HB 1587-FN – AS INTRODUCED
2010 SESSION
01/09
HOUSE BILL 1587-FN
AN ACT relative to the elimination of non-federally mandated benefits.
SPONSORS: Rep. Renzullo, Hills 27; Rep. Seidel, Hills 20
This bill eliminates all medical assistance benefits not mandated by the federal government.
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Explanation: Matter added to current law appears in bold italics.
Matter removed from current law appears [in brackets and struckthrough.]
Matter which is either (a) all new or (b) repealed and reenacted appears in regular type.
10-2002
01/09
STATE OF NEW HAMPSHIRE
In the Year of Our Lord Two Thousand Ten
AN ACT relative to the elimination of non-federally mandated benefits.
Be it Enacted by the Senate and House of Representatives in General Court convened:
1 New Section; Restrictions on Medical Assistance Services. Amend RSA 167 by inserting after section 4-b the following new section:
167:4-c Restrictions on Medical Assistance Services. Notwithstanding any provision of law to the contrary, medical assistance services for eligible recipients, including chronically needy public assistance recipients, shall be limited solely to those medical assistance services required to be provided by federal law or regulation.
2 Effective Date. This act shall take effect January 1, 2011.
LBAO
10-2002
12/08/09
HB 1587-FN - FISCAL NOTE
AN ACT relative to the elimination of non-federally mandated benefits.
FISCAL IMPACT:
The Department of Health and Human Services states this bill would decrease state expenditures by and indeterminable amount, and have an indeterminable fiscal impact on county and local expenditures in FY 2011 and each year thereafter. This bill would have no fiscal impact on state, county, and local revenue.
METHODOLOGY:
This Department of Health and Human Services (DHHS) states this bill would eliminate all medical assistance benefits not mandated by the federal government, effective January 1, 2011. The Department states optional services presently offered under New Hampshire Medicaid include: outpatient hospital for mental illnesses; mental health centers; prescription drugs; medical support in the home and durable medical equipment; ambulance services; wheelchair van services; audiology services; optometric services (eyeglasses); psychology; private duty nursing; physical therapy; speech therapy; occupational therapy; podiatry; medical services clinics; personal care; day habilitation; adult medical day care; chiropractic services (to be eliminated effective 1/1/10); crisis intervention; intensive home and community services; child health support services; home based therapy; placement services; private non-medical institutions for children; Intermediate Care Facility for the Mentally Retarded (ICF/MR); inpatient psych facility for individuals under 22 years of age; school based services; home and community based care (HCBC) waiver services (including the Choices for Independent waiver, Acquired Brain Disorder waiver, In-home supports waiver, and Developmentally Disabled waiver).
The Department states state plan services are subject to a 50/50 state/federal match, and long-term care services provided under HCBC waivers are subject to a 50/50 county/state match. The Department states in FY 2009 approximately $314,201,102 was expended on state plan services, of which 50% or $157,100,551 were state general funds. Approximately $232,090,525 was expended on long-term care services, of which 50% or $116,045,262 were county funds. Based on the previous estimates, total federal funds expended on both state plan and long-term care services in FY 2009 totaled approximately $273,145,813 ($157,100,551 for state plan services + $116,145,262 for long-term care services). The Department assumes state general fund, county, and state restricted (federal) expenditures would decrease by these amounts in FY 2011 and each year thereafter, recognizing that the FY 2011 impact would be reduced due to the bill’s effective date of January 1, 2011. The Department states elimination of a Medicaid funded service does not similarly eliminate the need or demand for the service. The Department assumes that demand will increase for local welfare assistance under RSA 165, thus potentially increasing local expenditures. Similarly, if HCBC services are eliminated, the Department assumes that demand for institutional care will increase with a corresponding increase in spending. It is not clear that the current universe of long-term care facilities could absorb all the individuals presently served by HCBC waivers. This shift of community based care to institutional care would likely erase any county based savings and increase overall costs to counties. The exact fiscal impact cannot be determined at this time.