New Hampshire nursing homes could lose $7 million in expected Medicaid reimbursements as part of a plan to close a $58 million budget hole in the state's Department of Health and Human Services.
"We don't have a whole lot of options," department Commissioner Nick Toumpas told lawmakers Friday.
Members of a joint legislative fiscal committee strongly opposed the cuts, but the changes do not require approval from legislators.
"We have got to find a different way to help you satisfy this shortfall without taking it out on these old folks," Sen. Andy Sanborn of Bedford said.
Health and Human Services' $58 million shortfall is largely due to an increase in the number of children eligible for Medicaid, administrative costs from implementing New Hampshire's Medicaid expansion plan, and the state's settlement of a lawsuit over mental health services.
Toumpas presented about $45 million worth of reductions Friday, including the cut to nursing homes and $9 million in savings from not filling vacant positions. There is no plan yet for the remaining $13 million budget gap.
The Department of Health and Human Services accounts for nearly half of the state's two-year, $10.7 billion budget, which ends June 30. Gov. Maggie Hassan is drafting a proposal for the next budget.
Lawmakers were only concerned Friday about the nursing home cuts.
Each year, money not spent from the budget for nursing homes and home care services goes back to the providers through increased Medicaid reimbursement rates, which lawmakers believe is required. But Toumpas wants to use this year's amount, $7 million, to help plug his department's shortfall. Hassan's office has approved the plan.
"Their surplus money from 2014 would have gone to increased rates and payments, and while extremely worthwhile, it would be hard to justify cutting the existing services or rates to pay for rate increases," said Hassan's spokesman, William Hinkle.
Nursing homes have been expecting the money. For the Merrimack County Nursing Home, the change means about $500,000 less in funding, administrator Lori Shibinette said.
"Either I cut programs or I take a reduction in my revenue line, and the county goes back to the taxpayers," she said.
Several Republican lawmakers say they've heard from nursing homes this week that are concerned about the cuts, and officials from public and private nursing homes say they were unaware of the changes until this week.
"The idea that we've been in discussions about this just is simply not true," said John Poirier, president of the New Hampshire Health Care Association.