4 hours Ago
FOR DECADES, New Hampshire has partnered with hospitals to help finance our state’s Medicaid program. The premise is quite simple. Hospitals agree to pay a statewide assessment called the Medicaid Enhancement Tax (MET).
The state more than doubles that MET revenue via a federal match. In return for paying the MET, hospitals receive disproportionate share payments (DSH) to partially offset losses from uncompensated care, while the state uses the remaining funds to support the Medicaid program. That system has served patients and the state well but beginning last year the state began to keep more money for itself, at the expense of our patients and health care.
The state’s action breaks faith with the original partnership with hospitals and undermines our ability to protect access to care and ensure Granite Staters are able to get the care they need, when and where they need it. That is why the New Hampshire Hospital Association (NHHA), Dartmouth Health and their affiliated hospitals, along with Concord Hospital Health System, have filed a lawsuit challenging the constitutionality of the Medicaid Enhancement Tax. Over the past several months, the NHHA and hospitals have been negotiating with the governor’s office to find a resolution to the MET/DSH program.
Hospitals made clear throughout these discussions that April 15th, the due date for hospitals to pay the MET, was the deadline for reaching an agreement. With no meaningful offer from the state, hospitals had no choice but to file this lawsuit to protect important health care services for all patients. Although two previous state superior courts have ruled the MET unconstitutional, hospitals have voluntarily agreed to pay the tax over the last decade under two settlement agreements, which outlined a fair solution for hospitals that ensured access to patient care, a strong health care system for all Granite Staters and enhanced financial support for the Medicaid program.
Those agreements have now expired, and we have been attempting to negotiate a new agreement with Governor Kelly Ayotte’s office. Over months of good faith negotiations, hospitals have offered fair and reasonable proposals that would have delivered substantial additional revenue to the state and the Medicaid system that could be used to invest in mental health, substance misuse or other critical health care services. Unfortunately, the state has not offered a fair or reasonable proposal and no resolution has been reached.
The governor’s budget embraces the punitive funding cuts to hospitals put in place by the prior administration. If enacted, hospitals would face a significant tax increase, and they would lose $70 million annually at the expense of patient care in local communities. Make no mistake, increasing the tax burden on hospitals will have negative consequences for patient access to care and is not a viable path forward.
This year, the MET is expected to generate $348 million. That funding will be used to bring $485 million in additional federal funding to New Hampshire to support the state’s Medicaid program. Without a new agreement, the state would have to look to the general fund to finance the Medicaid program.
Hospitals did not choose to file this lawsuit until it became clear that there was no other option left. But we did so with great resolve to protect access to care for patients across the Granite State. Hospitals remain committed to finding a fair and equitable solution that will protect and support access to patient care.
New Hampshire residents count on their hospitals to be there for them. Now is the time to come together and ensure our health care system remains strong — for every hospital, and every patient who depends on it..
