In the latest episode of New Hampshire Uncharted, host Gene Martin sits down with two of New Hampshire’s leading experts on health care policy to unpack a question that concerns every household, business, and budget in the Granite State: Why is health care so expensive here – and what can we do about it?

“New Hampshire consistently ranks as one of the most expensive states in the country for health care,” Martin notes at the top of the episode. “Whether it’s monthly premiums, prescription drugs, or other out-of-pocket costs, too many Granite Staters are asking the same questions: Why does it cost so much, and what can be done about it?”

In this episode, Deborah Fournier, Director of Health Law and Policy at the UNH Institute for Health Policy and Practice and a former director of New Hampshire’s Medicaid program, and Jennifer Frizzell, Director of the New Hampshire Health Care Cost Initiative, explore the root causes of high prices in New Hampshire’s health care system – from hospital consolidation and aging demographics to gaps in data and transparency – and highlight policy solutions that other states have used to rein in costs.

“It’s not one thing that leads to higher prices. It’s a huge combination,” explains Fournier. “And just by trying to address one of those factors, you don’t necessarily effectuate all of the other factors.”

Why health care is expensive in NH

Premiums and deductibles in New Hampshire routinely exceed the national average. Jennifer Frizzell shares how this complexity affects patients on the ground: “Nearly 70% of New Hampshire residents across income levels – including middle and even higher-income people – are foregoing and avoiding health care in our state, because they either know they can’t afford the cost…or because they’re afraid of the unknowns.”

What’s working in other states

Fournier walks listeners through successful efforts in Massachusetts, Connecticut, and Rhode Island to cap health care cost growth and introduce transparency benchmarks. She also outlines what a “New Hampshire-style” solution might look like, drawing on Rhode Island’s efforts as a helpful framework: voluntary, data-driven, and grounded in local decision-making.

Where we go from here

Both experts agree that more data alone won’t fix the problem. “You can have all of the oversight and all the transparency in the world,” says Fournier. “You still have to take policy steps to address the underlying costs and the prices.”

Frizzell highlights four key reforms gaining traction:

• Investing in primary care, which reduces the cost of providing care overall
• Expanding consumer protections
• Increasing oversight and transparency
• Establishing a long-term health care vision for the state

“We have to proactively speak up for the kind of health care system we think should be in every community,” Frizzell says.