Cindy Rosenwald – Telegraph OpEd

Op-Ed – Nashua Telegraph – April 23, 2017

Destroying NH’s ‘Wait List’

The GOP plan makes it more difficult for developmentally disabled residents

Since 1991, however, we have not always lived up to our obligation to provide the community services that Medicaid authorizes and for which the federal government will pay half. The sad result is that a number of vulnerable individuals have been forced to wait for services when they turn 21.

In 2007, the Legislature finally made good on its promise to eliminate the developmental disability waitlist and fully fund services through Medicaid. This was a great day for New Hampshire.

Over the past 10 years, sadly, the state’s track record has been mixed. From a high of 270 people waiting an average of five months to receive services, the number of people forced to wait in limbo was virtually eliminated.

Then the Great Recession hit, and the 2011-12 budget did not keep up with the demand of disabled adults eligible to receive services. By the next funding cycle, the wait list had ballooned again, reaching an all-time high of 288 individuals who were again waiting months for services.

Over the next four years, increased funding brought the size of the wait list back down temporarily, but now it has swelled again. The Department of Health and Human Services predicts that by June 30, when the current budget cycle ends, 250 individuals with developmental disabilities will be wait-listed due to inadequate state funding.

Gov. Chris Sununu’s budget added a total of $57 million in state and federal funds to the developmental disabilities program. The Department of Health and Human Services believes it is enough to serve most of the individuals who will be in line waiting on July 1. Unfortunately, it isn’t enough to also provide services to the 200 additional residents who will turn 21 over the next two years and qualify for disability services.

According to department figures, the governor’s budget would result in approximately 230 residents on a waitlist by the end of the next two years. Some of these individuals may get some level of services, but some would get none at all, and none would get the full range of services for which they are eligible.

The House budget would have made the developmental disability wait list significantly larger; in fact, it would have been the largest ever, since the legislature declared there would no longer be a wait list at all. This is because the House budget took $7 million of the governor’s recommended $57 million increase and dedicated it to raises for direct service providers. These raises would be essential for attracting and retaining workers. Unfortunately, the House budget did not provide the funding for the raises, so the budget for services would effectively have been $7 million less than as introduced by the governor.

If the House budget had passed, the impact of not funding the raises would be a developmental disability wait list that could reach as high as 380 people by June 2019. That’s 100 more than the highest level we saw during the Great Recession.

During a time when the economy is healthy, it is shameful for us to accept New Hampshire having the biggest wait list for services since before we proudly declared the end of the developmental disability wait list. Let’s hope the State Senate is not as willing as the House Republicans were to turn away from some of New Hampshire’s most vulnerable citizens.

Op-Ed – Nashua Telegraph – January 4, 2017

My Turn: Health insurance in a post-Obamacare world

The Republican-controlled Congress has pledged to repeal the Affordable Care Act, also known as Obamacare. Over the past six years since it became law, the ACA has brought major changes in health insurance laws that ended the worst insurance company abuses.

The effect of this has been important in New Hampshire, so, as we stand on the precipice of the ACA’s potential repeal, it’s a good idea to review the impact of these changes on New Hampshire’s people and consider how we will be affected if the law is repealed.

Perhaps the most important reforms involve the guarantee of insurance coverage. Thanks to the ACA, the 600,000 Granite Staters who have a pre-existing health condition can no longer be denied coverage or charged so much that they can’t afford it. Insurance companies can’t cancel their policies when they get sick or put caps on their coverage. Women can’t be charged more than men simply because of their gender, and young adults can stay covered through their parents until age 26 as they establish their careers. That’s a lot of peace of mind thanks to Obamacare.

The coverage itself is improved as well and has a better overall value. Important preventive services are always covered, such as colonoscopies and mammograms, and insurance companies are regulated on the amount of premium dollars that must go to pay for services, rather than marketing and executive pay. And with mental health services a critical need in New Hampshire, the ACA requires coverage of these services at parity to other medical services.

While the coverage has gotten better, the rate of cost increase for the 850,000 Granite Staters who get insurance through their employer has also slowed by more than a third. And more than 30,000 of us who buy insurance through the individual market qualify for tax subsidies to make the purchase more affordable.

Already more than 20,000 older New Hampshire residents are saving on average more than $1,000 a year on their medications. We must ask ourselves what will happen to this group of Granite Staters when the Donut Hole returns.

The Medicare program itself is also improved by the ACA. An annual exam and essential preventive services are now provided without cost sharing. In 2015, 74 percent of our seniors who are enrolled in Medicare Part B took advantage of this benefit. Medicare also brought payment reforms to hospitals to encourage fewer unnecessary readmissions.

Over the past five years, readmissions dropped 3 percent for New Hampshire’s Medicare beneficiaries, keeping our elders out of the hospital unless really necessary.

Finally, New Hampshire took advantage of the ACA’s Medicaid expansion, bringing health coverage along with mental health and substance abuse treatment access to many Granite Staters for the first time. Over the past two years since the expansion began, 107,000 residents have participated at some point; currently 50,000 people are enrolled. The Medicaid expansion has also brought financial stability to our smaller, rural hospitals since they are now compensated for care they must provide.

Virtually everyone in New Hampshire has felt the impact of the Affordable Care Act, whether they are on Medicare, get insurance through work, through or through Medicaid. For the past few years, they have had higher quality, more transparent coverage that treats them more fairly than in the past.

We can only wonder how Granite Staters will react and suffer when the Trump administration and Republican Congress take these benefits away.

Op-Ed – Nashua Telegraph – Oct 21, 2016

As I talk to voters around my district this fall, I ask them how their family is doing. I’m getting a consistent answer: “Things are OK, we’re doing fine.”

The numbers bear out their sense of confidence. Incomes in New Hampshire are up, unemployment is among the lowest in the country, and more people are working in New Hampshire today than ever before in our history.

At least in some measure, we can attribute our state’s recovery to prudent investments in our people and our infrastructure through the state budget over the past two cycles.

And there was a lot to clean up after the disastrous “O’Brien Budget” of 2011-12, which cut $40 million in general funds and devastated critical programs essential to safe, healthy communities and a vibrant economy.

We all remember the impact of the $40 million budget cuts under former House Speaker Bill O’Brien: downshifts of long term care costs to local property taxpayers, funding cuts to private nursing homes that forced staff reductions and put frail seniors at risk, elimination of the Children in Need of Services program that increased costs to local communities, cuts to hospitals that cost up to 2,000 jobs and brought on expensive litigation, and cuts to public universities and community colleges that drove tuition up. Funding for drug and alcohol prevention and treatment programs was decimated, and now we are faced with more than one drug overdose death each day.

The list goes on, affecting all areas of life in the Granite State.

It has taken several years for us to climb back from the O’Brien budget cuts of $40 million general funds, but we have, and residents of my district are happy with the quality of life in New Hampshire. But that quality of life could be threatened again with the legislature due to be elected next month.

The chair of the powerful House Finance Committee has filed a bill to eliminate the interest and dividend tax, which is paid by wealthier Granite Staters on their investment income. This bill would decrease state revenues by a whopping $187 million. The O’Brien $40 million budget cuts pale in comparison.

If New Hampshire residents didn’t like the impact of $40 million in cuts affecting seniors, individuals with disabilities, college students, property tax payers, and jeopardizing community safety with a rise in drug abuse, what would they think about a budget cut quadruple that size?

Would they want to see drug treatment services decimated again, with drug abuse our No. 1 public health problem? Cuts to snowplowing? Road paving? Nursing home care for our elderly family members?

Voters need to think very carefully about the legislators they choose to send to Concord in November.

If the Republican leadership’s bill passes, what important programs will be on the chopping block?

Will the next Legislature pass a tax cut for the wealthiest people in the state, shifting costs down to hard-working middle class families? New Hampshire can’t afford the risk, especially now that we’ve fought our way back from hard times.

2016 Legislative Summary

Now that the legislative term is nearly over, it’s time to look back on successes and failures and think ahead to what a Democratic majority after the November elections could mean for the residents of New Hampshire.

Under the leadership of Governor Maggie Hassan, we have made major progress towards addressing the state’s number one public health problem — the opioid crisis.  With more than one overdose death each day, our citizens are demanding help from Concord.  The Republican legislative leadership was unwilling to act last fall when Governor Hassan called us back into special session, but we Democrats kept the pressure on, and the Republicans in Concord have been forced to agree to allocate $5 million more to fund substance abuse treatment and supported housing.  We have also successfully passed legislation to require health care professionals to develop comprehensive approaches towards use of opioid medication for pain.  We have not been able yet to increase funding for a successful, focused law enforcement effort to intercept drug dealers, piloted in Manchester, because the Republicans insisted on tacking on an unrelated provision to the bill that would increase costs for state retirees to purchase health insurance.

We are proud of our bipartisan hard work that led to the re-authorization of Medicaid expansion for two years.  Almost 50,000 Granite Staters, with 5,000 in the Nashua area, now have health insurance, many for the first time.  Approximately 2,000 people have been able to gain coverage for substance abuse treatment services from this program.  It’s important to remember, however, that the extension is only for two years, so Democrats will keep pressing for solutions to make the expansion permanent.

Over the past session, Republicans have continued to take aim at public schools and public safety.  Over the objections of Democrats, the Republican majority passed a bill to allow public school funding to be used to send students to religious schools.  And they have twice passed a bill to remove the requirement to obtain a permit to carry a concealed weapon.  We are grateful to Governor Hassan for listening to the voices of law enforcement on this issue and issuing a veto.

In their commitment to lowering taxes for large, out-of-state corporations, the Republicans have continued to downshift more costs to overburdened cities and towns and local property taxpayers.  It’s a shell game designed to make the Koch brothers happy while the rest of us are left to pick up the tab.

The voices of Nashua’s residents, city government and businesses have been united in our request for funding to continue studying the feasibility of commuter rail.  The Republican leadership has turned its back on us, refusing to take the available federal funds that would move the rail project forward.

New Hampshire’s future depends on the prosperity of our working families.  Republicans have steadfastly refused to increase our minimum wage — the lowest in the country.  More than three quarters of New Hampshire workers do not have access to paid sick leave, but the Republicans have refused to consider approaches to expand access, leaving our workers to have to choose between the job they need and the family they love.

Our long term economic prosperity depends on workers finding good paying jobs with good benefits and the ability of employers to hire the skilled, 21st century workforce they need.  Under the Republican legislative majority this term, we have made no progress on this front.  That’s why it’s so important to elect Democratic majorities all the way up and down the ballot this November.  We will be working hard to win, and we hope you will join us on the road to victory.