NH Health providers deeply alarmed over Ayotte and Trump’s potential Medicaid cuts

Top community health service providers, advocates and impacted individuals joined Congresswoman Maggie Goodlander at Gateways Community Services in Nashua this week to voice their deep alarm over proposed Medicaid budget cuts at both the state and federal level.

Goodlander put the proposed federal Medicaid cuts, which Senate Republicans have been debating to help pay for a $4.5 trillion extension of Trump’s 2017 tax cuts, in stark terms.

“We are up against the biggest cuts to medicaid in American History.” Goodlander said. “No one voted for this.”

The state changes, proposed by Republican governor Kelly Ayotte in her state budget, include increased copays and work requirements, and are expected to have a devastating impact on the state’s most vulnerable residents who rely on Medicaid for a range of services.

“When we talk about what the Governor has proposed in terms of copays, $50 or $100 for someone who literally does not have a pot to piss in, it’s a problem,” said Mike Apfelberg, President of the United Way of Greater Nashua, who said individuals receiving community care services through Medicaid were already on the brink.

“We live in a society where people are just one $300 emergency away from having to declare bankruptcy.”

The cuts would jeopardize access to critical services like inpatient care, behavioral health treatment, and substance use recovery programs. Providers warn that the loss of Medicaid funding could force many agencies to scale back or even shutter their operations.

“Our clients are not capable of paying additionally for services,” explained Gregory White,

CEO of Lamprey Health “So when we talk about these proposed changes, it’s a real problem for this community.”

Beyond the direct impact on service delivery, the Medicaid cuts also threaten the stability of the state’s entire care system. Speakers expressed deep concerns about the ability to retain direct support staff, who may be lured away by jobs at fast food restaurants or big box stores offering higher wages.

“We’re really concerned about people leaving and going to work for McDonald’s or Target,” said Will Walker, legislative liaison for Gateways Community Services, a long-term healthcare services provider that serves low income Granite Staters.

“The wages for our direct support workforce are a major issue.”

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With state revenues already strained by repeated tax cuts for the state’s top 1%, legislators are facing pressure to find hundreds of millions of dollars in budget cuts from programs that serve the state’s most vulnerable. The Department of Health and Human Services, which oversees Medicaid, could be forced to reduce its spending by as much as $500 million.

Families at the event shared heartbreaking stories of the vital role Medicaid plays in supporting loved ones with disabilities and complex medical needs. They warned that the proposed changes would leave many without access to the services they depend on, placing an immense burden on aging caregivers and the broader community.

Advocates are calling on state lawmakers to prioritize the needs of Medicaid recipients and protect this critical safety net. With time running short, they are urging swift action to prevent the devastating consequences of these proposed budget cuts.

Peggy Gilmour, Chair of the board at Gateways, said Granite Staters should expect to have some level of support from Ayotte to protect the most vulnerable Granite Staters from the worst of these Medicaid service cuts, which are being made purely in service of tax cuts for the wealthy.

“I don’t know what your relationship is with our governor, but she has the opportunity, just party wise, to have a voice to some members of Congress that some of us don’t,” Gilmour said.Goodlander agreed.

“Yeah, (Ayotte) does, she does. And, you know, we gotta work with anyone who will work with us on this,” Goodlander said. “And I hope she will.”