the right resources to help them earn a fair and equal paycheck without fear of retaliation.

An Act Establishing a Commission to Study Career and Technical Education Centers

Creates a commission to study career and technical education centers and defines membership. Requires the commission to make recommendations about tax-credit programs for donations of equipment and funding for the cost of apprenticeship and training programs offered by a regional vocational center, funding for construction and renovation programs, and increasing partnerships among businesses, skilled trades, advanced manufacturing and CTE programs. Requires the commission to submit a preliminary report by November 2014 and a final report by Jan. 1, 2015.

An Act Establishing a Committee to Study and Identify New Hampshire Laws and Rules that Permit the Payment of Subminimum Wages to Persons with Disabilities

The committee would study and identify New Hampshire laws and rules that permit subminimum wages to individuals with disabilities that are fair and comparable to those wages paid to individuals without disabilities.

In other business, the Legislature raised the tax on gasoline by 4.2 cents per gallon beginning on July 1, 2014. Estimated revenue of $32 million would be used for infrastructure improvements. Lawmakers also banned the use of handheld phones or putting numbers into a GPS, including by drivers who are stopped at a traffic light.

K-12 Legislation Passed

An Act Relative to the Mathematics Requirement for High School Graduation

Establishes a four-year high school mathematics graduation requirement.

An Act Relative to the Collection and Disclosure of Pupil Data

Limits information that the Department of Education can store, and allows parents to see what information the department has on file about their children.

An Act Relative to Access to Assessment Materials

Requires the Department of Education to make available portions of a pupil’s assessment on the department’s website as soon as possible after the statewide assessment results are released.

Higher Education

Freeze, Decline in Tuition Rates

Trustees at the University of New Hampshire System (UNHS) are considering a four-year freeze on tuition that would keep the current in-state rate at $13,670. Previously, trustees voted to freeze tuition for two years in response to the Legislature’s restoring funding for the USNH, which was cut nearly in half in 2011.

Community College System of New Hampshire (CCSNH) students will pay lower tuition starting in fall 2014. Trustees approved a 5% reduction after Hassan restored funding to the system’s seven colleges, which had been cut in the previous budget. Approximately 95% of students enrolled in CCSNH colleges are New Hampshire residents.

Enrollment in Online Education Increases

Enrollment in summer online courses increased at CCSNH by 11% over the previous year. At New Hampshire Technical Institute in Concord, summer enrollment in online courses was up by 22%. Chancellor Ross Gittell said he expects the trend to continue with enrollment in fall online courses and programs.

USNH campuses are seeing an increase in online enrollment. Approximately 4,000 students are currently enrolled in degree programs offered entirely online according to Chancellor Todd Leach. The majority of students enrolled (74%) in online degree programs in the USNH are New Hampshire residents. At Granite State College, where the focus is nontraditional students, there is a robust selection of online courses. Total enrollment is up 30% with 60% enrolled in an online degree program.

At the private Southern New Hampshire University, a national leader in online programs, online enrollment is higher than traditional enrollment.

Session Losers

Several bills failed to pass after protracted debates including bills to allow casino gambling and expanding background checks for purchase of guns. Another rejected bill would have raised the minimum wage as the legislatures did in Connecticut, Massachusetts, Rhode Island and Vermont. Maine also rejected raising the minimum wage.

Carolyn Morwick handles government and community relations at NEBHE and is former director of the Caucus of New England State Legislatures.


Related Posts:

Vermont Lawmakers Boost Economic Development

Connecticut Enacts $19 Billion Budget

Maine Lawmakers Wrap Up Session Amid Record Number of Gubernatorial Vetoes



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