Health care costs pinch Granite Staters, but not as hard as rest of country

Failure to restore ACA tax cuts will only make things worse, according to U.S. Sen. Maggie Hassan

While Granite Staters certainly feel the pinch of health care costs, the squeeze isn’t as acute as most elsewhere in the country.

A new study puts New Hampshire at No. 49 among states where people spend the most and least for their health insurance.

Health insurance premiums are responsible for 4.77% of the median household monthly income among Granite Staters, according to WalletHub.

In findings released July 9, WalletHub said health care payments can consume 20.9% of median income in West Virginia as a high to 4.66% in Maryland as the bottom, just below New Hampshire.

The study’s author acknowledges that the squeeze on local household budgets is relative when reviewed nationally.

“New Hampshire’s ranking shows that health insurance is relatively affordable compared to most other states, but that doesn’t mean residents aren’t feeling the impact of rising health care costs,” said WalletHub analyst Chris Lupo.

“The state ranks 49th, because health insurance premiums account for just 4.77% of the median monthly household income, thanks to a combination of the lowest average health insurance premium in the nation ($394 per month) and the sixth-highest median household income ($99,031),” he added in a statement to NH Business Review.

A family’s basic costs — for housing, health care, child care, goods/services — have risen far faster than paychecks, according to the New Hampshire Fiscal Policy Institute.

In a study of its own in October 2025, it said the typical New Hampshire household earns nearly $100,000 a year, yet a family of four with this income still falls about $2,000 short each year of covering basic needs.

“Even families with employer-sponsored insurance are paying significantly more for care than a decade ago, as premiums, deductibles and out-of-pocket expenses climb faster than wages,” said the NHFPI report.

Affordability remains a growing concern, according to Lupo at WalletHub.

“Health insurance premiums across the country increased by 5% for individual plans and 6% for family plans in 2025 alone, and many households continue to feel pressure from rising medical costs. In fact, while New Hampshire ranks near the bottom for the share of income spent on health insurance, it ranks 40th for overall health care spending as a share of income,” said Lupo.

“That distinction highlights an important point: Relatively affordable insurance premiums don’t necessarily translate to low costs overall, but they do provide New Hampshire residents with a significant financial advantage compared to people in many other states,” he added.

In neighboring Vermont, residents spend 19% of their median income on health insurance, because average monthly premiums reach $1,289, which are the highest in the country. That puts Vermont at No. 2 in the national rankings behind West Virginia.

Within the rest of New England, Maine is No. 11 with 11.18% of income spent on health, Connecticut is No. 25 at 9.68%, Rhode Island is No. 42 at 6.67%, and Massachusetts in Nov. 48 at 5.49%.

For those Granite Staters who use the Obamacare/American Care Act (ACA) health insurance marketplace, 2027 could be a challenge.

The state’s insurance commissioner, D.J. Bettencourt, said New Hampshire was on good footing heading into 2026.

As open enrollment began in early November and ran through mid January, the New Hampshire Insurance Department said the state led the nation in affordability, with an average benchmark premium of $401 per month. It said it was the lowest average premium as determined by the Kaiser Family Foundation (KFF).

“New Hampshire’s insurance market continues to deliver stability, affordability and choice for Granite Staters,” said Bettencourt. “Our disciplined, data-driven approach — rooted in free-market principles, sound oversight, collaboration and supported by our state-designed reinsurance program waiver — has made New Hampshire a model for how states can protect consumers while fostering competition and solvency.”

But a KFF projection for 2027 says typical premiums for insurers participating in the ACA marketplaces would jump by more than one-third between 2025 and 2027.

July 15 is the deadline for health insurance companies to submit their proposed premiums for 2027 ACA Marketplace plans. Across the 77 insurers that have submitted rate filings so far, most are requesting premium increases of between 10% and 20% for 2027, with 20 insurers requesting premium increases of more than 20%.

KFF said the big drivers of the increases are the cost of hospitalizations, physician visits and prescription drugs, including GLP-1s and other specialty medications.

Another big driver is the lack of enhanced premium tax credits, which expired at the end of 2025, leading to a 58% average increase in out-of-pocket premiums in 2026 and deductibles of about $1,000 more per person.

A return of tax credits will be a political one in Congress, fraught by factions in the House, Senate and White House.

An attempt this year to restore the cuts failed in the Republican-led Congress, a decision that U.S. Sen. Maggie Hassan (D-NH) said was bad for Granite Staters this year and could get worse for them next year.

Hassan convened a roundtable discussion with health care professionals at Lamprey Health Care in Raymond on July 17 to discuss the recent decline in ACA enrollment by at least 13% nationwide and 7.8%  in New Hampshire.

Her contention is that the Trump Administration’s actions are straining the health care system and increasing costs for Granite Staters, hearing from the health care professionals that as a result of higher costs patients are delaying care or foregoing it altogether.

“President Trump and Congressional Republicans chose to make Americans’ health care premiums more expensive in order to give billionaires and corporate special interests a tax break. Now, we’re seeing the consequences of that decision, with enrollment in Affordable Care Act health insurance already down by almost eight percent in New Hampshire and that number is likely to grow,” said Hassan.

“I was grateful to hear from the doctors and health care leaders at Lamprey Health Care about how these higher costs are affecting their patients, and I will continue to advocate for solutions that bring down the cost of health care for Granite Staters,” she added.