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House cuts force Division 3 priorities; House leaders warn 3% Medicaid rate reduction could harm provider capacity
Summary
Representative Jess Edwards said Division 3 faced a sizable reduction mandate and that the House's top recommendation to the Senate is that any additional funds be used first to reverse a 3% Medicaid rate reduction that was included in the House package.
Representative Jess Edwards, chairing Division 3, told senators that Division 3 faced significant pressure from an approximately $290 million reduction target from the governor's original Division 3 request and that the House applied a combination of back-of-the-budget reductions and program prioritization.
Edwards said the House tried to protect direct care in developmental-disability services and to preserve the most vulnerable residential services, but that some reductions were unavoidable. He said the House included a 3% Medicaid rate reduction across certain provider payments — an item he recommended the Senate consider restoring first if additional revenues are found. "The number one thing I would tell you to do ... is restore the 3% Medicaid rate reduction. That is $57,500,000 over the two years," Edwards said, citing concerns that the reduction could reverberate through provider capacity and workforce stability.
Division 3 members also called attention to personnel and contracting shortfalls at Glencliff and staffing needs at the New Hampshire Hospital; Edwards said his division added modest personnel funding to Glencliff relative to the governor's budget but urged the Senate to re-examine staffing levels. The House also eliminated certain family-planning funding in some areas but left a path open to reconsider funding for Coös County after testimony that cross-border services had closed in the region.
Edwards described attempts to reduce duplication across substance-use funding streams: the House moved some opioid-abatement funding and changes to a governor's commission on alcohol and other drug misuse with the stated intent of reducing parallel programs and improving legislative oversight of large grants. He said part of the change was to bring greater legislative oversight to money that had previously flowed automatically from the liquor fund to the governor's commission.
Edwards told the Senate he thought Division 3's choices were defensible given the fiscal constraints but that lawmakers should prioritize Medicaid rate restoration, stability of Glencliff and New Hampshire Hospital personnel, and targeted family-planning funding if additional resources become available.
