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Sunday, July 31, 2011

NH hospitals take umbrage over cuts by Legislature

Kevin Landrigan

Make no mistake about it: the Republican-led state Legislature is now at war with the New Hampshire Hospital Association.

Anyone in the legislative leadership who thought the hospital lobby would try to make the best of a bad situation got conked on the head by a 2-by-4 last week with the 60-page lawsuit filed in U.S. District Court.

The hospitals knew just whom to hire to represent them: the same law firm that successfully sued Gov. John Lynch and the Legislature over its last budget-crunching scheme, taking $110 million in surplus from the Joint Underwriting Association.

And like the JUA lawsuit, Scott O’Connell and Co. from Nixon, Peabody threw the kitchen sink at Health and Human Services Commissioner Nick Toumpas with the initial complaint.

The lawsuit seeks everything from declaring the trailer bill to the state budget null and void to preventing the state from carrying out these cuts in payments to hospitals until the Obama administration decides whether it will approve this latest attempt to amend the state’s Medicaid plan.

In the meantime, hospital executives acted – and quickly – with several announcing layoffs or service cuts and others promising more gruesome details in the coming weeks.

Some of this clearly tries to reveal the actual “harm’’ their lawyers are going to have to argue in court to justify blocking the state’s use of the disproportionate share money to balance the budget.

For better or worse, the medical establishment in New Hampshire has always been a pretty negotiable lot.

During good times and bad, their political response more often than not has been to try to keep things intact and wait for time to improve things.

Obviously, they’ve decided this move was so extreme and so costly that they had to act.

The political response for the time being will be a legal one. Given the stakes, legislative leaders are of no mind to overreact to the lawsuit, at least until their lawyers can get a firm grip on the likelihood of success and the damages that could result.

Besides, even the most fiscally conservative Republican lawmaker can’t look forward to trying to find another $100 million plus in this budget.

There will be plenty of time to pore over those scenarios when and if they become likely.

Shift in power?

The political fallout from the hospital-Legislature fight should be the one that gives the power structure pause.

The New Hampshire medical community has never been a monolith, but many parts have moved together in the past – primarily to help those in power stay there.

When Republicans ran the place, they could count on their support. When Democrats took over with the 2006 elections, the majority money shifted to them.

At various times, the doctors, hospitals, nurses and specialists from eye surgeons and anesthesiologists have all formed political action committees and spread the campaign checks around.

Now what?

However this lawsuit plays out, could some or all of these financially flush groups decide it’s high time to be more deliberate and “surgical’’ in where their money goes?

This wouldn’t necessarily mean the cash swings to minority Democratic campaigns.

What it could mean is less money goes for GOP causes, particularly on the House side, as it provided the impetus for zeroing out all disproportionate share payments to the 13 healthiest hospitals.

Considering the rules

The House Rules Committee will meet Wednesday in Concord to consider legislation for when lawmakers return this fall to take up the remaining Lynch vetoes.

Topping that list is the fix-it bill from Weare Republican Rep. Neal Kurk that makes certain the state budget saves $8.3 million in total spending by reducing state welfare benefits to those already receiving federal Supplemental Security Income.

Right off the bat

There’s another big shoe to drop in the fight over pension reform when the New Hampshire Retirement System Board of Trustees meets Thursday.

This will be the first session for the four new members nominated and already confirmed to the new board, which takes away the labor super-majority that existed on the panel.

It will also be the first opportunity for the reconstituted board to heed the direction of the Republican-led Legislature and to adjust downward those pension rates charged to public employers that come due Aug. 15.

You may recall the retirement reform law (SB 3 and trailer bill to the state budget) required those rates for employers be lowered because all public employees had roughly 2 percent more taken out of their paychecks.

It’s a major focus of the labor coalition lawsuit challenging the retirement law.

Organized labor tried without success to convince a judge to issue an injunction against the retirement board going ahead with those changes.

That lawsuit will be fought out later this fall, with some legal arguments in the case to be filed later this week.

Labor leaders argued that the swap – lower employer rates for higher employee paycheck deductions – didn’t quite cancel themselves out.

Legislative budget writers conceded the point and agreed to set aside $3.5 million more for employers.

Retirement System Executive Director Kim France is scheduled to make a presentation on the recertification and $3.5 million pool issues at the meeting.

$50 million savings

Lynch can put a giant check mark next to one of the biggest challenges he faced in this next two-year state budget.

All that’s left are the important but fully expected votes of the rank and file of three labor unions, and he’ll have in hand the template for saving $50 million in total labor costs.

To be sure, the job of implementing those changes in health care and other benefits won’t be a walk in the park, and you can be sure there will be those who grumble at the labor concessions that have been reached.

State Employees Association President Diana Lacey believes the proposed sharing of incentives for state employee families to remain healthy and higher costs for coverage could be a model for other large employee groups in the state.

That may be so. Whatever givebacks are in the fine print, the health care plan state workers have here will remain in the top tier in the nation.

Out-of-state voting

The son of N.H. House Speaker William O’Brien, R-Mont Vernon, was again in the news over his voting patterns.

The Lewiston (Maine) Sun Journal seized on the case of Brendan O’Brien, who used to be chairman of the Maine College Republicans.

The Sunday Telegraph and other New Hampshire outlets reported he had run as a Republican for a state rep seat in the spring of 2010 and then months later voted back in Mont Vernon in the election where his father won re-election to the House.

The latest flap traces O’Brien’s voting movements and raises the question of why New Hampshire never alerted Lewiston officials that the younger O’Brien had signed up as a New Hampshire voter in the fall of 2010.

Meanwhile, the younger O’Brien told the Maine newspaper that he’s a resident of the Vacation State now.

“There’s no question about it, my residency is in Maine,’’ Brendan O’Brien said.

Just as Speaker O’Brien did here in the last year, Maine Republican Chairman Charlie Webster has mounted a campaign against out-of-state students voting in his state.

The Maine Legislature repealed the same-day voter registration law New Hampshire has had on its books for nearly two decades.

Webster turned in the names of 206 out-of-state students attending state colleges for investigation of possible voter fraud.

The younger O’Brien told the paper he doesn’t share the view voter fraud is one of the top issues facing the state.

“I don’t have strong feelings that there is that much voter fraud going on in that regard,’’ the younger O’Brien said. “I don’t see why it should be an issue in Maine. I think there are bigger issues for the party to focus on.’’

High-profile speaker

Former U.N. Ambassador John Bolton will be the keynote speaker for the September meeting of the Nashua Republican City Committee at the Crowne Plaza Hotel.

The event will include a $55 VIP reception, or $15 for the meeting and Bolton speech.

William O’Brien is enough of a Bolton fan that he asked and will introduce Bolton, a commentator and frequent Fox News contributor.

“His knowledge of foreign policy is a great asset to this country,’’ said Di Lothrop, communications director for the Nashua GOP group.

Kevin Landrigan can reached at 321-7040 or Also, check Landrigan out on Twitter (@KLandrigan) and The Telegraph’s new interactive live feed at