Yearly Archives: 2017


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 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.)