New Hampshire Legislative Wrap-Up

As we celebrate a successful year for American Heart Association health policy, we want to express gratitude for all the You’re The Cure advocates who helped to make a difference in New Hampshire.  Thanks to advocates like you, making our voices heard in support of priority policy issues, we have made strides in improving the health environment in our communities.

The American Heart Association engaged advocates and resources in 3 successful priority advocacy campaigns; one supporting a health policy passed into law, and two defensive campaigns opposing attempts to weaken current law:

Due to the efforts of American Heart Association advocates:

• Every public school under construction or substantial renovation will now install water bottle filling stations in place of ½ of all drinking fountains – to ensure children have access to clean, safe drinking water while in school. Besides helping keep children hydrated, encouraging students to drink more water will reduce the consumption of sugary drinks that impede children from growing up at a healthy weight. (SB 233)
• We protected municipalities’ power to enact strong public health policies for the health, safety, and well-being of their residents and visitors. NH has a long history of local control to develop solutions to issues that are best determined by residents working along with their elected officials to build healthy, equitable communities. (HB 1268 & HB 1272)
• Together with partners, we protected granite staters from an expansion of low-quality, inequitable health insurance plans. Currently, NH permits short-term, limited-duration health plans that are 3 months in duration with one renewal, for people who have a short-term disruption in coverage. Removing the limitation on renewals would have increased the likelihood of adverse selection in NH’s insurance market and exposed those with pre-existing conditions to financial risk from excessive charges or denial of coverage. (HB 1028)

The American Heart Association also engaged in advocacy efforts on several other issues that, despite not passing, have elevated the critical need for these health policies among NH lawmakers. We will continue to support these priority issues in the coming legislative session:

• Extending postpartum Medicaid coverage from 60 days to 12 months following a pregnancy would reduce the risk of maternal mortality from cardiovascular disease and other health complications. People on Medicaid due to pregnancy often lose their health coverage after 60 days postpartum.  This is a time of great risk to a birthing person’s health as many risk factors are either unknown prior to their pregnancy or develop during pregnancy. 60 days of coverage affords most only one healthcare visit, not enough time to get many critical health issues under control or treated.  Legislation to make this a benefit in NH was passed by both the Senate and the House, but during Committee of Conference deliberations, the bill died. (SB 407)
• NH Medicaid does not yet cover comprehensive tobacco/nicotine cessation services for all tobacco users who want to quit. The tobacco use rate among Medicaid patients is twice as high as the general population, and tobacco-related illness costs NH $729 million annually in healthcare expenses, $139.2 million paid for through Medicaid. A bill containing a provision to extend coverage to Medicaid patients covering both counseling and pharmacotherapy treatments was passed by the Senate, but the provision was removed in the House.  We will continue to support coverage and funding for comprehensive tobacco cessation services in Medicaid in the next state budget. (SB 430)
• The Department of Safety, Bureau of EMS updates its Patient Care Protocols (PCP) every two years. A basic statewide protocol for pre-hospital treatment of stroke patients exists but is missing recognition by the state of the hospitals which have been certified as one of four levels of Stroke Center.  For the next update, we will continue to work for Stroke Center recognition to be included in the state protocols, and for all NH hospitals to work with their local EMS providers to have a transport or transfer plan for stroke patients who can benefit from a higher level of care.

Other legislation and local policy supported in 2021-2022 are part of multi-year efforts:

• Supported evidence-based school nutrition standards for meals and competitive foods to ensure the health and well-being of children.
  • HB 1561 sought to align NH’s school nutrition standards with those supported by the most recent science on children’s nutrition needs regarding sodium, added sugar, and whole grains. The bill failed to pass, but the House Education Committee felt the bill worthy of being included in a legislative committee to study the full spectrum of considerations around strengthening school meals programs.
• Supported access to the Supplemental Nutrition Assistance Program (SNAP).
  • Funding for a SNAP Incentive Program for fruits and vegetables was secured in the last state budget, but not at an adequate level to meet the needs of those eligible. As part of the effort to elevate the need for this food assistance program to help those who are food and nutrition insecure, the AHA joined an effort requiring a state outreach program be established to promote this resource to those who at times struggle to get by.  SB 404 was passed into law to help increase enrollment in SNAP over the coming year.
• Focused efforts on local policy for Manchester NH.
  • We have begun to establish contacts with elected officials and city agencies to discuss the needs of residents and potential solutions for those impacted by health inequities. These policies include water bottle filling stations in existing school buildings, healthy food access through produce prescription programs, and establishing an equitable Complete Streets policy for safe and convenient for all modes of transportation.