(Full Version) New Hampshire’s ‘favorable’ conditions for hospital acquisitions

By Meera Mahadevan, Granite State News Collaborative

Why are big out-of-state hospitals eager to make a foray into the New Hampshire health care market? The answer partly lies in the fact that the state is uniquely situated, both geographically and politically.

Josephine Porter, strategic advisor for the N.H. Center for Justice & Equity, says when a community hospital is acquired, ‘there is concern that the benefit the hospital provides to the community no longer reflects the community needs.’ (N.H. Center for Justice & Equity photo)

Access to more patients just across the state border is attractive to hospitals in Massachusetts that have faced uphill regulatory battles in their own state, analysts say. New Hampshire also does not have large employers, like Massachusetts does, with the muscle to push for change in health care costs.

“New Hampshire, despite being small — the patient mix tends to be favorable,” said Josephine Porter, strategic adviser for the N.H. Center for Justice & Equity. “There’s good health insurance coverage (here), on the commercial side.”

Of New Hampshire’s 1.4 million residents last year, about 62%, 853,000 people, received private health insurance through their employer or by purchasing their own coverage, according to Lucy Hodder, director of Health and Life Sciences Law and Policy programs at the University of New Hampshire’s Franklin Pierce School of Law. Her data shows that 16% had Medicare and 9% Medicaid.

In addition, Porter said, “if I’m a big hospital system, and if there's an opportunity to explore a merger and acquisition, there is some benefit to looking at New Hampshire because the process isn’t as arduous here as it might be in someplace else.”

A decade ago, New Hampshire got rid of one big regulatory hurdle: the Certificate of Need Board. It required New Hampshire hospitals and clinics to get state permission before building or expanding facilities. New Hampshire formed the board in 1979 but shuttered it in 2016 after a long legislative battle over the board’s pluses and minuses. Critics said it created obstacles by requiring that, before a facility was built, evidence had to be produced to show it was needed. 

“There are other states where there are more stringent certificate of need boards and regulatory authorities,” Porter said. “There are certain parameters that have to be addressed that New Hampshire doesn’t have. There are many more steps in other states than what New Hampshire has.”

Lucy Hodder, director of the Health and Life Science Policy programs at the University of New Hampshire’s Franklin Pierce School of Law, says price pressures on hospitals could continue the consolidation trend. (Franklin Pierce School of Law photo)

Currently, the state Attorney General’s Office is the only entity overseeing hospital mergers through its antitrust bureau and charitable trusts unit. The state Insurance Department reviews health plan proposals for insurance premium increases and evaluates them, but it does not have a say over mergers. The Department of Health and Human Services licenses facilities, but also does not oversee mergers. 

The Attorney General’s Office has been ringing the alarm bell over hospital consolidations and their potential to reduce competition for the last several years. In fact, in 2022, it opposed Dartmouth-Hitchcock’s plan to purchase Granite One Health, a combined entity that included Catholic Medical Center in Manchester, saying the move would limit competition.

But earlier this year, Attorney General John Formella said he was compelled to approve HCA’s acquisition of Catholic Medical Center, in part because the Manchester hospital was in such dire financial situation that patients stood to lose services entirely if it shut down. So with the approval, the AG sought what he called compromises, including a requirement that hospital systems acquiring a New Hampshire asset would have to contribute money that would benefit New Hampshire health care consumers. 

The Legislature established a trust fund, known as the Healthcare Consumer Protection Trust Fund, and would direct the hospital that is doing the buying to contribute money toward the fund. Under that directive, Beth Israel Lahey, following its purchase of Exeter Hospital in June 2023, was required to deposit $10 million over 10 years into the trust fund. And HCA must pay $7.5 million over 10 years. 

“As we welcome a large out-of-state system into New Hampshire, we must be mindful of the potential risks the transaction poses to health care consumers,” Formella said after Beth Israel Lahey purchased Exeter Hospital two years ago.

In addition to the trust fund, the Healthcare Consumer Protection Advisory Commission was formed to help advise the AG on how to spend and manage that money. Expenditures from the fund need approval from the seven-member commission, the governor, and the N.H. Executive Council. The commission has been meeting monthly since July 2024. It is composed of the AG himself or a designee by him, two state lawmakers, a state insurance department designee, chief legal officer at the NH Department of Health and Human Services, and two members of the public, including one physician. 

Regulators have also stipulated that trust fund spending should prioritize forming a research entity to monitor, analyze and publicly report on the New Hampshire health care market. 

Toward that end, the advisory commission received proposals from the University of New Hampshire and Dartmouth College, and UNH was selected. Last November, the commission voted to spend up to $1.6 million from the trust fund for a three-and-a-half-year contract with UNH to create the Center for Studying Healthcare Markets. The governor and the executive council approved it on May 21. 

The goal is to evaluate the impact of health care consolidation and examine regional best practices from neighboring states in New England. Bradley Herring, a professor of health economics at UNH, will lead the research. 

In addition, commission members said transportation needs are atop New Hampshire patients’ concerns and they discussed whether a portion of the trust fund should be used to help people get to and from their appointments.

In light of consolidation, “we hope to look at things like, is it harder to get to a doctor? Does it cost more to get services I need? Can I have access to hospital-based services the same way I had before?” said Yvonne Goldsberry, chair of the commission. “Our goal is to get out there and hear different cases. We want to hear from consumers what the impacts have been from the consolidations and then hopefully we will be better informed about what to use the money for. “

Lobbyists have also asked the commission to explore the idea of what is known as a cost-growth benchmark, similar to policies in Massachusetts, Rhode Island and Vermont. It’s a cost-containment strategy that limits how much a state’s health care spending can grow each year. 

In addition, some are asking the state to establish a patient advocate office to help contain costs and hold the industry accountable.

In a statement to the commission in February, Jake Berry, vice president of policy at Concord-based health care advocacy group New Futures, said: “While New Hampshire has successfully implemented an Office of the Consumer Advocate to represent residential customers of the state’s regulated public utilities, and an Office of the Child Advocate to ensure the best interests of New Hampshire children are protected, the state does not have a similar independent agency to advocate on behalf of New Hampshire health care consumers and patients.”

Now, the health commission is beginning to study the impact of consolidations on consumers with a series of public hearings, including one planned in Exeter in June and one in Claremont in July.

The first hearing held by the state Healthcare Consumer Protection Advisory Commission on May 28 in Rochester attracted some 75 people, many of whom offered comments about the effects of the 2020 acquisition of Frisbie Hospital by the for-profit HCA Healthcare. Speakers included employees of the hospital, who praised the merger, and members of the public decried the deal, citing facilities closures and failure to be notified about changes in medical staff. (Photo by Meera Mahadevan)

The first hearing, held May 28 in Rochester, attracted over 75 people, with several HCA employees and a few members from the public showing up to speak. 

Nurses and hospital administrators at Frisbie praised the merger in their presentations to the commission, citing positive turnaround data, including shorter wait times at the ER. But members of the public who spoke said facility closures and patients not being properly notified of doctor departures following the Frisbie acquisition had been very difficult for them. 

“I’m a survivor of mergers and acquisitions,” said Marsha Miller, an 81-year-old Rochester resident who lives across from the hospital, but she added that Frisbie is no longer “her” hospital.

“I have institutional memory of what Frisbie used to be and what it is for my husband who is very ill. The lack of care in the ER is why we became patients at Wentworth-Douglass Hospital. … People who left took their institutional memory with them.” She said facility closures in Sanbornville and Barrington in 2021 – a year after HCA’s acquisition of Frisbie – were some of patients’ first introductions to HCA. 

“We have to deal with perceptions, which is that HCA is bad,” she told the commission. Referring to HCA employees’ favorable comments about the merger, she added: “Nobody knows all of these wonderful things. These changes are not a part of my reality. … I want to be clear. This community relies on Frisbie and its foundation.”

The commission hopes to hear more from people about how the hospital mergers have affected their lives.

“A lot has happened in the health care industry,” Formella told the audience in Rochester. “We are going to continue to see a lot of change. And we are going to need to be having a lot of conversation – a lot of thoughtful dialogue about where the state goes from here.” 

He told reporters after the hearing that asking the public to speak at a podium in front of a row of commission members might not be the most effective way of soliciting comments. He said it might be less intimidating and more productive for two or three commissioners to meet the public in a coffee shop. 

This story is part of Critical Condition: What hospital consolidation means for care, access, and your community, a special series co-produced by partners in the Granite State News Collaborative. These stories are being shared by media outlets across New Hampshire. We want to hear from you! Take our short survey at https://tinyurl.com/3au39uct about your healthcare experiences. For more information, visit collaborativenh.org.

(Full Version) Amid a flurry of hospital mergers, what is the effect on health care in New Hampshire?

Industry consolidation raises concerns about cost, access and impact on patients

By Meera Mahadevan, Granite State News Collaborative

Editor's Note: This story is part of Critical Condition, a special series co-produced by the Granite State News Collaborative and its local news partners. Together, we’re exploring how hospital consolidation is reshaping health care in New Hampshire—impacting costs, access, and the future of care in our communities. We want to hear from you: Tell us about your experience with health care in New Hampshire.

Map of Hospital Transactions 2025

Financial pressures, staffing shortages and scarce regulatory oversight have led to a  frenzy of consolidations among hospitals in New Hampshire in recent years.

That frenzy has raised significant concerns about reduced access to health care and the quality of that care at a time when patients are increasingly worried about ever-rising health care costs.

Of the state’s 26 acute care hospitals, only five remain stand-alones. And some of the state’s largest recent hospital acquisitions have been made by large out-of-state organizations, including a for-profit health company based in Tennessee and giant academic medical centers in Massachusetts, leaving some to wonder if they have their fingers on the pulse of New Hampshire residents’ health care needs. 

Further complicating the issue is that the Granite State has not routinely or formally tracked the impact of these mergers and acquisitions on patients and does not have research data that would shed light on cost, access and workforce implications. 

But that could soon change with the recent post-merger formation of the seven-member Healthcare Consumer Protection Advisory Commission, which will advise the state attorney general’s office on these matters.

Lucy Hodder, director of the Health and Life Science Policy programs at the University of New Hampshire’s Franklin Pierce School of Law, says price pressures on hospitals could continue the consolidation trend. (Franklin Pierce School of Law photo)

“I think the pressures on health care providers and health systems are significant,” said Lucy Hodder, director of Health and Life Sciences Law and Policy programs at the University of New Hampshire’s Franklin Pierce School of Law, and one of the state’s leading experts on health care policy.

“With policies reducing access to health insurance for many, and the costs and losses to health plans associated with specialty drugs like GLP1s (weight-loss drugs such as Ozempic and Wegovy), there will be lots of pressure on hospitals to reduce rates,” Hodder said. “This will result in more consolidations. Our biggest problem? We don’t have a plan.”

While hospitals say consolidations benefit patients and are inevitable amid rising costs, doctors on the front lines say their patients often feel left behind.

“There was this whole patient population which was totally devastated,” said Dr. Archana Bhargava, a medical oncologist who worked for 18 years at Frisbie Memorial Hospital in Rochester, which was bought in 2020 by Nashville-based HCA, the country’s largest for-profit health system.

HCA eventually whittled down Frisbie’s cancer unit and completely shut down its labor and delivery division. 

The closure of the cancer unit, Bhargava said, “was really hard. Every day there were only tears.They didn’t know how they were going to travel even beyond what they were already traveling to come to Frisbie.”

Access to care “is a very, very big issue” when hospitals consolidate, she said, and “when big systems decide to pick up a failing, smaller community hospital, there should be a certain level of responsibility for access to care.” 

A survey of 1,300 New Hampshire residents conducted by the Altarum Institute, a health care-focused research and consulting firm, revealed that Granite Staters are concerned about hospital costs, in addition to overall health care burdens.

Sixty-nine percent of survey responses identified hospitals as a primary contributor to rising health care costs, said Sam Burgess, health care policy coordinator at the advocacy group New Futures, which partnered with Altarum.

A look at the mergers 

HCA Healthcare Inc., which operates 182 hospitals in the U.S. with total revenue of $70.6 billion in 2024, established its New Hampshire presence in New Hampshire in 1983, when it acquired Portsmouth Regional Hospital and Parkland Medical Center in Derry. Its market share in the state grew bigger this year when the company’s purchase of Catholic Medical Center in Manchester was approved.

In addition, academic centers across the border in Massachusetts — which have faced tough opposition to expansion from their own state regulators — have been eager to add patients by dipping into the New Hampshire market. For example, Massachusetts General Hospital acquired Dover’s Wentworth-Douglass Hospital in 2017, and the Beth Israel Lahey health system acquired Exeter Hospital in 2023.

In addition, Dartmouth-Hitchcock, the state’s largest health system, which now owns five hospitals — Alice Peck Day in Lebanon, Cheshire Medical Center in Keene, New London Hospital and Valley Regional in Claremont — along with its flagship academic medical center in Lebanon. 

New Hampshire is not alone in the consolidation wave. Nationally, about 2,000 hospital and health system mergers were announced from 1998 to 2023, according to KFF, a California-based health policy research and polling organization formerly known as Kaiser Family Foundation. 

The percentage of community hospitals that are part of a larger health system increased from 53% in 2005 to 68% in 2022. And, the share of physicians working for a hospital or a practice owned at least partially by a health system increased from 29% in 2012 to 41% in 2022.

Health care mergers and acquisitions can take many forms and get quite complicated. They can happen when a health system acquires a hospital within the same market or state, known in the industry as horizontal mergers. When a hospital or an insurance company acquires an independent physician practice, it’s known as a vertical merger. A cross-market merger happens when two providers that operate in different geographic markets merge. And, entities can form affiliations without an outright ownership deal — known as soft consolidations. Moreover, corporations such as CVS, Amazon, and UnitedHealth, along with private equity firms, have acquired many physician practices.

Efficiencies and higher costs

Hospital officials say mergers offer benefits, such as efficiency in supply chains and shared resources among merged entities. And if an acquisition prevents an outright hospital closure, it may help preserve jobs and medical services that would otherwise be eliminated.

Steve Ahnen, president of the N.H. Hospital Association, says patients benefit when a smaller hospital partners with a larger institution because it provides access to specialists and specialty services. (N.H. Hospital Association photo)

Steve Ahnen, president of the N.H. Hospital Association, said patients benefit when a small hospital partners with larger institutions because it gains access to specialists and specialty services. 

“The cost of employing the high-quality level of doctors, nurses and technicians to provide lifesaving care continues to go up,” Ahnen said. “Our operating challenges have gone up. We also face a number of challenges from payers. 

“There has also been a significant consolidation in the payer market, which has given rise to significant challenges as hospitals negotiate rates. Plans are finding more and more ways of denying care, creating this mousetrap.”

But health care analysts say consolidations generally lead to higher prices and don’t always show clear gains in either access or quality of care. Costs often rise after consolidation because hospitals negotiate with insurers to determine prices, and a health system’s bargaining power increases when it owns several hospitals in the same market.

Burgess, the health policy analyst at New Futures, said, “HCA has a strong foothold in the state, and that’s likely to reduce bargaining power for health plans in the state,” perhaps leading to higher costs for insurers.

Not much data on patient care

A hospital’s quality of care can be measured in many ways, such as patient experience, one-year mortality rates, 30-day readmission rates, the rates of MRSA (a type of antibiotic-resistant bacteria) and other infections, safety problems, surgery problems, and what steps a hospital took to prevent errors. 

But data does not exist specifically on how mergers have affected quality of care at New Hampshire hospitals. 

As a KFF research brief notes, “There are many dimensions and measures of quality that have been or could be used to assess the effects of consolidation and it could take time for changes in quality to materialize.”

Hard data does exist, however, when it comes to costs going up after a merger or acquisition. For instance, Martin Gaynor, a professor of economics and health policy at Carnegie Mellon University, testified in front of a U.S. House subcommittee in 2019 that consolidation leads to substantial price increases. 

Research has shown “that hospitals and doctors who face less competition charge higher prices to private payers, without accompanying gains in efficiency or quality,” Gaynor told lawmakers. “Research shows the same for insurance markets. Insurers who face less competition charge higher premiums, and may pay lower prices to providers.”

Gaynor said one analysis found that prices at hospitals acquired by out-of-market hospital systems increase about 17% more than prices at unacquired, stand-alone hospitals.

Consolidations can also result in workforce cutbacks, as the merged entities seek efficiencies that can take a toll in New Hampshire, where health care is the largest workforce sector. That status is a big change from 10 years ago, when retail and trade was the largest employment sector, said Annette Nielsen, an economist with the state Economic and Labor Market Information Bureau. As of March 2025, the health care sector employed 99,700 people in New Hampshire.

Most recently, in February — almost five years after announcing its intent to purchase Wentworth Douglass Hospital — Mass General Brigham announced a series of layoffs,  the largest in the health system’s history. About 1,500 non-clinical employees lost their jobs throughout its network of hospitals, including in New Hampshire.

Another concern about hospital consolidations, say doctors and analysts, is that out-of-state entities don’t always have an accurate picture of what a New Hampshire community needs.

Josephine Porter, strategic advisor for the N.H. Center for Justice & Equity, says when a community hospital is acquired, ‘there is concern that the benefit the hospital provides to the community no longer reflects the community needs.’ (N.H. Center for Justice & Equity photo)

“If you’re getting acquired by an organization that is not local, the decision-making authority for what community benefit looks like is also not local,” said Josephine Porter, strategic adviser for the N.H. Center for Justice & Equity, a nonprofit that advances issues of health equity. “There is concern that the benefit the hospital provides to the community no longer reflects the community needs. That community benefit does need to address hyperlocal priorities, and if those decisions are not being made locally, then there can be a problem.”

‘Nobody cares for us’

One of the biggest concerns for members of the state’s Health Care Consumer Protection Advisory Commission is the impact that mergers have on a patient’s access to care, including maternity and behavioral health services. 

They have good reasons to be nervous.

HCA shut down its labor and delivery services at Frisbie Memorial Hospital two years after purchasing it, even though it originally said it would not do so until five years after the merger. Obstetrics tends to be a high-cost venture for hospitals, with less-than-attractive returns. Birth rates are also going down in New Hampshire, making it harder for hospitals to continue to offer services, and making it difficult for patients to get access to the services elsewhere.

“You know how many patients I used to get at Frisbie who did not have a car that would function and be reliable?” said medical oncologist Bhargava. And, she said, even if they had a family member who could drive, that person would often be working and not be able to take time off. 

“There were many times we had patients who were completely unsupported,” Bhargava said, “and God bless these nurses; sometimes I’ve seen nurses slip in taxi money for these patients to get back home.

“You start traveling from Rochester until you hit a wealthy pocket in Wolfeboro and a wealthy population here and there, but the rest of New Hampshire is very underserved,”  Bhargava said. “There are very socially and economically challenged people. If they don’t have health care close to them, they are going to die in their homes. Imagine an elderly couple living on some measly Social Security income. Do you think they will have an hour and half to go to Dover or Portsmouth?

“I had a patient who used to live in Ossipee,” Bhargava said. “She said — literally with tears – ‘Nobody cares for us because we are poor.’ It was a very sad thing to hear. Many of these patients (fall) in the poor category but that doesn’t mean they are illiterate. They wrote a lot of letters to the governor asking why isn’t health care closer to home for them and obviously it didn’t get heard.”

Staff shortages 

But the hospitals argue they are facing enormous challenges of their own. More than one-third of nonprofit acute care hospitals in the state reported they’re running in the red, said Ahnen, the state hospital association president. 

He said workforce shortages have led to high job-vacancy rates across all hospital departments — 14% for nurses, 20% for surgical technicians, 22% for respiratory therapists — even as health-care needs have kept hospital beds full, to the point where they cause a backlog in the emergency department. 

Ahnen also said studies reporting that costs go up after a merger are skewed and are not always accurate. 

“That research relies on outdated studies,” Ahnen said. “Charles River Associates also does studies, and it shows that hospital consolidations resulted in higher quality and lower cost.”

While hospitals struggle, independent companies see an opportunity.

For instance, Derry Imaging — which has seven locations in New Hampshire — is working to attract patients to use its services by directly comparing its cost for an x-ray with what a hospital charges for the same service. 

The company advertises that patients can save 40% to 70% over “expensive hospital imaging costs.” On its website, it says the average cost of a chest x-ray at a Derry Imaging facility can cost $95, compared to what it says is an average cost of $390 at hospitals within 15 miles of the company’s facilities. It also lists average costs for ultrasounds, CT scans and MRI scans at its facilities — all lower than the cost it cites at hospitals.

“MRI services at other providers or hospitals can cost as much as $3,000,” the company says on its website. “At Derry Imaging, the same MRI scan can be 40-70% lower. For patients with large out-of-pocket costs, that price can make a huge impact on your budget.”

‘Difficult to survive’

Experts predict the hospital consolidation trend will continue in New Hampshire over the next several years.  

The first hearing held by the state Healthcare Consumer Protection Advisory Commission on May 28 in Rochester attracted some 75 people, many of whom offered comments about the effects of the 2020 acquisition of Frisbie Hospital by the for-profit HCA Healthcare. Speakers included employees of the hospital, who praised the merger, and members of the public decried the deal, citing facilities closures and failure to be notified about changes in medical staff. (Photo by Meera Mahadevan)

“The financing of the health care system is complicated — it causes a lot of pieces to have to move all at the same time in order to make change,” said Porter of the N.H. Center for Justice & Equity. 

“Hospitals have had a lot of change in the last 15 or 20 years, not just in treatments that are available, but the entire delivery system, with acquisition of physician practices,” she said. “We have had a movement from hospitals running a hospital to a hospital running a health care system that might have outpatient ambulatory care facilities or mobile X-ray units. 

“All these dynamics make for a complicated system, and we’ve seen a lot of change and seen a lot of struggle to keep up with that change and figuring out what the right financing model looks like.” 

The result, she said, is that “it’s going to continue to be difficult for a community hospital to survive without a larger infrastructure. My hope is that as it continues to happen, we solve for the need to have larger systems that can also solve for hyperlocal needs — the needs around transportation, which services are required. The recognition that lower volume, less profitable services have to be salvaged somehow. There’s room for innovation in these models.”

According to Hodder of Franklin Pierce School of Law, “We have always had a close relationship with health care providers in the community — our communities are attentive to hospitals. We have so many of them.

“It’s going to continue to put pressure on our hospitals to compete with each other, which will result in higher cost, which is eventually going to hurt the system, and there will be pressure to consolidate. Some are going to win and some are going to lose in the process.” 

This story is part of Critical Condition: What hospital consolidation means for care, access, and your community, a special series co-produced by partners in the Granite State News Collaborative. These stories are being shared by media outlets across New Hampshire. We want to hear from you! Take our short survey athttps://tinyurl.com/3au39uctabout your healthcare experiences. For more information, visitcollaborativenh.org.

(Shorter Version) Amid a flurry of hospital mergers, what is the effect on health care in New Hampshire?

Industry consolidation raises concerns about cost, access and impact on patients

By Meera Mahadevan, Granite State News Collaborative

This story is part of Critical Condition, a special series co-produced by the Granite State News Collaborative and its local news partners. Together, we’re exploring how hospital consolidation is reshaping health care in New Hampshire—impacting costs, access, and the future of care in our communities. We want to hear from you: Tell us about your experience with health care in New Hampshire.

Map of Hospital Transactions 2025

Financial pressures, staffing shortages and scarce regulatory oversight have led to a frenzy of consolidations among hospitals in New Hampshire in recent years, raising significant concerns about reduced access to health care and the quality of that care at a time when patients are increasingly worried about ever-rising health care costs.

Of the state’s 26 acute care hospitals, only five remain stand-alones. And some of the state’s largest recent hospital acquisitions have been made by large out-of-state organizations, including a for-profit health company based in Tennessee and giant academic medical centers in Massachusetts, leaving some to wonder if they have their fingers on the pulse of New Hampshire residents’ health care needs. 

Further complicating the issue is that the Granite State has not routinely or formally tracked the impact of these mergers and acquisitions on patients and does not have research data that would shed light on cost, access and workforce implications. But that could soon change with the recent post-merger formation of the seven-member Healthcare Consumer Protection Advisory Commission, which will advise the state attorney general’s office on these matters.

Lucy Hodder, director of the Health and Life Science Policy programs at the University of New Hampshire’s Franklin Pierce School of Law, says price pressures on hospitals could continue the consolidation trend. (Franklin Pierce School of Law photo)

“I think the pressures on health care providers and health systems are significant,” said Lucy Hodder, director of Health and Life Sciences Law and Policy programs at the University of New Hampshire’s Franklin Pierce School of Law. “With policies reducing access to health insurance for many, and the costs and losses to health plans associated with specialty drugs like GLP1s (weight-loss drugs such as Ozempic and Wegovy), there will be lots of pressure on hospitals to reduce rates,” Hodder said. “This will result in more consolidations. Our biggest problem? We don’t have a plan.”

While hospitals say consolidations benefit patients and are inevitable amid rising costs, doctors on the front lines say their patients often feel left behind.

“There was this whole patient population which was totally devastated,” said Dr. Archana Bhargava, a medical oncologist who worked for 18 years at Frisbie Memorial Hospital in Rochester, which was bought in 2020 by Nashville-based HCA, the country’s largest for-profit health system.

HCA eventually whittled down Frisbie’s cancer unit and completely shut down its labor and delivery division. 

A survey of 1,300 New Hampshire residents conducted by the Altarum Institute, a health care-focused research and consulting firm, revealed that Granite Staters are concerned about hospital costs, in addition to overall health care burdens.

Sixty-nine percent of survey responses identified hospitals as a primary contributor to rising health care costs, said Sam Burgess, health care policy coordinator at the advocacy group New Futures, which partnered with Altarum.

A look at the mergers 

HCA Healthcare Inc., which operates 182 hospitals in the U.S. with total revenue of $70.6 billion in 2024, established its New Hampshire presence in New Hampshire in 1983, when it acquired Portsmouth Regional Hospital and Parkland Medical Center in Derry. Its market share in the state grew bigger this year when the company’s purchase of Catholic Medical Center in Manchester was approved.

Academic centers across the border in Massachusetts — which have faced tough opposition to expansion from their own state regulators — have been eager to add patients by dipping into the New Hampshire market. For example, Massachusetts General Hospital acquired Dover’s Wentworth-Douglass Hospital in 2017, and the Beth Israel Lahey health system acquired Exeter Hospital in 2023.

In addition, Dartmouth-Hitchcock, the state’s largest health system, which now owns five hospitals — Alice Peck Day in Lebanon, Cheshire Medical Center in Keene, New London Hospital and Valley Regional in Claremont — along with its flagship academic medical center in Lebanon. 

New Hampshire is not alone in the consolidation wave. Nationally, about 2,000 hospital and health system mergers were announced from 1998 to 2023, according to KFF, a California-based health policy research and polling organization formerly known as Kaiser Family Foundation. 

Efficiencies and higher costs

Steve Ahnen, president of the N.H. Hospital Association, says patients benefit when a smaller hospital partners with a larger institution because it provides access to specialists and specialty services. (N.H. Hospital Association photo)

Steve Ahnen, president of the N.H. Hospital Association, said patients benefit when a small hospital partners with larger institutions because it gains access to specialists and specialty services. 

“The cost of employing the high-quality level of doctors, nurses and technicians to provide lifesaving care continues to go up,” Ahnen said. “Our operating challenges have gone up. There has also been a significant consolidation in the payer market, which has given rise to significant challenges as hospitals negotiate rates. Plans are finding more and more ways of denying care, creating this mousetrap.”

But health care analysts say consolidations generally lead to higher prices and don’t always show clear gains in either access or quality of care. Costs often rise after consolidation because hospitals negotiate with insurers to determine prices, and a health system’s bargaining power increases when it owns several hospitals in the same market.

Not much data on patient care

Data does not exist specifically on how mergers have affected quality of care at New Hampshire hospitals. As a KFF research brief notes, “There are many dimensions and measures of quality that have been or could be used to assess the effects of consolidation and it could take time for changes in quality to materialize.”

Hard data does exist, however, when it comes to costs going up after a merger or acquisition. For instance, Martin Gaynor, a professor of economics and health policy at Carnegie Mellon University, testified in front of a U.S. House subcommittee in 2019 that consolidation leads to substantial price increases. 

Research has shown, he said, “that hospitals and doctors who face less competition charge higher prices to private payers, without accompanying gains in efficiency or quality.”

Consolidations can also result in workforce cutbacks, as the merged entities seek efficiencies that can take a toll in New Hampshire, where health care is the largest workforce sector. Most recently, in February, almost five years after announcing its intent to purchase Wentworth Douglass Hospital, Mass General Brigham announced the largest number of layoffs in its history.  About 1,500 non-clinical employees lost their jobs throughout its network of hospitals, including in New Hampshire.

Another concern about hospital consolidations, say doctors and analysts, is that out-of-state entities don’t always have an accurate picture of what a New Hampshire community needs.

Josephine Porter, strategic advisor for the N.H. Center for Justice & Equity, says when a community hospital is acquired, ‘there is concern that the benefit the hospital provides to the community no longer reflects the community needs.’ (N.H. Center for Justice & Equity photo)

“If you’re getting acquired by an organization that is not local, the decision-making authority for what community benefit looks like is also not local,” said Josephine Porter, strategic adviser for the N.H. Center for Justice & Equity, a nonprofit that advances issues of health equity. “There is concern that the benefit the hospital provides to the community no longer reflects the community needs.”

‘Nobody cares for us’

One of the biggest concerns is the impact that mergers have on a patient’s access to care, including maternity and behavioral health services. 

HCA shut down its labor and delivery services at Frisbie two years after purchasing it, even though it originally said it would not do so until five years after the merger. Obstetrics tends to be a high-cost venture for hospitals, with less-than-attractive returns. Birth rates are also going down in New Hampshire, making it harder for hospitals to continue to offer services, and making it difficult for patients to get access to the services elsewhere.

“You know how many patients I used to get at Frisbie who did not have a car that would function and be reliable?” said medical oncologist Bhargava. And, she said, even if they had a family member who could drive, that person would often be working and not be able to take time off.” 

She added: “There are very socially and economically challenged people. If they don’t have health care close to them, they are going to die in their homes.”

‘Difficult to survive’

The hospitals argue they face enormous challenges of their own. More than one-third of nonprofit acute care hospitals in the state reported they’re running in the red, said Ahnen. 

He said workforce shortages have led to high job-vacancy rates across all hospital departments — 14% for nurses, 20% for surgical technicians, 22% for respiratory therapists — even as health care needs have kept hospital beds full, to the point where they cause a backlog in the emergency department. 

Experts predict the hospital consolidation trend will continue in New Hampshire over the next several years.  

The first hearing held by the state Healthcare Consumer Protection Advisory Commission on May 28 in Rochester attracted some 75 people, many of whom offered comments about the effects of the 2020 acquisition of Frisbie Hospital by the for-profit HCA Healthcare. Speakers included employees of the hospital, who praised the merger, and members of the public decried the deal, citing facilities closures and failure to be notified about changes in medical staff. (Photo by Meera Mahadevan)

According to Hodder of Franklin Pierce Law, with so many local hospitals in New Hampshire, “it’s going to continue to put pressure on our hospitals to compete with each other, which will result in higher cost, which is eventually going to hurt the system, and there will be pressure to consolidate. Some are going to win and some are going to lose in the process.”

This story is part of Critical Condition: What hospital consolidation means for care, access, and your community, a special series co-produced by partners in the Granite State News Collaborative. These stories are being shared by media outlets across New Hampshire. We want to hear from you! Take our short survey at https://tinyurl.com/3au39uct about your healthcare experiences. For more information, visit collaborativenh.org.

(Shorter Version Critical Condition Sidebar) New Hampshire’s ‘favorable’ conditions for hospital acquisitions

By Meera Mahadevan, Granite State News Collaborative

Why are big out-of-state hospitals eager to make a foray into the New Hampshire health care market? The answer partly lies in the fact that the state is uniquely situated, both geographically and politically.

Josephine Porter, strategic advisor for the N.H. Center for Justice & Equity, says when a community hospital is acquired, ‘there is concern that the benefit the hospital provides to the community no longer reflects the community needs.’ (N.H. Center for Justice & Equity photo)

Access to more patients just across the state border is attractive to hospitals in Massachusetts that have faced uphill regulatory battles in their own state, analysts say. New Hampshire also does not have large employers, like Massachusetts does, with the muscle to push for change in health care costs.

“New Hampshire, despite being small — the patient mix tends to be favorable,” said Josephine Porter, strategic adviser for the N.H. Center for Justice & Equity. “There’s good health insurance coverage (here), on the commercial side.”

Lucy Hodder, director of the Health and Life Science Policy programs at the University of New Hampshire’s Franklin Pierce School of Law, says price pressures on hospitals could continue the consolidation trend. (Franklin Pierce School of Law photo)

Of New Hampshire’s 1.4 million residents last year, about 62%, 853,000 people, received private health insurance through their employer or by purchasing their own coverage, according to Lucy Hodder, director of Health and Life Sciences Law and Policy programs at the University of New Hampshire’s Franklin Pierce School of Law. Her data shows that 16% had Medicare and 9% Medicaid.

In addition, Porter said, “there is some benefit to looking at New Hampshire because the process isn’t as arduous here as it might be in someplace else.”

A decade ago, New Hampshire got rid of one big regulatory hurdle: the Certificate of Need Board. It required New Hampshire hospitals and clinics to get state permission before building or expanding facilities. New Hampshire formed the board in 1979 but shuttered it in 2016 after a long legislative battle over the board’s pluses and minuses. Critics said it created obstacles by requiring that, before a facility was built, evidence had to be produced to show it was needed. 

“There are other states where there are more stringent certificate of need boards and regulatory authorities,” Porter said. “There are many more steps in other states than what New Hampshire has.”

Currently, the state Attorney General’s Office is the only entity overseeing hospital mergers through its antitrust bureau and charitable trusts unit.

The Attorney General’s Office has been ringing the alarm bell over hospital consolidations and their potential to reduce competition for the last several years. In fact, in 2022, it opposed Dartmouth-Hitchcock’s plan to purchase Granite One Health, a combined entity that included Catholic Medical Center in Manchester, saying the move would limit competition.

But earlier this year, Attorney General John Formella said he was compelled to approve HCA’s acquisition of Catholic Medical Center, in part because the Manchester hospital was in such dire financial situation that patients stood to lose services entirely if it shut down. 

The Legislature established a trust fund, known as the Healthcare Consumer Protection Trust Fund, and would direct the hospital that is doing the buying to contribute money toward the fund. Under that directive, Beth Israel Lahey, following its purchase of Exeter Hospital in June 2023, was required to deposit $10 million over 10 years into the trust fund. And HCA must pay $7.5 million over 10 years. 

In addition to the trust fund, the Healthcare Consumer Protection Advisory Commission was formed to help advise the AG on how to spend and manage that money. Expenditures from the fund need approval from the seven-member commission, the governor, and the N.H. Executive Council. The commission has been meeting monthly since July 2024.

Last November, the commission voted to spend up to $1.6 million from the trust fund for a three-and-a-half-year contract with the University of New Hampshire to create the Center for Studying Healthcare Markets. The goal is to evaluate the impact of health care consolidation and examine regional best practices from neighboring states in New England.

In addition, some are asking the state to establish a patient advocate office to help contain costs and hold the industry accountable.

The health commission has begun holding a series of public hearings, including one planned in Exeter in June and one in Claremont in July.

The first hearing, held May 28 in Rochester, attracted over 75 people, with several HCA employees and a few members from the public showing up to speak. 

The first hearing held by the state Healthcare Consumer Protection Advisory Commission on May 28 in Rochester attracted some 75 people, many of whom offered comments about the effects of the 2020 acquisition of Frisbie Hospital by the for-profit HCA Healthcare. Speakers included employees of the hospital, who praised the merger, and members of the public decried the deal, citing facilities closures and failure to be notified about changes in medical staff. (Photo by Meera Mahadevan)

Nurses and hospital administrators at Frisbie praised the merger in their presentations to the commission, citing positive turnaround data, including shorter wait times at the ER. But members of the public who spoke said facility closures and patients not being properly notified of doctor departures following the Frisbie acquisition had been very difficult for them. 

“I have institutional memory of what Frisbie used to be and what it is for my husband who is very ill,” Marsha Miller, an 81-year-old Rochester resident who lives across from the hospital, told the commission. “We have to deal with perceptions, which is that HCA is bad.”

Referring to HCA employees’ favorable comments about the merger, she added: “Nobody knows all of these wonderful things. These changes are not a part of my reality.”

Attorney General Formella, told the audience, “A lot has happened in the health care industry. … And we are going to need to be having a lot of conversation – a lot of thoughtful dialogue about where the state goes from here.” 

This story is part of Critical Condition: What hospital consolidation means for care, access, and your community, a special series co-produced by partners in the Granite State News Collaborative. These stories are being shared by media outlets across New Hampshire. We want to hear from you! Take our short survey athttps://tinyurl.com/3au39uctabout your healthcare experiences. For more information, visitcollaborativenh.org.

Yes, I have a felony. No, I won’t apologize.

By Shamecca Brown, Columnist, Granite State News Collaborative

First off, no I’m not angry.

My directness stems from self-awareness, not anger. I possess clarity, confidence and self-awareness, not attitude. 

Being unapologetic means owning my survival, voice and truth without shame or regret for my experiences. Labels like "emotional," "aggressive," or "too much" are attempts to control strength. Having been through difficult experiences leads to speaking out with wisdom and boldness. Protecting my peace, setting boundaries, and acknowledging my experiences are not things I apologize for.

And just because I’m not rich or famous doesn’t mean I owe the world an apology for surviving. Celebrities get to move wild and stay untouchable. But people like me? We get dragged for simply trying to stay afloat.

So let me tell you my truth:

Back in 2019, I was publicly humiliated and criminalized for something that came from trying to provide for my family as a struggling mother. I was charged with a felony for using my son’s Social Security and food stamp benefits. I hadn’t reported that I remarried; I didn’t know that was a problem until an investigator started knocking on doors, asking neighbors about me. 

It wasn’t fraud. It wasn’t a scheme. It was survival. I thought I could make it right by being honest from the start. I showed up without a lawyer and with my truth, but the system didn’t care. They twisted the narrative and made me a headline, just another statistic instead of a human being. I never thought I would have a felony conviction. I came with my truth, but without an attorney, my story was turned inside out. 

Being a single Black mother, I was reduced to a stereotype: the angry, struggling, bitter mom. People saw a caricature, not a full person. They didn’t see the late nights, the hard work or the deep love I have for my children. By making me that character, the system tried to erase my strength and silence my voice.

I was ashamed then because my children had to see me go through this, but not remorseless. I did not pity myself and I refused to let that narrow image define me. Threatened by jail time and overwhelmed by the system, I plead guilty to a felony. It shouldn’t have happened. But it did. 

And I started to work to overcome it. 

Even though it cost me professionally and personally, I didn’t fold. I didn’t let it define me. I learned. I rose. I kept moving, because I had children to raise, a life to live, and a purpose bigger than my pain.

I was bold then. But that version of me was hard, guarded and defensive. That was survival mode. Standing firm for my kids was tough but felt right, and that's why I won't apologize for something I believed in. I knew my worth, even when others tried to diminish it. 

Living with a felony made me realize I can overcome anything. Staying stuck isn't in my nature. Taking responsibility meant facing the consequences head-on: no excuses, no running. It meant owning it, learning from it, and doing the hard work to rebuild my life with integrity, not just for me, but for my children and everyone watching my journey. I take full responsibility and own my actions, but I don’t need society reminding me of them constantly.

Unapologetic now looks like freedom.

It looks like walking into rooms like I belong, even if someone wants to remind me of my past. It looks like advocating harder for single moms, for women navigating unjust systems, for people criminalized for surviving. It looks like helping survivors rebuild, supporting people with disabilities, and showing up every day with empathy, even when I could’ve led with anger.

Unapologetic now means I speak firmly and protect my peace. I don’t dim my tone, shrink my voice or edit my truth. I know how to walk in Jordans and still lead with power. I know how to carry wisdom and still sound like I’m from Queens. I don’t move messy, I move with purpose. And if that makes someone uncomfortable, that’s their issue, not mine.

I’m not loud, I’m heard. Not bitter, I’m built. Not intimidating, you’re just unfamiliar with someone who knows their worth.

I’ve walked into rooms not made for me and created space anyway. I’ve endured what would’ve broken others, and still choose joy, purpose and service. I carry the voices of ancestors who couldn’t speak. I stand for those still learning it’s okay to take up space.

I’m not seeking validation. I’m telling my story before someone else tells it for me, without the heart, the context or the truth.

So to every person who’s been labeled “too much,” “too real,” or “too complicated” you’re not the problem. You’re powerful. You’re necessary. And you don’t owe anyone your silence.

You owe the world your truth.

This is what being unapologetic looks like, then and now.

These articles are being shared by partners in the Granite State News Collaborative. For more information, visit collaborativenh.org.

Growing up, I didn’t celebrate Juneteenth. As a Black mom, I make sure my kids do.

By Shamecca Brown, Columnist, Granite State News Collaborative

When I dance on Juneteenth, it will be for my ancestors. It is for every Black person who walked the path of slavery and discrimination. This is for those who never got to taste freedom, who dreamed of a day they’d never live to see. 

I’m bringing all of that to the stage with me. Every step, every turn, every breath, is a story. A real story. A Black story, My story.

I’m dancing at the Currier Museum of Art, in an event organized by the nonprofit Racial Justice Team. Yet this isn’t just a performance. This is us. Our history. Our pride. Our moment. And trust me when I say, everyone in that audience is going to feel it. 

Our performance will feature Sam Cooke’s “A Change Is Gonna Come,” a song that has long served as an anthem of hope and perseverance, along with African folk songs that connect us to the rhythms and traditions of our heritage. 

You know what makes this year’s Juneteenth even greater? My two youngest children will be right there with me, representing. My 12-year-old son and my 15-year-old daughter will be part of this moment, and that means everything to me. My son, especially, has so many questions. And I love that. 

As a child he couldn’t express himself much at an early age because of his delayed speech, but one thing he could do? Dance. Now, he’s the one who challenges the world around him, the one who asks his teachers, “Why are we celebrating St. Patrick’s Day so hard, but when it was February, Black history was barely even mentioned, maybe just once?” He knows what’s up, and he wants to share the stage.

Growing up, Juneteenth was a day like any other for me. I never heard anyone mention it, even though both my grandmothers were deep Southerners, living in Alabama and North Carolina. But there were no parades, no cookouts, no big community gatherings. I never heard my friends talk about it or my family to be honest.

This was a discovery for me and my family: The understanding about honoring those who came before us, those who struggled, and those who carried the torch to make sure future generations would one day know their freedom. It’s a learning experience for all of us, filling in the gaps that schools still don’t teach, and encouraging my kids to ask hard questions. 

When I was young, I wasn’t allowed to ask our elders certain questions. Even now, my 90-year-old grandma from Alabama keeps a lot to herself. When I ask about her experiences in the Jim Crowe south, she just gets quiet and says, “That’s my space, it’s not for y’all to worry about.” 

My grandma doesn't talk about the past because she’s been through and seen so much. She once told me, “I wasn’t free.” Those words never left me. Maybe–and this is just me thinking– my grandmother can’t justify Juneteenth as a holiday because some of her relatives and friends never made it to freedom. They were stuck. 

Caption: My grandma (far right) who is 90 today, with her mother (top left) and three of my great-grandmother’s 13 children. 

My grandmother had one thing going for her: she was a landowner, something many other Blacks weren’t able to become because of systematic oppression. Her own mother bought the land, earning money through sharecropping and making dresses. It’s still a source of pride, but I get teary eyes, thinking about the hardship that went into getting and keeping that land.  

In New Hampshire Juneteenth is not officially a state holiday, it has been acknowledged as a day of observance since 2019. Many organizations and communities across New Hampshire celebrate this day. I think the more we take the time to celebrate and truly recognize Black American history, the more we begin to understand just how rich, complex, and deeply connected it is to all of our lives. 

While writing this I was feeling overwhelmed thinking about what is happening in our world. I think about how my kids, and their kids, will have to struggle just to keep teaching the truth; how they’ll have to fight to make sure Black stories don’t disappear. But no matter what, being free from oppression and able to live with dignity is a reminder to all of us about the power of liberation, the importance of remembrance, and the responsibility we have to ensure freedom for all people, regardless of the color of their skin. 

So let’s continue to celebrate Juneteenth and keep it alive. I know once I’m on that stage dancing, that overwhelming feeling will disappear right through my feet. That’s my Juneteenth celebration: to share my movement and capture smiles.

These articles are being shared by partners in the Granite State News Collaborative. For more information, visit collaborativenh.org.

Tackling the increase in New Hampshire’s motor vehicle crashes and fatalities (Copy)

Just a few months into 2025, the Granite State is experiencing a deadly surge on our state highways and roads. As of May 2025, there was a 9.68% increase in motor vehicle crashes from this time last year, along with a disturbing projection of possible fatalities to come. Rosemary Ford talks about the increase in motor vehicle crashes and fatalities in New Hampshire with Lt. Chris Storm, N.H. State Police commander of special services, and Tyler Dumont, the N.H. Department of Safety’s strategic communications administrator and public information officer.

By Rosemary Ford and Caitoin Agnew

This article has been edited for length and clarity.

Rosemary Ford:

Lieutenant Storm, you’ve been with the N.H. State Police for over 20 years. What have you seen that explains the reasons behind the increase in crashes? What are the leading causes?

Chris Storm:

​​First and foremost, our impairment. Second, our speeding. And third, distracted driving. These three continue to be the leading factors in our fatalities out here on our highways in New Hampshire.

Rosemary Ford:

From 2020 to 2024, studies have shown a 233% increase in fatalities among 16-to-21-year-old vehicle operators. Lieutenant Storm, that’s a steep statistic. During the pandemic in 2020, fewer people were driving. As things opened up, that obviously changed. Did that play a role in forming these statistics? 

Chris Storm:

We don't actually have any statistics that tell us that it was the absolute factor, but if you look at it holistically, it obviously contributed to some of that. I can't give you a specific number or tell you that, yes, that was the reason, but we have seen an increase in those youth and younger drivers that are seen to be crashing and dying on our highways.

Rosemary Ford:

What about other changes? During the pandemic, some 15-to-16-year-olds experienced driver’s ed over Zoom. Could there be a connection with some of this? 

Chris Storm:

I don't know if there was a difference between having it in a classroom or not having it in a classroom — the students still had to get out there and get all their driving hours. So it wasn't that they were just driving virtually. They were actually out on the roads, practicing and driving. They still had to do the required hours with that individual that's 25 years or older, so I don't have a good statistic on that and whether that was a factor or not.

Rosemary Ford:

What role has technology played in these increases?

Chris Storm:

Technology, even though it has some unbelievably great benefits, also can be very detrimental if you're taking and dividing their attention or being distracted while you're operating a motor vehicle anytime. A moment of inattention can easily lead to something that could be catastrophic.

Rosemary Ford:

Tyler, you are the New Hampshire Department of Safety’s strategic communication administrator, and public information officer, can you tell us about your role? 

Tyler Dumont:

My position here is really focused on trying to educate and inform people about issues that are going on in our state when it comes to highway safety issues. Really obviously, our target is drivers, pedestrians, cyclists — all different people who use the roads. We’re trying to get the message out about the risks of dangerous behaviors on the road and encourage safer behaviors.

Rosemary Ford:

So what’s the plan? How can the state prevent crashes and deaths? 

Tyler Dumont:

Our plan has really developed over the past year. I'd say we have started to integrate a lot of the work that we're doing with an external organization. In fact, we've hired a media vendor to work with us on creating New Hampshire-centric, homegrown campaigns to ultimately reduce crashes and save lives on our roads. We do that kind of in two different ways. It's really a data-driven approach that targets those two areas, which are deterrence and prevention.

Rosemary Ford:

Is there anything that the state Legislature can do that hasn’t been done already? Any new laws for seat belts, helmets or driver’s ed curriculum?

Chris Storm:

Currently, the Legislature actually has several bills before them to help increase traffic safety. First and foremost, there's a bill to increase the penalties for refusing to take a post-arrest chemical test if you've been arrested for DWI. There is a bill on the table right now to increase the penalties for individuals that are traveling over 100 miles an hour. There's also another bill on the table right now that will add penalties to aggravated driving while intoxicated if you were driving on a controlled access highway in the wrong direction, because we've also seen a spike in wrong way driving. 

And then we have another bill, right now, that would increase the license loss for youth operators for every time that they get a traffic summons and not only lose their license, but they would also have some educational mandates, and they would have to attend certain classes to help better their driving abilities.

Tyler Dumont:

My role is to really analyze the current crash data that we have, and not so much to really focus on the possible laws or ways that we could change. It's really focused on what we do have and trying to identify some of those issues and the ways that we can address them, as to what's currently in the books.

Rosemary Ford:

As we continue into the summer, when there are more drivers of all ages, and New Hampshire gears up for Bike Week on the 14th, are there some things that we can do as drivers to keep everyone safe on the roads? 

Tyler Dumont:

I think trying to get ahead of some of these issues. The lieutenant mentioned earlier that motorcycle crashes often trend up in the summertime — just in 2023, unfortunately, we had a near 20-year high in motorcycle deaths. Again, it's about monitoring the data and tracking the data. With Motorcycle Week arriving, along with warm weather, we've rolled out some motorcycle safety messaging for riders and drivers. We started that early, before the season even started, back in April, and we've tried to get that messaging to those who will be using the road.

Chris Storm:

We can encourage everybody to share the road. We want to make sure that people understand that — that motorcycles are everywhere, that we want people to be able to see them. It's not necessarily that the motorcyclists are always doing something that is wrong. Oftentimes they're not doing anything wrong, and it's because someone didn't see them, or they pull out in front of them. We want people to share those roadways with everybody. We also want our motorcyclists to remember to also drive safe as well and ride safe so that everybody gets home safely.

Rosemary Ford:

Lt. Chris Storm, N.H State Police commander of special services, and the N.H. Department of Safety’s strategic communications administrator and public information officer, Tyler Dumont — thank you so much for joining us today. 

“The State We’re In” is a weekly digital public affairs show produced by NH PBS and The Marlin Fitzwater Center for Communication at Franklin Pierce University. It is shared with partners in the Granite State News Collaborative, of which both organizations are members. For more information, visit collaborativenh.org.

Will Canadians boycott New Hampshire this summer?

By all accounts, Canadians are not happy with us. Could it be the talk of making them the 51st state? Or perhaps the 25% tariffs? Maybe it’s both. And because of that, they might not visit us here in New Hampshire this summer. In New Hampshire, fewer visits could mean millions in lost revenue and taxes. Here to discuss what’s going on and why is writer Granite State News Collaborative reporter Jonathan Decker. 

By Rosemary Ford and Caitlin Agnew

This story had been edited for length and clarity.

Melanie Plenda:

You recently wrote a story for the Granite State News Collaborative looking into how a Canadian boycott of the U.S. could affect the New Hampshire tourism industry. What inspired that? 

Jonathan Decker:

I was actually just having breakfast with my fiance, and we were both just kind of talking about tariffs and the economy. She actually asked me, “I wonder if it's gonna affect visitors from Canada,” and I thought “That’s a really good idea for a story.” Then I started looking into it and then I pitched it to the Collaborative. I thought there's really something here. It turns out there was.

Melanie Plenda:

What did the Canadians you talked to say about visiting the States this year. What are they thinking? Why aren’t they coming? 

Jonathan Decker:

The primary Canadian I talked to was a dual citizen, and because she travels back and forth from the U.S. and Canada all the time, I asked her about what people are saying. A lot of people are kind of boycotting travel, and even just spending in general, that is associated with the United States over the 51st state comments and the tariffs. 

I think it depends on which person you're talking to, but this source told me people were much more upset with the 51st state comment than the tariffs. The 25% tariffs were baffling — that’s the word she used — because Trump did come up with and sign the trade agreement between the U.S., Canada and Mexico in 2017-18, and now he's kind of reneging on that.

A lot of Canadians also expressed confusion, but it really seemed to be more of a personal thing that's really what's keeping people from visiting. It’s almost like a betrayal from a friend. I think a lot of Canadians think that things soured really quickly. It’s like having a friendship with somebody and then they say, “I don’t want to see you anymore” — that type of thing.

However, it does look like it's going to be more older people who are boycotting and younger people who still might come down, especially for hiking, outdoor recreation — that type of thing. 

Melanie Plenda:

There are even marketing campaigns in Canada advising citizens not to visit the States and buy Canadian goods. What’s going on there?

Jonathan Decker:

Yes, so that seems to be happening in various different businesses. It seems to be pretty grassroots. I first heard about this, actually, from my editor, Jeff Feingold, when he was traveling in Canada, when I was working on this piece. He actually wrote to me and said, “Hey, there's actually all these signs in the grocery store that say, ‘Buy Canadian,’ that products are labeled so you know if you're going to buy the U.S. product or the Canadian product, to encourage local consumption and production.”

Another one of my sources was Charlie St Clair. He's a state representative, but he's also the man behind Bike Week, and every year he goes on a big odyssey across the country to promote Bike Week in Laconia, sending out mailers and magazines. And he told me that when he was driving, he was listening to an AM radio station in Canada, and he heard an ad telling people to stay home, don't travel to the United States this summer, and spend your money in Canada. So it just seems to be a grassroots and populist movement to counter President Trump's rhetoric.

Melanie Plenda:

What will that mean for New Hampshire’s economy? What sort of an impact will that have? 

Jonathan Decker:

It's a little difficult to get exact numbers, because even the Division of Tourism here doesn't track specifically how many Canadians are coming in. Many of them come through Vermont. But we do know that the state raises a significant amount of tax revenue from the rooms and meals tax — I think in 2023, $450 million was raised. So if you just saw a 5% dip, that could be $22 million of lost revenue from Canadians not spending on those hotel rooms and those meals and restaurants. But again, we can't really know the exact big number of the year until it happens.

Melanie Plenda:

What about the local tourism industry? Do they see a way to adapt to this change? 

Jonathan Decker:

I think it depends on what region you're in. One of my sources mentioned that they might be able to adapt due to lower gas prices. So we might just get more American visitors willing to travel and drive into New Hampshire. That was probably the biggest adaptation I saw. But as far as replacing Canadians specifically, I didn't hear anything about that. But again, you might be able to make up for this with domestic travel.

Melanie Plenda:

What about repairing our relationship with Canada? What will it take? 

Jonathan Decker:

I think that's going to vary from individual to individual, but one theme that I noticed was that there seems to be just more blame at the higher levels. As far as Canadian and American citizen interaction goes, there doesn't seem to be that much bad blood. But when it comes to the top of the pile, the political class, I honestly think a change in American leadership would be a strong first step to that. 

One of my sources thinks it could take a generation to get over this. It depends from person to person, but a lot of Canadians do feel very hurt by this sudden turn on them as a trading partner and as an ally, especially with the rhetoric surrounding being the 51st state. 

I'm not sure what Trump is trying to achieve with that rhetoric. I don't know if the United States would actually like to manage Canada and add an additional 35 million citizens. His motivations surrounding the trade war are a bit difficult to splice as well, because if it's not a dissatisfaction with the initial trade deal — he said it's been to pressure them to do more about fentanyl trafficking. But according to the DEA, Canada is not a major supplier of fentanyl to the United States, it is Mexico, China and India. Canada already has its own huge fentanyl problem as well. They're much more of a consumer than an exporter of the drug and the components needed to make it. 

So I'm not sure what his strategy is in that sense. I understand pressuring Mexico — that makes a lot more sense to pressure Mexico and China, because that's where it's coming from, but we will see.

Melanie Plenda:

That was interesting. Granite State News Collaborative reporter Jonathan Decker — thank you so much for joining us today. 

“The State We’re In” is a weekly digital public affairs show produced by NH PBS and The Marlin Fitzwater Center for Communication at Franklin Pierce University. It is shared with partners in the Granite State News Collaborative, of which both organizations are members. For more information, visit collaborativenh.org.

What the first American pope means for Catholics and the world

The world’s 1.4 billion Roman Catholics now have a new leader, Pope Leo XIV. What does that mean for the future? The Very Rev. Jason Jalbert, one of the vicars general for the Roman Catholic Diocese of Manchester — which encompasses all of New Hampshire — and the rector of St. Joseph’s Cathedral in Manchester, discusses what the papacy is, former Pope Francis’ legacy and what lies ahead for his successor.

By Rosemary Ford and Caitlin Agnew

This article has been edited for length and clarity.

Melanie Plenda:

For those who may be unfamiliar, can you briefly explain the role of the pope in the Roman Catholic Church?

Father Jalbert:

The pope is the head of the church, the Vicar of Christ. He has many different titles, but most importantly, he's the successor of the apostle Peter. So we call him the successor of St. Peter because Peter received that role from Jesus himself, and we read about it in scriptures. Jesus said, “You are Peter, and upon this rock I will build my church.” And so the church was built on him.

So each pope after Peter has been the successor of Peter. We respect him very highly because of who he is, the person that's chosen to be the pope then represents Christ on earth for us and for all the Catholics.

Melanie Plenda:

Popes usually pick new names upon their election. Can you explain this tradition and what it means?

Father Jalbert:

It goes back to St. Peter again. Peter, son of Simon, son of John, became Peter, the name that Jesus gave him. And so over the history of the church, those who have been elected as pope have taken on a name, and many of the names have been repeated over and over and over, just like Pope Benedict was the 16th, and now we have Leo, the 14th. Pope Francis was just Pope Francis, because no other Pope ever had the name Francis, and no other pope has ever taken the name Peter. So there will probably never be a Peter the second. They'll only just be one Peter.

The pope's name says a lot about who they are and how they look to the future. So it means a lot to choose that name, and it gives them a whole new identity, when you think about it.  It's very life-changing.

Melanie Plenda:

Let’s turn to Pope Francis, who, before becoming pope, was a cardinal in Argentina. He served as pope for 12 years. What impact did he have on the world and the church? What will his legacy be?

Father Jalbert:
Like all other popes, they have an impact with the role they have. Everything they say and do has an impact. Going back to the day that Pope Francis was elected — he came out on the front of St. Peter's Basilica in the square, in the white cassock, having just been elected, and he looked pretty serious, because it's a very serious role. There's a great weight to the role of being pope. He came out and he asked people to pray for him.

I think people remember that quite clearly. Then, at the end of his pontificate, after being sick, he went out on that same balcony in St. Peter's Square, asked people to pray for him again, but gave his final blessing — which we didn't think would be his final blessing — to Rome and the world, but then so many different things in between showed his desire to make Christ known. He was an evangelist, he preached, he taught Jesus Christ, and he traveled to many different places throughout his pontificate. He really cared for the poor, the elderly, the sick, the unborn. He had a great desire to lift up the dignity of human life.

During the COVID pandemic, when everybody was just in their homes and not traveling, there he was in the middle of St Peter's Square, praying for the world, praying for each and every one of us. He held the monstrance, which is a gold-looking object that looks like the sun, but in it is the host that we believe is truly Jesus Christ. He blessed the world that evening with Christ in his hands. There are so many different things.

Melanie Plenda:

Turning back to the current pope — what were your first thoughts when you learned about the election of Cardinal Robert Prevost, now Pope Leo XIV?

Father Jalbert:

I think it came quite quickly after the fourth vote on that Thursday afternoon. I was with a priest friend, and we had the television on, watching live coverage, just like so many people were — all eyes on the chimney and the seagull family that hung out by the chimney, just waiting for the smoke. And all of a sudden the smoke started, and it was white smoke, and we had a pope.

Then the cardinal announced his name in Latin. When I heard that name, Prevost, I wasn't exactly sure who it was, except for the friend I was with who said, “Oh my. That's Cardinal Prevost from the United States.” You wait to hear the name and he took the name Leo, the fourteenth. What is that going to mean?

Then he comes out onto the balcony and says his first few words, hearing him speak in Italian for that first greeting, and it kind of made me feel a little better, because it's just hard to think about an American pope as a typical American speaking English. I spent most of the day learning more about him as more news came out about who he was in interviews — people that know him, from priests to his own siblings, which was another interesting thing to hear from the relatives of the new pope, which we haven't really had that before.

Melanie Plenda:

Did you ever think you would see an American pope? And what do you think the impact of his papacy will be in the United States?

Father Jalbert:

I think, first, like so many other people, I never thought there would be a pope who was born here in the United States, or a pope from the United States. So that idea was something that I think most of us just sort of put in the back of our minds. I'm not even sure if many people hoped it would happen, but it has happened.

They say that out of all the American-born cardinals he's probably the most un-American, in the sense that he was born here, grew up here, and had his formative years here in the United States, but then served outside of the United States for so many years as the head of the Augustinian order, then as a bishop in Peru, then as a archbishop and cardinal working in Rome. So he's had a great experience, and it's not like he was just plucked from here to become pope.

As far as the impact in the United States — I think he will, and I think he already has had an impact. They say the number of searches online about the Catholic Church in the United States has skyrocketed. People are interested. The more that we get to know him, I think the more people are getting to love him, and if they love him and they see that he's a genuine, authentic man who has been elected to lead the church, people might be interested in learning more about the church and about how to become Catholic. We'll have to wait and see. But I think he’s really making a great impression already in the short amount of time that he has been the pope.

Melanie Plenda:

How have local Catholics reacted to the news of a new pope?

Father Jalbert:

From what I've heard in my own parish, people are excited. They're happy. It's very unusual to have a pope who can speak perfect English. So to hear him speak English is a little strange at first, but then to be able to hear the pope speak our own language very clearly feels like we should be proud. He's from here, he's one of us, just like the Polish people were so proud when Karol Wojtyła was elected Pope John Paul II, and they still are so proud.
Melanie Plenda:

As you mentioned, Pope Leo XIV comes from the Augustinian order. Can you explain what that means?

Father Jalbert:

It's an order that follows a rule that comes out of the teachings of St. Augustine. St. Augustine is an early saint. His mother prayed for his conversion for many years, and he became Christian, then became a priest and a bishop and wrote extensively, and his writings are very well known, especially the confessions. There’s an order that’s based on St. Augustine. They're best known for being teachers and educators in high schools and colleges — Villanova being one of them, and closer to us is Merrimack College.

Melanie Plenda:

Can you touch a little bit more on what you think his priorities will be?

Father Jalbert:

I don’t think the secular media wouldn’t fully understand his role and what his mission is as the pope. It's not to be political, but it is to be Christ here the world, the visible presence of Christ. He’s looking out for the people, from the unborn to the elderly and everyone in between. That’s not being political — that’s just being Catholic, being Christian, what we believe the human person to be.

He's already had quite a few opportunities to give homilies and give talks, and he really is focused on unity. He wants to be a bridge-builder, and that's also one of the roles of the pope. “Pontifex Maximus: is the great bridge, and so popes have been given that title. So unity, communion and just the love of Christ and the peace that Christ has come to offer — made that known right from the beginning as he offered Christ's peace to the people on the day of his election, as he came out for the first time as Pope Leo XIV.

Melanie Plenda:

That was so interesting. The Very Rev. Jason Jalbert, thank you for joining us today.

“The State We’re In” is a weekly digital public affairs show produced by NH PBS and The Marlin Fitzwater Center for Communication at Franklin Pierce University. It is shared with partners in the Granite State News Collaborative, of which both organizations are members. For more information, visit collaborativenh.org.

New Hampshire Humanities faces a new reality after abrupt withdrawal of federal support

Funding cuts have a ripple effect on cultural programming, communities across the state

By Kelly Burch, Granite State News Collaborative

Funding cuts have a ripple effect on cultural programming, communities across the stateThis spring, about 1,100 people — more than live in the entire town — visited a former elementary school in Jefferson to view a Smithsonian exhibit about rural America. 

Schoolchildren, elderly residents and everyone in between discussed the present and past of the North Country, creating new bonds within the community.

“We don’t know each other well, but we are starting to now,” said Joe Marshall, president of the Jefferson Historical Society, which orchestrated the event. “This brought a lot of people together, and everybody has really really enjoyed it.”

The exhibit, which has since moved to Plymouth, took place in part through a $3,000 grant from New Hampshire Humanities, a nonprofit that distributes federal funding to support humanities activities — those that explore culture, history and social values. Last year, grants from the organization touched 172 of New Hampshire’s 234 cities and towns, said Michael Haley Goldman, executive director of the organization.  

The Smithsonian exhibit, ‘Crossroads: Change in Rural America,’ drew hundreds of people to the North Country town of Jefferson this spring. The exhibit was ‘a real game changer’ for the community, says Joe Marshall, president of the Jefferson Historical Society. (Courtesy Jefferson Historical Society).

But similar programs across the state are facing an uncertain future — and some are already canceled — because of federal funding cuts. In April, the National Endowment for the Humanities canceled nearly all its grants, including to New Hampshire Humanities, to comply with requests from the Trump administration and the Department of Government Efficiency, or DOGE. In turn, NH Humanities has had to reduce its own grantmaking, canceling grants to a program exploring artificial intelligence in Hampton Falls and Holocaust education in Meredith, among others. 

“We’re already thinking about cutting back on the programs we’re going to offer next year because the funding has ceased,” said JerriAnne Boggis, executive director of the Black Heritage Trail of New Hampshire, which depends on grants from NH Humanities for its Tea Talks series exploring the Black experience.

At the same time, funding has been halted for Granite State organizations that had received grants directly from the National Endowment for the Humanities, including the state’s largest-ever humanities grant, awarded to support a library currently under construction in Mont Vernon. 

“It’s a betrayal,” said Cindy Raspiller, a trustee at the Mont Vernon Library. “It sounds harsh, but it’s an apt word.”

‘A real game changer’

Each year, NH Humanities has received about $900,000 from the federal endowment. A large portion of that money must be matched through private fundraising, bringing the organization’s operating budget to $1.6 million annually, said Haley Goldman. The organization doesn’t receive any state government funding.

NH Humanities then makes 20 to 25 grants each year to support organizations around the state, Haley Goldman said. That includes major project grants of up to $10,000 and mini-project grants of up to $2,000. 

In addition, NH Humanities provides ongoing programs for organizations like libraries, schools and community groups around the state. One of its most popular programs — Humanities to Go — is a speaker series.

With the funding cuts, many of those operations are on pause. So far this fiscal year, NH Humanities has awarded about two-thirds of its allocated grant funding, Haley Goldman said. Programs that have already been promised a commitment will go ahead, but the other third of grant dollars will not be given out, and NH Humanities is not accepting applications for in-house programs such as Humanities to Go or Perspectives, a book group. 

Instead, the organization is focused on making sense of its new funding reality. 

“We’re really trying to figure out what’s sustainable for next year,” Haley Goldman said. “There is a sustainable path forward, which relies on the support of the community."

Funding from NH Humanities has a ripple effect for communities. The Jefferson Historical Society, for example, used its $3,000 grant for the Smithsonian exhibit as a “springboard to generate all the other in-kind dollars,” Marshall said. It also led to community partnerships and connections that will continue long after the exhibit leaves. 

“This is a real game changer,” Marshall said. 

‘Deep conversations’

Last fall, the Cohen Institute for Holocaust and Genocide Studies at Keene State College received a grant from NH Humanities to host a series of book groups centered on the book “Treblinka: Archaeological and Artistic Responses,” which explores the response to human remains and artifacts found at the notorious Nazi concentration camp in Poland. 

The recent showing in Jefferson of ‘Crossroads: Change in Rural America’ led to community partnerships and connections that will continue long after the exhibit leaves, says Joe Marshall, president of the Jefferson Historical Society. (Courtesy Jefferson Historical Society).

Participants received the book for free and were invited to attend a lecture by author Caroline Sturdy Colls last September. 

The program “opened up deep conversations about the meaning of human remains (both historically and today), and it also inspired some of my own students at (Keene State College) to delve deeper into the field of forensic anthropology,” said Kate Gibeault, director of the Cohen Institute.

In addition, the funding allowed the Cohen Institute to partner with other libraries and schools across the state “in ways that otherwise wouldn’t have been feasible,” Gibeault said. 

Often, NH Humanities grants support programs that are replicable in other communities, amplifying the impact of the dollars spent. 

“It’s one of the things that is special about New Hampshire — being able to share this information freely,” said Erin Sniderman, outreach librarian at the Hampton Falls Free Library. 

Sniderman has used NH Humanities funding in the past to create events that weave together Hampton Falls’ past and present, including a 2023 historical display and expert lecture about indigenous artifacts in town, after a community reading of “Braiding Sweetgrass,” a book that brings together indigenous wisdom and science. 

“Being able to pull all of these elements in together … we wouldn’t be able to do that without the humanities funding,” Sniderman said. 

Sniderman was planning a similar community event this summer, exploring the impact of artificial intelligence and robotics. The program was meant to serve as a template that other libraries could use to open discussions about those technologies, but it’s been scaled back now that NH Humanities isn’t making new grants. 

Some elements — such as a robot petting zoo — have found other funding sources, but without funding from NH Humanities, “we lose those professional scholars,” Sniderman said. “We get the toys, but we don’t get the education.”

A small library forges ahead

Mont Vernon is a small town of about 2,500 people in Hillsborough County. It’s also the location of the largest National Endowment for the Humanities grant in New Hampshire’s history: $655,000 to support construction of a new library. 

“We were very impressed with ourselves that we won,” said Raspiller, the library trustee.

Winning the grant — one of 23 given out nationwide — was only the beginning, however. The grant required $4 in matching funds for each $1 of grant money. The community met the challenge, and last September broke ground on the new library, which is slated to be finished in the fall, Raspiller said. 

So far, the project has collected about $164,000 from the national endowment, but on April 29 Raspiller received a notification that the grant had been terminated. No appeals process was available, the notice said. 

Now, the town is left scrambling to finish the library without the federal funding. Luckily — with many adjustments and with contingency funding — the project remains on track, but the loss of the grant is a major upset. 

A Smithsonian exhibit came to Jefferson earlier this spring, in part thanks to a $3,000 grant from NH Humanities. Similar programs are now under threat due to federal funding cuts. (Courtesy Jefferson Historical Society).

“It’s a little like someone tripping you at mile 25 of the marathon,” said Bonnie Angulas, library director in Mount Vernon. “You know you’re going to finish, but you might crawl across the line.”

The substantial federal humanities grant wasn’t a win just for Mont Vernon, Angulas said, but for New Hampshire as a whole. Each day she was fielding calls from other librarians, asking for advice on their own grant applications. 

“They were so hopeful about this project,” she said. After the cancellation, “it’s a little disheartening to everyone. … The federal government should come through on their promise.”

Planning for the future

Previous grant recipients say less funding for NH Humanities could lead to fewer community events and deeper discussions that bring people together. 

“Grants like these are critical in ensuring that all community members have access to conversations about what it means to be human,” said Gibeault of the Cohen Institute. 

Boggis, of the Black Heritage Trail, said that, just as the grants have a ripple effect, so does their cancellation.

“The trickle-down effect of this loss of funds is more than that one grant,” she said. “It’s felt in the community.”

Small organizations that “can’t go one season without that support may never come back,” she added.

Nevertheless, NH Humanities will continue to exist, no matter what happens with federal funding, Haley Goldman emphasized. 

“We see a path to sustainability without the federal funding because of the type of support we’ve had within the state,” he said. “Not every state is feeling as fortunate.”

In April, the Mellon Foundation announced $15 million in emergency funding to state humanities councils, including NH Humanities. That infusion of about $200,000, plus possible matching funds, will allow NH Humanities “to start next financial year in a much better place,” said Haley Goldman. Yet the organization is still working hard to decide what its new normal will look like without federal funds. That loss remains “detrimental,” he said, especially at a moment when Americans are feeling increasingly disconnected from those around them. 

"The cultural work of our communities isn’t a nice bonus if we can do it,” he said. “It’s the core of what we do as a society.”

These articles are being shared by partners in the Granite State News Collaborative. For more information, visitcollaborativenh.org.

60 years later, Community Action Programs are still on the front lines of fighting poverty

Amid threats to their funding, CAPs around New Hampshire remain determined to provide assistance

By Scott Merrill, Granite State News Collaborative

Sixty years after President Lyndon Johnson declared a “War on Poverty” and launched his vision for a “Great Society,” the ideals of equal opportunity and human dignity can feel distant, especially amid moves right now to roll back the programs and initiatives enacted in the 1960s that were meant to uplift marginalized communities.

A Head Start classroom in Tamworth that’s run by the Tri-County Cap. (Courtesy Tri-County Cap)

Among programs in the crosshairs are the funding sources for over 1,000 Community Action Agencies across the country — including five in New Hampshire – that were created through the landmark Economic Opportunity Act in 1964. The agencies administer anti-poverty initiatives such as Head Start and the Low-Income Home Energy Assistance Program and distribute food to pantries and soup kitchens. 

In his 2026 budget request, President Donald Trump is seeking to eliminate the $770 million Community Services Block Grant program, a key funding stream exclusively for Community Action Agencies. Though relatively modest, the grants are highly flexible.They’re used to fill service gaps, support clients who fall outside typical funding categories and leverage additional resources. Last year, New Hampshire’s share of that block grant funding totaled nearly $4 million, helping local Community Action Programs attract an additional $152 million from federal, state, local, and private sources. Agency officials warn that losing the block grants could seriously undermine their ability to secure matching funds.

Trump’s budget request would eliminate the $4 billion Low-Income Heating Assistance Program,  and in March the U.S. Department of Agriculture announced a $500 million funding cut for the Emergency Food Assistance Program, which supplies USDA food to Community Action Programs for distribution.

Amid the uncertainty, the agencies still quietly carry out President Johnson’s vision of providing food, housing, job training and financial literacy services to thousands in the Granite State and millions across the country, and CAP leaders in New Hampshire remain committed.

“What I really love about community action is that we are built to respond to specific community needs,” said Betsy Andrews Parker, CEO of the Dover-based Community Action Partnership of Strafford County. “We are truly the backbone of keeping people fed, housed, warm and in jobs, and most people don’t even realize it’s us doing that work.”

Every corner of the state

The Community Action Partnership of New Hampshire  — a collaboration of the state’s five Community Action agencies — is celebrating its 60th anniversary in May. The agencies serve every corner of the state, from the North Country south to the Monadnock Region and the Seacoast, and provided services last year to 111,638 low-income individuals in New Hampshire. Last winter, the LIHEAP program alone provided fuel assistance to 28,235 low-income individuals — those who earn 60% or less of the state median income. They received an average benefit of $1,049.

  • In Berlin, 74-year-old George Sanschagrin volunteers for the Tri-County Community Action Program, which runs the Senior Center of Coös County’s Senior Meals Program. 

    He does everything at the center, from fixing doors to delivering hot meals, often offering a warm hello to folks who might not see anyone else that day.

    Sanschagrin, who retired from millwork at age 62, calls volunteering the best decision he ever made. “I started volunteering after retirement and I’ve been volunteering ever since,” he said. Much of his work involves serving and delivering food to North Country seniors.

    Among the most essential yet under-recognized roles Community Action Programs play in New Hampshire is food distribution, says Betsy Andrews Parker, CEO of the Strafford County CAP. 

    “If you want to see something incredible, watch the tractor-trailers roll up to our agencies and start distributing thousands of pounds of food,” she said. “That food is what supplements nearly every food pantry and soup kitchen in the state.”

    Much of that food comes through TEFAP — The Emergency Food Assistance Program — which supplies U.S. Department of Agriculture food to agencies such as Tri-County CAP. In March, the USDA paused half of TEFAP’s funding, $500 million.

    The scale of food distribution is massive, said Michael Tabory, chief operating officer of the Concord-based Community Action Partnership of Belknap and Merrimack Counties. “Last year, we distributed over 4 million pounds of food. That’s more than $6 million worth, reaching over 225 organizations and about 25,000 households each month.”

    Sanschagrin, born and raised in Berlin, worked for 32 years in the city’s once-thriving mills. His French-Canadian family was part of the town’s industrial fabric. 

    “Back in the day, you had to know someone to get a job at the mill,” he says. “It was a real community — French Canadians on one side of town, Italians and English on the other.”

    That community spirit lives on in Sanschagrin. At the senior center, he sharpens knives, assembles furniture, unpacks food, installs bolts and serves garlic bread — his specialty — on pasta days. “I have all kinds of tools. I can do a lot of stuff,” he says. “Whatever needs to be done.”

    Beth Daniels, CEO of Southwestern Community Services, the CAP based in Keene, says the impact of its food distribution goes well beyond groceries. “We’re also providing administrative infrastructure — completing the paperwork, organizing the distribution, making it possible for tiny volunteer-run pantries to exist,” she said. “It’s not just food. We’re supporting a whole system that delivers the food.”

    Food programs are especially vital for seniors, Tabory said: “Meals on Wheels, for instance, is more than just food. It helps seniors stay in their homes longer by providing daily welfare checks and socialization.”

    In Berlin, Sanschagrin’s dedication extends beyond the senior center. He also delivers meals to more than 100 seniors through the home-delivered meals program. For many, those visits are more than a delivery — they’re a lifeline.

    “You don’t just knock and leave the meal,” Sanschagrin said. “You knock, talk to them a bit. Sometimes it’s the only person they’ll talk to all day.”

From shelter beds to food boxes and job training, New Hampshire's CAPs offer a wide range of services, often using volunteers, and tailor their work to meet local needs. While offerings vary slightly across the state’s five CAPs, core programs remain consistent nationwide. All told, New Hampshire’s CAPs operate more than 70 programs. 

“We’re often the first point of contact when someone needs help,” said Andrews Parker.

“There’s fuel assistance, electric assistance, weatherization, Head Start, emergency food through TEFAP, WIC, senior housing, Meals on Wheels, housing stability services, and even public transit in some places,” said Jeanne Robillard, CEO of Tri-County CAP in Berlin. “No matter where you are in the U.S., there’s a CAP agency doing these things.”

Donnalee Lozeau, CEO of the Community Action Partnership of Hillsborough and Rockingham, was one among the first Head Start students in New Hampshire. She is shown here with her Head Start teacher at the White Wing School in Nashua in 1965. The Head Start program in New Hampshire is administered by CAPs around the state. (Courtesy Donnalee Lozeau)

CAP Hillsborough and Rockingham, based in Manchester, runs workforce development programs that help hundreds throughout southern New Hampshire, and it operates Head Start, Early Head Start and child care programs. CEO Donnallee Lozeau — who herself was part of an early Head Start class as a child in 1965 — said demand is high for the services.

Last year, she said, “we served a total of 432 children, and sadly we have a waitlist. Even if we were fully staffed and opened all the rooms, we would still have a waitlist.”

‘The glue that lets us do the work we do’

Statewide, CAPs serve one in every 13 New Hampshire residents; in the North Country, it’s one in six, Robillard said. According to the U.S. Census Bureau, Coös County has a 13.1% poverty rate, the highest in the state. The statewide average is 7.6%.

Beth Daniels, CEO of Keene-based CAP Southwestern Community Services, said her agency provides hundreds of affordable housing units and operates six shelters, with a seventh in winter. In Strafford County, the Community Action Partnership runs almost all homeless services, including a new shelter, rapid rehousing and outreach. 

Daniels’ agency had revenue of $23 million, including money from Community Services Block Grant funds that were shared among all five CAPs statewide. “CSBG is the glue that lets us do the work we do,” she said.

George Sanschagrin is a volunteer for Tri-County Community Action Program in Berlin. Much of his work involves serving and delivering food to North Country seniors. (Photo by Scott Merrill)

CAP leaders say that, while people may know about programs like Head Start, they rarely understand those services fall under the Community Action umbrella, or how interconnected they are.

“We’re helping to keep fuel vendors’ accounts current, reassuring landlords their tenants’ pipes won’t freeze, making sure people have IDs so they can apply for housing,” said Andrews Parker. “None of that would happen without CAPs.”

“Not all the money gets handed directly out the door to clients,” said Michael Tabory, chief operating officer of CAP Belknap-Merrimack in Concord. “A lot of the money stimulates local economies. We hire local contractors for weatherization projects and support fuel providers — money goes back into communities.”

In total, the CAPS in New Hampshire employ a total of over 1,114 staff members and have over 5,000 volunteers.

CAPs receive a mix of federal, state and local funding, along with private donations, to carry out services. The federal block grants are a key source of funding, allowing them to leverage other funds, Robillard said.

The block-grant program “isn’t tied to a specific service area and that’s part of what makes it so powerful,” said Robillard. “Betsy [Andrews Parker] might use hers for a shelter start-up. I might use mine for our low-cost dental clinic. It’s tailored to what the community needs.”

Doris McDonald is another volunteer at the Tri-County CAP’s Berlin Senior Center. (Courtesy Tri-County CAP)

In 2024, New Hampshire Community Acting Programs received $3,965,243 in federal block grants, and a total of $152 million from a variety of sources — other federal funds, private industry, and state funding — all leveraged from CSBG dollars. The state provided CAPs with $6,043,729 last year, which helped fulfill state contracts for a variety of services, including child care and shelters.

As legislators continue their state budget work, it’s unclear how much money will go to the Community Action Programs over the next two years. While the overall N.H. Department of Health and Human Services budget would increase under Gov. Kelly Ayotte’s spending plan, 13 of the 28 sub-agencies within those departments would get less money than they got this fiscal year, according to the N.H. Fiscal Policy Institute. Two of those agencies include child behavioral health and child development.

‘Stability and dignity’

As an example of the flexibility of the block grant funding, Parker pointed to an initiative being undertaken by the Strafford County CAP. It has been awarded money for a new bus to expand bus routes, but needs to make a 5% match. “If we don’t have CSBG dollars, we’ll need to find the match somewhere else,” she said. “Without those funds, we won’t be able to do a lot of the work we do, including training for child care workers, which the state depends on.”

In rural areas, philanthropic support is thin, Robillard said, which makes the block grants even more important. “There are fewer large businesses and wealthy donors to shoulder the burden,” she said. “You can only tap a small donor pool so many times.”

The Community Action executives warn that federal cuts in programs such as LIHEAP and the block grants would harm efforts to lift people out of poverty. Still, they remain hopeful.

“LIHEAP was zeroed out,” Lozeau said, “but I have confidence elected officials have seen the benefit of those dollars and how they help people.”

Adds Robillard: “We’ve been doing this for 60 years. We take a nonpartisan approach to advocacy, but we’re clear: These services are essential.“

Betty Gilcris, health and nutrition director at Tri-County CAP in Berlin remains optimistic about the future of Community Action Programs in New Hampshire. ‘We’ll weather the storm,’ she says. (Photo by Scott Merrill)

Betty Gilcris, health and nutrition director at at the Tri-County CAP in Berlin, also remains optimistic. “We’ll weather the storm,” she said, noting contingency plans are being developed for state-subsidized child care and other programs.

As funding questions loom, CAP leaders say their mission — connecting dollars to human need — has never been more vital.

“We’re helping people move toward stability with dignity,” Andrews Parker said.

Tabory, who worked in the corporate world earlier in his career, said his community action work has set an example for his children. “I look at them and they are sensitive to the needs of other people. They’re conscious of inequalities,” he said. “The fact that I've been able to instill in them the values of community action makes me feel they’re going to be good contributors to society.”

“When it comes right down to it, ” said Robillard, “Community Action Programs are about helping people and changing lives. Our goal is helping families become self-sufficient.”

These articles are being shared by partners in the Granite State News Collaborative. For more information, visitcollaborativenh.org.

The impact on New Hampshire of potential massive cuts in public funding for the humanities

Art, culture, literature, thought — collectively, these disciplines and others make up what’s known as the humanities. Recently, the Trump administration’s Department of Government Efficiency, or DOGE, cut 80% of the National Endowment for the Humanities’s staff, also cutting almost all grant programs and rescinding grants and program contracts that have already been awarded. Why are the humanities important, and how does public funding help society — and you? Here to explain that, we have two guests — Michael Haley Goldman, executive director of New Hampshire Humanities, and Joe Marshall, president of the Jefferson Historical Society. 

By Rosemary Ford and Caitlin Agnew

This article has been edited for length and clarity.

Melanie Plenda:

Michael, can you give us some background on the cuts? What happened and when? How did you find out?

Michael Haley Goldman:

This has all taken place in just the last few weeks, really. April was when we got notice of the changes in policy. 

It's probably important to take a step back and think about how this federal funding has been coming. New Hampshire Humanities is an independent nonprofit, so we're a little bit different from some of the other groups that have been seeing changes to the federal funding coming in the state, like the State Library or the State Council for the 

We aren't part of the state government, but we do have an affiliation with the National Endowment for the Humanities, meaning that, even though we're a nonprofit, we receive federal funding that is matched by private funding here in the state of New Hampshire. That federal funding is something that we usually get in about a five-year contract, and we received notice late on April 2nd that an email came out from the National Endowment for the Humanities indicating that our existing grants in contract had been fully canceled. 

So that means all funding before April 1st was stopped, which is about $500,000 of funding for New Hampshire Humanities to support the cultural sector of New Hampshire that was pretty much unavailable in the middle of our year.

Melanie Plenda:

What impact has this had so far on New Hampshire Humanities and New Hampshire?

Michael Haley Goldman:

I’ve been proud to say that we've been able to head off a lot of the worst possible impacts. But that doesn't mean there's not been a lot of damage here in New Hampshire from this change. We've been as careful and clever as we can be in using the funding that we have available. All of the grants that we give out — we usually give out more than $100,000 in direct grants each year — that we had already scheduled are going out, but there's about $40,000 that we were planning to, with the second half of the year, that's just not going out to New Hampshire. 

We had to reduce it by a little less than 100 programs this year. That's usually hundreds of programs that we do around the state that we basically fund in what you could call mini-grants.

Melanie Plenda:

Joe, please tell us about the Jefferson Historical Society and its work with New Hampshire Humanities. 

Joe Marshall:

The Jefferson Historical Society is also an independent nonprofit, and we are staffed entirely by volunteers. Our mission is to preserve and promote the town of Jefferson's history.

In regards to Michael and his staff and our deepening relationship with them over the past couple years, we applied for us to be able to present an exhibition, “Crossroad Changes in Rural America.” We worked with Michael and his team through that application process. 

Through the process as we were ultimately chosen to be one of the venues to host the exhibit,our relationship with the humanities has deepened, and it is become extremely obvious to us as to how important it is for organizations like ourselves, to be able to bring what is really quite a large event to our community, and it's all been through the help of the New Hampshire Humanities.

There's been a tremendous, tremendous amount of training in personal work and site visits and just overall support and encouragement through the humanities to essentially help all of us bring our communities together up here.

Melanie Plenda:

And Joe, that exhibit is going on now. What impact has the society or Jefferson seen from it?

Joe Marshall:

In regards to Jefferson, we have been through quite a little bit, as with everybody else, during the tail end of COVID. We lost our town hall to a fire in February of 2021, and with that, we had to find a new home for the town to do its work. We are now situated in what's known as the Jefferson Community Center, and it's a very large building, a former elementary school, and is being repurposed to house the community. 

That is when we applied for the exhibit. It was kind of a crossroads moment for us as a community, with this type of venue becoming available to us. As far as I'm concerned, and I know there are many others that feel the same way, it has enhanced our ability to function as a community and brought people together in a way that we have not been able to do previously. So we're pretty excited about that and what it opens up to us for the future. 

Melanie Plenda:

Let’s talk more about the benefits of the humanities. What are the tangible, or perhaps in tangible, benefits for having the humanities and these public programs? 

Michael Haley Goldman:

People get hung up on this idea of “what is the humanities?” and you can go through this laundry list of academic subjects, but what I think is really important, what's often maybe intangible, is what the humanities does, and at the heart of that is how it brings people together in community. Just like what's happening in Jefferson, just like what's going to be happening around the project at the Museum of the White Mountains at Plymouth State University.

It's really about the way that we come together to talk about who we are as individuals, talk about who we are as communities, and talk about where we're going. The humanities is the fabric within which all of that happens. When we go into communities, we are trying to help those communities do what they want to do as a group. We are about how they come together to talk about the problems they have, about what's important to them, about how they see their challenges and their solutions — all of those things come naturally out in the kind of humanities program that we do. We've been learning over the last 50 years as an organization, how to create the environment for that to happen. 

Joe Marshall:

We've had this fantastic run of togetherness within our community. This has been something that has built a great deal of anticipation over the past two years, brought the community together, and that has been a wonderful thing to see. I believe it's helped us as an organization, and it will help us in the future. We cannot thank the humanities enough for what they've done to help us move forward. 

Michael and his group have promoted and made available to us some of those “New Hampshire Humanities To Go” programs. We've had four of them here, and it has brought in incredible audiences and tremendous speakers, and it is really bringing that community aspect, and I can’t say this enough. I can just see this after all this happening just moving forward exponentially.

Melanie Plenda:

Michael, you mentioned investing in the humanities. Can you talk about the economic impact of that?  

Michael Haley Goldman:

There's a lot of different numbers, and I will talk about the economic impact, because that  knowledge is really important and a really big part of why it's necessary to have cultural investment within the state. But I also want to remember that economic value is only one value, as we are investing in New Hampshire.

But economically, we know that we have a pretty much a 2-1 investment. So for every dollar of investment from the federal government, there's $2 invested privately to respond to that. And if you look at the creative economy, which we’re a part of and is an affiliated, but not identical, part of what we do, that's more of an average of 5-1.

Even for what we're talking about with Jefferson — this is a small Smithsonian exhibit that my organization and organizations like mine bring to the entire country, and they talk about even larger investments around the idea that this little exhibit is really having something like a 7-1 impact in terms of what it brings to a community, because people come to see an exhibit, and then they spend their time in town spending money that they wouldn't otherwise spend.

So this is really not something that we should see as a free meal that is being given to New Hampshire. It is an investment that brings back far more local investment than what it actually costs us to do in the state.

Melanie Plenda:

Michael, what happens next for New Hampshire Humanities? How will it deal with these cuts going forward?

Michael Haley Goldman:

I think the most important thing for me to say is that we are not going away. We have been in the state for 50 years, and we intend to be here for the next 50 years. But I also can't say that that is going to be as easy as it would have been under other conditions, and that we really need the community to show its support for New Hampshire Humanities and show its support for the cultural sector at large. 

This is a really difficult time for all of the cultural organizations within the state as we look at the possibility that the State Council for the Arts might be dropped from the state budget. I realize that is not final yet, but the fact that we're even talking about that as a real concern. The fact that the Institute for Museum and Library Services, which is one of the least-known federal groups but is a huge underpinning of libraries across New Hampshire through the State Library, is talking about having that funding lost to the state. This is an incredibly important time for groups like mine to be present and to be supporting amazing groups like Joe's and other groups in every city and community. All these places in New Hampshire that need their support to keep these cultural touchstones, these incredible organizations that underpin our communities alive and well and active within New Hampshire, and we intend to do that. But we are going to need culture, we are going to need the support, and we aren't going to do the work at the level that we've been doing if we have half the budget that we had last year. We won’t be in 172 communities next year. We will still be there, but it will be on a much lower level. It’s going to be felt town by town in New Hampshire.

Melanie Plenda:

Well, good luck to you both. Michael Haley Goldman, executive director of New Hampshire Humanities, and Joe Marshall, president of the Jefferson Historical Society. Thank you for joining us. 


“The State We’re In” is a weekly digital public affairs show produced by NH PBS and The Marlin Fitzwater Center for Communication at Franklin Pierce University. It is shared with partners in the Granite State News Collaborative, of which both organizations are members. For more information, visitcollaborativenh.org.

How will New Hampshire’s summer tourism industry fare amid a Canadian boycott?

Despite uncertainty and concerns, hospitality businesses try to remain hopeful

By Jon Decker-Granite State News Collaborative


Businesses across the Granite State are bracing for what could be a momentous decline in the number of Canadian tourists this summer, the result of souring relations between the U.S. and its northern neighbor. 

Many Canadians have essentially been boycotting the United States in response to President Trump’s trade policies and rhetoric. The president threatened to make Canada the 51st U.S. state on Jan. 23, shortly after he took office — a threat he has repeated several times since. He followed that up by implementing 25% tariffs on Canadian exports to the U.S. 

Since then, land travel has declined 32 percent from March 2024 to March 2025, according to Statistics Canada. The U.S. Travel Association reports air travel from Canada dropped 14% during the same period.

Canada is the top source of international visitors to the U.S. as well as to New Hampshire. In 2024, there were 20.4 million visits by Canadians to the U.S., generating $20.5 billion in spending and supporting 140,000 American jobs.  A 10% reduction in Canadian travel could mean 2 million fewer visits, $2.1 billion in lost spending and 14,000 job losses, the organization estimated.

“It’s not so much the tariffs,” said Nathale Hirte, assistant director of Manchester’s Franco-American Center. “It's the attitude, not of Americans in general. It's the whole ‘Canada is the 51st state,’ disrespect of calling the prime minister the governor. It’s the disrespect towards the country of Canada that has been the biggest impact.”

As a dual citizen, Hirte travels frequently between the two countries to visit family, and vice versa. This year, Hirte says, her family will not be visiting the U.S. They’ve even started avoiding American-made products in their day-to-day shopping. 

“That started before the tariffs. That started more because of the disrespect,” Hirte said. “The attitude is ‘F you Trump.’”

Trump’s comments may even have played a pivotal role in boosting the floundering Canadian Liberal Party to electoral victory last month. 

Stores throughout the country are emphasizing the purchase of Canadian-made products over American ones, while marketing campaigns encourage citizens to travel within the country and keep their money out of the U.S. 

“At night, when I was going through New York and Ohio, I was listening to a Canadian station, AM 740. They have ads every few hours that say, ‘Stay in Canada. Spend your money here,’” said Charlie St. Clair, president of Laconia’s Motorcycle Week, the annual event that will take place this year from June 14 to 22. “There is a concerted effort in Canada to get that message out, and it’s resonating.”

St. Clair heard the ads on his annual journey to spread the word about Motorcycle Week. According to St. Clair, the motorcycle festival world has already been hit by the Canadian travel boycott.  

“It affected Bike Week in Daytona in March,” St. Clair said. “I’ve had nine different people call me personally to say they were canceling their trip to Laconia. They felt it was important enough to call me to say their piece.” 

While nine people doesn’t seem like much, St. Clair iterated that every single Motorcycle Week visitor is economically significant to the Lakes Region. The event attracts between 275,000 and 300,000 bikers each year.

“Even if only 50 tourists don’t come because of this, that equals a lot of money in Motorcycle Week,” St. Clair said. “Talking to other business owners, this is not good.”

St. Clair acknowledged Trump’s ultimate alleged goal of using tariffs to bring manufacturing to the United States, but noted that most of the businesses moved production overseas on their own accord. 

“It’s going to take a long time to build that stuff up,” St. Clair said. “Meanwhile, we're going to suffer greatly, and I don’t know if this is the way to do it. This is just like the high school bully going nuts.”

A sign on display at a liquor store in Vancouver, British Columbia. Stores throughout the country are emphasizing purchasing Canadian-made products over American ones as part of a wider boycott of the U.S., including travel. (Photo by Jeff Feingold)

‘Volatility and uncertainty’

Hirte of the Franco-American Center became a U.S. citizen 29 years ago. Her love of both countries has only made the current situation more painful, she said. 

“It’s so hurtful, sad and stupid, and there’s absolutely no reason for it,” Hirte said of Trump’s tariffs and comments. “I feel bad for those small businesses, especially on the border, that live off of tourism. The businesses, the hotels, how are they going to suffer? They suffered bad enough over the pandemic, and they're finally recovering, now this crap? My heart goes out to them.”

“Certainly, Canadian visitation is a topic of interest right now,” said Mike Somers, president of the N.H. Lodging & Restaurant Association. “We've seen that in the first quarter — Canadian visitation to the northern border was down 20%, or something like that. There is concern that will carry through the important summer season.”

Somers stated that some of his members have already seen cancellations from Canadian visitors, but the exact forecast for the coming summer is uncertain. Decreased gas prices, he said, could offset some of the loss by increasing the total number of drive-in visitors to the state. Anecdotally, Summers said, the areas where Canadians stay — including North Conway, the Lakes Region and Hampton Beach — could account for 5 to 15 percent of New Hampshire tourism. 

“We had a discussion with our board of directors this morning,” Summers said. “Most are anticipating they will be flat, slightly up by the end of this year, maybe next year with slight growth.”

“The whole tariff thing, quite frankly, causes a lot of volatility and uncertainty,” said René Sylvestre, delegate of the Quebec Government Office in Boston. “It costs more for Canadians to travel to the U.S., and more people are afraid to lose their jobs because of the tariffs.”

Sylvestre did say that economic impacts of the tariffs vary greatly from industry to industry, and many Canadian businesses are continuing to trade with their American counterparts. 

“The real impact is around tourism. In Vermont, in New Hampshire, Maine as well,” Sylvestre said. The U.S. immigration crackdown has made traveling in and out of the states a much more uncomfortable process, he said. “More questions are being asked of more travelers, and some are now afraid to travel to the U.S., based on perceptions,” Sylvestre said.

 “It’s unfortunate, the current situation. We have to get through this, because our economies are intertwined, especially upstate New England,” Sylvestre said. “Today I was in Maine, and we get the same kind of comments; ‘I’ve been doing business with Canadians for decades, and we have great business partners, so let's find ways to get through this.’” 

Dampened expectations

Scott Labnon, owner of the Town & Country Inn in Gorham, said he doesn’t expect to be affected by a Canadian travel boycott, but it’s tough to gauge or predict the number of Canadian travelers this early in the season. 

“A pretty good percentage of people don’t book out as far as they used to,” Labnon said. 

According to Butch Ladd, executive director of the North Country Chamber of Commerce, the brunt of the boycott has yet to come to his territory, and it will be a few more weeks before the picture becomes more clear.

“The general thought is that business is probably going to be down,” he said. “I don't think it will be as bad as Covid. If something doesn’t change, there will be people that just decide to spend their money in Canada. I hope not, but I get it.”

At Hampton Beach, John Nyhan, director of the Chamber of Commerce, estimated that Canadians provide 10 to 15 percent of the tourism revenue in his neck of the woods. 

“They’ll spend three to three and a half million (dollars) during their stays at Hampton Beach,” Nyhan said. He expects a drop in the number of Canadian visitors, but “I don’t project it right now to be a massive drop.”

In March, Nyhan and other U.S. Chamber of Commerce heads attended an outdoor recreation event in Montreal to speak face-to-face with Canadians in light of the “confusion in Washington,” he said.

“Everyone coming to our booths were very friendly. We found that the seasoned travelers, the people over 50, would come up and say, ‘We love Hampton Beach, we’ve been coming for years, and we’re going to postpone this year,’” Nyhan said. “Those in the range of 25 to 40, primarily couples, didn't care about what was going on in Washington. They were going to come because they really want outdoor recreation and that the state offers a variety of outdoor recreation, from the mountains to the lakes to the beaches.”

Karmen Gifford, director of the Lakes Region Chamber of Commerce, said she had a similar experience at the expo. 

“‘Not this year’ was the comment that came back, but it was very positive other than that,” Gifford said. “There’s just uncertainty. That’s their way of addressing it.”

Regardless of the economic impact this summer season, the relationship between the two long-term allies is clearly strained.

“Saying sorry is not enough,” Hirte said. “I think the injuries are so deep, it’s like a cancer that needs to be completely cut out. It’s going to take decades.”

But she hopes for signs of improvement over the next few months.

“There are people who still work together, talk to each other, and so on,” she said. “At the end of the day, we live in the same region, so hopefully things will be back to normal.”

She pointed out that her daughter recently drove through Vermont with Nova Scotia license plates on her car and found a note on her windshield that read: 

“Dear Canadian friend, thank you for being here.”


These articles are being shared by partners in the Granite State News Collaborative. For more information, visitcollaborativenh.org.

After House passage, bill to allow no-cause evictions is in the hands of the N.H. Senate

Measure would overturn 2005 state Supreme Court ruling requiring ‘good cause’ before tenant can be evicted

By Aimee Rothman-Granite State News Collaborative

Amid New Hampshire’s continuing tight housing market, legislators are considering a bill that threatens to strip what critics see as vital protections for renters, contending it would put thousands at greater risk of eviction and homelessness.

House Bill 60 seeks to remove protections that have been in place since 2005. In March, the House of Representatives approved the bill, and the Senate is now considering it. If approved and signed by the governor, it would go into effect Jan. 1, 2026.

New Hampshire Housing’s 2023 Residential Cost Survey report found that the state had a 0.6% vacancy rate for apartments, far below the 6.6% national average. According to a 2024 analysis by the N.H. Fiscal Policy Institute,  the vacancy rate needed to create a balanced rental market is 5 percent — a percentage not seen in New Hampshire since 2010. 

The result: a 36% jump in the median rent for a two-bedroom apartment — to $1,833 — between 2015 and 2024, according to New Hampshire Housing..

Under HB60, landlords could evict a tenant without cause at the end of a lease period. Since a 2005 N.H. Supreme Court decision, landlords have been required to show “good cause” to evict tenants, even after a lease ends. That means landlords can't simply remove a tenant at the end of a lease without a valid reason. 

Current legal protections for tenants means they ‘can stay at their apartments for perpetuity,’ says House Bill 60 sponsor Robert Lynn, whose bill would eliminate once again allow no-cause evictions at the termination of a lease. The Windham Republican adds that the protections also discourage landlords in the business. (Screenshot)

State Rep. Robert J.  Lynn — a former chief justice of the state’s top court — is the bill’s sponsor. “The Supreme Court decision in 2005 was really the wrong decision,” he said, and HB60 would “ really return the law to what it should have always been.” 

Under current protections, “tenants can stay at their apartments for perpetuity,” Lynn said. By adding expiration of a lease as a “good cause” to evict a tenant,  landlords could feel more encouraged “to take risks on riskier applicants,” such as people who have a low credit score, unstable job history or a criminal record, Lynn said.

According to Lynn, HB60 would simply enforce the terms of a lease agreement in which a tenant and landlord agree that the tenant can live at the apartment and pay rent for an agreed upon period, “which would be mutually beneficial for both tenants and landlords.”

While Lynn acknowledged that landlords “could abuse the law if they had the mind for it,” overall, “landlords are in the business of making money, so it doesn’t line up that they would kick out a good tenant.” 

Bill raises concerns

Housing advocates disagree. They say HB60 could make the search for housing even more competitive for renters and could open the door for no-cause evictions and housing discrimination.

“Our biggest concern as a housing provider is that evictions on tenants’ records make them that much harder to place in housing down the road, and we do everything we can to avoid evictions,” said Betsey Andrews Parker, chief executive officer of the Community Action Partnership of Strafford County. “Otherwise, those that are hard to house — those with bad credit, those with an unstable job history — it’s one more strike against them.”

Senate approval of HB60 would be “an even bigger detriment for tenants and housing advocates in the state,” Andrews Parker said, “It concerns me in an already-tight housing market that we are making it harder for people to obtain housing.”

Housing providers already “did not have adequate resources to meet the demands before our current budget cycle,” she said.

Others in the housing field agree that HB60 could intensify the housing crisis for tenants.

“We’re very concerned about this bill,” said Nick Taylor, director of Housing Action NH. “With the housing market as tight as it is, any increase in evictions or increase in folks who are displaced unnecessarily could lead to increased homelessness, and it is going to be really hard for those folks to find a place that they can afford moving forward.”

He said the bill “is overturning years of precedents when it comes to allowable evictions, and in this market, that is really concerning. There are already processes in place for cause evictions that cover a whole range of reasons why a landlord might want to remove a tenant.”

House Bill 60, which would once again allow no-cause evictions, 'has the potential to increase discrimination against people with mental illness,’ said NAMI NH Executive Director Susan Stearns. (Courtesy photo)

He’s concerned “that if someone is complaining about real repairs that need to be done to their unit, maybe the landlord will say, ‘OK, we’re going to evict you instead of having to deal with your complaints’ and wait for someone else who is more desperate or more willing to go along with the current status of a unit and rent to them.”

The National Alliance on Mental Illness New Hampshire has been following the bill in the Legislature, because “the bill has the potential to increase discrimination against people with mental illness,” said NAMI NH Executive Director Susan Stearns. “There are a lot of areas of significant concern.”

In written testimony submitted to the Senate, Holly Stevens, director of public policy at NAMI NH, stated that “individuals with serious mental health conditions already experience discrimination in the housing rental process. HB60 would only suffice to make it easier for landlords to discriminate against a person who they find out during the tenancy period has a mental illness.“

 “Given the housing crisis facing NH and the overrepresentation of individuals with a mental health condition in the unhoused population, the passage of HB60 would only contribute to the increase of unhoused, hospitalized, or incarcerated individuals with a mental illness,” her testimony concludes.

The bill is currently in the Senate Commerce Committee. It was also tucked into the budget trailer bill (HB2) by the House.


These articles are being shared by partners in the Granite State News Collaborative. For more information, visit collaborativenh.org.

Breaking down the potential fate of key bills in the Legislature after crossover

The current legislative session at the State House is winding down. What have our legislators been up to? And what’s next in the current session? To discuss that is Anna Brown, executive director of Citizens Count, a nonprofit and nonpartisan organization dedicated to educating voters about the political process, as well executive director of the Warren B. Rudman Center for Justice, Leadership and Public Service at the University of New Hampshire’s Franklin Pierce School of Law.

By Rosemary Ford and Caitlin Agnew

This folder is edited for length and clarity.

Melanie Plenda:

You’ve been following the work at the State House. The Legislature recently had something called crossover. Can you explain to our audience what that is and why it’s important? 

Anna Brown:

Crossover is the last chance to vote on bills before they cross over to the other chamber. You can sort of think of it as halftime in the Legislature. In New Hampshire, they vote from January to June, and at this halfway point, we really see what bills really have a chance to become laws, and which bills just don't stand a chance.

Melanie Plenda:

Which bills made the cut at crossover? 

Anna Brown: 

The state budget passed to the House, and that kind of is its own story. We could do an entire interview all about that budget, but certainly there were other big bills that moved forward. 

We have both the House and Senate passing bills to expand eligibility for the Education Freedom Account program, which lets students take the per–pupil share of state education funding and spend it on private or homeschool expenses. The House and Senate have also passed parental Bill of Rights, which vary a little bit, but among other things, they would require teachers to respond to parent inquiries within five to 10 days. And both the House and Senate have passed versions of a ban on sanctuary cities. So what that means is towns and cities would have to cooperate with federal immigration enforcement. They couldn't adopt policies that are intended to block immigration officials.

Melanie Plenda:

Were there any surprises? 

Anna Brown: 

I was surprised that the state Senate passed a lot of bills that are pushing back on restrictive zoning at the local level. Historically, in recent years, the Senate has really been hesitant to say what local cities and towns can and can't do when it comes to minimum lot sizes or parking requirements, and so on. A lot of those bills moved forward. 

Also, one thing that surprised me a little bit is there is a bill that passed the Senate that would increase eligibility for free meals for students at up to 200% of the federal poverty level, with some reimbursement from the state. But this would allow schools to do it. It would sort of be an opt-in. That's not the full-blown expansion that Democrats have been advocating for in the past, but it was still movement forward on an issue that I wasn't sure was going to change this year.

Melanie Plenda:

Which bills have a chance of passing both houses and head to the governor for approval or veto? 

Anna Brown:

I mentioned the Parents’ Bill of Rights, the expanded eligibility for the Education Freedom Account, the bills that are related to immigration enforcement. Those are moving simultaneously, with slightly different versions in both the House and the Senate, and we've seen Governor Ayotte indicate she's in favor of these sorts of things.

Also, I think that it's likely we're going to see a bill that would move the state primary from September to June. This was another issue that the House and Senate wrangled with in the past, but now we have some new legislators, and it looks like it's going to happen — not for the next election, but the one after that. Lastly, we actually already saw the House and Senate fast-track a bill to roll back some bail reform measures, and that has been signed by Governor Ayotte already. It was a big priority for her, and so we're seeing some additional restrictions on bail.

Melanie Plenda:

Which ones are unlikely to pass, and thus stall at the State House?

Anna Brown:

When I'm looking at bills that were popular in the House of Representatives and really have no chance in the Senate, the first thing that comes to mind is bills to expand legal marijuana. Expanding legal use — whether it's medical or saying you can use it for private consumption — all of those bills, I think, are pretty much dead on arrival in the Senate. 

I think the Senate is also going to be hesitant on some bills related to harm reduction. So in particular, HB226 would allow drug-checking equipment, which is currently illegal, to be used for some harm-reduction purposes. So think a fentanyl test strip, right? So people using drugs, ideally, are not going to use something that is highly lethal or contaminated, but the Senate has been pretty unsure about that. 

There's also a bill that would limit the ability of the Department of Health and Human Services to require vaccinations beyond what is in state law. The bill specifically notes requirements for chicken pox, hepatitis B vaccinations will expire, and it would just limit that ability going forward, unless the Legislature specifically puts it in law and says, ‘This specific vaccine can be required.’ So I'm not sure how that's going to fare in the Senate, and definitely I'm going to keep an eye on it more if that.

Melanie Plenda:

Let’s talk more about housing. We already discussed zoning. What else about housing made it to crossover and what might make it to the governor’s desk?

Anna Brown:

We are seeing simultaneous bills moving forward in the House and the Senate that block local regulations that are stricter than state building codes, cap minimum lot sizes, allow residential development in commercial zones most of the time, and limit parking requirements to no more than one space per unit. So, as I said, it's moving in the House. It's moving in the Senate. Those seem likely to move forward to the governor. 

A couple other bills: In the House, we have HB577, which would expand the right to build a detached ADU, which stands for accessory dwelling unit. The size of those would go up under this bill. So that one passed the House. We're waiting to see what will happen in the Senate. Then the House also had a big priority, which would allow eviction at the end of a lease without cause, HB60. This has come up a couple times in the House of Representatives over the years, and so that's another one that we'll wait to see what happens in the State Senate.

Melanie Plenda:

What about education bills? What did and didn’t make the cut? 

Anna Brown: 

Education was probably one of the biggest topics this year. So much legislation has moved forward on this issue. We've already touched on Education Freedom Account eligibility. We've talked about the Parents’ Bill of Rights. Governor Ayotte has also prioritized adding restrictions on cellphones in classrooms. We are seeing that move forward. But then there's sort of social issue policies that are moving forward that we're seeing, particularly coming out of the House. 

HB446 would require parental consent to administer the annual Youth Risk Behavior Survey, and that's from the Centers for Disease Control and Prevention. It asks questions about potentially harmful behavior, such as drug use or violence in your home. I remember when I took it in high school, there were also questions about how much milk you drink a day. It's a public health piece, and there's always been, or not always, but there is a state law that requires opting in for parents for other general surveys. But there was an exception for this, so parents can opt out, but there's this assumption that students are going to participate. This would reverse that, and it could potentially decrease our ability to get data on some of these public health concerns, and potentially could reduce funding. 

Another one, HB324, prohibits K through 12 schools from making, “any material that is harmful to minors available to students.” That's a pretty subjective phrase. The bill defines the material to include various content related to sex and violence, so it requires school boards to adopt policies that would address complaints regarding harmful material and so on. This is definitely one of those trickier social issues. Is this a book ban? Is this about protecting children from groomers? You'll hear a lot of really heated language. So watch for that in the Senate as well.

Melanie Plenda:

Related to that, let’s explore bills connected to trans rights. What has gone through the Legislature so far? 

Anna Brown:

There is an intersection with school policy here, for sure. For example, SB211, would limit school sports teams based on the biological sex of each student's birth certificate issued at the time of birth. Male sports would be open to all sexes. It would apply to grades 6 through 12, as well as public colleges and universities. So that's definitely been a big priority for a lot of Republicans. I think that it probably has a pretty good chance of passing in the Senate.

The House and Senate have also passed their own versions of a bill that would create an exception to the state anti-discrimination law related to gender so that you could segregate biological sex for locker rooms, sports, hospitals, and so on. Sununu vetoed a very similar bill last year because he said it conflicted with current state law against discrimination based on gender. But it looks like the House and Senate are eager to see if Governor Ayotte has a different position.

There are two other bills that would prohibit medical treatment or interventions related to gender. So HB377 would make it a felony to provide hormone treatments and puberty blockers to a minor unless there is a “medically verifiable disorder of sex development,” and then HB712 would prohibit breast surgery on persons under age 18. Once again, exceptions in the bill are malignancy, injury, infection or malformation.

Melanie Plenda:

What about immigration? How will the bills that made it to crossover fare? 

Anna Brown:

This is definitely something Governor Ayotte has been very vocal about. I definitely expect those bills to become law.

There are a couple of bills that we're still sort of waiting to see what happens. SB13 prohibits undocumented or illegal immigrants that were issued a license in another state from driving in New Hampshire. This has come up in the past. It hasn't gone through because there are some concerns about, “aren't we supposed to have reciprocity with other states and driver's licenses?” What would this look like? It would be a violation, similar to a speeding ticket at this point. So that bill passed the Senate and is going to the House.

The Senate passed another bill that prohibits state and local government from blocking law enforcement participation in a federal program that allows law enforcement to perform some immigration enforcement duties. I think that will go forward because it's very similar and sort of in tandem with that anti-sanctuary city stance that a lot of Republicans are talking about. Of note, though, the House and the Senate both rejected bills that would require employers to use E-verify. That's a system from the federal government that checks the identity of someone who's authorized to work in the United States. But there was a lot of opposition from businesses in particular, because they say there are errors in the system. It slows things down. It's a burden. So that's definitely not an immigration policy that we will see come to.

Melanie Plenda:

What about bills concerning abortion? What’s going on with those?

Anna Brown:

We all know this was a big topic of conversation during the 2024 elections, but we're not seeing a ton of big movements on that issue right now. In New Hampshire, the Legislature has not passed any direct restrictions, and in fact, they voted down a 15-week ban. There are bills on the margins, however.

HB191 passed the House, and now it's on to the Senate. It was originally focused on making it a misdemeanor to help a pregnant minor obtain an abortion without parental consent. The House amended the bill to more generally prohibit transporting a minor to a surgical procedure without parental consent. Also, the Senate passed SB36, which requires healthcare providers to report non-personally identifiable data about abortions to the state and then provide an annual report on this aggregate data. This has come up more than once in the past, and the argument is, “How can we make really good policy around this issue if we don't have data on how often it's happening, where it's happening, what else might this be related to? Are there other underlying health issues or public health concerns we should know about?” It’s worth noting that New Hampshire is definitely a minority here. Most other states are collecting this data and publishing it in some form, but there's a lot of privacy concerns in New Hampshire. So we'll see how that bill fares in the House.

Melanie Plenda:

As always, very interesting. Thank you for breaking that down Anna Brown, executive director of Citizens Count and executive director of the Warren B. Rudman Center for Justice, Leadership and Public Service at the University of New Hampshire’s Franklin Pierce School of Law.


“The State We’re In” is a weekly digital public affairs show produced by NH PBS and The Marlin Fitzwater Center for Communication at Franklin Pierce University. It is shared with partners in the Granite State News Collaborative, of which both organizations are members. For more information, visitcollaborativenh.org.

Centuries-old traditions of medieval combat flourish in a Nashua mill building

A diverse community of combatants helps keep an over 600-year-old sport alive

By Jon Decker-Granite State News Collaborative

On the top floor of the Lake Street Mill building in Nashua, tucked among various studios and workshops, is The Knights Hall, “an armored combat training and fitness center” where students learn to master the ways of war from over half a millennium ago as a means of getting and staying physically and mentally fit.

Amid the battle ropes, kettlebells and weights, one can find battleaxes, polearms and steel swords tucked in corners and shelves. Knight-themed trophies and medals decorate the walls, while European and Pride flags dangle from the ceiling 

During a recent session, students practiced swings on dummies as Knights Hall founder Jaye Brooks wove his way through the flailing foam blades like a cat through high grass, pausing to provide instruction. The 59-year-old Brooks has practiced medieval combat since 1981. He opened The Knights Hall to the public in 2014, and ever since has been shaping fantasy and history lovers into armored athletes who compete against their counterparts across the globe. 

“Just about everyone here is into science fiction, fantasy, comics,” said Brooks, a lifelong Tolkein reader, said of his students. “It’s kind of a Venn diagram of nerd pancakes, and the overlaps are continual.”

At competitions, the foam and plastic is replaced with steel, transforming padded 21st century history buffs into 15th century armored warriors. Period-accurate metal axes, blades and maces crack against armored suits that weigh up to 95 pounds. Matches range from one-on-one duels to massive 16-vs.-16 melees, where fighters can trip, throw, grapple, kick and punch their opponents with metal gauntlets. (Gauntlets are the gloves worn by medieval knights.)

“There’s a certain savagery to it – but also esoteric. There is nothing else like it.” said student Jack Conway, after watching a bout of armored duels at a recent demonstration held at New England College in Henniker. 

Despite the intensity, numerous safety precautions are taken. Axe and sword blades are dulled, and stabbing and thrusting strikes are completely forbidden. The helmets worn by combatants are thicker and heavier than those used by their historical counterparts in battle, and they employ modern padding to reduce the chance of a concussion. 

During the 14th and 15th centuries, Brooks explained, European knights and men at arms demonstrated their prowess in tournament-like sporting events. The goal was not to kill, but to best their opponent to gain renown as well as military and social status.

Today, Brooks and other practitioners rely on techniques straight out of medieval fencing manuals. Brooks’ expertise has also landed him a few consulting roles for fantasy books, film projects and video fighting games, including “For Honor.” 

Armored combat fighting, he said, is “a thing of valor, it’s hard. It’s difficult, and there’s risk. “I tried to make myself as good as I could be as a fighter, so I trained in medieval combat maybe four days a week since the 1980s.”

Brooks eventually found his way to The Knights Hall because of his fragile health condition growing up. 

 “I was the asthmatic with bad eyes and a trach,” Brooks said, pointing to a scar on his throat from a tracheotomy.

Brooks’ condition kept him cooped up in the winters due to the effects of living among the family’s pets and with his father’s smoking habit. 

“I got sick, so I’d be stuck in my room. So I read fantasy books,” Brooks said. 

Brooks’s literary wanderings in the worlds of J.R.R. Tolkien and other writers struck a chord. He became an avid Dungeons & Dragons player during the popular role-playing game’s infancy in the 1970s. D&D led to participating in Renaissance fairs, ultimately sealing Brooks’ fate.

In 1981, Brooks attended the Florentine Fair in Lincoln, R.I., and saw his first armored fight, albeit with wooden weapons and metal armor. It was “the coolest thing ever,” for the teenaged Brooks, he said.

From there, he started training and competing through the Society for Creative Anachronism (SCA), an organization that re-creates history through combat and cultural reenactments. For three decades, Brooks moved up the ranks, and eventually became the U.S. champion of the SCA’s combat league. In this version of the sport, competitors wear metal armor, but use wooden weapons.

At the time, Brooks said he had a day job in “corporate America,” and found himself somewhat bored, feeling constrained by the required use of weapons that didn’t meet medieval standards. 

“I said, ‘What do I do now?” Brooks recalled. He found the answer online.

‘Where has this been my whole life’?

Just as medieval reenactments like the SCA grew in the West, so did historical societies throughout Eastern Europe, in countries like Ukraine and Russia. In the late ‘90s, Eastern European reenactors were already using steel weapons and armor. In 2010, the first official “Battle of the Nations” was held in Ukraine. 

In 2011, Brooks saw a Battle of the Nations video on Facebook. He was enthralled with the use of full armor and steel weapons. After watching, Brooks said to himself, “Where has this been my whole life?”

By October, Brooks reached out to old reenactor friends and members of the SCA to build a team to fight at the third Battle of the Nations in Warsaw, Poland. 

“I opened up The Knights Hall to kind of train me to do this,” Brooks said. “We were doing SCA stuff here and some steel stuff here. I invited people here to come and try out and play with it. Next thing you know, I got people coming here to train pretty regularly.”

Brooks cobbled together a team for the third Battle of the Nations in Warsaw. Team USA finished among the top four countries overall, and Brooks received a mention in the Congressional Record for his efforts. 

“A couple years go by, and it's 2014, and we come home from Spain with two world championships, and Team USA wins seven out of nine events in 2014,” That’s when he decided to open The Knights Hall to the public.

As part of Brooks’ efforts to introduce more people to the sport, The Knights Hall hosts Renaissance fairs and other public events across New England. Spectators get to watch bouts, learn some history and hold the weapons and armor used in matches. 

One of Brooks’ top fighters, Colton Kilcoyn, a former Nashua resident who now lives in Rhode Island, demonstrated their prowess at a Renaissance fair held in early April at New England College. Kilcoyne’s brigandine – a piece of chest armor – was purchased abroad while in Ukraine, which continues to be a hub for both the sport and the equipment.

However, due to the ongoing war there, it’s been harder and harder to obtain armor and weapons. Since the Russian invasion, members of Ukraine’s men’s team have traded their blunted battle axes and swords for automatic weapons and hand grenades, and smiths who once dedicated their talents to making replicas of historical armor are using their skills to make weapons of modern war. 

‘All types’ welcome

For Kilcoyne, it is the combination of competitive intensity, athleticism and the tight-knit community that keeps them coming back. Many of the practitioners are neurodivergent, or like Kilcoyne, are members of the LGBTQ community. On the battlefield and in the training hall, they find acceptance and camaraderie. 

“We’re very open to all types here,” Kilcoyne explained. “We have people who have never played a sport in their life before, and they’re just like, ‘This is what I’m going to do,’ and we will go from start to finish with you.”

“You will see the flavors of autism, ADHD (attention-deficit hyperactivity disorder), nerd overlap with everyone here,” added Kilcoyne, who has been diagnosed with attention deficit disorder. “Where else are you going to get so much stimulus all ot once where you have to think strategically and keep moving?”

“If I were to write an autobiography, it would probably be titled, ‘Sword Fighting Saved My Life’,” said student Brian Chabot, a Nashua resident who has trained in the sport since 2012. “When I started, I couldn’t get up a flight of stairs without getting winded. My asthma was out of control, I was drinking heavily, smoking heavily, living a pretty sedentary lifestyle.”

Chabot is now learning horseback riding in the hopes of competing in modern jousting competitions, further fueling his love for history, which drew him into the sport initially. 

Chabot joined The Knights Hall in 2012 to hone his rapier fencing skills, and by 2018 switched to armored combat. After over a decade of training, he now helps museums with weapons and armor curation on the side. He remains connected to The Knights Hall for the community, he said,

“The chivalry aspects come with it as a sport,” Chabot said. “There’s no bullying. No matter how bad or good you are. If you take to the ring, you have the respect of everybody.”

Kilcoyne started their medieval journey after 10 years of roller derby and 16 years of horseback riding. Unlike many other practitioners, Kilcoyne didn’t have childhood dreams of knighthood, instead, they digitally stumbled into the sport.

“I got this Facebook invite to an all-women’s combat practice,” Kilcoyne recalled. “I said, ‘Let me go support it and see what happens.’ I never left.”

Since then, Kilcoyne has competed internationally and nationally, collecting medals as they go. The sport, in Kilcoyne’s own words, has taken over half of their life. 

“It’s my job, it’s my profession.It’s my life,” Kilcoyne, who started running a second Knight’s Hall location in Charlton, Mass., said. 

The Knights Hall doesn’t just value diversity in athletic ability. On its website, is a statement  describing the institution as an “unapologetic ally of women’s rights, the LGBTQ and BI-POC communities and freedom of religion.”

Kilcoyne wears a small shield on their hip bearing the colors of the pride flag, a decision that has turned heads in certain countries when competing internationally. 

“You’re going to meet people from other countries, and you’re going to have to figure out how the sport works with their culture in a way,” Kilcoyne explained. “I’m not going to get into it, but in Spain I had some issues, partially because I had a rainbow flag on.”

“It just depends on what kind of battles you want to fight there,” Kilcoyne added. “But I’m going to continue fighting for everyone to be able to fight in the division that they believe they should be in.”

These articles are being shared by partners in the Granite State News Collaborative. For more information, visit collaborativenh.org.

Breaking down the economic effects of tariffs and market fluctuations

[Click here to watch the full conversation on The State We’re In]

By Rosemary Ford and Caitlin Agnew

This article has been edited for length and clarity.

What’s going on with the economy? It seems a lot like typical New England weather lately — wait awhile, and it might change. But how do changes like tariffs, inflation and stock market fluctuations — and the ones coming down the pike — affect your wallet? Here to discuss that is Dr. Marie Duggan, professor of business management at Keene State College.

Melanie Plenda:

Let’s start with tariffs. What are they exactly, and why do they matter? 

Marie Duggan:

Tariffs are a tax on an import. Recently, my students and I were looking at Apple and the iPhone 16. The Wall Street Journal had a little article about it — it was selling in the United States for $1,100 and it cost $550 to make, mostly in Asia.

On the day we were looking, the tariffs were 54% and that was going to raise the selling cost of making the product to $850, so you would have the original $550 that was the cost of making the iPhone in China before the tariffs, then you have an extra $300, which is this tax that importers have to pay. So Apple, importing the phone to the United States, would pay the $300 to the U.S. government. The question comes up: Would Apple accept a lower profit margin,or would they pass the increase on to customers by raising the selling price from $1,100 to $1,400? So that's kind of how a tariff works. 

One of the reasons the United States wanted to put tariffs in place is because we've really had a skyrocketing situation with our national debt in the past, really the past 15 years, and we either have to raise taxes, especially on the rich, who are the people that have most of the money. We can't really cut spending more than we already have. It seemed to some people like a good loophole to create this tax on imports, and that would be a way for the government to amass more money, and it would also tend to make companies such as Apple reconsider their decision to make the product overseas and to consider making more parts of it in the United States. It seemed like a win-win in that situation. 

Melanie Plenda:

What do they have to do with the trade deficit? And what exactly is a trade deficit?

Marie Duggan:

A trade deficit is exports minus imports. Exports are things we build in the United States and sell to other countries. Here in Cheshire County, we build a machine called the diamond turning machine, and it is used to make touchscreens. We don't make touchscreens here, but we make the machine that makes touchscreens. The touchscreens are often made in Asia, so we make these machines here, and we export them around the world. We sell them to people in other countries. 

When we look at the amount we export minus the amount we import, we get to the trade deficit. It's basically like you earn foreign exchange when you sell exports and you spend foreign exchange when you buy imports. Of course, I personally don't have to spend Chinese yuan when I go to buy an iPhone, but Apple does. Apple has to pay and they ask us to pay people in China through some point in their supply chain.

So what happens if there's a gap? Well, if there's a gap, you have to borrow from the rest of the world. In the same way, if I have my income and I have repairs to my house that exceed my income, I'm going to have to go borrow a loan to solve the problem. If we export less than we import, we're going to run a trade deficit, and we're going to have to borrow from the rest of the world to plug the hole. We borrow tremendous amounts from the rest of the world. You might not be really aware of that, because the borrowing comes in kind of funny forms. Yes, sometimes foreigners buy U.S. Treasuries or they buy stocks and bonds. But even when I go to get a loan from the bank, say, for a new car, a lot of the money that's in the banking system may be coming from Japan or China or Saudi Arabia. It's just a giant swimming pool full of money in our banking system that we're lending out to people, and a good bit of the money comes from other countries.

Melanie Plenda:

Before President Trump, how would you describe the United States’ approach to tariffs? 

Marie Duggan:
Well, I would say that our approach to tariffs actually started to shift in 2016 with the first Trump election, but Joe Biden also had a different approach to tariffs than other Democratic presidents had.

Prior to the Obama era, the Clinton era, the George Bush era, going back many decades, the United States believed in having no tariffs. The argument was that it was a wonderful position to have if you're the world's leading exporter. So this was a position the United States came up with between 1945 and 1973, when we were the world's leading exporter. We wanted nobody to put any barriers to anybody in the world buying American items. 

So we always said, “Don't put tariffs in place. Remove as many tariffs as you possibly can.” But that did change.

Melanie Plenda:

If these tariffs go into effect, what will that mean for the average consumer here in New Hampshire? What will that mean for the state economy?

Marie Duggan:
I'm someone who firmly believes that we can do more manufacturing in the United States. However, tariffs have to be used judiciously.

For example, a 5% tariff would be a significant tariff, and right now, as it stands today, Donald Trump has put a 145% tariff, an additional tariff, on Chinese goods. I think some goods already had tariffs. For example, Joe Biden had put a 100% tariff on Chinese electric cars. So that is now 245%, and, as you said, they change day to day. First of all, they're too drastic, and they're too changeable. 

If you're going to suddenly say, “There's a 145% tariff,” then the companies in Keene that have worked for 20 years to develop customer relationships with people are going to see orders for their million-dollar machines suddenly canceled. That could really kill what has been a bright spot. It could cause firms to go belly-up.

So putting dramatic tariffs suddenly does not have the effect of protecting U.S. industry. It has the effect of causing immediate loss of customers. So that really creates instability, and I'm afraid we might see that. I really hope that none of the diamond turning machines or optics companies in Cheshire County fail. I hope they all make it. 

There are some benefits to tariffs. We have had this problem of companies going offshore for about 20 years now, of moving manufacturing offshore. So some American companies will begin to consider, for example, buying a machine here in Cheshire County, instead of buying a machine in Germany. 

Melanie Plenda:

As you mentioned, President Trump is doing all this in an effort to bring back manufacturing to the United States. What do you think of that idea? What will that look like? How long will that take? 

Marie Duggan:
I think I want to make it very clear, I don't think that President Trump is putting tariffs in place primarily to bring back manufacturing. I think that the national debt situation in the United States is critical at the moment, and he has to raise taxes. He has to raise taxes on rich people, unless he can find a way out, and it’s very difficult for any politician of either political party to raise taxes on the top earners in the system where we have a political system financed by donations.

So Trump thought he had found a way out. He could tax imports, and that would be a really different way to raise money that could be used to pay down the national debt. So I think that was the desire to find a way to pay down the national debt without raising income taxes at the high end. It was a really important part of his decision process. 

Melanie Plenda:

Let’s move to another related topic — the stock market fluctuations. What role has tariff news played in that? 

Marie Duggan:
I think it played a major role. If you just think of Apple where the $1,100 selling price for the iPhone 16 Pro — if the cost is $550 to produce it in China and there's a 54% tariff, well, then Apple's profits are going to fall from like $550 per phone to like $150 per phone. So that is immediately going to make Apple stock price fall. Then, if you remove the tariffs — boom, Apple’s stock price rises. 

Every company would like to pass the cost of a tariff on to its consumers. So we are all going to have to pay more too, but companies are going to have to absorb some of the cost too, and that's going to push their profits down. That's why the stock market reacts — if expected future profits are falling, then your stock price will drop like a stone.

Melanie Plenda:

Some people, especially Democrats, have asked for an investigation into stock market manipulation. Why is that? And what does that mean? 

Marie Duggan:
When we heard 54% tariffs on China, Apple’s stock did drop quite a bit because everybody knows that Apple's supply chain comes from the production in China and other parts of Asia. Now, if eventually Donald Trump removed the tariff on Apple, so if you or a staffer was at a meeting who heard that Donald Trump was planning to remove the tariff on Apple, you could have run out and purchased Apple stock at a low price, and then once the tariff is removed on Apple, it's going to rise immediately. Depending on how much money you put into that you could make quite a bit in one day.

Melanie Plenda:

Many people are invested in the stock market in a variety of ways — through personal accounts, or something like a 401(k) or IRA. What should people be asking their investment or financial advisers when they see this kind of volatility? 

Marie Duggan:
I'm not a financial advisor. I see what businesses do, like Elon Musk with Tesla — they have investments in different countries. Tesla isn't like

Apple. Tesla makes the entire car in China to sell it mainly to Chinese people. It makes the car in Germany to sell to Europeans, and makes the car in the United States to sell to Americans. But what they've done is they kind of insulated themselves from dramatic changes in any one country by being tied to three different parts of the global economy.

So it seems that when we talk about diversification with investments, people are always talking about whether you should have stocks or you should have bonds, and that's probably a good idea. But it also seems to me that right now, diversifying in terms of investments in different parts of the globe, because we don't really know how it's all going to shake out. 

Melanie Plenda:

Given this volatile economy, what will the future financial situation look like in the next year, or the next five years? What should consumers or businesses do to navigate this environment?

 Marie Duggan:
Well, things are going to freeze up because businesses don't know what's going to come next. They don't really know right now what kind of technology or partnerships around the globe they should invest in. What's going to happen to their old relationships? Are their Chinese customers even going to talk to them now? Is this going to be something where it's kind of like the Cold War, where you have a total break?

Also, people think reducing government spending is going to solve everything. Actually, the businesses in Cheshire County have long relied on producing under government contracts. So that's been kind of a quiet backbone to a lot of industry in this area.  I think businesses had planned to make products that would be sold to the government, and now there's a lot of uncertainty as to whether those government contracts will be solid as they were in the past. So there's a lot of uncertainty, and when businesses have uncertainty, they kind of freeze.They don't spend, and that's what could cause us to have a recession. 

Melanie Plenda:

Fascinating. Dr, Marie Duggan, Keene State College professor of business management, thank you for joining us and discussing these issues. 

“The State We’re In” is a weekly digital public affairs show produced by NH PBS and The Marlin Fitzwater Center for Communication at Franklin Pierce University. It is shared with partners in the Granite State News Collaborative, of which both organizations are members. For more information, visit collaborativenh.org.

‘Trying to find a life’: telling the stories of the immigrants among us

Who are the immigrants among us? Where do they live? And what do they do?Thanks to Nashua Ink Link and the Granite State News Collaborative, we have some answers to these questions — and many more. Ink Link publisher, editor and founder Carol Robidoux and writer/photographer Dan Splaine join us to talk about the news outlet’s special report, “Immigrants Among Us.” This project was made possible through support from the Eppes-Jefferson Foundation. The Granite State News Collaborative and Ink Link maintained editorial control over the contents.

By Rosemary Ford and Caitlin Agnew

This article has been edited for length and clarity.

Melanie Plenda:

Carol, how did this series come about? 

Carol Robidoux:

Just like everything else, it came from conversations around what we're seeing and hearing in the news and trying to kind of figure out how to relate that to our coverage area. So in this case, it's Nashua and the greater Nashua area. Dan felt strongly compelled to tell a story that might actually balance out some of the negativity that we were hearing. Now, remember, this kind of all took shape well before the election last year, so it was really an idea of what role the idea of immigration was going to play in the election and what was going to happen in the aftermath, depending on the outcome. 

So there were a lot of unknown factors in all of that. Dan, who's primarily a photographer with a strong photographic sensibility in terms of storytelling — I think he just felt that seeing, hearing, connecting tangibly, one-on-one with people in our community who are new immigrants or who are long-established immigrants would really tell a more authentic story, especially for our readers

Melanie Plenda:

Dan, what got you interested in this subject? Why did you want to tell this story?

Dan Splaine:

Let's go back to last spring and summer. There was an onslaught of just this use of the words “immigrant” and “immigration.” It was almost an amorphous thing, and I found it dehumanizing, because we were just using this big, broad term to describe people. For me, I thought the best thing I could do with my camera was kind of humanize, put a human face on the people, and in the naive belief maybe that it's hard to hate someone, have much contempt or malice if maybe people actually knew. 

I pitched the idea as a photo story to Carol, and then we went into a much more elaborate process that took a few months of thinking and putting it together, but I'm glad we did. 

Melanie Plenda:

Dan, talk about reporting these stories. How long did it take and what was involved? 

Dan Splaine:

It took about six months. Carol had good wisdom on this — to talk to first-generation immigrants on the complete spectrum of status, from undocumented to permanent green card and naturalized citizen. I also had the objective to try to talk to as many people from as many distinct countries of origin, just because one thing is that we really do have a wide range of people in New Hampshire. But also, just the stories of them, where they're from, their journey to get here, and then what their experience has been here — they’re all very individual, and yet it's very universal to the moment. I just thought a wider range would be better.

Melanie Plenda:

Dan, how did you find the people you spoke to for these stories? Were any of your sources reluctant to talk, given the current climate? 

Dan Splaine:

A lot of time was spent making connections, particularly with refugee agencies and some of the service groups in the state that work with refugee communities in particular, and then kind of building trust. It really took a lot more legwork up front than I actually anticipated, because people are reluctant. As we progressed through the summer, that climate of fear was gaining momentum, but people did speak up, and I found some really great stories.

Melanie Plenda:

Dan, what were some of the key takeaways from your reporting? Were there any surprises? 

Dan Splaine:

One thing I thought is that — and it may be just because of my sample and how I was directed to it — but I found a lot of individuals that really are engaged in their communities, in lots of civic organizations, in their faith groups, in their ethnic communities, some are politically active. I saw the embrace of democracy by some of these people, and it reminds me of my grandfather. My grandparents are Irish, and for him to be able to vote, and the importance of voting — I saw that kind of embrace of our institution and values. That’s the secret sauce for America.

Melanie Plenda:

Carol, what about you? What were some of your takeaways from these stories?

Carol Ribidoux:

There's a phrase I've heard, “immigrants are like astronauts,” and I've thought about that with my own family as well. My grandparents came here from Germany sometime between World War I and World War II. My dad was born here — the only one in his family who was born here — but for his family to leave their country, centuries of established history, family history and familiarity to come to this strange new world with hope, obviously, for their children and their children's children. It's a humbling idea. I think that's another part of the humanity that we miss when we talk about immigrants, refugees, people seeking asylum. We clump them into a group that doesn't have any faces or names or ideas about why.

As a journalist, it's troubling to me. I have deep thoughts and deep feelings about things like this, but I don't know how to translate that to people, or how to get people to think bigger and deeper about the world. Why do we accept things as they are without even questioning them? Or why do we operate from a place of fear instead of understanding? Everything we do, we try to do something that allows people to have a deeper understanding of themselves in the context of the world. 

Melanie Plenda:

Carol, what has the reaction been from readers? 

Carol Robidoux:

One reader commented, “I'm not against immigration. It's illegal immigration.That's a criminal thing, and that's what we're against”.

Again, the narrative that we get a lot of is there's this swarm of dangerous people, like killer bees moving up from South America, and when they get here with their knives and guns and ill intent and cross over our borders illegally and sneakily, they're bringing backpacks full of dangerous drugs, and they want to do everybody harm, so we must build a fence and stop them at all costs. That's probably true that there are some people with bad intentions who want to come to the United States to capitalize on some of our problems here. There's guns going in the other direction to fuel some of that violence and gang activity and illegal drug activity. But I don't think it's a genuine picture of what happens at the entry points, whether it's north or south, and the media has to help to tell the truth. 

Melanie Plenda:

Dan, what about the people featured? Have you heard anything from them?

Dan Splaine:

What I'm hearing is that people appreciate the insights. I suspect that people who are anti-immigrant are not going to, but I think it is important we put the marker down, particularly now in the last eight to weeks, when all of the administration's immigration policies are in hyper drive, and they're much more excessive. 

People appreciate hearing the story. Also maybe it will help motivate people to act, to maybe say, “Hey, we have something that's at risk here, something that we're going to lose if we keep on this path.”

Melanie Plenda:

So what happens now? What’s the next step in this story? Let’s start with Dan and then to Carol.

 Dan Splaine:

I think I've made connections with people, and I'm going to stay in touch. I think there's a nascent reaction, mostly grassroots. It's starting to happen, particularly around ICE enforcement, and I think that's a story that should be tracked. 

Carol Robidoux:

One thing I learned in some of this process was that the vetting process for people to come into the United States is something we don't hear a lot about unless you've gone through it yourself. So it's like understanding that you're not just opening the floodgates and welcoming people into the United States without really knowing who they are or what there is to know about them. 

Another is that people just don't really have a great understanding of it — myself included, prior to that. Also, the idea of weighing out whether it is more important to be angry at people for coming here if they came illegally, or saying, “Why are you here? Let's find a pathway to citizenship if that's possible.” Same with anybody who tries to apply to get here as a student, or as a green card holder, or any of those things.

Again, humanity is absent from the equation. They’re criminals, not good guys, or need to be locked up forever with no hope of anything. Some of the people who came here didn't have a choice. They were just on a list of places they could go that wasn't their home country with war, turmoil, or violence. They didn’t come here to take our jobs and make our lives miserable. They’re just trying to find a life and as good people we owe it to them to try to do better, to come up with some better processes, to use our elected officials to help us figure that out. What can we do differently? Maybe it's time to rethink all of this. How do we shake that up a little bit?

Melanie Plenda:

Great work you two. Ink Link publisher, editor and founder Carol Robidoux and writer/photographer Dan Splaine — thank you for joining us today.

“The State We’re In” is a weekly digital public affairs show produced by NH PBS and The Marlin Fitzwater Center for Communication at Franklin Pierce University. It is shared with partners in the Granite State News Collaborative, of which both organizations are members. These articles are being shared by partners in the Granite State News Collaborative. For more information, visit collaborativenh.org.

Are local zoning rules the biggest impediment to solving the N.H. housing crisis?

Legislation seeks to limit regulations to encourage more development

By Jon Decker, Granite State News Collaborative

The N.H. Legislature is weighing several bills that would strip local zoning obstacles in favor of state mandates to speed up and cheapen construction, particularly for multi-family homes like townhouses, duplexes or cottage courts — that is, the higher-density, so-called “missing middle” homes that advocates support to help address the state’s formidable shortage of housing.

However, many communities oppose stripping away local control in favor of developers’ ambitions. According to the National League of Cities, single-family zoning laws, which often require that homes be built on relatively large lots, have made construction of smaller multifamily structures difficult or outright illegal. New Hampshire, a state known for its strong local zoning laws, is no exception. 

In fact, according to the New Hampshire Zoning Atlas — a comprehensive study conducted in 2021 — single-family homes are allowed on less than 1 acre on only 16% of New Hampshire's buildable land.

Builders and housing advocates have called for allowing denser housing projects, but critics of that approach, especially in small, more rural communities, worry about their impact on local infrastructure and character. 

“Our position is that the Legislature gave zoning to municipalities because it empowered them,” said Margaret Byrnes, executive director of the N.H. Municipal Association. “What we’re seeing this session is close to, if not a complete, dismantling of local authority, government and resident input in decision-making in zoning in cities and towns.”

During the 1970s and 1980s, the Granite State went through a population boom, with growth rates of over 20 percent. Some towns began requiring large building lots to preserve the rural feel of their communities. Some communities required 1, 2 or 3-acre lots for single-family residences, driving up construction costs considerably. 

“It was that sort of growth in population and building patterns that freaked people out,” recalled Rob Dapice, CEO of the N.H. Housing and Finance Authority, also known as New Hampshire Housing. “I don't want to say that everything about that was wrong. Some of it was sprawling and forced people to be more car-dependent than needed; it ate up more farmland than was maybe necessary. 

“I’m not saying that everything about zoning is bad. I think conservation, agriculture and open space are really important.”

But, Dapice said, “What people fail to grasp is that the ordinances in response to that growth requiring larger lots have sort of produced the opposite of what they wanted in terms of open space. Now you have a house every 2 to 3 acres, and everyone wants to think their community is perfect the day they build their house, and nothing should change.”

But change is inevitable, Dapice said, and the choices communities make about construction will dictate the nature of that change, with prices rising if nothing new is built. 

Moving the needle?

For Matt Mayberry, executive director of the N.H. Home Builders Association, the key to solving the housing shortage is modifying legislation to make it easier, faster and cheaper to build homes. 

“There are nine bills the New Hampshire Home Builders association has drafted, is tracking, and lobbying, because we feel they will move the needle in a positive way to help housing,” Mayberry said.

One of the bills, Senate Bill 84, introduced by Sen. Keith Murphy, R-Manchester, is a “game changer,” Mayberry said, that “shifts power from communities to builders.” 

Under the bill, he said, “if you have a building lot that has town water and sewer, the town cannot mandate that you build on more than half an acre. We have municipalities dictating 3- and 5-acre minimums. If you look at land at roughly $250,000 an acre and you have a town like Hanover, that's over 600k before you cut the grass.”

Under SB84, if the lot is linked to town water but not sewer, that minimum lot size goes up to 1 acre, instead of one-half, Mayberry said.

But New Hampshire has long been defined by a sense of “local control,” with individual towns setting many of their own rules. As a result, many of these bills are facing strong opposition from the N.H. Municipal Association and many of its member communities. 

Byrnes, at the municipal association, said the causes of the housing crisis are both multifaceted and wide in scope, and the United States as whole, not just New Hampshire, is facing similar problems. 

“The Legislature is taking a complete tunnel-vision approach of ‘focus on slash-and-burn of local zoning and regulations and that will be the answer to the housing crisis,’” Byrnes said. “I feel certain that the average person in New Hampshire doesn't understand the extent to which their decision-making and authority at the local level is being razed, for lack of a better term.”

Dapice, at New Hampshire Housing, said “the framing of this as a battle between towns and state has been a misperception that many have an interest in perpetuating. There are plenty of towns with exclusionary zoning that want to cast this as big government stamping down, but the reality is that there are some towns allowing construction of all kinds — affordable, market rate, townhouses — and there are other towns that are not.”

Dapice noted that, despite perceptions, New Hampshire is not a “home rule state.” 
“We are a Dillon’s Rule state,” Dapice explained. “Municipalities do not have a right to do anything except when the state grants it. It’s in the (state) constitution.” 

“That’s a convenient and easy argument to make,” Byrnes said of Dillon’s Rule, while citing the 1925 New Hampshire Zoning Enabling Act. ”We gave municipalities zoning, so it's disingenuous to use that as an argument to take over local decisions and commitments that have been made by communities who were granted authority to regulate zoning.”

Other development rules

Other pieces of legislation touted by Mayberry, at the builders association, include HB577, which would loosen restrictions on homeowners interested in building accessory dwelling units, or ADUs. The bill would allow ADUs to include “detached units, adds definitions related to accessory dwelling units, and increases the maximum square footage.”

“This says ADUs are allowed by right, so the town has to start with ‘yes, but let's see if we can make this work,’” Mayberry said, with “common sense” provisions such as acreage, septic and well capacity.

Byrnes expressed skepticism that expansion of ADU rights would translate to more affordable housing because of the costs of construction.

“I struggle to see how that’s going to make a dent in the housing need, especially since we’ve had the current ADU statue since 2017,” she said. “We really don’t have data to the extent that it mattered or even helped. It’s always unfortunate to extend a policy change without knowing how the first version worked.” 

Byrnes also pointed to the state’s longstanding debate about short-term rental units, such as B&Bs, which have made housing much more scarce and expensive in tourism communities such as Conway and Laconia. HB577’s allowance of detached units could make the short-term rental issue a “more acute problem,” she said.

“With a separate structure, it’s even easier to treat it as a short-term rental because it’s detached,” Byrnes said. “If you have money and a house in a nice touristy area, you could afford to build a detached STR and profit off it.”

Byrnes also said many of the zoning overhaul bills are poorly written and messy, which will cost taxpayers in the form of legal fights and debates if they pass. 

She focused on HB410, “relative to adding conditions to zoning boards of adjustment imposing restrictions on the building and development of residential properties,” as deeply problematic. 

“It prohibits municipalities from passing zoning ordinance that restrict residential building unless the legislative body produces empirical evidence under a strict scrutiny standard that the regulation is needed,” Byrnes said. “Are we saying they (the voters) have to produce evidence? Where? At the town meeting? What qualifies as empirical? Why are we using a strict constitutional standard?”

She said another bill, HB92, that defines what a planning board is, differs from current state law. 

“Even if you wanted to pass the zoning mandate, why would you create a second definition of a planning board?” Byrnes said. “They sound like such small things, but they will throw the building and planning process into chaos.”

As for what municipalities can do to alleviate the state’s housing shortage, Byrnes pointed to existing programs that, if funded properly, could provide some relief without limiting local regulation. 

“What’s particularly interesting is that the Legislature has made it clear that they want to solve the housing situation, yet what we're seeing in the state budget is that they aren’t funding any of the programs created in the last few years to create partnerships in local governments,” Byrnes said. “No new funding in InvestNH or Housing Champions.”

InvestNH was funded in 2022 with $100 million from the American Rescue Plan Act “to accelerate the approval and construction of affordable workforce housing in New Hampshire.” Housing Champions is a voluntary funding and grant program created in 2023 that’s intended to help municipalities that take steps to create more housing.

Regardless of what the Legislature decides, it won’t change the costs of development anytime soon. 

According to the analytics firm Altus Group, construction costs in the U.S. have risen 25 to 40 percent since 2020. That’s not just materials and labor, either, according to Moe Archambault, a Laconia-based real estate broker who also works on housing developments. So-called “soft costs,” such as obtaining permits and hiring lawyers, have also substantially increased, he said. 

“Your first-time homebuyer or entry-level housing is almost impossible to produce at today’s elevated cost for building materials and labor to construct, plus the added value of cost and land and getting it developed,” Archambault said. “Town approvals can also take two to three years for a raw piece of land.” 

And now, the Trump administration’s tariffs on a wide range of building materials could make costs rise even higher.

Relatively high interest rates on home loans are also freezing out many first-time buyers, but Archambault said those rates are well within the norm, and the ultra-low interest rates below 5 percent in the 2010s are unlikely to return. 

“I’ve had some buyers that will say, ‘I’m gonna wait for the rates to back down to 3%,’” Archambault said. “I know a 100-year-old man, and you can ask him how many times he saw 3% rates, and he’ll tell you, ‘Only once.’”

Repealing the N.H. Vaccine Association would hurt taxpayers and businesses, critics say

Support has emerged on both sides of the aisle for the organization, which buys vaccines at a discount at no cost to the state.

By Kelly Burch, Granite State News Collaborative

The N.H. House of Representatives has voted to do away with the N.H. Vaccine Association, a nonprofit that buys vaccines at a roughly 30% discount at no cost to the state. 

But people who oppose the bill — including doctors, public health experts, and some Republican lawmakers — say that repealing the N.H. Vaccine association would result in higher costs to the state (and thus, taxpayers), inflict a financial burden on doctors’ offices, increase insurance premiums, and ultimately result in fewer vaccinated children in the state. 

“This program has worked extremely well for a long time and hasn’t cost the state any money,” said Rep. David Nagel, R-Gilmanton, who is also a physician. “What’s problematic about this bill [is] from the very beginning, virtually no stakeholders supported it. That should be a red flag for everybody.”

The bill — HB 524 — passed the House on a vote of 189-181 on March 6. This week, it was considered by the House Ways and Means Committee, which evaluates all bills that affect state spending. The committee retained the bill, meaning it will be reconsidered later in the legislative session. 

Rep. Mary Murphy, R-Francestown, initially voted for the bill, but later testified against it during the committee meeting, after conducting hours of research that she said shows the bill would result in higher insurance premiums and thus greater cost to the state. 

“We don’t want to support any bills that are going to add to the tax burden of the public,” she said. “That’s where I’m coming from and why I decided to try and sustain this organization.”

What is the N.H. Vaccine Association?

The N.H. Vaccine Association is a nonprofit that buys vaccines in bulk at a 30% discount from what doctors’ offices would otherwise pay, according to Dr. Julie Kim, president of the New  Hampshire chapter of the American Academy of Pediatrics.

“It has nothing to do with policy or requirements to get a vaccine,” she said. “All it is, is a buying discount.”

The nonprofit was established in 2002 by state law (RSA 126-Q) and had bipartisan support at the time, said Patrick Miller, executive director of the N.H. Vaccine Association. The cost of running the association — including the price of vaccines and a 0.84% administrative cost — is paid entirely by assessments levied on health insurers who operate in the state. 

These funds — roughly $24 million last year — are then given to the state and combined with federal funding that covers vaccines for children who are uninsured or on Medicaid. Using those two funding sources, the state then buys vaccines at a 30% discount and makes them available to all doctors’ offices in the state, Miller said. 

The state has no cost in operating the program. 

“We’re not requiring vaccines, we’re not impacting vaccines policy, and we’re not taking state dollars,” Miller said. 

The impact of repeal

Repealing the vaccine association would impact the economy, taxes and public health, experts say. 

“Vaccines are crucially important to maintaining the health of our population and, honestly, the economic prosperity of our communities,” said Dr. Sally Kraft, population health officer for Dartmouth Health System.

The most immediate impact of a repeal is that vaccines would no longer be available at a discounted rate to providers, and thus patients. (The state would still be able to buy at a discount for children on Medicaid or who are uninsured, Miller said.) 

“There’s no question that the cost of vaccines will go up,” Kraft said. 

That would likely result in higher insurance premiums, which affects individuals who have commercial insurance and businesses that pay for insurance for their employees. The N.H. Insurance Department has estimated there will be an increased cost of $7.19 million annually to the private insurance market if the vaccine association is repealed.

The state would incur greater costs to provide insurance to its employees because of rising premiums, which could impact taxes, experts say. 

"We’ll all be spending more money,” Kraft said. 

In addition, providers would need to buy vaccines on their own, which might mean that some clinics — particularly small clinics in rural areas — have fewer vaccines available, experts say. That’s one of the reasons Murphy, who represents towns of Deering and Francestown, testified against the bill. 

“I’m concerned about the effect it would have on the doctors,” she said. 

Rather than keeping vaccines on hand in their clinics, doctors might order vaccines as needed, meaning that patients may need to return for a second appointment to get a vaccine, creating a barrier to timely vaccination, experts say. In addition, offices would need to shoulder the administrative and financial burden of ordering and billing insurers for vaccines. 

“It took a long time to build up such an efficient framework that runs pretty smoothly and takes a lot of the administrative burden off of providers,” said Tory Jennison, a registered nurse who is executive director of the N.H. Public Health Association.

People in favor of keeping the N.H. Vaccine Association say that payers, providers, patients and taxpayers all benefit. 

“This is a win, win, win, win,” said Nagel. “There are four wins in this and no losses.”

What’s the reason for the bill?

Rep. Michael Granger, R-Milton Mills,, and Rep. Mike Belcher, R-Wakefield, two of the bill’s seven Republican sponsors, did not return requests for comment about the impetus behind the bill. 

In a March 7 press release, Rep. Jim Kofalt, R-Wilton, senior adviser to House Speaker Sherman Packard, said, “Contrary to the fearmongering we have heard from the bill’s opponents, it will have zero effect on the cost and availability of vaccines. What it will do is make government more accountable to New Hampshire taxpayers, who are currently footing the bill for a costly program run by a quasi-governmental organization.” 

Experts who spoke with the Granite State News Collaborative said that’s a fundamental misunderstanding of the N.H. Vaccine Association. 

“There's a misconception that this is costing the state money, and it’s not,” Miller said. 

Some lawmakers have raised concerns about transparency, but Miller said the vaccine association has addressed those in recent testimony and has always been entirely transparent. 

“The website has every document that we’ve ever created,” he said. 

Nagel, one of the Republican lawmakers who voted against the bill, said any concerns he had about transparency were addressed in a different bill, which he supported. 

“The people who have opposed [the vaccine association] have never given a good argument to what the problem is,” he said. 

Nagel was recently removed from his post on the House Health, Human Services and Elderly Affairs Committee in part, he says, because of his stance on vaccines and other health-related issues. He said he needs to prioritize his knowledge as a physician over party lines.

“People taking on legislation … that have virtually no expertise in this area, that aren’t willing to listen to the people who have the expertise – that’s a problem,” he said. “As a physician, I’m really struck with how often the Legislature wants to tell me how to do my job. And what’s really concerning to me, increasingly, is they’re not willing to listen to me explain to them … what the unintended consequences [of legislation] will be.”

Health care workers, including Kim, Nagel, Kraft and Jennison, said those unintended consequences of removing the vaccine association could include higher health care costs and more Granite Staters with preventable disease. The full economic consequences could be seen a decade or more down the road, as hospital systems in the state face increased costs of caring for unvaccinated individuals, Jennison said. 

That’s why there’s such strong bipartisan support for the N.H. Vaccine Association among people who understand its function, they say. 

“This vaccine association highlights the best parts of New Hampshire,” Kraft said. “It’s innovative. It puts that Yankee ingenuity into effect, and it’s incredibly effective.”

These articles are being shared by partners in the Granite State News Collaborative. For more information, visitcollaborativenh.org.