[{"_1":2,"_88":-5,"_89":-5},"loaderData",{"_3":4,"_26":27},"root",{"_5":6,"_17":10,"_18":19,"_20":21,"_22":10,"_23":-5,"_24":-5,"_25":10},"user",{"_7":8,"_9":10,"_11":10,"_12":-5,"_13":-5,"_14":15,"_16":-5},"roles",[],"isAuthenticated",false,"isPremium","planName","subscriptionStatus","featureFlags",{},"insightsBudget","isDevelopmentHost","userPreferences",{},"recaptchaSiteKey","6LcvOJcUAAAAAHsB-gPGfGktcRlKpH7OTIU_dMTD","isImpersonating","impersonation","affiliateStatus","isFreedomPortal","routes/v2/article/layout",{"_28":29,"_30":31},"notFound",true,"relatedArticles",[32,76],{"_33":34,"_35":36,"_37":38,"_39":40,"_41":42,"_43":44,"_45":46,"_47":48,"_49":50,"_51":52,"_53":54,"_55":56,"_57":58,"_59":60,"_61":62,"_63":64,"_65":66,"_67":68,"_69":70,"_71":72,"_73":74,"_75":74},"mediaId",6572883,"mediaKeyId","3150440-435642e5c9269d99bfd4cfb1ef5374b3","parentId",3150440,"title","Committee hears Senate bill to restore higher hospital MET/DISH payments amid litigation and budget concern","audioSeconds",1601,"startMs",5295000,"endMs",6896000,"viewUrl","/Search/View?dp=1&key=3150440-435642e5c9269d99bfd4cfb1ef5374b3&start=5295&end=6896","thumbnailUrl","https://assets.pipeline.soar.com/3150440-435642e5c9269d99bfd4cfb1ef5374b3/thumbnail_5295000.jpg","articleUrl","/articles/6572883/New-Hampshire/Committee-hears-Senate-bill-to-restore-higher-hospital-METDISH-payments-amid-litigation-and-budget-concern","mediaUrl","https://secure.pipeline.soar.com/6572883-ad7d5e16058136e22f6b9cc3dbec2672/orig.mp4?Expires=1771185767&Signature=gYLWrVBFDfaFBQv3RbZ7dkrR7X62P12Hn5114eLc9YJfqpzfByCxakDA72VEuojy5tq~WPye1CeUWeZTJDYdFo3Sa6Vo4BcFjcIcIOU0FaXEMY5F6ixyzEh4SfPXbthtinXDqKip3HrvCoIR6Zh5q~qqxkgeXOLiBkRrzsJMGG2ZmxXWp8HDmxJqZXR4WNNyLhYSpUb0-5jEPfdlWpI1s8J7PvGqbiAJK21~rqgy~HXmBz-ZW1vTsPtYB~uzDiiW8W~GyU7j~aS4hWWxSJodpuz5PWXmV6y4PYG4urKZQjLUOkR5wT8JQeD361Z6LcZSlnXMjIv8DDtaTvP3TCYgMg__&Key-Pair-Id=KUT5TJCACFTXG","author","New Hampshire Legislature","date","2025-04-29T16:44:05Z","article","Senate Bill 249, a proposal to set Medicaid Enhancement Tax (MET)‑related hospital payments and return a larger share of collections to hospitals, received extensive testimony during a House Ways and Means public hearing on May 1. The bill would establish a hospital payment pool based on MET revenue from the prior state fiscal year and makes temporary changes intended to increase the dollars returned to hospitals while capturing additional federal matching funds.

What the bill would do: Sponsor Sen. Regina Birdsall (District 19) and co‑sponsor Sen. Cindy Rosenwald described the bill as an interim, two‑year framework to increase the portion of MET receipts returned to hospitals and to change the distribution methodology (from primarily disproportionate‑share payments to a mix that includes Medicaid rate and directed payments) to leverage higher federal match. Witnesses and agency staff explained that the MET is a 5.4% assessment on hospitals’ net patient service revenue; fiscal‑year 2024 MET revenues were cited at approximately $319.2 million and nonbinding estimates for FY25 were about $348.3 million.

Why it matters: Hospitals, and the New Hampshire Hospital Association, argued that lowering the share returned to hospitals is effectively a tax increase on hospitals that risks destabilizing inpatient and community services. Steve Onan, president of the New Hampshire Hospital Association, said hospitals pay the MET and receive federal match; the overall distribution historically returned about 91% of the MET pool (state + federal) in the aggregate to hospitals; a lower return rate would result in tens of millions of dollars in reduced revenue to hospitals. \"Hospitals lose money serving Medicaid patients,\" Onan said; the MET/DISH structure is used to offset under‑reimbursement and uncompensated care.

State analysis and revenue mechanics: State Medicaid officials (Deputy Medicaid Director David Chorney and Rob Berry, general counsel) told the committee that the bill ties the hospital payment pool to prior‑year MET receipts and that shifting some payments from DISH to Medicaid service rates or directed payments can increase the federal match and thereby allow a larger total pool (in dollars) while reducing the state general‑fund share. The agency said the bill as drafted could be implemented for FY26–FY27 and that the governor’s budget contained an 80% return level for hospital payments, while other proposals and the bill’s negotiated language offered approaches to increase the overall dollars hospitals would receive to levels closer to the historical 91%.

Budgetary stakes and litigation: Witnesses said the numbers are large and time‑sensitive. The House fiscal note attached to the bill projects roughly $19 million per fiscal year in additional general‑fund cost versus the governor’s 80% baseline (the exact number depends on distribution methodology and federal match assumptions). Hospital witnesses said the 80% implementation directive ordered by the governor after last year’s negotiations broke down would reduce hospital revenues materially—estimates offered in testimony ranged from tens of millions to about $100 million for larger hospitals if the 80% plan remained. Several large hospital systems said they have withheld MET payments pending resolution and some have sued the state, creating litigation and collection uncertainty.

Stakeholder positions and next steps: Hospitals, Dartmouth Health and other systems urged a negotiated settlement and proposed using enhanced federal match to increase hospital payments without increasing state general‑fund outlays as currently budgeted. State Medicaid staff said federal policy uncertainty (possible limits on MET percentages at the federal level) argues for a temporary two‑year approach. Committee members from finance emphasized the need to reconcile the bill’s costs with House budget actions and suggested either moving the policy into the budget process or pressing for precise amendment language that would be revenue neutral to the general fund. Several members said they would prefer to see technical amendment language and financial modeling before a vote.

Ending note: The committee closed public testimony after receiving requests from numerous institutional stakeholders for additional negotiation and for the department to provide clarified fiscal modeling. Lawmakers and hospital representatives signaled willingness to continue talks to craft amendments that could increase hospital payments while minimizing or eliminating additional general‑fund cost.","mediaType","Video","parentTitle","House Ways and Means (04/29/2025)","oneSentenceSummary","Senate Bill 249, which would set hospital payment distributions tied to the Medicaid Enhancement Tax (MET) and change the distribution methodology to capture greater federal match, drew extended testimony before the House Ways and Means Committee.","taxTitle","Ways and Means, House of Representatives, Committees\t, Legislative, New Hampshire","taxId",17769,"location","New Hampshire","headline","","shortSummary",{"_33":77,"_35":36,"_37":38,"_39":78,"_41":79,"_43":80,"_45":81,"_47":82,"_49":83,"_51":84,"_53":85,"_55":56,"_57":58,"_59":86,"_61":62,"_63":64,"_65":87,"_67":68,"_69":70,"_71":72,"_73":74,"_75":74},6572888,"House committee hears bill to broaden property-tax exemption for church housing, limit set at six units",464,356000,820000,"/Search/View?dp=1&key=3150440-435642e5c9269d99bfd4cfb1ef5374b3&start=356&end=820","https://assets.pipeline.soar.com/3150440-435642e5c9269d99bfd4cfb1ef5374b3/thumbnail_356000.jpg","/articles/6572888/New-Hampshire/House-committee-hears-bill-to-broaden-property-tax-exemption-for-church-housing-limit-set-at-six-units","https://secure.pipeline.soar.com/6572888-5d671b180782a7411bb0f05e0230925a/orig.mp4?Expires=1771185767&Signature=dGNvHf0Rwq3Ad1Lh7r4xQvW-sYfkcox4SLlQPy3ryXOJr3cE3b3HZvyDMBE84eUUHcWFmI9-AbXMWsEuQg0Z6tFeYltGU3cnsAKTBuCzHFL4nV8o-1cHiE2jSN~V25szTKvOkektjUdwo5cewKNndnz79bg4BHPl6VqQFo6c5kDucgtGeoTUvGmg7T3zNy0HAJECinXmo0tSswKxSKtxBnTNAwnEWKBHDfkVLU0tJv5NCiPFdTeoC~DVDhS1d1sDuFOYQOtFQQcXLWNQXQ564EeR57RKznK3hJFZW6q22Ch7TEB-dJksZ1XNZlG~IwIiDu5jvogBLSBOrjXcPJKk7g__&Key-Pair-Id=KUT5TJCACFTXG","Senate Bill 291, which would expand property-tax exemptions for church-owned housing used for religious purposes, was the subject of an extended public hearing before the House Ways and Means Committee on May 1. The bill, introduced to the committee by Sen. Tim Lang (R‑District 2) on behalf of Sen. Abbas, would clarify that housing owned by a house of worship and used to advance its religious mission can be tax exempt even when occupied by designated church employees or used for small congregate residential programs.

Supporters said the measure addresses a change in practice: clergy increasingly live in privately owned homes while church-owned parsonages remain on church lots and sometimes are repurposed. \"The intent was not to allow, for lack of a better phrase, a commercial rental unit, but to allow the church to continue its works,\" Sen. Tim Lang said. He described uses such as placing a part‑time staff member in a parsonage or operating a small congregate program for people recovering from addiction as examples of activities that advance a church's mission.

The bill would explicitly allow up to six residential or congregate housing units on church lots to be treated as exempt when those units are used for religious purposes. It also adds language that such land and structures remain subject to \"objective and defined regulations\" for height, yard sizes, lot area, setbacks, open space, building coverage and DES (Department of Environmental Services) requirements, the senator said.

Why it matters: municipalities, assessors and municipal advocates warned the committee that the proposal could remove sites from the local property-tax base and erode municipal revenues. Brody Deshanes of the New Hampshire Municipal Association said the bill has two distinct features: (1) an apparently unlimited exemption for housing occupied by church employees and (2) a separate new exemption for up to six rental or congregate units that could be used more broadly unless the term \"religious purposes\" is narrowly defined. \"It could be difficult for municipalities to try to interpret whether or not it's truly a religious use,\" Deshanes said. He added that the draft also contains a zoning mandate with an effective date that municipalities may not have time to address before it takes effect.

Municipal and legal concerns: Danielle Pasek, Concord city attorney, told the committee the bill contains ambiguities. She noted that the text as drafted could allow new construction or property purchases to qualify immediately—potentially bypassing the five‑year ownership language in one part of the draft. Pasek raised the prospect that a church-owned nursing home or other facility could be interpreted as a religious use and therefore become exempt unless the bill is tightened.

Supporters and housing advocates: Nick Taylor, director of Housing Action New Hampshire, testified in support and framed the proposal as one small way to increase affordable housing supply by enabling religious institutions to make better use of existing land and structures. Taylor said the senate removed an earlier version's unlimited density and replaced it with the six‑unit cap during the amendment process.

Religious and advocacy perspectives: Ian Hewitt, attorney for Cornerstone (a Christian advocacy organization), argued churches historically carry out community‑oriented services as part of their religious mission and that the bill removes barriers that could discourage churches from offering housing or other services. Hewitt and other testifiers said churches have encountered aggressive tax assessments and zoning restrictions in some towns.

Questions from committee members focused on multiple points: how \"religious purposes\" would be defined and verified by assessors; whether renting units at market rates to members of the public could be interpreted as advancing a church's mission; whether the six‑unit cap is sufficient; how the bill's \"same lot\" language would apply when parsonages are on separate tax lots owned by a church; and whether the effective dates and zoning mandates give municipalities enough time to respond.

Clarifications offered on the record: Sen. Lang and others said the sponsor's reading is that the exemption applies only to lots owned by the church and that reasonable zoning rules—height, setbacks, lot coverage, and DES compliance—remain enforceable. Several committee members said they wanted explicit statutory definitions and drafting clarifications before any final vote.

What happens next: Committee members urged further work on amendments to clarify (1) the definition of \"religious purposes,\" (2) limits on commercial rental uses and revenue‑raising, (3) whether existing case‑law language such as \"appertaining to\" should be used to constrain the exemption, and (4) the effective date for municipal compliance with the zoning mandate. The hearing record includes potential amendment discussions and offers by stakeholders to draft language for a future work session.

Ending note: Witnesses on both sides asked for additional drafting time and for the committee to coordinate with municipal and legal stakeholders to resolve ambiguities before the measure proceeds. The committee closed public testimony and indicated further consideration at a work session would follow.","Senate Bill 291, which would expand property-tax exemptions for church-owned housing used for religious purposes, was the subject of an extended public hearing before the House Ways and Means Committee. The bill would clarify that housing owned by a house of worship and used to advance its religious mission can be tax exempt even when occupied by designated church employees or used for small congregate residential programs.","actionData","errors"]

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Committee hears Senate bill to restore higher hospital MET/DISH payments amid litigation and budget concern

House committee hears bill to broaden property-tax exemption for church housing, limit set at six units