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New Hampshire Bulletin

10 stories

State Policy·NH·2d ago

New Hampshire Delays Medicaid Premiums Pending Federal Approval

New Hampshire has not implemented its new Medicaid premium system, which was due to start July 1, because it still lacks required federal approval, according to a Department of Health and Human Services spokesperson. State officials have flagged since January that the premium structure may conflict with the federal cost-sharing program created by the One Big Beautiful Bill Act (H.R. 1), which caps enrollee charges at $35 per service and takes effect in October 2028. Under the state plan, premiums would range from $60 to $270 monthly based on household size and income, up to 255% of the federal poverty level. Democratic lawmakers are citing the unresolved federal conflict to push for scrapping the premium system entirely, while Gov. Kelly Ayotte's administration has defended it as necessary to sustain generous eligibility limits.

State Policy·NH·5d ago

NH Committee Recommends Overhaul of Disability Abuse Reporting System

New Hampshire's System Review Committee finalized recommendations to reform the state's oversight of developmental disability care, following a Bulletin investigation that found hundreds of abuse and neglect incidents in the taxpayer-funded, privately-run care network. Key proposals include a centralized complaint intake system, a single designated lead agency for investigations, a 24/7 reporting hotline, a new 'inconclusive' finding category for investigators, a public education campaign on reporting obligations, and unannounced facility visits. The recommendations target the state Department of Health and Human Services, which currently splits oversight across multiple siloed offices including Medicaid Program Quality, Adult Protective Services, and Licensing and Certification. No implementation timeline was specified in the recommendations released Thursday.

State Policy·NH·17d ago

New Hampshire ACA Marketplace Enrollment Falls 8% After Enhanced Premium Tax Credits Expire

New Hampshire saw 4,868 fewer residents enrolled in ACA Marketplace plans in 2026 compared to 2025, an 8% decline, following the December 2025 expiration of Enhanced Premium Tax Credits. Nationally, enrollment dropped from 21.8 million to 19.2 million. The analysis by KFF used effectuated enrollment data, which reflects both non-enrollment and coverage loss due to non-payment of premiums. The decline coincides with broader federal Medicaid cuts under the One Big Beautiful Bill Act and new state Medicaid premium requirements in New Hampshire, raising concerns among community health providers about access to primary care and emergency department utilization.

Federal Policy·19d ago

Maine Democrat Says Republicans Expect Future Congress to Restore Medicaid Cuts

Rep. Chellie Pingree (D-ME) reported that some Republican colleagues privately expect Democrats to reverse Medicaid cuts enacted by the current GOP majority. The comments, made over the weekend, suggest internal Republican divisions over health spending reductions already implemented. No specific cuts or timeline for potential restoration were detailed in her remarks. The statement highlights ongoing partisan disagreement over Medicaid funding levels ahead of future budget and appropriations cycles.

State Policy·NH·33d ago

New Hampshire Disability System Records 21 Abuse Cases, 30 Deaths in First Half of 2026

State records show 21 confirmed cases of sexual, physical, or emotional abuse and 30 deaths occurred in New Hampshire's state-run intellectual and developmental disability care system from January through June 2026. The system, which contracts with private agencies to serve people with disabilities including autism and cerebral palsy, received 280 reports of abuse, neglect, or exploitation during this period; state investigators deemed 75 credible, with 88 investigations still incomplete. The data indicates continued systemic problems nine months after a media investigation documented widespread abuse and neglect in the program, which serves Medicaid-funded LTSS beneficiaries.

State Policy·NH·34d ago

New Hampshire Child Food Insecurity Rises to 15.5% in 2024

Child food insecurity in New Hampshire increased from 36,160 children (14.5%) in 2023 to 38,430 children (15.5%) in 2024, according to Feeding America's Map the Meal Gap report. Coös County experienced the highest rate at 22.1% of children food insecure, while Rockingham County had the lowest at 11.6%. The state remains below the national average of 19.5%. Data on the impact of 2025 federal SNAP restrictions—including tighter work requirements, benefit reductions, and migrant eligibility changes enacted through the One Big Beautiful Bill Act—will not be available for several years due to federal reporting delays.

State Policy·NH·34d ago

New Hampshire Food Insecurity Rises as Federal SNAP Cuts Take Effect

Food insecurity in New Hampshire increased from 10.7% to 11.7% of residents between 2023 and 2024, with child food insecurity rising from 14.4% to 15.5%, according to Feeding America's annual report. Federal SNAP restrictions enacted in the July 2025 One Big Beautiful Bill Act — including work requirements, migrant benefit bans, and funding caps — are now taking effect on a rolling schedule. Food bank officials report rising demand, increased costs, and declining donations, with particular concern about homeless students and working families unable to afford food despite employment. The federal Food Security Survey was canceled in 2025, eliminating the primary data source for tracking hunger trends.

State Policy·NH·82d ago

New Hampshire Enacts Budget With Medicaid Copays, Premiums, and DHHS Cuts

In June 2025, Governor Kelly Ayotte signed New Hampshire's two-year budget cutting $51 million from the Department of Health and Human Services and imposing new Medicaid copays and premiums on certain recipients. The budget also reduced Department of Corrections funding by $10 million and cut support for the state university system. The policy changes affect Medicaid beneficiaries and state health services delivery. Managed care organizations operating in New Hampshire will need to implement the new cost-sharing requirements and adapt to reduced state DHHS capacity.

Legal·NH·86d ago

Federal Trial Set for November on New Hampshire LTSS Program ADA Compliance

A federal judge has scheduled a November 2026 trial to determine whether New Hampshire's Choices for Independence program violates federal law by failing to provide adequate home and community-based services for elderly individuals and people with physical disabilities. The case centers on allegations that the state's LTSS program forces beneficiaries into institutional settings in violation of the Americans with Disabilities Act and the Supreme Court's Olmstead decision. The trial outcome could establish precedent for evaluating HCBS adequacy and state compliance with federal integration mandates. U.S. District Judge Paul Barbadoro will hear evidence on whether the program meets federal standards for community-based care.

State Policy·NH·86d ago

CMS Approves New Hampshire $205M Rural Health Transformation Spending Plan

CMS approved New Hampshire's spending plan for approximately $205 million in federal Rural Health Transformation Program funding awarded in late 2025. The GO-NORTH initiative will fund rural health infrastructure and service delivery improvements across the state. The approval allows New Hampshire to begin deploying federal dollars for rural provider support and access expansion. Medicaid managed care organizations operating in rural New Hampshire counties should anticipate changes in provider networks and potential care delivery model shifts as these federal investments take effect.

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