Please read and respond. Fiscal Chair Rep. Neal Kurk, Weare, 529-7253, neal.kurk@leg.state.nh.us is a target (all are listed below) and one of Goffstown’s re-elected reps.

The following Alert has been requested by NH CAN Partner Children's Alliance of NH:

What: A vote by the legislature's Joint Fiscal Committee on whether to authorize Dept. of Health and Human Services John Stephen to begin negotiations with the federal government on the "GraniteCare" proposal that would dramatically restructure NH's Medicaid and Healthy Kids programs.

When: Next Tuesday, Nov. 23, at 9 a.m.

Action needed: Contacts to targeted Senators and Representatives (list at bottom of this message), requesting that they delay this vote by supporting a Motion to Table action on the GraniteCare proposal.

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What you need to know: Many important questions remain about the GraniteCare proposal Stephen presented to the Joint Fiscal Committee last week. (The 72-page proposal in PDF format, as well as the PowerPoint presentation with which Stephen presented it, are available on the DHHS Website.
The plan would create health service accounts for the medical needs of children and pregnant women whose family incomes are as low as $25,070.50 for a four-person family.

Each person's budget would contain two accounts. One would cover a list of preventive services, including regular physician and dental visits, immunizations, and prenatal care for expecting moms. The second account would be used for non-emergency services; the amount in it would be predetermined and capped.

Persons who don't have a primary care physician would be assigned one. Hospital and emergency care, and people with acute or chronic disease would be covered by a separate fund.
The Health Services Accounts proposal creates includes two levels of incentives for families. Families or women who fulfill their
prevention requirements and meet health and wellness targets set by their primary care physician would receive vouchers that could be used for "wellness related activities," defined in the proposal as "child care, housing, transportation and/or education." Families or women who meet their prevention goals but don't use their entire non-emergency account budgets would receive vouchers that could be used for wellness-related activities, including "summer camp for a child, and any other activity as determined by the legislature."

The Children's Alliance has several concerns about GraniteCare's Health Service Accounts:

1. These accounts are an untested scheme that would move children out of New Hampshire's successful Healthy Kids health insurance program, which was recently praised as a national model by U.S. Senate Majority Leader Bill Frist.
2. Awarding vouchers to families who don't spend all of the money in the non-emergency account creates an incentive for low-earning parents to forego routine health care for their children. Any incentives should reward those who seek appropriate care for their children.
3. DHHS proposes that the Legislature consider paying for the preventive incentive by using Temporary Assistance to Needy Families (TANF) funds. TANF funds should be used for job training, child care, education and other services that help families achieve self-sufficiency.
4. Consumers who have used all of the funds in their accounts will receive drug discount cards that can be used to buy prescriptions at participating pharmacies. Families in this income bracket do not have the income even to buy discounted drugs. Some will forego medicine their children need.

Tuesday's vote will be on whether to grant Stephen "authorization to begin negotiations with and seek to gain approval from the U.S. Department of Health and Human Services for waivers re: N.H. Medicaid program as outlined in GraniteCare plan." We are asking the Fiscal members who have not publicly committed their vote to postpone the decision by supporting a "Motion to Table" the vote.

Talking points:

1. The GraniteCare proposal is flawed and contains incentives that could harm, not help, children. (See points 2 and 4 above).

2. NH Healthy Kids is a very successful program that shouldn't be tinkered with. (See point 1 above).

3. Now that a specific GraniteCare proposal exists, there should be time for meaningful public discussion before it moves forward (use any or all of the numbered concerns above to support the need for discussion).

4. Moving forward on this without the approval of the incoming Governor and legislature will waste time and may be counterproductive.

What you can do:

Before Tuesday, please contact as many of the Fiscal members below as possible.

Fiscal Chair Rep. Neal Kurk, Weare, 529-7253, neal.kurk@leg.state.nh.us

Rep. Joe Stone, Deerfield, 463-8309, joe.stone@leg.state.nh.us

Rep. Bev Rodeschin, Newport, 863-1941, no e-mail

Rep. Edwin Smith, Hinsdale, 256-6133, no e-mail

Senate President Sen. Tom Eaton, Keene, home-352-8887, office-271-2111, thomas.eaton@leg.state.nh.us

Senate Majority Leader Sen. Bob Clegg, Hudson, home-880-6193, office-271-2106, robert.clegg@leg.state.nh.us

Thank you for raising your voice for children!

Public Policy Director
Children's Alliance of NH
2 Greenwood Ave.
Concord, NH 03301
(603) 225-2264
fax: (603) 225-8264
svarnum@childrennh.org