Published DateCONCORD — When the New Hampshire House of Representatives voted on the 2014-2015 state budget and companion bill on Wednesday, the 18 members of the Belknap County Delegation divided strictly along party lines with the five Democrats voting in favor and the 13 Republicans against both bills, which carried by majorities of 194 to 172 and 193 to 166 respectively.
However, some county Republicans broke ranks over three of four amendments to House Bill 2, the companion bill, proposed by Republicans that would have transferred funds appropriated for uncompensated care payments to hospitals, including LRGHealthcare, to the general fund, where they would be reallocated to a variety of purposes. The five county Democrats opposed all four amendments, which along with another dozen proposed by GOP lawmakers, were rejected by the full House.
Before the budget reached the House floor the New Hampshire Hospital Association (NHHA), whose largest members, LRGHealthcare among them, have gone without uncompensated care payments for the last two years, claimed that the inadequate appropriation for 2014 and 2015 threatened to leave them empty-handed again. The association urged House members to vote against the budget as wells as against the Republican amendments.
One Republican amendment proposed transferring $7 million from uncompensated care payments to spare the 10 counties an equivalent increase in the cost of long-term care for the elderly. All 13 Belknap County Republican lawmakers voted for the amendment.
Another amendment proposed transferring $13 million to reduce business taxes. Three Republicans — Representatives Don Flanders, a trustee of LRGHealthcare, and Frank Tilton of Laconia and Stephen Holmes of Alton — joined the the five Democrats in opposition.
The third amendment would have transferred $20 million to reduce the proposed increase in the tobacco tax from 30 cents to 20 cents. Again Flanders and Holmes joined the Democrats in voting no.
Five county Republicans — Representatives Flanders, Holmes and Tilton, together with Jane Cormier of Alton and Bob Luther of Laconia — defected on the last amendment to transfer $7.2 million to fund the school building program, which failed to carry a majority of the county delegation.
The House Finance Committee reduced Governor Maggie Hassan's recommended appropriation for uncompensated care by $32.9 million, from $197.3 million to $164.4 million. The payments are funded with the proceeds of the Medicaid Enhancement Tax (MET), which is levied against the net patient income of hospitals and matched dollar for dollar by the federal government, effectively doubling the appropriation. The committee also changed the order of priority for distributing the proceeds from the MET, relegating the hospitals to the bottom of the list, behind other Medicaid providers and the general fund. Altogether the amendments would have reduced funding for uncompensated care by another $47.2 million, to $117.2 million.