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County official warns HB2 managed‑care changes could remove $60–70 million from long‑term care; committee convenes in Concord
Summary
A county health‑policy speaker said language in House Bill 2 could shift Medicaid long‑term supports into managed care and eliminate existing supplemental payments (ProShare/Medicaid incentives), potentially costing the sector an estimated $60–70 million; a legislative committee will report back by Oct. 1.
Strafford County staff and a former state health official told county commissioners that language in House Bill 2 (HB 2) and related legislative activity could shift long‑term supports and services into managed‑care arrangements and eliminate longstanding supplemental payments to nursing homes, amounts they estimated on the order of $60–70 million.
Nick Compass (introduced in the meeting as a former commissioner of health and human services) described a legislative committee convened under HB 2 that includes area legislators—Senator Rivard and Representatives Lucas, Markill and Coval—and said the committee intends to report on implementation before Oct. 1. Compass said the committee’s work aims to evaluate managed long‑term supports and services, but that certain federal funding streams and programs (such as ProShare or other supplemental payments) may not transfer into a capitated managed‑care framework.
Compass told the commissioners: "Our best estimate... is 60 to 70,000,000. And that would be gone because it's unavailable under a managed care program." He and others warned that Medicaid—already a low payer for long‑term care—would be difficult to supplement once patients and payments are folded into a capitated managed‑care contract. Compass said two parallel efforts are under way: the HB 2 committee and a hospital‑nursing home working group addressing discharge and bed availability problems.
Speakers noted provisions in HB 2 permit managed‑care organization involvement for certain benefits but do not make clear whether all supplementing funds or programs would continue. Compass also discussed the possible revival of PACE (Program of All‑Inclusive Care for the Elderly) variants and noted practical workforce constraints: county officials said nursing workforce demographics and the regional labor supply will complicate any shift to managed care without special workforce strategies.
There was no formal county action recorded; Compass said he would attend the initial committee meeting in Concord and share updates with county leadership. County officials asked for follow‑up and indicated they will monitor the committee’s work and potential impacts on county and private nursing homes.
