By PAULA TRACY, InDepthNH.org
CONCORD – In a unified message of support for healthcare for the state’s most vulnerable, the Senate unanimously passed a bill to make its nine-year Medicaid expansion program permanent and approved extending Medicaid coverage for young moms from 60 days to a year on Thursday.
These measures now go to the House for consideration.
It also agreed to change the bail laws to hold potentially dangerous individuals up to 36 hours to see a judge rather than giving them personal recognizance bail, a matter supported strongly by law enforcement following recent bail reform.
And it agreed to hold on to a handful of spending measures, including a plan to spend $2 million toward the development of a handicap-accessible pier at Hampton Beach, which will come up later this spring as part of the overall budget discussions moves to their chamber for consideration.
GRANITE ADVANTAGE PASSES
For the past nine years, New Hampshire’s expanded Medicaid program, now known as the Granite Advantage Health Care Program, provides health coverage to approximately 50,000 Granite Staters with low incomes, with the federal government paying 90 percent and the state providing ten percent.
It is due to end on Dec. 31. But it will become permanent under Senate Bill 263-FN. A https://www.gencourt.state.nh.us/bill_status/billinfo.aspx?id=894&inflect=2
They passed unanimously to the House for consideration.
Advocates say that health coverage is associated with better outcomes, such as lower mortality, and children are more likely to have health coverage when their parents are covered.
Senate President Jeb Bradley, R-Wolfeboro, said the program has done “a remarkable job of protecting taxpayers, helping individuals, and helping grow the economy.”
“We heard compelling testimony for people who have been able to access healthcare for preventative services as well as life-saving services. The fact of the matter is that for nine years, we have set up this program, it has worked as intended. It has been a hand-up for people,” many of whom have gone on to private insurance with their employer, Bradley said.
He said the question has been asked many times, ‘Should we make it permanent?’ Absolutely ‘yes,'” he said. “Because of the certainty involved to get us the best cost for the program.”
He said the federal commitment to funding had been there “as well as our ability to provide the ten percent share,” which includes funding from state liquor sales and other sources.
While expanded during the pandemic, the overall numbers on the program are going to be decreasing at the end of the month, as some will no longer qualify for this federal program, making it less expensive for the state, Bradley said.
He said the state Department of Health and Human Services has done a good outreach for those who will need to consider other options they are entitled to, but the transition will make the state’s ten percent share for the program even more manageable.
Bradley said the business community largely supports the measure, and when asked if it is a disincentive to returning to work, he said he heard testimony it actually does the opposite and helps retain workers.
Democrats were also pleased with the passage of the bill.
“Today, we are finally making good on our state’s longstanding commitment to providing Medicaid coverage to Granite Staters of modest means. We were happy to have our Republican colleagues join us in the work on this important legislation, something our Caucus has worked towards for many years,” according to a statement from the Democratic Caucus.
“Now that the bill is making its way over to the House, we trust that our colleagues on the other side of the wall will treat this vital bill with the same level of consideration, respect, and bipartisanship that we engaged in here in the Senate. This bill is about meeting the needs of our constituents, and that is what we should all be focused on here in the State House.”
This program is for adults ages 19-65 that fall under certain income limits.
On Jan. 1, 2019, per state law, the Granite Advantage Health Care Program replaced NH Health Protection Program (NHHPP). This Medical coverage continues through one of the state’s Medicaid Care Management plans, AmeriHealth Caritas New Hampshire, NH Healthy Families, and Well Sense Health Plan.
While coverage varies, Granite Advantage covers services like regular check-ups with a doctor, emergency room visits, prescription drugs, visits to specialists, and more. It’s not for those eligible for or enrolled in Medicare, pregnant at the time of the application, or in any traditional Medicaid mandatory eligibility groups. Those in the program have monthly household incomes at or below 133 percent of the Federal Poverty Level.
For those who think they might qualify, call (1-844) 275-3447 for personalized assistance.
“MOMNIBUS”
The Senate also passed SB 175-FN, relative to Medicaid coverage for mothers, also known as the “New Hampshire MOMnibus.”
It extends coverage from 60 days postpartum to the first 12 months of motherhood.
Assistant Democratic Leader Rebecca Whitley, D-Hopkinton, Senator Rebecca Perkins Kwoka, D-Portsmouth, and Senator Suzanne Prentiss, D-Lebanon, issued the following joint statement:
“For too long, we have allowed preventable deaths, life-altering complications, and untreated mental health and substance use disorders to persist for mothers – as well as missing opportunities to help our state evolve into the modern, thriving economy that moms can be a part of. The New Hampshire MOMnibus, SB175, is a comprehensive, solutions-based bill that will help improve maternal and infant health outcomes, expand the perinatal workforce, and support New Hampshire working mothers and their families, so they can go back to work if they choose.
“Although we live in the richest country in the world, our support for moms has much room for improvement. The maternal mortality rate in the United States remains high in contrast to economically similar countries. We do not do enough to support working mothers, despite the ongoing workforce shortage across the country and here in New Hampshire. Our moms have so much to contribute, and this legislation will not only address the urgent health needs of our moms and babies, but it will also support almost half of our workforce needs. It is beyond time to address these issues, and SB175 will do just that by benefiting New Hampshire babies, working mothers, and our economy. We look forward to seeing this bill become law.”
Republicans also supported the bill.
Senator Denise Ricciardi, R-Bedford, stated after the passage that “there has never been a greater need than now for legislation helping children, mothers, and families of our state. That is why I am so grateful to my Republican and Democratic colleagues in the Senate for their bipartisan support in unanimously passing SB175,” stated Senator Ricciardi.
“This bill increases the services covered for pregnant women to 12 months postpartum, which will provide mothers with preventative care, acute care, and mental health care. The MOMnibus bill not only helps New Hampshire mothers and their babies but also our state’s economy. That is why this bill is a win for every Granite Stater. Mothers need our support, and that is why this bill is simply the right thing to do. As legislators, we must help protect mothers, babies, and families, and that is why I am proud to support SB175. I thank all my Senate colleagues for voting with me today to pass this critical legislation.”
SENATOR GANNON IN HOSPITAL
State Sen. Bill Gannon, R-Kingston, was hospitalized and at Elliot Hospital in Manchester undergoing testing Thursday and could not remotely participate in the Senate votes Thursday.
Senate President Bradley, said although Senators now have the option of being able to participate remotely, Gannon was undergoing testing and would not be able to reasonably participate in voting and was excused from voting for the day with good wishes that he return, soon.
He said he spoke with Gannon’s wife, Janice, who said the senator is “getting great care.”
BAIL REFORM BILLS PASS ON VOICE VOTE
Senate Bill 249 and Senate Bill 252-FN passed related to the release of defendants pending trial.
If passed, individuals charged with certain violent offenses – where the public is potentially in danger – should be confined for up to 36 hours.
The bills are intended to strengthen the language of the current law, which allows for those to get personal recognizance bail and hold some until a judge can make a decision.
Senator Daryl Abbas, R-Salem, released the following statement on the passage of 249 and 252:
“Families shouldn’t be left at risk to dangerous individuals, and habitual offenders shouldn’t be provided with the opportunity to recommit crimes. Nor should violent offenders be granted bail before standing in front of a judge. As the prime sponsor of Senate Bill 249 and has spearheaded these efforts, I’m proud to have taken on this public safety initiative to secure a safer community for our children and generations to follow. Without public safety, the New Hampshire Advantage ceases to exist.”
SB249 would require that suspects arrested for a second offense while out on bail would be presumed to be a risk of violating bail conditions.
SB252 lists certain offenses which, if committed, create a presumption that the defendant is a danger to the public and shall be detained for up to 36 hours.
Neither bill would prevent defendants from receiving reasonable bail or require nonviolent defendants to be held because they cannot afford bail.
ACCESS TO CHILD’S MEDICAL RECORDS
Senate Bill 253 regarding parental access to a minor child’s medical records passed along partisan lines 13-10.
Sen. Daryl Abbas, R-Salem, said in order for parents to make the best decisions, it would require them to have access to their child’s medical information allowed under the law.
There are exceptions where they don’t need the parent’s permission, and the doctor would still be able to articulate from clear and convincing evidence that such information would pose a danger to the child.
But Prentiss, asked, as a mother, how, if she already had access, is this different? She said she had access the whole time to her daughter’s data when she was in high school and had access to a portal at DHMC.
Sen. Sharon Carson, R-Londonderry, said parents want to be involved.
“We want to know, and I, as a parent, should not have to hire a lawyer. We have to stop hiding things,” Carson said. “We want them to come to us” and have that relationship with a child established for life.
“What this bill says…is we want the right to look at their medical records and see what is going on,” she said and noted there are exceptions in the law.
DEMS DIVIDED OVER VITAL RECORDS BILL, PRIVACY RIGHTS VS. FEDERAL MONEY
Senate Bill 105-FN relative to information collected by the division of vital records administration as part of the “live birth worksheet” drafted by mothers was supported as a privacy measure on an 18-5 vote, despite a “last minute” recommendation by five Democrats to hold on to it for more work.
The five were Senators David Watters, D-Dover, Prentiss, D-Lebanon, Whitley, D-Hopkinton, Lou D’Allesandro, D-Manchester, and Perkins Kwoka, D-Portsmouth.
Five other Democrats supported passage, along with 13 Republicans. It now goes to the House.
D’Allesandro said he agreed with critics that there were privacy concerns and “I think DHHS was a little slow on the draw” when the problem began, but he was only made aware of the problems at the last minute and wanted to rework the bill.
The data lost in the efforts for maternal privacy would not allow vital statistics to carry with the child, some argued, and the possibility of losing federal funds in the vicinity of $10 million was to be considered.
State Sen. Cindy Rosenwald, D-Nashua, said the bill should pass. She said it does not change the birth certificate in any way.
It changes only the medical information mothers send to vital records at the same time as the birth certificate, but it is not part of the birth certificate.
The data to the state Division of Vital Records and to Public Health indicate that only specific health information is shared with the federal Centers for Disease Control, including when the mother had her last menstrual period, if she used assistive reproduction techniques, if she is breastfeeding and much more, Rosenwald said.
Her race, place of birth, and information on education is sent to CDC, and this is happening to 12,000 women a year, “which is contrary to what we have been told for two years,” she said.
The DHHS has offered “zero suggestions” on how these worksheets could be improved to protect privacy without losing federal support, Rosenwald said.
She noted the state has not ever lost federal funding for lack of an adult seatbelt law.
Carson said she didn’t get the “eleventh-hour” argument by the five Democrats.
She asked if privacy protections are covered at the state archives where the vital records are kept.
“So all those great HIPPA protections, do they apply over there?” she said, referring to federal health privacy law protections.
She said the bill represents a lot of effort to protect women’s private health information, not men’s.
“I’m asking members to support this…send it over to the House,” where she said they can fix it and send it back to the Senate, Carson suggested.
Sen. Prentiss, whose district includes the state’s largest and only teaching hospital, where many records are kept and important data on infants and mothers is collected, said a lack of data could impact maternal mortality. She asked for more time to work on the measure.
“I agree we have fault lines…data traveling between two agencies, and both don’t have the same privacy of information.”
Sen. Whitley said the consequences could be significant.
“These are significant funds directed to our needy moms and babies,” Whitley said. “Without clear data sets, they will not provide funds for data records and could undermine important work…”
SPENDING BILLS
The list of bills this session in the Senate got a lot longer Thursday.
Ones passed Thursday include bills to help affordable housing initiatives, one for a new handicap-accessible pier at Hampton Beach, a water main interconnection project to help those impacted by PFAS contamination between Nashua and Litchfield, a cost of living adjustment for the state retirement system, and appropriations to the Department of Transportation.
They join tabled bills including the replacement of the Cannon Mountain Aerial Tramway at about $25 million, re-establishment of the special supplemental nutrition WIC program at farmers’ markets, a public awareness campaign on dementia, establishing a homeownership innovations fund, and money for the Eastern Slopes Regional Airport.
They will all be on the table as the budget debate goes forward.
Senator Dan Innis, R-Bradford, issued a following statement following the vote on SB231:
“This affordable housing initiative dedicates $75 million over the next two years to a variety of solutions to our state’s affordable housing crisis…(it) dedicates $10 million to fight homelessness, including $8 million for local shelters and $2 million for towns without shelters that are nevertheless responsible for housing the homeless in their communities.
“This bill additionally allocates $30 million in state funding to InvestNH, helping cities and towns bring affordable multifamily rental housing onto the market, and provides $5 million dollars in tax credits to encourage historic conversion to housing.
“SB 231 brings a multifaceted solutions approach to a problem facing families across New Hampshire. I look forward to seeing this important legislation benefit Granite State families.”
Senate Bill 122-FN-A, a proposal to spend $2 million to perform engineering and analysis to build a handicap-accessible pier at Hampton, began as a $22 million construction bill.Bill 122-FN-A https://www.gencourt.state.nh.us/bill_status/billinfo.aspx?id=878&inflect=2.
Sen. Watters said there are a lot of environmental and handicap issues related to such a pier and impacts to changes in ocean currents, endangered species, and access issues that need to be analyzed before groundbreaking.’
“If the sea level is coming up, there may not be parking there. I am glad this will be studied carefully. Let’s be real careful about it,” Watters said.
Senator Kevin Avard, R-Nashua, said, “This important project will serve Granite Staters and visitors by providing above-water access to our beautiful Hampton Beach…The passage of SB 122 marks an important step forward toward the completion of this project by appropriating the necessary funding to our department of natural and cultural resources for the siting, permitting, design, and construction of a public pier at Hampton Beach.”
The bill appropriates $2 million to the Department of Natural and Cultural Resources for the siting, permitting, and design of a public pier at Hampton Beach.
Senate Bill 122-FN-A, a proposal to spend $2 million to perform engineering and analysis to build a handicap-accessible pier at Hampton, was tabled on a voice vote.
