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May 31. 2014 7:02PM

Garry Rayno's State House Dome: So many NH legislative bills get left at the roadside

WHEN THE DUST cleared after the conference committees had met, a number of bills were left to die when the two sides could not agree.

For example, a bill increasing benefits for those on unemployment insurance, House Bill 1499, did not make it.

The House had increased weekly benefits for laid off workers earning between $28,500 and $40,500.

The increase would have been the first increase in benefits in 12 years, and now it will be at least 13 years.

The bill had broad bipartisan support in the House, passing on a voice vote, but ran into trouble in the Senate.

Under the House plan, weekly increases would range from $3 to $25, depending on salary and would have cost the state trust fund about $4.8 million.

Businesses were expected to see a slight reduction in their rate because of the size of the trust fund, but senators were concerned the boost would cost companies money and instead stripped the increase out of the bill, leaving just a study committee to review rate reduction triggers.

The Senate also changed the definition of full-time work to be more than 35 hours a week.

House and Senate negotiators explored increasing the trust fund trigger to $300 million, up from $250 million, which would put off the benefit increase until 2016. However, that did not fly with Senate leadership and the bill died.

Also in the slag heap is Senate Bill 355, which prohibits educational institutions from requiring or requesting their students disclose or provide access to personal social media accounts.

The Senate limited the prohibition to colleges and universities; the House exclusion went from kindergarten through college.

The two sides could not agree which institutions would fall under the prohibition and the bill died.

One very loud disagreement doomed House Bill 1409, which would have prohibited landlords from discriminating against potential tenants who are eligible for subsidized housing, or victims of domestic violence, sexual assault or stalking.

The Senate had turned the bill into a study committee and House members said more study was not needed, that action was, and it went from there.

A similar, but highly partisan battle, erupted over Senate Bill 307, which would have established a committee to study possible amendments to the federal constitution to address the Citizens United ruling by the U.S. Supreme Court. That opened the spigot to unregulated special interest money in political campaigns.

The Senate believed the House wanted a stacked committee with a predetermined outcome and thus wanted committee members more to its liking.

Senate Majority Leader Jeb Bradley, R-Wolfeboro, accused the House of first agreeing to a more neutral committee and then backing away from that agreement.

"A legislative study should be objective and unbiased. Unfortunately, the House did not agree and now this bill, which had overwhelming bipartisan support, will not move forward," he said.

A bill that would have changed how cities and towns adopt municipal charters, a policy initiative of the New Hampshire Municipal Association, died in committee when the two sides could not agree.

The Senate version of the bill would allow any 25 city or town residents signing a petition to place a charter question on a city's or town's general election ballot.

Opponents argued that in placessuch as Manchester that could be problematic, particularly after the city just completed a charter revision.

The bill would have exempted Manchester and other communities with charters or in the process of adopting them until their charters are opened again for changes.

Every year, bills that appeared to be headed for law end up in the trash heap when either the House - or more often the Senate - decides to dig in its heels.

MET Settlement: The settlement with 25 of the state's 26 hospitals on the Medicaid Enhancement Tax reached last week looks an awful lot like the "unspoken agreement" between hospitals and the state under the original legislation, which was changed in 2011, but with guaranteed money for the hospitals.

Under the agreement, which lawmakers will have to ratify this week, the hospitals would pay more MET tax, but would receive nearly all of it back from the state and federal government.

The small rural or critical access hospitals would recoup 75 percent of their uncompensated care, which includes charity care and the money they lose treating Medicaid patients. The state has the lowest Medicaid rates in the country, paying about 50 cents on the dollar for Medicaid services.

The growing difference between what it costs hospitals to treat a patient and what Medicaid pays for the care is one of the driving forces behind health insurance premium increases that have state businesses and individuals crying foul.

With more people insured courtesy of the Affordable Care Act, subsidies through the state health insurance exchange and Medicaid expansion using private insurers, hospitals' uncompensated care costs should reduce significantly over time.

The ACA anticipates the reduction and is lowering the money available through the Disproportionate Share Hospital (DSH) program. New Hampshire has never hit its allowable limit and state officials believe the state will continue to receive enough federal matching money to satisfy the agreement.

The hospitals receive a slight reduction in rates during the 2016-17 biennium of .05 percent a year from the current 5.5 percent, but lose nearly that much in DSH payments. If total uncompensated care is below $375 million in 2018, the rate will fall to 5.25 percent for the next biennium and beyond.

There are numerous contingencies in the agreement that make final tallies very difficult to ascertain.

But when all is said and done, hospitals are expected to double the amount of money they receive for uncompensated care from today to the 2019 fiscal year. The state will have to find an additional $180 million or so over the next two bienniums to make up what it loses in general fund money.

That is not going to be easy, unless you find a new source of revenue.

The hospitals will pay more money to the state but receive more help with uncompensated care with a good amount of that money guaranteed.

It's a pretty good deal for the hospitals that have significant uncompensated care, but not for those that do not, like St. Joseph's in Nashua, the only hospital not to agree to the settlement.

Some may believe the deal is too rich and gives hospitals too much, but they need to remember that two superior courts said the MET is unconstitutional and trying to fill a $200 million budget gap every biennium would have been more difficult than the task the state has under the settlement.

Passage in the House and Senate is not guaranteed, but is a good bet when lawmakers gather this week to take a final vote on the deal and about 60 other bills that were negotiated in other conference committees.

Legislative Fallout: The MET settlement agreement will be added to long list of sins that conservative Republicans, like the Republican Liberty Caucus and Americans For Prosperity, will hang on state senators, particularly Republicans, who vote for it and are on record supporting Medicaid expansion and the gas tax.

Groups have already targeted Sens. David Boutin, R-Hooksett, Nancy Stiles, R-Hampton, and Bradley with radio ads for their votes for Medicaid expansion.

The three will face primary challenges. The sign-up period opens Wednesday.grayno@unionleader.com


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