Our Turn: Sununu should fight to preserve Medicaid expansion

For the Monitor
Monday, August 28, 2017
New Hampshire’s bipartisan Medicaid expansion plan is boosting our economy and providing access to life-saving services, including substance use disorder treatment and recovery programs, to more than 50,000 Granite Staters.
That is why it is so troubling that Washington Republicans keep trying to sabotage it – if they can’t eliminate it altogether. Before Donald Trump took office, congressional Republicans tried to repeal Medicaid expansion more than 60 times from 2011 to 2016. In the Trump era, Washington Republicans tried to repeal Medicaid expansion in March, April, May, June and July.
The Trump administration takes every opportunity to sabotage Obamacare. Every month, the administration plays coy about whether it will make what’s known as cost-sharing reduction payments, creating uncertainty that is sending health insurance premiums skyrocketing. The administration has cut funding efforts that help people find out what insurance plan would be best for them. And the administration is even cutting the amount of time people will have to enroll in an insurance plan – while ending advertising campaigns to let people know when they can sign up for insurance.
Gov. Chris Sununu’s record on Medicaid expansion hasn’t always been much better. He opposed Medicaid expansion in 2013 and 2014, and he often trumpets the idea of “block granting” Medicaid, which would mean massive cuts to critical services for Granite Staters.
Now, we’re unfortunately gearing up for yet another challenge to Medicaid expansion as the Trump administration threatens to cut off funding for the program because of the unique way that New Hampshire’s program was designed by the Republican Legislature in Concord. This is no surprise, given President Trump’s desire at every turn to sabotage the Affordable Care Act.
This is a fight that we have already fought and won before under the leadership of then-Gov. Maggie Hassan. When federal officials previously raised concerns about the innovative way New Hampshire’s program was designed, Hassan did her job, fighting for the state and working to ensure that the Obama administration allowed the program to go forward.
The difference, of course, was that the Obama and Hassan administrations were committed to ensuring access to health care. We hope Gov. Sununu will fight just as hard to preserve our innovative Medicaid expansion program, ensuring the health and well-being of 50,000 of our friends and neighbors.

Fiscal irresponsibility a product of partisan politics

The Nashua Telegraph

JUL 11, 2017


Gov. Chris Sununu and our friends in the Republican majority chose a partisan path for the budget, one even former House Speaker Bill O’Brien has praised. Gov. Sununu’s partisan Republican budget spends tens of millions more now and hundreds of millions more in the future on additional tax cuts for business owners and big corporations. And New Hampshire already has the seventh lowest overall business taxes in the country. These massive tax cuts for the wealthy mean the taxes of big corporations will go down, while local property taxes will go up, it means the wealthy elite will win, while everyday Granite Staters, especially our most vulnerable, will lose.

This is simply neither fiscally responsible nor morally acceptable. Gov. Sununu recently denounced the U.S. Senate health care bill because it would mean New Hampshire’s budget would lose more than $1 billion by 2026. However, the same partisan state budget Gov. Sununu recently signed into law will cost New Hampshire upwards of three-quarters of billion dollars over the same time frame. That’s right. Upwards of three-quarters of a billion dollars in tax cuts for the wealthy elite by 2026.

Gov. Sununu and the Republican majority in the Legislature chose to give a huge tax break to the largest, wealthiest corporations, many of which are headquartered out of state, instead of investing in our own people in ways that would help include them in our communities so they could contribute to the economy right here at home.

That choice is not fiscally conservative, especially not when we could use some of the corporate tax giveaway to help fund the successful expansion of health care coverage to over 50,000 people right here in New Hampshire. Some of the tax giveaway could cover the cost of fully funding developmental disability services instead of the large waiting list the Sununu budget creates. A small portion could cover necessary raises for community mental health workers, who are overworked and underpaid, leading to burnout and big workforce shortages. It’s difficult to see how anyone could call this budget a “win” for New Hampshire. Under the same logic as his opposition to the U.S. Senate health care bill, Gov. Sununu should have vetoed the budget, but he was clearly more concerned with getting a one-party, partisan budget than New Hampshire’s fiscal future.

Even Republicans in Kansas have recognized this fiscal error. Recently, Republicans in the Kansas legislature overrode a veto of their budget, which actually raised business taxes to deal with the deep deficits caused by previous tax cuts for business owners and corporations. But our Republican friends in the majority at the Statehouse didn’t heed the lesson from their Republican colleagues in Kansas. As a result, critical and cost-effective priorities – like essential health programs and combatting our epidemic of substance abuse and mental illness – fell by the wayside now, and will suffer even more down the road.

We recognize the Republican party supports massive tax cuts for the wealthy elite. But this shouldn’t be about unifying one political party; it should be about building a budget that invests in important human potential while being fiscally responsible. This budget fails that most basic test.


My Turn: House Republicans would send developmental disability wait list into stratosphere

For the Monitor

Sunday, April 23, 2017

In 1991, New Hampshire was the first state to close its institution for individuals with developmental disabilities. All Granite Staters have a right to be proud of the closure of Laconia State School, which acknowledged the right of our residents with developmental disabilities to live meaningful lives in the community.

Since 1991, however, we have not always lived up to our obligation to provide the community services that Medicaid authorizes and for which the federal government will pay half. The sad result is that a number of vulnerable individuals have been forced to wait for services when they turn 21.

In 2007, the Legislature finally made good on its promise to eliminate the developmental disability wait list and fully fund services through Medicaid. This was a great day for New Hampshire.

Over the past 10 years, sadly, the state’s track record has been mixed. From a high of 270 people waiting an average of five months to receive services, the number of people forced to wait in limbo was virtually eliminated.

Then the Great Recession hit, and the 2011/2012 budget did not keep up with the demand of disabled adults eligible to receive services. By the next funding cycle, the wait list had ballooned again, reaching an all-time high of 288 individuals who were again waiting months for services.

Over the next four years, increased funding brought the size of the wait list back down temporarily, but now it has swelled again. The Department of Health and Human Services predicts that by June 30, when the current budget cycle ends, 250 individuals with developmental disabilities will be wait-listed due to inadequate state funding.

Gov. Chris Sununu’s budget added a total of $57 million in state and federal funds to the developmental disabilities program. The Department of Health and Human Services believes it is enough to serve most of the individuals who will be in line waiting on July 1. Unfortunately, it isn’t enough to also provide services to the 200 additional residents who will turn 21 over the next two years and qualify for disability services.

According to department figures, the governor’s budget would result in approximately 230 residents on a wait list by the end of the next two years. Some of these individuals may get some level of services, but some would get none at all, and none would get the full range of services for which they are eligible.

The House budget would have made the developmental disability wait list significantly larger; in fact, it would have been the largest ever, since the Legislature declared there would no longer be a wait list at all. This is because the House budget took $7 million of the governor’s recommended $57 million increase and dedicated it to raises for direct service providers. These raises would be essential for attracting and retaining workers. Unfortunately, the House budget did not provide the funding for the raises, so the budget for services would effectively have been $7 million less than as introduced by the governor.

If the House budget had passed, the impact of not funding the raises would be a developmental disability wait list that could reach as high as 380 people by June 2019. That’s 100 more than the highest level we saw during the Great Recession.

During a time when the economy is healthy, it is shameful for us to accept New Hampshire having the biggest wait list for services since before we proudly declared the end of the developmental disability wait list. Let’s hope the state Senate is not as willing as the House Republicans were to turn away from some of New Hampshire’s most vulnerable citizens.

(Cindy Rosenwald of Nashua is the House deputy Democratic leader.)


What Does Repealing Obamacare Mean for New Hampshire?

My Turn: Health insurance in a post-Obamacare world

For the Monitor

Wednesday, January 04, 2017

The Republican-controlled Congress has pledged to repeal the Affordable Care Act, also known as Obamacare. Over the past six years since it became law, the ACA has brought major changes in health insurance laws that ended the worst insurance company abuses.

The effect of this has been important in New Hampshire, so, as we stand on the precipice of the ACA’s potential repeal, it’s a good idea to review the impact of these changes on New Hampshire’s people and consider how we will be affected if the law is repealed.

Perhaps the most important reforms involve the guarantee of insurance coverage. Thanks to the ACA, the 600,000 Granite Staters who have a pre-existing health condition can no longer be denied coverage or charged so much that they can’t afford it. Insurance companies can’t cancel their policies when they get sick or put caps on their coverage. Women can’t be charged more than men simply because of their gender, and young adults can stay covered through their parents until age 26 as they establish their careers. That’s a lot of peace of mind thanks to Obamacare.

The coverage itself is improved as well and has a better overall value. Important preventive services are always covered, such as colonoscopies and mammograms, and insurance companies are regulated on the amount of premium dollars that must go to pay for services, rather than marketing and executive pay. And with mental health services a critical need in New Hampshire, the ACA requires coverage of these services at parity to other medical services.

While the coverage has gotten better, the rate of cost increase for the 850,000 Granite Staters who get insurance through their employer has also slowed by more than a third. And more than 30,000 of us who buy insurance through the individual market qualify for tax subsidies to make the purchase more affordable.

Already more than 20,000 older New Hampshire residents are saving on average more than $1,000 a year on their medications. We must ask ourselves what will happen to this group of Granite Staters when the Donut Hole returns.

The Medicare program itself is also improved by the ACA. An annual exam and essential preventive services are now provided without cost sharing. In 2015, 74 percent of our seniors who are enrolled in Medicare Part B took advantage of this benefit. Medicare also brought payment reforms to hospitals to encourage fewer unnecessary readmissions.

Over the past five years, readmissions dropped 3 percent for New Hampshire’s Medicare beneficiaries, keeping our elders out of the hospital unless really necessary.

Finally, New Hampshire took advantage of the ACA’s Medicaid expansion, bringing health coverage along with mental health and substance abuse treatment access to many Granite Staters for the first time. Over the past two years since the expansion began, 107,000 residents have participated at some point; currently 50,000 people are enrolled. The Medicaid expansion has also brought financial stability to our smaller, rural hospitals since they are now compensated for care they must provide.

Virtually everyone in New Hampshire has felt the impact of the Affordable Care Act, whether they are on Medicare, get insurance through work, through Healthcare.gov or through Medicaid. For the past few years, they have had higher quality, more transparent coverage that treats them more fairly than in the past.

We can only wonder how Granite Staters will react and suffer when the Trump administration and Republican Congress take these benefits away.

(Rep. Cindy Rosenwald of Nashua is the deputy House Democratic leader.)


Nashua Telegraph

Friday, October 21, 2016

NH can’t afford to backtrack

Cindy Rosenwald

As I talk to voters around my district this fall, I ask them how their family is doing. I’m getting a consistent answer: “Things are OK, we’re doing fine.”

The numbers bear out their sense of confidence. Incomes in New Hampshire are up, unemployment is among the lowest in the country, and more people are working in New Hampshire today than ever before in our history.

At least in some measure, we can attribute our state’s recovery to prudent investments in our people and our infrastructure through the state budget over the past two cycles.

And there was a lot to clean up after the disastrous “O’Brien Budget” of 2011-12, which cut $40 million in general funds and devastated critical programs essential to safe, healthy communities and a vibrant economy.

We all remember the impact of the $40 million budget cuts under former House Speaker Bill O’Brien: downshifts of long term care costs to local property taxpayers, funding cuts to private nursing homes that forced staff reductions and put frail seniors at risk, elimination of the Children in Need of Services program that increased costs to local communities, cuts to hospitals that cost up to 2,000 jobs and brought on expensive litigation, and cuts to public universities and community colleges that drove tuition up. Funding for drug and alcohol prevention and treatment programs was decimated, and now we are faced with more than one drug overdose death each day.

The list goes on, affecting all areas of life in the Granite State.

It has taken several years for us to climb back from the O’Brien budget cuts of $40 million general funds, but we have, and residents of my district are happy with the quality of life in New Hampshire. But that quality of life could be threatened again with the legislature due to be elected next month.

The chair of the powerful House Finance Committee has filed a bill to eliminate the interest and dividend tax, which is paid by wealthier Granite Staters on their investment income. This bill would decrease state revenues by a whopping $187 million. The O’Brien $40 million budget cuts pale in comparison.

If New Hampshire residents didn’t like the impact of $40 million in cuts affecting seniors, individuals with disabilities, college students, property tax payers, and jeopardizing community safety with a rise in drug abuse, what would they think about a budget cut quadruple that size?

Would they want to see drug treatment services decimated again, with drug abuse our No. 1 public health problem? Cuts to snowplowing? Road paving? Nursing home care for our elderly family members?

Voters need to think very carefully about the legislators they choose to send to Concord in November.

If the Republican leadership’s bill passes, what important programs will be on the chopping block?

Will the next Legislature pass a tax cut for the wealthiest people in the state, shifting costs down to hard-working middle class families? New Hampshire can’t afford the risk, especially now that we’ve fought our way back from hard times.

Cindy Rosenwald, D-Nashua, is the Deputy Democratic Leader in the New Hampshire House.


Opioid prescribing bill signed into law

For Immediate Release
June 7, 2016

Communications Office

Governor Hassan’s Statement on Signing Bipartisan Legislation Requiring Updated Prescribing Rules for Opioids

CONCORD – Governor Maggie Hassan issued the following statement after signing House Bill 1423, legislation that she proposed in November as part of a comprehensive strategy to fight opioid abuse, requiring all prescribing boards to update prescribing rules for opioids:

“While opioids can play an important role in pain management and our healthcare system, we know that the heroin and opioid crisis stems in part from the overuse, misuse and abuse of addictive prescription opioids. In order to prevent the overprescribing of opioids, we have been working to improve provider training and to update the rules for prescribers, with the boards of medicine, nursing and dental examiners taking important steps forward with their own updated rules.

“House Bill 1423 builds on those efforts by requiring the boards governing all prescribers to adopt updated, permanent rules this year and by providing a uniform, statewide standard. I thank Representative Rosenwald, Representative Sherman, the New Hampshire Medical Society and our physicians for their leadership on this issue, and I am proud to sign this bipartisan bill into law in order to build on our efforts to prevent the overprescribing of opioids.”

House Bill 1423 builds on emergency rules that boards of medicine, nursing and dental examiners put in place in collaboration with Governor Hassan to ensure that best practices are followed in prescribing opioids, and the boards of medicine and nursing have been working to establish permanent rules. Beginning in September, the new law mandates the use of the prescription drug monitoring program and requires all boards governing prescribing to have new rules establishing standards for assessing the need for opioids, the risk for abuse and educating patients. It also requires boards to set standards for limiting the amount of days for an opioid prescription obtained in an emergency room to ensure follow-up care for patients.

The new law also contains exceptions for opioids prescribed for cancer patients, patients with terminal conditions or patients in long-term non-rehabilitative care settings, such as nursing homes.

Governor Hassan has outlined and consistently worked to implement a comprehensive strategy to support law enforcement and strengthen prevention, treatment and recovery in combating the crisis, including calling a special session of the legislature last November. In addition to House Bill 1423, the Governor has signed legislation to increase the penalties for the illegal sale and distribution of fentanyl, to limit prior authorizations for outpatient substance abuse treatment and to improve the state’s prescription drug monitoring program. The Governor also fought to reauthorize the bipartisan New Hampshire Health Protection Program, which has provided substance misuse and behavioral health services to thousands of Granite Staters, and she has revised licensing requirements to make it easier for providers to open treatment facilities, worked to increase the safe and effective use of Narcan, and launched a statewide substance misuse hotline to help connect individuals with resources 24 hours a day, seven days a week.

Over the course of the next several weeks, Governor Hassan will also sign bipartisan legislation to limit insurance companies’ prior authorization requirements for in-patient hospital stays, to expand the use of the prescription drug monitoring program and to provide $5 million in additional resources for prevention, treatment and recovery programs and supportive housing. The legislature has also heeded Governor Hassan’s call to return next week to consider additional funding for law enforcement, expanding statewide the successful Operation Granite Hammer model that she helped launched last year.


Inefficient defense spending hurts New Hampshire


My Turn: Inefficient defense spending hurts New Hampshire

For the Monitor
Tuesday, March 15, 2016
(Published in print: Tuesday, March 15, 2016)

As Congress begins considering President Obama’s final budget request, it’s a good time to take stock of where our hard-earned tax dollars are going. As a state representative, I am concerned that some urgent funding needs in New Hampshire – such as drug treatment, education, our aging roads and bridges, and community development – are being squeezed out by wasteful spending at the Pentagon.

New Hampshire currently relies on federal funds for about 30 percent of its revenue. Yet, this flow of federal dollars to the state is constantly under siege because more than half of the nation’s discretionary budget goes to the Pentagon. While I strongly believe in the responsibility to provide for a robust national defense, there are far too many examples of inefficient spending eating up our tax dollars.

One area that deserves particular scrutiny is the planned full-scale update of the U.S. nuclear weapons arsenal, expected to cost taxpayers $1 trillion over the next three decades. The so-called nuclear “modernization” programs include new fleets of nuclear-armed submarines, bombers and ground-based ballistic missiles, a new air-launched cruise missile, and new bells and whistles for the associated nuclear warheads.

The president and his military advisers have stated that we can reduce the deployed arsenal by one-third while maintaining stability with other nuclear powers. Yet, the current plans lock in a nuclear force structure that looks the same as it did 25 years ago and a spending trajectory that some experts are calling a budget train wreck. For instance, in 2029, the Pentagon will be spending $34 billion on nuclear force modernization alone, or “about as much . . . as the total budget of the U.S. Department of Justice,” according to the Center for American Progress.

Indeed, the Defense Department and supporters in Congress are beginning to justify the nuclear build-up with Cold War-like rationales, calling investments a counter to Russian aggression. Such thinking is backward, dangerous and provocative. Nuclear weapons did not stop Russia from invading Crimea or intervening in Syria.

Wasteful spending on dangerous weapons takes away from the safety and welfare of Granite Staters where they need it the most. Over the last several years, New Hampshire has seen a sharp increase in heroin overdoses and many families have been affected by the devastating epidemic of drug abuse. In addition, in public education, taxpayers have been picking up the slack where the current funding formula does not cover schools that are growing. Our state’s businesses and manufacturers also suffer when Congress cannot nail down long-term highway and transit appropriations. It will take purposeful resource mobilization to provide drug addicts with effective rehabilitation, students with a first-class education and commuters with highly efficient transit systems.

Budget decisions are hard to make. Yet, today, unchecked public spending largely benefits the military-industrial complex without tackling 21st-century security threats and needs. New Hampshire’s hard-earned tax dollars ought to be put toward the things that really keep us safe and secure.

President Obama entered office calling for the “peace and security of a world without nuclear weapons,” but given the current political atmosphere, we cannot assume the next president will be quite as visionary. It is time for all of us, at the local, state and federal level, to speak out against excessive, wasteful and counterproductive nuclear weapons spending.


Magical thinking in Republican budget will turn NH into Kansas


We stand with Gov. Hassan in her decision to veto the fiscally irresponsible and unbalanced Republican budget, which we can only describe as a trail of false promises.

You may have heard Republicans claim that their budget increases funding for critical priorities like substance abuse treatment, mental health services and our seniors. But there’s one very big problem. Republicans’ fiscally irresponsible budget isn’t actually balanced, placing every single one of those priorities – and more – at risk.

This budget overpromises and under-delivers. Our Republican colleagues know that their budget doesn’t actually do what they say it does, but that doesn’t seem to bother them.

Instead of making tough choices and being honest with the people of New Hampshire about what their budget actually funds, Republicans would rather pass a budget riddled with magical thinking and false promises.

Republicans know that because their budget is unbalanced as written, they are simply passing the buck onto state agencies who will inevitably have to decide what critical services to cut down the road to keep the state in the black.

Even worse, their budget hurts our state’s long-term economic outlook by including unpaid-for tax giveaways for big corporations that will blow a $90 million hole in future budgets.

By blowing a massive hole in future budgets, it will be impossible for our state to invest in critical priorities like holding the down the cost of tuition, maintaining safe roads and bridges, and ensuring access to affordable health care.

We don’t have to guess what would happen as a result of these large, unpaid-for tax giveaways. We only need to look at the example of other states across the country, particularly Kansas.

The governor of Kansas proudly declared that his state was a real-world experiment in trickle-down, Koch Brothers’ economics when he pushed through massive, unpaid-for tax giveaways in his state.

What resulted? The state teetered on a fiscal cliff, deficits exploded, bond ratings sank, and none of the economic benefits that were promised actually materialized.

From Kansas to New Jersey to Louisiana and Wisconsin, we’ve seen what happens as a result of unpaid-for tax giveaways: first, deficits balloon, and then critical economic priorities must be cut.

New Hampshire’s economic outlook is promising. In 2014, New Hampshire’s economy grew the fastest in New England and faster than the national average. Not to mention that our unemployment rate is fifth lowest in the country, and our businesses have recovered all of the jobs lost in the recession – and then some.

This is the time to build on our progress by investing in our people and businesses, not let Republicans turn us into Kansas.

House and Senate Democrats will continue to stand with Gov. Hassan as we fight together for a responsible budget that is balanced and that will live up to the promises we make to our families and our businesses.

Rather than repeating the mistakes of states like Kansas, we encourage our Republican colleagues to come to the table and negotiate in good faith so that we can pass a responsible budget that will build on our economic progress and move our state forward.


Proud to Help Promote North Country Economic Development



Budget is a twisted tale of Broken Promises

The Telegraph
Sunday, April 5, 2015

Budget is a twisted tale

The House Republican budget is a twisted tale of broken promises. It breaks its word to voters, to taxpayers, to employers and employees, to the elderly, to people with mental illness or disabilities, and to our state’s future. It is a budget with shocking and Dickensian assaults on our economy and our citizens.

The Republican majority made a public promise at the beginning of the session that their budget would not raid dedicated funds, downshift costs to local taxpayers, or use other budget gimmicks. Their budget breaks all three promises.

In a dazzling money grab, this budget raids $51 million dollars from the Renewable Energy Fund. This money, collected from ratepayers, is dedicated to helping municipalities, businesses and individuals lower their energy costs.

As the majority’s budget passes down costs in the millions to counties for long-term care, it breaks its promise not to downshift to local taxpayers. Adding to the $12 million in downshifts to county property taxpayers are the yet-undetermined costs to municipal taxpayers that will result from deep cuts in safety net programs. Property taxpayers will be left holding the bag for these broken promises.

Perhaps the most shocking aspect of the O’Brien-Jasper budget’s broken promises is their decision to empty the state’s Rainy Day Fund. According to the state treasurer, such a move could jeopardize New Hampshire’s credit rating, which has recently improved. In a growing economy, wiping out our emergency savings account is completely irresponsible.

We have a long-standing social commitment to our elders who helped ensure the previous generation could live their lives with security and dignity, with the trust that we would do the same. Yet this budget reduces the level of important services for frail seniors, putting their safety at risk.

We have a social commitment, also, to individuals with developmental disabilities and mental illness. This budget reduces funding below current levels and cuts back on mental health treatment and services. As a result, vulnerable populations will find themselves pitted against each other as they struggle to gain access to critical services without adequate funding.

Our business community has been clear that they need a healthy workforce and they are sick of the impact on their insurance premiums that comes from uncompensated care costs. The failure to extend the New Hampshire Health Protection Plan breaks our promise to help reduce uncompensated care. It also leaves almost 40,000 Granite Staters out in the cold when their insurance is cancelled next year.

This budget won’t promote economic development or attract youth to the state – two promises that we cannot break if we are to commit ourselves to a prosperous New Hampshire. The budget passed by the House is a budget so filled with broken promises as to shatter our prospects for a better tomorrow. We must hope that the Senate takes a different approach, and works across party lines to pass the kind of responsible budget that our future is counting on.