Governor, House and Senate Budgets Largely the Same in Health and Human Services Spending

May 2013

Joshua Elliott-Traficante

Note: An earlier version of this report did not include the $1.25 million in the back of the budget cuts made by the House to the Sununu Center. They have been added and the relevant numbers and charts updated accordingly.

Summary: The spending levels proposed for the Department of Health and Human Services (HHS) by the Governor, passed by the House, and proposed by the Senate Finance Committee are actually quite similar. The notable exception to this is the Uncompensated Care Fund, which are payments to hospitals to help pay for charity care. This difference is a result of the Senate Finance Committee correcting Medicaid Enhancement Tax (MET) revenue projections and revising them downwards on the advice of HHS. Uncompensated Care aside, the bottom line numbers, taking into account back of the budget reductions, have the House spending $1.3 billion in General Funds over the biennium and the Senate spending $1.32 billion, a difference of about 1.8%.

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Appropriations for the Department of Health and Human Services, (with the notable exception of the Uncompensated Care Fund,) across the Governor’s Recommended, the House Passed, and Senate Finance Budgets are virtually identical.[i]

The Similarities:

Developmental Services and Behavioral Health are two areas that lawmakers of both parties have traditionally considered the top funding priorities in the budget.

The appropriation  for Developmental Services, which provides for those with developmental disabilities and acquired brain disorders, in the Governor’s Recommended, House passed and Senate Finance Proposed budgets are in fact exactly the same, down to the dollar.

For fiscal year 2014, the Governor’s Recommended Budget, the budget passed by the House and the budget proposed by the Senate Finance Committee all include $138,486,334 for Developmental Service in General Fund spending. Likewise in fiscal year 2015, all three budgets include $148,758,998 for the division.

Behavioral Health, which is the main conduit for mental health spending at the state level, saw only minor differences. The Senate Finance Committee decreased General Fund spending by less than seven hundredths of a percent from Governor’s proposed and the House passed budgets for 2014 and just shy of over six hundredths of a percent for 2015.

The Major Difference: Uncompensated Care and the Medicaid Enhancement Tax

The major difference in the Health and Human Services budget is in the Uncompensated Care Fund line item. The Uncompensated Care Fund is money paid by the state to hospitals to help reimburse the costs of treating poor and indigent patients. The Medicaid Enhancement Tax (MET), together with its federal match, makes up nearly all of the funding for the Uncompensated Care Fund.[ii] Typically it does not contain General Fund spending, however, in Fiscal 2014, there is a onetime infusion of $20 million added by the Senate Finance Committee.