New Hampshire
NH hospitals, Gov. Sununu, lawmakers in standoff with healthcare system at stake
New Hampshire’s 26 hospitals stand to lose millions in state payments for uncompensated care with the collapse Thursday of negotiations between the governor, lawmakers, and the hospitals. With a deadline fast approaching and a legislative fix seemingly off the table, a frustrated Gov. Chris Sununu has ordered the Department of Health and Human Services to arrange even deeper cuts to the hospitals than he initially offered.
By one estimate, the loss to hospitals could reach $35 million a year.
Steve Ahnen, president of the New Hampshire Hospital Association, called Sununu’s plan a “direct threat” to the hospitals.
“The governor scuttled a bipartisan solution on (Medicaid tax payments) in favor of massive, arbitrary and punitive cuts to hospitals,” he said in a statement Thursday evening. “In doing so, the governor is effectively raising the tax paid by hospitals, driving costs up for patients, and destabilizing our entire health care system.”
Ahnen did not say how hospitals intend to respond or whether they will take the state to court as they have twice before.
Senate President Jeb Bradley, who shepherded the now-failed compromise through the Senate, warned the same. “The viability of hospitals is at stake,” he told his House counterparts Thursday. “At the end of the day, our health care system, I think, is at stake.”
At issue is the nearly $320 million hospitals pay the state in Medicaid Enhancement Taxes (MET) annually. The state receives a federal match on that money and returns 91 percent of it to hospitals to help them cover primarily uncompensated medical care costs. This money is separate from the Medicaid reimbursements they get that cover part of their treatment costs.
The current arrangement, which was reached in 2018 as part of a lawsuit filed by the hospitals, expires at the end of June. Hoping to avoid another lawsuit from the hospitals, Bradley began negotiating late last year with hospitals, the governor, and other stakeholders on a legislative fix. Those negotiations took far longer than expected, Bradley said, so much so that the Senate passed its legislation just two weeks ago without time to let the House review it and hold its own public hearing.
Had that legislation succeeded, it appeared unlikely Sununu would have signed it.
Sununu said he was willing to continue returning 91 percent of the MET revenue to hospitals but wanted to distribute it differently. Those changes would have allowed the state to get a more generous match from the federal government, money Sununu wanted to give to non-hospital providers who care for Medicaid patients but do not pay the tax, including community mental health centers and substance use disorder clinics.
But Sununu’s plan would have left some hospitals with more money and some with less. For example, under one proposal, Lakes Regional General Hospital would have lost $2.5 million a year while Elliot Hospital would have gained nearly $2.9 million.
The hospitals objected to Sununu’s proposal and reached a compromise with the Senate. Under that deal, they would continue getting the 91 percent and an additional $14.3 million to make up for the lost revenue. About $5.7 million of that would have been state dollars, the rest federal.
Sununu said in a statement this week he was “fundamentally opposed” to using state money to boost the hospitals’ payments.
That deal fell apart Thursday when House and Senate negotiators decided they could not reach an agreement before they meet a final time next week. For House members, it was largely because the Senate’s legislation, tacked onto House Bill 1593, reached them so late.
“Everybody knew this deadline was coming,” Deputy House Speaker Steve Smith, a Charlestown Republican, said Thursday during negotiations. “Why didn’t you start working earlier so that it could have gone through the proper process and maybe I’d be sitting here with a smile and a yes today. But that’s not what happened.”
Like Sununu, Smith said the House could support much of the bill but not the measure giving hospitals an additional $5.7 million in state money.
Bradley acknowledged Smith’s complaint about the late hour but implored his House counterparts to sign on, warning them it would cost the state far more if the hospitals take it back to court.
“It’s really nobody’s fault that we are here on June 6 at the deadline (for negotiations),” Bradley said. “This is complicated. It’s contentious. It’s been subject to litigation. A lot of money is at stake.”
Sununu weighed in on the Senate’s proposal indirectly Wednesday in a letter to DHHS Commissioner Lori Weaver, which he shared publicly. He directed Weaver to tell federal Medicaid officials that the state would be returning only 80 percent of the MET revenue to hospitals.
He did so, he wrote, in anticipation of legislation failing. And as he has done consistently, Sununu blamed the hospitals for insisting on a deal that he said would prevent the state from giving non-hospital providers Medicaid funding and leveraging a higher financial match from the federal government.
“The hospitals have remained insistent upon an arrangement which crowds out other providers and greatly diminishes general fund savings.”
Ahnen responded in a statement late Wednesday.
“The proposal put forward by the governor results in an effective tax increase to those New Hampshire hospitals losing money over the current agreement, at a time when they are struggling financially,” he said.
This story was originally published by the New Hampshire Bulletin.
New Hampshire
Plymouth’s tap water beats Concord at state festival – Concord Monitor
The students had some tough decisions to make as they eyed phalanxes of Dixie Cups filled with water.
It’s a ritual of the New Hampshire Water Drinking Festival, where fourth and fifth-graders learn about how water systems work from state professionals in the Department of Environmental Services.
At the Manchester Water Treatment Facility on Wednesday, they participated in workshops touching on everything from how sewage treatment works to PFAS contamination. Then, students, teachers, parent chaperones and professionals sampled tap water from a handful of municipalities across the state. Blind to the origins of each water cup, they placed a vote for which one they thought tasted the best.
Each year, participating towns provide a cooler of tap water, poured that same day. Colder water generally tastes better, so organizers check to make sure it hasn’t been iced, and refrigeration is frowned upon. Water from the coolers is then dispensed into the paper cups in front of a corresponding letter to ensure the test is blind.
Relatively few towns and cities enter into the competition – this year, just Manchester, Concord, Hooksett and Plymouth – but still, there is some rivalry.
A water works employee from a city not competing in the contest completed the blind test and cast his vote. Organizers wouldn’t disclose which cups were which. As he walked away from the station with coworkers, he said, “As long as I didn’t vote for Concord.” He had, in fact, unknowingly selected Concord’s water as the tastiest.
Concord has been dominant in this taste-test for years, taking home the top spot for most of the last decade – including last year. With a well-protected surface water source in Penacook Lake, the city has invested in a system that delivers tasty, fresh water with minimal need for treatment. It’s paid off in the results.
This year, however, Plymouth took the top spot.
With an influx of federal money, Plymouth has been working to upgrade its water system for the last several years, including with a new well near Holderness. Department of Environmental Services staff at the tasting said this was the first year water from the new well had been “entered” by Plymouth in the competition.
The upgrades in Plymouth appear to be paying off, with the town taking home the award for best-tasting tap water in the state.
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New Hampshire
FAA Employee Accused Of Threatening Trump | Teen Reported Missing | Summer Forecast | More: Nearby News NH
Community Corner
Also: Head-on and rollover crashes; teen arrested after shooting; machete threat at homeless camp; armed career criminal sent to prison.
CONCORD, NH — Here are the Top 10 most popular stories and posts from around New Hampshire Patch sites last week.
Rollover Crash Shuts Down Part Of Downtown Concord; 2 People Hospitalized: Video: An elderly driver and passenger of a crossover with a Massachusetts registration were taken to Concord Hospital Monday night after a crash.
FAA Employee From Nashua Threatened To Kill President Donald Trump: U.S. Attorney: Dean DelleChiaie was accused of writing that he was going to “neutralize/kill” Trump, adding “God knows your actions and where you belong.”
Find out what’s happening in Concordfor free with the latest updates from Patch.
Head-On Crash | Brush Fire Near Homeless Camp | Students Feted | Fun Things To Do | More: PM Patch NH: Also: Recall roundup; elderly man, experiencing a medical condition, crashes into a cop cruiser; week-ahead weather; mom tribute survey.
Nashua Teen Accused Of Shooting A Massachusetts Man In The Leg: Angers Manuel Hernandez Peguero faces first-degree assault, felonious use of firearms, and stalking after a fight on Eaton Street Saturday.
Find out what’s happening in Concordfor free with the latest updates from Patch.
Rollover Crash Shutters Downtown | Montana Armed Career Criminal Sent To Prison | More: PM Patch NH: Teen faces shooting charge; franchisees open 10th Aroma Joe’s; Granite State Challenge semis; FAA employee accused of threatening Trump.
One Driver Injured After Head-On Crash On Clinton Street Near Page Road In Bow: Video: Police are investigating a crash just over the Concord line in Bow on Route 13 Friday. A fatal crash is also under investigation in Deering.
Concord Man Arrested On Criminal Threatening Charge On Hall Street: Concord Police Log: Plus: An Amherst man was arrested on credit card fraud charges; man arrested for stalking, breach; man charged with speeding on Loudon Road.
Elderly Man Experiencing Medical Episode Gets Into Minor Crash With Concord Police Cruiser Downtown: Video: An officer was not hurt Friday night after investigating a man who was passed out behind the wheel at Loudon Road and North Main Street
Man From Pembroke Arrested On Domestic Violence, Obstruction Charges On Centre Street: Concord Police Log: Boscawen man charged with aggravated DUI; man arrested on assault and mischief charges on Mountain Road; stalking incident at Royal Gardens.
El Niño Summer Forecast: How Hot And Stormy Will It Be In New Hampshire: Driven by warming ocean waters in the Pacific, the El Niño is likely to strengthen through the summer.
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Here are some other posts readers may have missed:
Ward 5 City Councilor Booted From Council’s City Manager Review Process Due To Conflict Of Interest
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New Hampshire
New Hampshire mothers’ labor force participation rate – Valley News
This Mother’s Day, the NHFPI team is recognizing the hard work of New Hampshire mothers by doing what we do best: highlighting key data that underscores both the challenges mothers face and the vital contributions they make across the Granite State.
Below are five key facts surrounding New Hampshire’s mothers and families.
Mothers with children under age 18 make up 13% of NH labor force
Based on 2020-2024 aggregated data, there were approximately 125,418 Granite State mothers between the ages of 20 to 64 with children under 18 years old who lived with them. Among this group, about 80% were in the labor force.
Mothers ages 20 to 64 with at least one child under 18 years old made up about 13% of the total 2024 Granite State labor force. However, labor force participation varied depending on the age and number of children in the household. Here’s how that total 13% breaks down:
- 3%: Mothers with at least one child under age 6
- 2%: Mothers with at least one child under 6 and at least one child between 6-17
- 8%: Mothers with at least one child between ages 6-17
While many parents may choose to remain out of the labor force to care for children, the high cost and low availability of child care may push many mothers to reduce their work hours or leave the workforce entirely. The average cost for an infant and four-year-old in center-based care in New Hampshire was nearly $30,000 per year during the 2022-2024 period; this equates to about 19.0% of household income for median-income married couples with children under 18 ($157,670 in median household income in 2020-2024), and 59.1% for median-income single mothers ($50,766).
More than half of NH mothers took unpaid maternity leave in 2023
While maternity leave can allow women to remain in the labor force after giving birth and bond with their newborn, access to paid leave may be limited for some Granite State mothers. According to 2023 data collected by the New Hampshire Department of Health and Human Services, 52.2% of mothers took paid leave and 54.5% took unpaid leave, with some mothers taking a combination of both; 7.1% did not take any leave from work after their child was born.
While the survey data does not specify how long mothers were out of work, both paid and unpaid leave time varies depending on workplace and governmental policy. The New Hampshire Paid Family and Medical Leave (NH PFML) Program is a voluntary insurance program that provides workers with 60% wage replacement for up to six weeks per year when they take time off for qualifying life events, including caring for a new child. However, unawareness of the program, a lack of access among smaller employers, concerns around job loss, and affordability constraints can deter enrollment, with only around 3% of Granite State workers participating in the program in 2025.
The federal Family and Medical Leave Act (FMLA) allows for up to 12 weeks of unpaid leave with job protection for eligible employees, although many families may not be able to forgo that income and still cover household costs. Nationally, new mothers returning to the workforce take an average of ten weeks of maternity leave, including both paid and unpaid time.
About 23% of all single female-headed families with children live in poverty
According to 2020-2024 aggregated data, around 2.3% of married-couple Granite State families with at least one related child under five years old lived in poverty. In contrast, single female-headed families with a child or children all under five years old were more than thirteen times more likely to live in poverty, with over one out of four families (29.3%) having household incomes below the federal poverty threshold.
According to the same five-year data, having at least two related children, one under age five and one between the ages of five and 17 years, increased a family’s likelihood of living in poverty. Around 47.8% of single female-headed households with this family composition were in poverty, compared to only about 2.3% of married-couple families.
Healthcare barriers remain for postpartum mental health services
Adequate health care access before, during, and following pregnancy is crucial for maintaining and improving the health status of a mother and her baby. According to the most recent data from 2023, around 85.9% of Granite State mothers started prenatal care during the first trimester, with 88.5% attending at least nine prenatal care visits throughout their pregnancy. Around 94.7% reported having at least one postpartum checkup.
Despite relatively high prenatal and postpartum care, engagement with the health care system before pregnancy was more limited. Among those who had a health care visit in the 12 months before their pregnancy, 69.2% had a regular family or primary care visit, 67.3% had a regular OB/GYN visit, and 20.4% had a visit for family planning services.
New mothers are also more likely to experience symptoms of anxiety and depression. In 2023, about 69.7% of Granite State mothers reported being able to receive needed mental health services following birth. Among those who were not able to receive that needed care, the most common reasons identified by mothers included not having the time due to work, child care, or other commitments (44.9%); not knowing where to go for services (40.2%); not being able to afford care (24.1%); and not being able to get an appointment as soon as they needed (20.0%).
Medicaid finances more than a fifth of healthcare services for new Granite State mothers
Medicaid is a state-federal fiscal partnership that provides health coverage for New Hampshire adults and children with low incomes, people with disabilities, certain older adults, and other eligible populations. In 2023, New Hampshire expanded Medicaid coverage for new mothers, permitting up to 12 months of postpartum coverage regardless of income changes.
Medicaid remains crucial for providing health care access for new mothers and their children across the state. In 2023, around 21% of births in New Hampshire were financed through Medicaid, and nearly 24% of mothers had their prenatal and postpartum care covered by Medicaid. Future data, if made available, can provide more insight into the results of recently expanded coverage.
On this Mother’s Day, these data highlight how New Hampshire mothers play a crucial role in supporting families, communities, and the state’s economy, while also navigating financial and health-related challenges. Policies that expand access to affordable child care, paid leave opportunities, and accessible health care can help ensure Granite State mothers and families have the support they need to thrive.
Williams is a senior policy analyst at NHFPI.
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