PAULA TRACY, InDepthNH.org
CONCORD – From cutting Medicaid rates by 3 percent to eliminating funds for family planning clinics, to suspending the farmers market program for poor women, infants and children the House Finance Committee voted to recommend a state budget for Health and Human Services Tuesday, reducing $290 million from the next two years of general fund distributions.
The goal was to meet direct-care needs of individuals and meet Ways and Means estimates for reduced revenue in a state that requires a balanced budget, explained Rep. Jess Edwards, R-Auburn, who chaired the Division III finance committee.
He said it was not his favored budget, but his goal was to provide the least amount of harm.
“This has been a horrible process,” Edwards said. “But I am happy how the committee worked together,” he said. “We at least know where we agree to disagree.”
All the Democrats voted to oppose the HHS budget cuts on a vote of 14-10.
Rep. Laura Telerski, D-Nashua, said this budget will lead to deaths and delayed care.
Rep. Mary Jane Wallner, D-Concord, noted that those cuts in Medicaid and other aspects will also lead to federal funding cuts as the state gets money for money spent on those who need health services.
Rep. Telerski said she thought the family planning line is impacted by a lie that the clinics provide abortions.
She said we are talking about people who are under-insured or in rural or underserved areas who have no place to go but these clinics for preventive health care.
Will Coos County have a double whammy of no help and freezing a program that is aimed at attracting health care providers to rural areas.
As for offering $50,000 to RNs to work in remote areas like Coos County does increase the possibility that more nurses will do that, but the plan is to not eliminate it but suspend funding for this budget cycle due to needed cuts, Edwards said.
Telerski said abortion has been a target by Republicans on the committee and the state’s Executive Council in the past.
Passing the Division III aspect of the budget concludes the House Finance Committee’s job on the budget before a vote expected April 10.
On Monday they agreed to cut $14 million for tourism promotion, to eliminate all funding for the arts, increase fees for Department of Environmental Services work, make back-of-the-budget cuts to many departments leaving the commissioners to decide how to fund those cuts well over 10 percent and also deal with some policy matters under HB 1 and HB 2.
Gov. Kelly Ayotte, a Republican who is new to this job but familiar with the budget process as a US Senator in Washington has been very active, with many saying she has been interacting with lawmakers after she produced her own budget, visiting with them and monitoring the process from her office.
The governor’s proposal is less austere but came in before revenue projections went further south.
Among the wins in the governor’s column also was funding for the Group II pension plan which the House Finance Committee agreed to on a bipartisan basis Monday with Democrats strongly supporting it.
Those first responders and prison workers were at the meeting in force to demand restoration of benefits which were lost in 2011, and the bill is seen by the governor and others as critical to retaining these employees across the state at a time when it is hard to fill those jobs.
The morning Tuesday was spent voting on a number of bills which will all go before the House April 10 when it is likely to vote on its version of the two-year budget, and it is informed by House Ways and Means numbers which show fewer dollars available than what the governor was able to use as numbers in her February roll out.
While revenues dropped off a cliff last August and remained sharply lower than in the past budget cycle the revenues have stabilized and in some cases are starting to tick up slightly which will be key to what the Senate does as it is likely to see differences in the governor’s budget and that of the Senate and are the last to make a bite at the budget apple which is due to be completed in June. The revenue projections can also go further down which would require the Senate to look at deeper cuts or different ones.
While the morning was spent going through and retaining, passing or recommending the House kill a whole assortment of bills, the afternoon focused on a presentation about Health and Human Services budget cuts which are recommended by House Finance Division III.
Rep. Edwards gave the committee the overview and said there was a $290 million problem with direct care for people who are in state beds and have nothing but state care.
“Taking direct care off the table, we began to look at a very narrow center,” Edwards said.
Looking to find more revenue was also a method to the budget creation.
The recommendations include selling buildings to development, including the Philbrook Center on the DHHS campus in Concord.
The Sununu Youth Services Center in Manchester is an $80 million property but that will take time and is likely part of the next budget cycle, Edwards said.
Another consideration is to sell a portion of the Hampstead Hospital property.
“We didn’t just get complacent with the Ways and Means budget,” Edwards said.
Some were large cuts of more than $30 million and others were smaller including suspending the WIC farmers market program for $560,000 savings.
What could be controversial is reducing Medicaid rates by 3 percent, Edwards acknowledged.
This could be fought by hospitals and medical care providers.
Such a reduction could save $17.5 million in the first year and $35 million in the second year.
Some argued that by reducing that will only mean more costs later with sicker people who need help.
The budget looks at everything from dialysis expenses which can be mitigated by a home based version and that will be incentivized to save money and about $25,000 a year in savings on circumcision following a narrowly passed vote in the House.
There could be spread to the hurt to counties in long-term nursing care as the state looks to ease the caps they have.
As previously stated, it also looks to remove family planning lines to keep mostly women and men free of sexually transmitted diseases, treatment and wellness checks.
Edwards said even though that sounds like very direct care that is being removed, there is alternative care or help.
Others disagreed, noting it is particularly hard to get alternative help in rural areas of the state.
The bill also allows for anyone who wants to be charitable and help to accept their money.
It looks to eliminate the tobacco cessation program to save $607,000.
It would fund current scholarships for rural kids up to $50,000 for college debt but freeze new enrollees in the next budget cycle.
Edwards noted a real concern for the underfunding of the Glencliff home for disabled elderly.
There is a shortfall which the governor’s budget proposal did not fill.
“We don’t have a more needy population in the state than those there at Glencliff,” Edwards said. The committee voted to defund the Prescription Drug Affordability Board and direct that money to Glencliff.
Also cut were peer to peer support for the grieving, community mental health support, even mold remediation in state buildings.
And there is the back of the budget cut for DHHS at $23 million for each year with cuts to be found by the department.