New Hampshire Legislative Session Roundup

The state made solid reforms this session, tapping some new revenue to address the budget crisis, making needed reforms in health care, and notably becoming another state to approve gay marriage legislation.

Budget:  Lawmakers made some tough decisions to fill a $500 million deficit and pass an $11.6 billion budget.  Budget cuts include $25 million pulled from the state workforce, resulting in 250 lost jobs and 18 mandatory furlough days for the unionized state workforce, $27 million in retirement system contributions and $50.4 million in state/municipal revenue sharing. To raise revenue, lawmakers increased the state cigarette tax by 45-cents, which has an added benefit of reducing smoking rates,and raised various other fees and taxes on tolls, rooms and meals, auto registration, and a 10% tax on gambling winnings exceeding $600.  Another part of the deficit fix was tapping $110 million from a state created medical malpractice insurance pool that is funded from doctor's premiums.  A Superior Court judge, however, ruled this was not allowed and returned the funds to the pool.  Governor Lynch has indicated he will appeal the decision to the State Supreme Court, but if it holds lawmakers will need to find the funds elsewhere.

Health Care:

  • Public Option for Young Adults:  In a small but notable step to improve access to health care, lawmakers approved SB115 to allow uninsured young adults from ages 19 to 25 and with incomes below 400% of poverty to purchase coverage through the state's CHIP program.  The option, a form of public option, will soon be available to 21,000 young adults, who will need to pay the full premium.
  • Hospital Errors:  Joining a growing trend across states, lawmakers passed HB592 to require hospitals and ambulatory surgical centers to report to the state any of 28 avoidable adverse medical events, and include analysis of the cause of the error and a corrective action plan.  Similarly, HB433 was enacted allowing the state to assess hospitals a fee to fund the hospital-acquired infection reporting program.  HB40 was also enacted to require the state to create rules listing requirements for reporting infections.  Lawmakers originally passed legislation requiring hospitals to report infections three years ago.
  • Uninsured Data:  To improve understanding of the uninsured, lawmakers passed SB147 to require hospitals and community health centers to submit data to the state on care provided to uninsured patients.  Lawmakers hope the new reporting law will inform them and providers about the needs of the uninsured, the ability of the existing safety net to meet their needs, and the impact of the uninsured on 
  • Billing:  Lawmakers passed SB188 to create a commission to study the billing practices of hospitals and hospital-owned facilities. 
  • TelemedicineSB138 was enacted to require insurers to reimburse providers for consultation provided through telemedicine, as long as the service would have been covered by the insurer if it was provided in person.
  • Medical Records and Privacy:  New Hampshire has been a leader in patient privacy.  This year lawmakers passed HB542 to to advance the creation of a Health Information Exchange to allow for the secure sharing of medical records among providers. The legislation will enable the state to access a share of the federal stimulus' $20 billion set aside to promote health information technology.  The bill includes important privacy protections, such as allowing individuals to opt-out of the Exchange and preventing the use of medical records for non-medical purposes, such as marketing and other commercial purposes.  Additionally, lawmakers passed HB619 to give patients greater control over the use of their medical information for non-medical uses, such as marketing.  The bill will require marketing entities to seek consumers' opt-out of marketing restrictions before material is disseminated.

Gay Marriage:  Notably, New Hampshire became the sixth state to legalize same-sex marriage, and the third to do so by legislative action, rather than court decree, following Vermont and Maine.  The law includes certain exceptions for religious institutions.

Environment:  Lawmakers passed a number of bills, including two water ecosystem billsHB350 bans the use of phosphorus in all household cleaning products, including dishwashing detergent where it is abundant.  Phosporus is a leading water contaminant and encourages the growth of algae and invasive plant species.  SB134 amends the Comprehensive Shore Land Protection Act to make it more efficient and effective. Some of the changes include lessening the approval time and amount of paperwork required for small projects and creating a single inventory list of all of New Hampshire's water bodies so people don't have to consult several sources.

Public Education:  In the mid-90's, the State Supreme Court ruled that the state's school funding and administrative practices were not providing adequate public education across the state and were therefore unconstitutional.  The ruling resulted in a 15 year process to define an adequate education, determine and fund the cost, and create accountability measures.  SB180, dubbed the accountability bill, is the fourth step in this multi-year process and requires schools to prove they are providing an equal and adequate education to students in 12 specific areas, including math, science, and language.  The bill includes accountability methods for school districts and measures for the state Department of Education to determine if schools are providing an adequate education.  Schools can show adequacy in two ways, by meeting specific standards or by showing students are meeting academic goals based on various performance measures.  Elsewhere, lawmakers voted to extend a moratorium on new state-authorized charter schools.

Unemployment:  Taking advantage of $21 million in federal stimulus funds, lawmakers extended unemployment benefits and worked to shore up the state's unemployment trust fund which was set to become insolvent in early 2010.  Lawmakers also raised employer contributions to the trust fund over the next three years.  In related action, lawmakers passed a bill requiring firms with 75 or more full-time employees to give workers and the state 60 days notice of an impending layoff or closure

Missed Opportunities:

  • Death Penalty:  The Senate failed to follow the House and did not vote on a bill to abolish the death penalty in New Hampshire.
  • Medical Marijuana:  Legislators passed, but the Governor vetoed, a law that would have made New Hampshire the 14th state to offer some form of medical marijuana.  The bill, the result of bipartisan compromise, created a narrowly defined distribution system for small amounts to alleviate pain for patients with acute or terminal medical conditions.  Despite not allowing home-grown marijuana, as other state medical marijuana laws allow, Governor Lynch vetoed the bill saying it lacked sufficient oversight of what would have been three "compassion centers", staffed by workers who passed background checks, to grow and dispense marijuana to registered patients.  Advocates say the law would have been the strictest in the country.