Cost shifting from the State to the Counties - Granite Grok

Cost shifting from the State to the Counties

Cost shifting, the act of forcing another part of overall government to pay for something it shouldn’t, is one of the hot topic in NH in the race between Jeb Bradley and John Stephen in the Republican Primary  in the Congressional District 1.  A guest blog from John E. Poirier, President and CEO of the NHHCA, speaks to this issue:

Opinion Editorial:  August 22, 2008

John E. Poirier, President & CEO,  New Hampshire Health Care Association

Politics and Truth

Every political season brings claims of qualifications, past successes and promises for a brighter future.  There are always experienced, successful office holders past and present, some experienced at running and some newcomers.  This year’s 1st congressional district has an interesting race on the Republican side. 

There is an experienced former Congressman Jeb Bradley that has shown New Hampshire and the nation who he is and what he will do if re-elected.  And then there is a person who has run unsuccessfully in the past and chosen to pursue the bureaucrat path to office.  John Stephen is using his tenure in New Hampshire government to claim he is a conservative.  In his campaign literature he claims to have “saved” $143 million of taxpayer money.  Some think he is a conservative.  I beg to differ. 

I work for long term care providers including nursing homes.  The great majority of the people in nursing homes, both county and private nursing homes, are paid through the state Medicaid program.  During his tenure as Commissioner, Mr. Stephen intentionally paid the nursing homes less than the amount the legislature had decided nursing homes should be paid.  In other words, Mr. Stephen took it upon himself to override the legislature’s will.

What was the impact of Commissioner Stephen’s decision to override the legislature?

In private nursing homes, people paying privately had to pay more to balance the books.  In county nursing homes, the county taxpayer had to pay more to balance the books.  Either way, someone was paying the bill.  The 10’s of millions of dollars which Commissioner Stephen says he “saved” was actually paid for by others, much of it by county taxpayers.  And to make matters worse, at a time when the State has to count every penny, Commissioner Stephen’s decision not to spend the money which the legislature appropriated kept millions of matching federal funds in Washington, D.C.

When John Stephen chose not to pay these bills, the additional cost did not magically vanish.  Someone else had to pay the bill.  The money came from higher property taxes, higher costs to residents or their families or from nursing home operations.  Stephen will tell you the State paid more to nursing homes during his tenure and that is true.  But it is also true that nursing home costs, as with medical cost generally, escalated significantly more than Medicaid payments during this time. 
Is it conservative to leave money in Washington?  Is it conservative to pass on hidden taxes to citizens and local property taxpayers?  Is it conservative to override the policy decisions of the legislature?

It is easy to save other people’s money.  Claiming that makes you a conservative is disingenuous at best.