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 For employers and employees in , the story is the same - premiums are going up by . Rates are predicted to rise for small employers on healthcare.gov by about 7.5% (low) to 20% (high) depending upon the plan and company.  

The is concerned, and urged health carriers to submit revised, data-driven rates for 2026, considering the expiration of federal subsidies, and federal and state policies putting upward pressure on costs.   

Rising Prescription Drug Costs in New Hampshire 

Prescription drugs are a  of rising insurance premiums in New Hampshire. In 2024, commercial health plans and their members spent $1.33 billion on prescription drugs dispensed at retail pharmacies alone. The bulk of that spending was concentrated on a small number of high-cost specialty drugs, in fact 46% of pharmaceutical spending is on expensive specialty medicines and that percentage increases every year.  

In New Hampshire, of the top 6 drugs by total spending, three were GLP-1s for diabetes and weight loss - together accounting for more than half of the total amount spent. &�Բ�����;

The pressure from the use of these high-cost drugs is not limited to commercial insurance. In New Hampshire’s public employee plans (excluding Medicaid), Ozempic, Wegovy, and Mounjaro also rank among the top five by spending - even though they only entered formularies in the past few years. 

For New Hampshire, the rapid uptake of these high-cost specialty therapies will push insurance rates higher in 2026 and beyond. In fact, the New Hampshire Insurance Department’s 2024  reinforces this picture: pharmacy accounted for more than one-fifth of overall medical trend in the group markets, and specialty drugs represented 54% of pharmacy spending. In the individual market, pharmacy costs spiked nearly 13% in a single year, underscoring how the rapid uptake of high-cost drugs like GLP-1s directly translates into higher premiums for New Hampshire families and taxpayers.² &�Բ�����;

Without policy action, the math ensures tomorrow’s premiums will bear the weight of today’s drug prices. &�Բ�����;

Hospital Consolidations and Affiliations – It’s a Thing in NH 

Hospitals have been consolidating and rearranging ownership structures frequently across New Hampshire, for patients, employers and taxpayers, and confusing anyone seeking to navigate healthcare choices and budgets for their families. 

Just in the past few years, out-of-state hospital systems have been moving into the Granite State. HCA Healthcare, Inc. of Nashville, the largest hospital system in the US, purchased Catholic Medical Center assets resulting in the ownership of 4 for-profit hospitals across the Southern and Seacoast areas. Massachusetts based hospital systems formed Exeter Beth Israel Lahey Health in 2023, and Wentworth Douglass Mass General Bringham in 2016.  In addition, most New Hampshire non-profit community hospitals have consolidated. Most recently its intent to join Dartmouth Health, and Elliot and Southern New Hampshire Health Systems proposed dissolving resulting in unknown costs (or savings) to communities.  

Often communities are left in the dark about the actual impact of the consolidation on their healthcare and health costs - for example, almost immediately after HCA ‘purchased” assets of CMC earlier this year, HCA demanded “” from health insurance plans, and proposed to duplicate existing services in both Concord and Nashua by building “free-standing emergency rooms” in order to attract patients to their for-profit hospitals. According to publicly reported data, HCA operates the highest priced hospitals in New Hampshire. See  

And So… What do We Do? 

Healthcare will become more expensive and health insurance more difficult to navigate for employers, families, health providers and tax payers into the future due to ongoing hospital consolidation, rising prescription drug costs, the impact of federal policy changes on access to insurance, workforce shortages and tariffs.  

 What can be done to help New Hampshire weather the impact?