New Hampshire Health Leaders See Severe Pressures on Patients, Providers One Year After H.R. 1

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CONCORD, N.H. – One year after the passage of H.R. 1, healthcare leaders joined Protect Our Care New Hampshire today to discuss the negative impacts that federal healthcare policy changes are already having on New Hampshire patients, providers, and communities. This comes as newly released federal enrollment data show that more than 4 million Americans lost their ACA coverage following the expiration of enhanced premium tax credits and sharp premium increases, causing deductibles and out-of-pocket costs to reach record levels.

The briefing focused on healthcare affordability and access to care, as well as the challenges facing rural healthcare providers, community health centers, and other essential healthcare services as a result of the largest cuts to healthcare in history. So far, more than 4,300 Granite staters have dropped their ACA coverage after premiums skyrocketed due to the expiration of the enhanced premium tax credits, and over 16,000 have been kicked off Medicaid and CHIP. This only represents the beginning, as an estimated 32,000 people in New Hampshire total are anticipated to lose their healthcare over the next decade because of the One Big Beautiful Bill Act. Nearly 13 percent of New Hampshire residents currently rely on Medicaid for health coverage.

Speakers noted that the impacts extend beyond individual patients. Coverage losses and funding cuts create significant challenges for hospitals, community health centers, behavioral health providers, nursing homes, and rural healthcare systems that already face workforce shortages and financial pressures.

“It has been a year since the passage of H.R. 1, and this week, the impacts are clear: New Hampshire's Affordable Care Act marketplace is in a period of significant uncertainty,” said Jayme Simões of Protect Our Care New Hampshire. “New national data show that more than 4 million Americans have dropped ACA coverage following the non-renewal by congress of enhanced premium tax credits. At the same time, New Hampshire is experiencing a decline in Marketplace enrollment, with thousands fewer residents covered than a year ago, or 4.1%. The outlook became even more uncertain this week with the announcement that Ambetter Health will exit New Hampshire's ACA Marketplace at the end of 2026, forcing almost 12,000 policyholders to select new coverage for 2027.”

"Once the insurance pool gets smaller, costs go up for everyone. We've already seen insurers respond by leaving the market, making coverage even harder to afford," said Christin H. D'Ovidio, Founder and Principal Consultant of Putney Consulting New England.

"Critical access hospitals were already fragile before these changes. If we don't invest in access to care, that fragility will only increase—and once a hospital closes, it doesn't come back," said Edward D. Shanshala II, Chief Executive Officer of Ammonoosuc Community Health Services. "People are going to have fewer choices at a higher cost. They'll have to make hard decisions between food, gas, child care—and health insurance."

Speakers emphasized that healthcare affordability remains a growing concern for many New Hampshire residents, and urged their elected leaders to reverse course.

"This isn't just about people losing insurance. It's a squeeze on everyone—patients, providers, employers, and communities—and ultimately affects both our economy and our collective health," said D'Ovidio.