New Hampshire Health Care Ass'n v. Governor
161 N.H. 378
| N.H. | 2011Background
- NHHCA (trade association) and several nursing homes petition about DHHS Medicaid reimbursements in NH.
- DHHS administers Medicaid; rates are set prospectively with per diem components including capital costs.
- Budget neutrality factor (BNF) adjusts reimbursements when state budget is imbalanced.
- Laws 2007, 129:1 created non-lapsing nursing home funds with eventual supplemental payments; Laws 2008, 296:18 allowed lapse if unspent.
- Federal approval for one-time supplemental payment (Nov 2008) tied to 2007–2009 balances.
- Executive Order 2008-10 (Nov 21, 2008) reduced DHHS expenditures by about $8.87 million, eliminating supplemental rates.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether RSA 9:16-b is facially unconstitutional | NHHCA argues it illegally vests line-item veto power in Governor. | State contends RSA 9:16-b is a valid executive tool to balance budgets. | RSA 9:16-b not facially unconstitutional. |
| Whether RSA 9:16-b as applied conflicts with prior legislative mandates | RSA 9:16-b overrides Laws 2007, 129:1 and 2008, 296:18. | Budget balancing mandates prevail; the Governor may adjust expenditures. | Applied correctly; conflicts resolved in favor of balancing budget. |
| Whether Executive Order 2008-10 constitutes a taking | Petitioners had vested rights to supplemental payments. | No vested right; payments were anticipatory, not fixed. | No taking under state constitution. |
| Whether petitioners received due process before EO 2008-10 | Petitioners entitled to due process before expenditure reductions. | No constitutionally protected property interest; due process not required. | Procedural due process not applicable here. |
| Whether EO 2008-10 preempts NH or federal law under Supremacy Clause | EO conflicts with Federal Medicaid Act rate requirements. | No real conflict; rates and methodology remained under NH control. | No supremacy/preemption issue established. |
Key Cases Cited
- Bel Air Assocs. v. N.H. Dep’t of Health & Human Servs., 154 N.H. 228 (2006) (funding and administrative context for NH Medicaid)
- Bel Air Assocs. v. N.H. Dep’t of Health & Human Servs., 158 N.H. 104 (2008) (arguments on budget and budgeting rules)
- O’Neil v. Thomson, 114 N.H. 155 (1974) (separation of powers and executive spending authority)
- American Cancer Society v. Commissioner of Administration, 769 N.E.2d 1248 (Mass. 2002) (executive power to reduce expenditures during deficit)
- Hunter v. State, 865 A.2d 381 (Vt. 2004) (shared powers at budget deficit)
- Opinion of the Justices to the Senate, 376 N.E.2d 1217 (Mass. 1978) (executive spending discretion in balancing budget)
- State v. Kimball, 96 N.H. 377 (1950) (constitutional limit on spending; warrant clause)