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Federal budget agreement contains windfall for anti-opioid fight

New Hampshire Union Leader

February 10. 2018 6:04PM
House Majority Whip Steve Scalise (R-La.) heads to the House floor before a vote to pass a budget and to end a government shutdown on Capitol Hill in Washington, D.C., Feb. 9, 2018. (REUTERS/Joshua Roberts)

New Hampshire's two U.S. senators said the bipartisan budget deal President Trump signed Friday contains a six-fold increase in federal spending for states to battle the opioid epidemic.

But Sens. Jeanne Shaheen and Maggie Hassan, both D-N.H., said finding out how much this agreement will help New Hampshire win the battle is at least six weeks away.

Congressional budget writers have until March 23 to fill in all the details of the massive spending bill, the passage of which ended a brief shutdown of the federal government early Friday.

Congress approved a 10 percent increase in spending for the Pentagon and domestic agencies - lifting the military budget to $700 billion this year and the domestic budget to $591 billion but appropriators on 12 different committees now get to drill down and make the final calls.

New partisan clashes are expected over sensitive issues such as where the Pentagon will spend its money and whether the Department of Homeland Security might try to get funding for a border wall.

The biggest spending increase in almost a decade has at least one casualty: fiscal restraint.

The nonpartisan Committee for a Responsible Federal Budget projects that the United States will have a $1 trillion budget deficit by next year - extremely high by historical standards - and that it will probably last for years.

"It's fiscally dangerous, but politicians are willing to trade their favorite priorities for someone else's and put it all on a credit card," said Maya MacGuineas, the president of the group.

The 21st Century Cures Act that Congress adopted in 2015 earmarked $500 million a year for programs that address substance abuse prevention, treatment, recovery and law enforcement.

This deal bumps that up to $3 billion for each of the next two years.

In 2017 and 2018, New Hampshire received only $3 million, or the least amount given to the nation's smallest states even though the state ranks in the top three in the country for opioid-related deaths.

"What we know is the formula under 21st Century Cures Act went out based on population and a very small percentage based on mortality rates," Shaheen said during a conference call with reporters late last week.

"We also think there has to be a higher floor so every state gets a minimum amount to fight this epidemic and that would help New Hampshire."

Shaheen said there still needs to be more education among some of her colleagues about the depth of this problem.

"I think we can always put more resources to good use because we know the extent of the problem here in New Hampshire," Shaheen said.

"It's a very good down payment; we want to make sure now that we use it well."

The money should not be sent out as a bigger, blank check for states to spend as they wish, Shaheen said.

"I don't support block granting those funds to the states," Shaheen said. "We know what has been working and we need to make sure we support those efforts."

Shaheen is in a good position to make those decisions as the ranking Democrat on the Senate Appropriations Committee working group that makes recommendations about Commerce, Justice, Science and related federal programs.

The White House will make its desires more clearly known Monday when it releases its 2019 budget.

Shaheen said Trump played little role in bringing about this latest compromise.

"Short of saying there should be a government shutdown, I am not aware of any impact he had," Shaheen said.

The Portsmouth Naval Shipyard and private companies that rely upon defense contracts will do better as this budget deal ends artificial caps on Pentagon spending, Hassan added.

"Having a predictable federal budget is critically important for our military, for all the New Hampshire businesses that contract with our military and other federal entities," Hassan said.

The state's lobby for the nursing home industry is one group that's unhappy with the agreement.

The New Hampshire Health Care Association said the Congressional Budget Office has confirmed this agreement calls for a $3.5 billion cut in home health services and a $1.9 billion cut to nursing home care over the next decade under the federal Medicare program.

The nursing home cuts of $140 million nationwide would begin Oct. 1 while the home health cuts would not begin until 2019.

New Hampshire has the third-largest gap between payments it receives under Medicaid and the cost of nursing home care in the state.

Nursing homes lose money on the 64 percent of their patients on Medicaid and association president Brendan Williams said they remain solvent only by the payments they receive for the 15 percent of patients in nursing homes who are on Medicare.

"New Hampshire has the nation's second-oldest population, and yet, again and again and again, we see our most vulnerable citizens treated as expendable in any budget debate," Williams said in a statement.

"For less than the cost of two F-35 fighters, we could have avoided this October's Medicare cut to vital nursing home care. Where are our moral priorities? Medicaid underfunding has fueled a crisis in caregiver recruitment and retention, and this cruel Medicare cut will only further reduce resources for caregiver compensation."


The Washington Post contributed to this report.

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