North Country Leaders Raise Alarm About Medicaid Cuts and the Future of Rural Health Care in New Hampshire

Concord, NH — July 2, 2025 — Protect Our Care NH convened a virtual roundtable today with three North Country leaders—Ed Shanshala of Ammonoosuc Community Health Services, Raymond F. Bower of Strafford County’s 229-bed Riverside Rest Home, and small-business owner and veteran Bob Tortorice—to examine the mounting threats to rural health care in New Hampshire. The discussion focused on proposed federal cuts to Medicaid and the ACA now moving through Congress. After the Senate approved the “Big Beautiful Bill” by a single vote yesterday, the House will take it up next; if enacted, its deep reductions could jeopardize hospitals, nursing homes, assisted-living facilities, and veterans’ services that rely on these programs throughout the North Country. Today’s panel highlighted what is at stake for patients, providers, and local economies—and what steps communities may need to consider next.

Speakers offered firsthand insight into the day-to-day reality of delivering health care, running a local business, and supporting workforce needs in the North Country. All emphasized the vital role that nearby hospitals and community health providers play in ensuring timely, effective care for residents—especially in emergencies or for those managing chronic conditions.

Edward Shanshala, Ammonoosuc Community Health Services said “If the Senate bill passes, we’re looking at a $500,000 adverse impact on our budget—yet almost no one is talking about what these cuts mean for the entire continuum of care, from assisted living to nursing homes.”

Raymond Bower, Administrator, Riverside Rest Home said “New Hampshire is a 50 percent state on Medicaid—we already pay the highest non-federal share. If Washington pulls funding, rural counties like mine have no cushion to fill the gap for our 100 percent-Medicaid nursing-home residents.”
Bob Tortorice, Veteran and Small-Business Owner said “Roughly one in ten veterans depends on Medicaid, but many won’t enroll because they simply don’t trust the system. Cuts will only deepen that mistrust and leave more vets without care.”

Across the country, up to 338 rural hospitals are considered at risk if Medicaid funding is reduced. In New Hampshire, community leaders worry that cuts could accelerate staff shortages, reduce services, and create new barriers for families, veterans, and older adults who rely on accessible and affordable care close to home. The healthcare of more than 16 million Americans is at risk.

The event underscored the importance of continued investment in rural health infrastructure such as nursing homes and veteran services, especially at a time when providers across the state are navigating economic pressure, staffing challenges, and growing patient needs.
You can watch the full event here, and learn more about the ongoing conversation on rural health care at www.nhhealthcostinitiative.org.

You can watch the full event here, and learn more about GOP threats to hospitals here.