In this segment, Matt Mowry and Christine Carignan of Business NH Magazine break down key findings from their September 2026 feature on the potential financial impacts of federal Medicaid policy changes on local employers.
Key Highlights & Context:
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The Drivers Behind Rising Costs: Implementation of the federal One Big Beautiful Bill Act—including new work requirements and six-month eligibility redeterminations—alongside the expiration of Affordable Care Act tax credits, is projected to increase New Hampshire’s uninsured population by 32,000 by 2034.
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Impact on Uncompensated Care: Uncompensated care costs borne by hospitals are projected to rise by $54 million by 2034. Concurrently, state revenue from the Medicaid Enhancement Tax (MET) will begin decreasing under federal caps in 2028, reducing funds available to offset hospital losses.
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Squeeze on Small Businesses: Uncompensated care costs traditionally shift to private insurance markets, leading to higher premiums. Small group market (50 or fewer employees) plan premiums already grew 19% between 2020 and 2024 (from $530 to $635 per month), creating competitive disadvantages in hiring and retention.
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Potential Policy Solutions: Experts highlight mitigation strategies, including tax incentives for Individual Coverage Health Reimbursement Arrangements (ICHRAs), employee cafeteria plans, Section 1332 waiver extensions, and leveraging federal GO-NORTH (Rural Health Transformation Program) grant funding.
