Sen. Maggie Hassan met with the executive team at Monadnock Community Hospital Monday morning before touring the hospital’s obstetrics ward.
Hassan is visiting New Hampshire hospitals to discuss the impact of the recently passed “Big Beautiful Big,” which will cut funding for rural hospitals, and Medicare and Medicaid patients.
“We are thinking that 46,000 Granite Staters will lose their health care as a result of this bill,” Hassan said. “This budget bill makes massive cuts to not only Medicaid, which has gotten the most press because it’s the most obvious cut, but it also makes cuts to Medicare, and to the Affordable Care Act.”
Hassan told the management team at MCH that several smaller health care facilities in New Hampshire, including in Concord, Laconia and Canaan, have already announced they will close.
“What I’m learning from traveling around the state is that healthcare providers and families are already feeling the effects of the Republican budget bill,” Hassan said. “We are already seeing healthcare centers, particularly in rural areas, planning to close. It is going to take longer for people to get the healthcare they need, assuming they have coverage to get to healthcare.”
Hassan said as a result of the bill, nationwide, private health insurers “are coming in with an 18% across-the-board increase in premiums.”
“In New Hampshire, I recently met with a middle-aged couple who are 60 years old and earning about $80,000 a year, and their health insurance costs are going to go up by $9,500 for the year because of these changes,” Hassan said. “When fewer people are covered generally, health insurance providers charge more.”
Richard Scheinblum, executive vice president and CFO of MCH, said that about 9% of all the hospital’s business is paid for by Medicaid.
“What is key to look at is who we serve with Medicaid, and it is a large percentage of OB and pediatric patients, and those services are essential to the health of community, ” Scheinblum said.
Scheinblum said that due to the growing existence of “maternal health deserts,” or areas where there is no obstetric care, 40% of the patients are coming from outside MCH’s service area.
Cynthia McGuire, president and CEO of MCH, said the hospital is committed to continuing to provide obstetric and pediatric care to the community despite the financial challenges.
“Our pediatric program and our obstetrics program go hand in hand, and the board has made a very deliberate decision to maintain these services for our community. That said, these services are not well reimbursed,” McGuire said. “To recruit a provider here is significant. We actually have providers who are so committed to our community that they are willing to work for less in order to enable us to recruit another physician at the going rate.”
Chief Medical Officer Dr. Daniel Perli said that providing obstetric care is also challenging when patients lack the coverage to obtain prenatal care.
“We have patients who show up in active labor in the Emergency Department, and we don’t even know their blood type,” Perli said. “We’re trying to figure out, do they have their vaccinations? Do we have their screenings? Do they need to go to the OR?”
Scheinblum said noted that maternal healthcare deserts that already exist in many states because of the high cost of providing obstetric care.
“We do about 300 births a year, and about 20% of them are Medicaid,” he said. “Labor and delivery is very intensive, and it’s not predictable. You have to have full staffing all the time.”
Laura Gingras, VP of Community Relations, said that behavioral health is another area that is vital to the health of the community but is poorly reimbursed by insurance.
“The hospital significantly subsidizes the cost of behavioral health for the community,” Gingras said.
Scheinblum said the cuts and hospital closures will also have a deep impact on employment in New Hampshire.
“This will cost a lot of people their jobs,” he said.
Hassan said she is working with her colleagues in the Senate to find a way to restore funding for healthcare.
“We need to hear from all of you, and how this is affecting you all at the granular level,” she said. “Reach out to your legislators are tell them what’s happening.”