More than 2,100 new patients signed up with New Hampshire’s Therapeutic Cannabis Program last year, bringing the total registry to nearly 17,000, according to new state data.
That increase — about 14.5% from the year prior — is the largest since 2021.
Likely driving the growth were changes to state law in 2024 that allowed more people to qualify for medical marijuana use. They can now join the program at doctors’ discretion — which covers any debilitating or terminal condition or symptom, as long as their medical provider agrees the benefits of cannabis could outweigh the risks — or with a diagnosis of generalized anxiety disorder.
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More than 900 patients list anxiety as their qualifying condition, according to the report issued this week by the state Department of Health and Human Services, which oversees the program.
“There was certainly an uptick in growth after those bills took effect in late 2024. It hasn’t skyrocketed, but has somewhat accelerated the growth of the program,” said Matt Simon, a lobbyist for GraniteLeaf Cannabis, one of three licensed cannabis providers in the state. “Where we’ve been, this extremely tiny program that was tiny for years, it is steadily growing.”
With 16,846 people, about 1.2% of the population are either certified patients or designated caregivers, who are authorized to buy cannabis on behalf of a patient. That’s close to one in every 84 Granite Staters.
The data released by the state was collected in June 2025. Simon estimates roughly 1,000 more people have joined since then.
The Therapeutic Cannabis Program, established in 2013, is the only way to lawfully consume marijuana in New Hampshire, as recreational use remains illegal. Patients require a doctor’s approval to join and receive a state-issued card that licenses them to buy medical cannabis products from seven dispensaries across the state, operated by three producers: GraniteLeaf Cannabis, Sanctuary Medicinals and Temescal Wellness.
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The new data comes as the Trump administration reclassified medical marijuana last month as a less dangerous drug, effectively legitimizing programs run in 40 states, including New Hampshire’s. The change opens the door for more cannabis research and potential tax breaks for producers.
NH Therapeutic Cannabis Program patients by municipality Credit: NH Department of Health and Human Services
In New Hampshire, program demographics skew older. Nearly a quarter of patients are between 55 and 65 years old, and almost 70% of patients are over the age of 45. Pain is far and away the most common condition that people aim to treat with cannabis.
Patients are concentrated in southern New Hampshire and in towns where dispensaries, also called alternative treatment centers, are located. There are seven across the state in Chichester, Conway, Dover, Keene, Lebanon, Merrimack and Plymouth.
Concord has between 300 and 734 patients, according to the state data. Manchester has the most patients out of any municipality, at 1,150.
Despite the program’s growth, cost and accessibility remain a challenge. Jerry Knirk, a retired surgeon and state representative who now chairs the state’s Therapeutic Cannabis Medical Oversight Board, said New Hampshire’s strict regulatory environment plays a role.
“Part of the issue is we have a very high-quality, highly regulated program with testing of all products and lots of restrictions and things, and that does make things more expensive, but it’s how you keep the quality to be really high,” Knirk said. “We want to have really good quality. Unfortunately, it does make it a little bit harder.
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One family of three spent $548 after discounts on a six-week supply of their medicine, which they use for chronic pain and other ailments, the Monitor reported last year.
Limited retail locations also mean that in some parts of the North Country, patients must drive upwards of an hour to obtain their medicine.
“The lack of dispensary locations, well, yeah, that is a problem,” Knirk said.
The oversight board, joined by other advocates, has pushed for laws to alleviate those concerns. Some of the biggest include allowing patients to grow their own medicine at home and letting dispensaries use outdoor greenhouses to cut down on electricity costs.
That legislation is introduced in the State House almost every year but is often torpedoed by Republicans’ concerns over security protocols.
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While advocates expected little movement on marijuana policy under Gov. Kelly Ayotte, who opposes legalizing recreational use, the bill to allow greenhouse cultivation is nearing the finish line this session. Former governor Chris Sununu vetoed a similar bill two years ago; Ayotte hasn’t indicated whether she’d sign it.
Simon said that while cost and accessibility are still challenges, patient satisfaction with the program is improving.
“We started in a tough place with a lot of people really not liking the law and the program,” he said. “I think it’s been steady growth and steady improvement. Prices have come down somewhat, and the vibes are better.”
‘New Hampshire Outright’ began more than 30 years ago, founded by a group of parents at the University of New Hampshire. It’s the only LGBTQ+ organization in the state with a dedicated focus on young people, their allies, and their families.
ERROL, N.H. (WHDH) – One person is dead and five others have been hospitalized after a head-on crash in Columbia, New Hampshire on Friday night, officials said.
Officers responding to a reported crash on Route 3 around 9 p.m. determined a Chevrolet Silverado heading southbound was struck head-on by a Chevrolet Camaro that was heading northbound and crossed the centerline, according to New Hampshire State Police.
Two adults and three children in the Silverado were taken to Upper Connecticut Valley Hospital in Colebrook. Two had non-life-threatening injuries and three had life-threatening injuries. All five were later transferred to Dartmouth Hitchcock Medical Center.
The driver of the Camaro, Courtney Diamond, 25, of Pelham, New Hampshire, was pronounced dead at the scene.
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Anyone with information that may assist in the investigation is asked to contact Trooper Jacob Ingerson at (603) 846-3333 or Jacob.J.Ingerson@dos.nh.gov.
(Copyright (c) 2026 Sunbeam Television. All Rights Reserved. This material may not be published, broadcast, rewritten, or redistributed.)
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Recently published data reflect the ongoing increases in the price of child care and decreases in access to care in New Hampshire, placing additional economic strain on Granite State families seeking affordable and high-quality care for their children. The price of child care for a family with an infant and a four-year old seeking center-based care averaged about $30,000 in 2025, up from $22,500 in 2017, while the number of licensed center and home-based child care providers has declined by 120 since 2017.
The national organization Child Care Aware of America (CCAoA) released its 2025 annual report on May 13, 2026. The report outlines the state-by-state early childhood education landscape, including both the price of care and provider supply within each state. In New Hampshire, these data were collected through the CCAoA’s New Hampshire Child Care Resource and Referral Agency and the New Hampshire Department of Health and Human Services (DHHS). Together, these data provide valuable, and updated, insights into the state’s early childhood care landscape and the challenges Granite State families face in accessing and affording child care services.
Rising price of early childhood education in NH
Based on analysis conducted by CCAoA, the average price of child care in New Hampshire in 2025 remains high for Granite State families. The average price of care for an infant and toddler in center-based care was $16,462 and $15,262, respectively, in 2025. For home-based care, the 2025 average price was $12,017 for an infant and $11,732 for a toddler. Furthermore, for a family with an infant and toddler making approximately the median income for a married couple with two children under age 5 in New Hampshire, the price of center-based care for their children would amount to approximately 25% of their family income. This financial burden is even greater for a single or unmarried mother, earning the median income of approximately $52,000 in New Hampshire, as paying the full average price of center-based child care for an infant and toddler would consume 61% of family income.
Additionally, these prices in care have increased substantially over time. From 2017 to 2025, the average enrollment price of center-based care and home-based care increased 32% and 30%, respectively. The largest increase in tuition prices during this period was 33% for toddlers and 4-year-olds in center-based care, as well as for 4-year-olds in home-based care. These increases in tuition prices outpaced inflation during the same period.
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For many Granite State families, the price for child care tuition will represent their greatest annual expense, particularly for families with multiple children and those living in rural regions of the state. According to Economic Policy Institute’s Family Budget Calculator, a family with two adults and two children living in Coos County, the New Hampshire county with the lowest cost of living, would spend on average 2.5 times more for center-based care for an infant and toddler than they would on housing. As affordability challenges and the overall cost of living continue to rise, some families may have to contend with difficult tradeoffs among essential household and family expenses, including child care services.
Although care for infants and toddlers are often the most expensive forms of care, child care-related expenses do not end once children enter kindergarten. Many families continue paying for before- and after-school programs, summer care, and school vacation coverage for years afterward. As a result, the costs outlined in this analysis likely represent only one portion of the broader child care expenses many Granite State families face.
Childcare supply challenges persist
While the price of child care tuition in New Hampshire remains high, the number of licensed providers has declined over time. The CCAoA’s report indicated that, in 2025, there were 613 licensed center-based programs and 104 home-based programs across New Hampshire. However, since 2017, the number of licensed center-based and home-based programs decreased by 10% and 32%, respectively. The greater closure rate in home-based programs across the State may have a disproportionate impact on families with low and moderate incomes seeking more affordable care options, as well as families in rural regions, communities of color, and families seeking non-traditional hour care, who rely more on this type of care to fill the gaps in available care from other providers. This decrease in number of providers, particulars those in home-based settings and in rural regions of the State, has likely placed further strain on family’s access to care, as they may have to travel longer distances for child care services.
Alongside the overall decline in child care providers during this period, the number of center-based programs participating in the New Hampshire Quality Rated Improvement System, or Granite Steps for Quality (GSQ), a statewide program designed to assess and improve the quality of care services in early childhood education settings, has decreased 16%. Of the remaining 99 providers that participated in the GSQ in 2025, only four reached the highest level of quality, or step 4 of the GSQ. These findings suggest that, as families navigate New Hampshire’s shrinking child care supply landscape in the State, they are encountering fewer options that offer recognized high-quality care services.
Families and providers continue to face growing financial pressures
The average tuition prices reported in the CCAoA’s analysis of the New Hampshire Early Childhood Education landscape do not necessarily reflect the cost of care all families pay for enrollment, or the cost providers pay for delivery of care services. Many families with low and moderate incomes qualify for the New Hampshire’s Child Care Scholarship Program (NHCCSP), a federal-State fiscal partnership that helps Granite State families afford child care through a tiered voucher system. Families who are eligible to participate in the NHCCSP may pay a weekly “cost share” of anywhere from $0 to 7% of their family income, with different tiers of eligibility depending on those family income levels. Families enrolled in the NHCCSP may also be charged a “co-payment” by the provider if tuition exceeds the weekly standard rates set by DHHS. In 2024, State policymakers expanded NHCCSP income eligibility for families, resulting in a significant increase in the number of families enrolled in the program, though this growth has slowed in recent months.
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Beyond the increase in eligibility for families in the 2024 expansion, policymakers also increased reimbursement rates for participating providers. While the provider reimbursement rates are set through the State’s Child Care Market Rate Survey, the prices only account for enrollment tuition prices. Consequently, these rates only capture what providers estimate families are willing and able to pay, but do not necessarily account for the provider costs for delivering high-quality care services and operating costs, including facility expenses, workforce and staff compensation, staff training, professional development training, as well as other costs. To supplement this gap in revenue, some providers turn to additional revenue streams such as grants, donations, and fundraising initiatives.
The rising price of child care tuition, coupled with the declining supply of providers in recent years, reflects the growing financial pressures families and child care providers face in New Hampshire. While programs such as the NHCCSP have an important and necessary role in reducing these barriers, additional State funding initiatives and policy strategies may be needed to more adequately address these challenges and provide meaningful financial relief for families seeking to access child care.
The New Hampshire Fiscal Policy Institute is sharing these articles with the partners in The Granite State News Collaborative. NHFPI is an independent nonprofit organization that explores, develops and promotes public policies that foster economic opportunity and prosperity for all New Hampshire residents. For more information visit nhfpi.org. These articles are being shared by partners in The Granite State News Collaborative. For more information visit collaborativenh.org.
