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Little Progress Made Toward Solving Legislature’s Biggest Remaining Policy Question

Todd Bookman

The first public meeting between House and Senate negotiators working to fix the state’s Medicaid enhancement tax lasted all of 20 minutes, but parties are optimistic a deal can be struck.

Representative Cindy Rosenwald, a Nashua Democrat, used the hearing to reiterate the House’s position that despite court rulings declaring the tax unlawful, the New Hampshire Supreme Court will see otherwise.

“We continue to believe that our Medicaid enhancement tax is constitutional,” Rosenwald told colleagues. She says it adheres to both federal and state law.

Two New Hampshire superior courts found the current application of MET violates the law because it taxes certain procedures at hospitals differently than if those same procedures were done outside of a hospital.

The House seeks to pass legislation clarifying the intent of the tax in more detail, and potentially broaden it to more providers.

Senate President Chuck Morse (R-Salem) opposes that plan, and instead wants to phase down the Medicaid tax rate over time. Senate leadership released a set of ‘guiding principles’ for negotiating a fix that includes ensuring predictability for the state and hospitals, but the meeting was recessed before its plan could be detailed.

The MET is expected to generate $185 million this fiscal year. Both chambers agree any revenue raised by the tax should be spent on healthcare rather than supporting the state’s budget. 

The real work here is taking place behind the scenes, as the Governor’s office, hospital officials and lawmakers work to hammer out a deal.

“Deadlines focus people’s attention, and hopefully we’ll get a compromise,” says Senate Majority Leader Jeb Bradley (R-Wolfeboro).

Lawmakers have until the end of the week to reach an accord. The committee is scheduled to meet again Thursday.

Todd started as a news correspondent with NHPR in 2009. He spent nearly a decade in the non-profit world, working with international development agencies and anti-poverty groups. He holds a master’s degree in public administration from Columbia University.

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