Two years ago, Sue Prentiss got a sobering reality check at her doctor’s office. The news was blunt: She qualified for bariatric surgery, a procedure for patients whose weight poses life-threatening risks.

She was aware of her weight and had tried everything from high-intensity workouts to weight loss programs and diets. Nothing seemed to help until she started taking GLP-1 medications.

Prentiss said between then and now, she had lost almost 80 pounds. 

But at a $500 out-of-pocket monthly fee, every refill is a financial pinch.

“I’m just getting by, but I’m so much healthier, and if this can work for me, think about everybody else’s life where this would impact,” said Prentiss, a state senator.

To keep up with the cost, she’s made hard choices like cutting back on retirement contributions and squeezing her budget wherever possible.

Now, Prentiss is sponsoring Senate Bill 455, which would require the state to provide GLP-1 medications under the state Medicaid plan as a treatment for people with obesity.

As of January, New Hampshire’s Medicaid program has ended coverage for GLP-1 drugs like Saxenda, Wegovy and Zepbound for weight loss. The state still covers the medications when they’re part of a treatment plan for other chronic conditions, such as type 2 diabetes, certain cardiovascular diseases, severe sleep apnea and Metabolic Dysfunction-Associated Steatohepatitis (MASH).

According to the New Hampshire Department of Health and Human Services, the state paid managed care organizations $49.5 million to cover GLP-1 medications between July 1, 2025, and June 30, 2026. The policy change in January reduced that cost to $41 million.

With these drugs gaining popularity, the state estimated that if were to resume covering GLP-1s for weight loss, it would need to spend an additional $24.2 million on top of the $41 million per fiscal year.

Jonathan Ballard, chief medical officer at DHHS, said the agency opposes the bill, which would require Medicaid coverage for anyone with a body mass index above 30 seeking GLP-1 medications specifically for weight loss.

Ballard said the state cannot afford such an expansion when budgets are already tight.

“The department does not have this money today,” he said. “So, living within the realities of our current budget, there will be significant trade-offs. We will have to cut other things that are very important to the health and well-being of New Hampshire to pay for this unless there’s some change.”

GLP-1 drugs carry a steep price tag that puts significant pressure on state budgets, particularly within Medicaid programs. Several states, including California, Pennsylvania and South Carolina, have moved to drop coverage of these medications for weight loss.

Prentiss initially drafted her legislation with private insurers in mind, but later pivoted to focus on Medicaid to serve more vulnerable populations. She is covered by commercial insurance and said the outcome of the bill will not personally affect her.

Lost coverage

GLP-1 medications mimic a natural hormone in the gut that helps regulate blood sugar, digestion and appetite.

Sarah Finn, section chief for obesity medicine at Dartmouth Health, said she has seen firsthand the impact on her patients after the state dropped Medicaid coverage for weight-loss GLP-1 drugs. 

Without access to these medications, patients experience increased hunger, cravings and persistent “food noise,” as their bodies attempt to return to a higher fat percentage, a process known as metabolic adaptation, she said.

“This is the reality of the state I’m in right now, where I don’t have options except bariatric surgery for my Medicaid patients and a lot of times patients don’t want to do a surgery,” said Finn, at a hearing for the bill on Wednesday. “What I have to tell that patient is there’s nothing I could do to advocate.”

The Department of Health and Human Services faced a $51 million budget cut when the New Hampshire Legislature passed its biennial budget last year, forcing the department to reduce several services.

While Prentiss acknowledges the financial strain on the department, she wants the state to consider the long-term impact of using GLP-1s to prevent chronic conditions like diabetes, which is largely linked to weight gain and can drive up costs for the state over time.

“By driving down obesity, we can drive down the costs that are related to it,” she said. 

Prentiss remains on GLP-1 medications and said she feels much healthier than before.

She said that after a few months on the drugs, her blood sugar levels and kidney function began trending toward more normal ranges.

“It’s not cosmetic,” she said. “Obesity is a medical condition.”

In New Hampshire and across New England, nuclear energy is in the spotlight. But as plans for the region’s nuclear future are charted, some of the big questions that stirred New Hampshire in the 1980s remain unanswered.

Gov. Kelly Ayotte has called for New Hampshire to embrace new nuclear technology, while state legislators have introduced multiple bills to promote its development. Then, last week, Ayotte joined the rest of New England’s governors in a bipartisan joint statement calling for the region to pursue advanced nuclear technologies while championing its two existing nuclear power plants.

There are timeline and economic questions about the implementation of emerging nuclear technologies. But front-end logistics aside, some say there’s a bigger and enduring problem: How will we safely handle nuclear waste, in New Hampshire and nationwide?

The spent fuel that nuclear reactors spit out is hot and remains dangerously radioactive for thousands of years. The U.S. Nuclear Waste Policy Act of 1982 requires it be safeguarded and separate from nearby populations for at least 10,000 years. The law also requires the United States to come up with a national system to facilitate that at a centralized location, but no plan has yet emerged.

The matter is close at hand in New Hampshire, from the hilly west of the state, where a federal proposal for a deep nuclear waste storage site once threatened to displace residents, to the Seacoast, where spent fuel from the Seabrook Station power plant is generated and stored. To activists, just how we will handle the hazardous material is a hanging question that challenges the wisdom of embarking on a new nuclear era.

“There have been efforts over several decades here in New Hampshire to raise attention to this issue, but, obviously, we haven’t seen much real movement,” said Doug Bogen, executive director of the Seacoast Anti-Pollution League.

No stranger to nuclear waste

Three hundred or so million years ago, the long, fiery process that turned New Hampshire into the Granite State began. As magma seeped up into the crust from below and began to cool, seams of grainy, crystalline granite slowly formed.

The immense pockets of stone formed through this process are called plutons. When erosion washes away the sediments and soils around them, plutons can form mountains like the 3,155-foot Mount Cardigan. That peak is the crest of New Hampshire’s largest pluton: an approximately 60-mile long and 12-mile wide stretch of granite running through western New Hampshire.

In the 1980s, this swath of stone attracted an unexpected visitor: the United States Department of Energy, searching for a site to excavate a long-term storage facility for the nation’s nuclear waste.

Spent fuel remains radioactive for several million years, but its radioactivity decreases with time. The period of “greatest concern,” where levels of radiation are more dangerous to humans, lasts about 10,000 years, according to the International Atomic Energy Agency.

So, to keep the waste contained over that period, the U.S. government plans to rely on a combination of engineering and favorable geology, according to Scott Burnell, senior public affairs officer with the Nuclear Regulatory Commission. A long-term storage site is envisioned underground, because certain minerals can help shield radiation.

Granite is one such mineral. That’s what drew the department to western New Hampshire in the ’80s, Bogen recalled.

In 1986, the department announced that a 78-square-mile area on the pluton, centered around the town of Hillsborough, was one of a dozen sites across the country under consideration for a potential deep storage facility. Residents understood then that a number of surrounding towns would have been partially or entirely seized by the federal government through eminent domain to make way for the facility. Many were distraught.

“There weren’t any Yankees that were going to take that,” said Paul Gunter, a founding member of the anti-nuclear Clamshell Alliance.

The “Clams,” as well as the New Hampshire Radioactive Waste Information Network, which Gunter also co-founded; the Seacoast Anti-Pollution League; and other environmental groups, towns, and individuals mobilized quickly. In addition to organizing demonstrations, activists also circulated a warrant article opposing the generation and dumping of nuclear waste in New Hampshire. One hundred and thirty-seven towns ultimately voted to pass it, according to the New Hampshire Municipal Association.

Their opposition was multi-pronged, Gunter said. Organizers had health and safety concerns about the management of nuclear power and highly radioactive waste, including a lack of faith that the radiation would be safely isolated from human populations. They were also concerned about the proliferation of nuclear technology and the security risks that would come along with the transport of highly enriched nuclear fuel through their region. With some pacifist Quaker roots, the Clamshell Alliance also was, and remains, deeply opposed to nuclear weapons, Gunter said. They consider the matters of nuclear power and nuclear weapons inextricable.

News that New Hampshire was under consideration for a possible dump broke in January 1986. Later that year, the New Hampshire Legislature passed a law opposing the siting of such a dump in the state. When the Department of Energy dropped New Hampshire from its list, the storm seemed to have passed.

But while the Clams and others celebrated that, they continued to oppose the issue around which they had first come together: Seabrook Station nuclear power plant. At the time, then-Gov. John H. Sununu said he believed the two matters had to be considered separately. But Gunter said opposing the generation of nuclear waste went hand-in-hand with opposing its storage.

To this day, he said, the issues are often discussed separately, allowing the threat of nuclear waste to take a backseat in discussions and planning around nuclear energy.

New Hampshire’s high-level radioactive waste act was quietly repealed in 2011, and a subsequent attempt by the late former Rep. Renny Cushing to reintroduce legislation on the topic, opposing the siting of a high-level waste facility in New Hampshire, was defeated in 2020.

Where we are now

Hillsborough’s story has echoes elsewhere across the country. The most progress toward a potential deep storage site occurred at Nevada’s Yucca Mountain, where excavation took place, but the site was abandoned amid opposition from the state.

In broad strokes, a similar story has repeated in other instances where a site was proposed, Burnell said. But a spokesperson for the Department of Energy, the agency charged with finding a location, said their search continues nonetheless.

President Donald Trump’s administration has taken a new tack, framing the search for a waste facility along with potential new development as a search for a “nuclear lifecycle innovation campus.” The move comes as Trump has attempted to bolster the U.S. nuclear industry, calling for a surge in nuclear generation and development with multiple executive orders.

“The Nuclear Lifecycle Innovation Campuses Initiative is a new effort to modernize the nation’s full nuclear fuel cycle,” a spokesperson for the department’s Office of Nuclear Energy said in an email. That would involve a federal-state partnership with funding for a nuclear technology facility where many stages of the process could be colocated, they said, naming fuel fabrication, enrichment, reprocessing, and “disposition of waste” as some of what would occur at such a site.

The deadline for states to submit “statements of interest” for hosting sites was April 1, and the spokesperson said “dozens” of responses had been filed. But they declined to say whether New Hampshire was among those, and the New Hampshire Department of Energy did not immediately respond to the same question.

In the meantime

Spent fuel generated at Seabrook Station is initially stored in 40-plus-foot-deep pools of water for preliminary cooling, then moved to steel-and-concrete casks, according to Burnell and NextEra spokesperson Lindsay Robertson. The concrete casks remain on-site on a concrete pad, Burnell said. Until another plan is developed, this is the case for spent fuel generated at reactors across the nation.

The storage facilities in use at Seabrook were tested and built to government standards, intended to withstand “extreme weather,” Robertson said. She declined to say how much spent fuel was generated or stored at Seabrook Station.

Since coming online in 1990, Seabrook Station has generated a significant portion of New England’s power without generating much news. Yet Gunter said his concerns about the station and storage of its spent fuel have not been ameliorated with the passage of time.

“They’ve been affirmed,” he said.

Gunter has concerns about concrete degradation and wiring at Seabrook Station and other power plants nationwide. Regarding waste, Gunter and Bogen said they worry about sea level rise affecting the storage area; Seabrook Station is located adjacent to tidal marshland. And, lacking a national plan for more long-term storage of nuclear waste, they wonder what will happen to the material currently stored on a temporary basis at Seabrook if no such plan emerges.

Gunter said his concerns about nuclear waste are part and parcel to his overall opposition to nuclear power, including those generators already in use.

“The new reactors are still on paper. The real threat is really in the day-to-day operation of aging nuclear power plants that are way past their shelf life,” he said.

Nuclear power plants are expensive to construct, creating what Bogen called the “opportunity cost” of embracing them at the expense of other sources of power generation. He and Gunter see renewable energy, principally through offshore wind, as safer and faster to deploy, and were disappointed to see politicians renew their focus on nuclear energy.

“It is coming back in a rebranding, which this industry is very well versed in,” Gunter said. “… Nuclear waste is going to be a persistent hazard over geological spans of time, while the electricity is going to be a fleeting benefit.”

Bogen said he wanted to see more reinforcement of the waste stored at Seabrook in a model called hardened on-site storage. But in terms of dealing with future waste, he and Gunter believe the best solution would be to stop generating it altogether.

“If you find yourself in a hole,” Bogen said, “the first thing you do is stop digging.”

Conversely, the New Hampshire Department of Energy does not see the question of nuclear waste as a barrier to further development in the state, according to an email from department Legislative Liaison Megan Stone. The nuclear roadmap that Ayotte’s March executive order directed the department to craft would include consideration of the “nuclear lifecycle,” including storage and “disposition” of waste, Stone said.

Then, she alluded to the expectation that a federal plan would emerge. “Dry cask storage is a safe and effective method of storing spent nuclear fuel until it is collected by the federal government,” she said.

A motorcyclist from Douglas was killed in a crash on Friday, April 17 in Campton, New Hampshire.

Police in Campton identified the victim as Elias Alexandro Ramos, 18, of Douglas. He was pronounced dead at the scene, police said.

The crash occurred shortly before 11 a.m. on Route 3. The initial investigation indicates Ramos was traveling north on a Honda motorcycle when it went off the road and into a guardrail, police said. He was thrown from the motorcycle.

It appears speed or alcohol were not factors in the crash, according to police. Ramos wore a helmet, although it may not have been properly worn, police said.

The crash remains under investigation.

Ramos was due to graduate from high school in the spring. He had dreams of becoming a mechanic, according to his older brother, Alexander.

“He was so mature for his age, already having the next couple of years planned out,” said Alexander in an email to the Telegram & Gazette.

On a GoFundMe page he created to help with family expenses after his brother’s death, Alexander wrote of the way Elias would bring joy and laughter to those around him.

“Elias had a gift for making people smile, and he was always there to help anyone in need,” he wrote.