Building a Better New Hampshire: Panelist Solutions from NHFPI’s 10th Annual Conference

Last month, NHFPI held our 10th Annual Budget and Policy Conference, “Working Hard and Falling Behind: The High Cost of Living in New Hampshire,” where we convened experts from across sectors to discuss the drivers of high costs and offer solutions for building a more affordable future for all Granite Staters. Among the four featured panels, speakers shared ideas around collaboration, increased investment, and data-driven decision making as promising solutions for addressing the most pressing challenges in health care, caregiving, housing, and the state’s rural communities.

Below are some of the key challenges, and solutions highlighted by our guest speakers, throughout the conference. These solutions were offered by panelists at the conference, and are not necessarily specific policy recommendations from NHFPI; this blog chronicles recommendations discussed by our guest speakers.

High Cost of Health Care

Increase Collaboration and Shared Accountability: With various hospital closures and consolidations shaping the state’s health care landscape, Director of Health and Life Sciences Law and Policy programs at the University of New Hampshire (UNH) Franklin Pierce School of Law Lucy Hodder emphasized the importance of shared responsibility and collaboration among policymakers, providers, and insurers. As private, for-profit entities have taken over a larger share of the health care system, more state oversight can increase accountability and help prevent service gaps, particularly in the state’s rural communities.

Invest in Primary and Preventive Care: Rather than investing heavily in high-cost, emergency health care, panelists highlighted the need for more primary and preventive care. By increasing access to routine screenings, behavioral health care, and maternal health care, improved health outcomes could lead to lower health care costs across the system.

Improve Data-Driven Conversations: While Director of Health Law and Policy at the Institute for Health Policy and Practice Deb Fournier and Green Mountain Care Board Project Director Kirk Williamson discussed how more accessible data can help inform policy conversations, they emphasized that data alone does not lower costs. Transparency is important for targeting solutions, but data is only a portion of the overall health care conversation.

Support Navigators and Community Health Providers: While long-term structural changes are needed to address high costs, panelists emphasized the importance of short-term solutions to address immediate needs in the health system. As NH Health Cost Initiative Project Coordinator Jennifer Frizzell noted, patient navigators can help Granite Staters better access and understand their health insurance coverage. Support for the state’s community health providers is also important for addressing immediate needs among the uninsured and underinsured who are unable to access services elsewhere.

High Cost of Caregiving

Increase Wages and Improve Career Pathways: With many caregiving professionals earning wages far below the state average, noncompetitive salaries remain one of the biggest challenges for workforce recruitment and retention. Across the conversation, panelists highlighted the importance of increasing pay for caregiving professions, as well as improving early career programs to encourage students to enter caregiving fields.

Expand Employer Flexibility: While support for caregiving professionals is important, panelists noted that support for family caregivers is also essential. With many Granite Staters having to leave work or reduce hours to care for children, aging parents or grandparents, and family members with disabilities, policy solutions such as paid family leave and flexible work schedules could offer support and strengthen the state’s workforce.

Increase Respite Care Services: Nationally, more than one-third of family caregivers say having respite services would be helpful, yet only about 14 percent receive them. According to panelists, New Hampshire took a step forward in the current State Budget, allocating $100,000 to expand caregiver respite services, although sustained future investment will remain important.

Improve Data Infrastructure: Jess Carson mentioned, improved data transparency is important for understanding the success of policy initiatives. Consistent data system tracking is crucial for measuring outcomes and tracking needs across the caregiving system.

High Cost of Housing

Maintain Balanced Momentum: While the New Hampshire Legislature passed several housing-related laws during the 2025 session, declines in State Budget funding could disrupt ongoing housing initiatives. As Housing Action NH Director Nick Taylor emphasized, both regulatory action and financial investment is important for helping to ensure communities can build more affordable housing.

Increase Housing Availability Through Other Regulatory Action: Panelists mentioned that many reforms that the State has considered in the past could increase housing options and available inventory. Regularly actions, such as reducing minimum lot size requirements, expanding duplexes and other “middle” housing, and updating zoning policies, have offered promise in other states.

Strengthen Local Infrastructure: As New Hampshire Housing Manager of Community Engagement and Education Sarah Wrightsman noted, many New Hampshire communities lack the staff and resources to plan new housing developments and update local zoning laws. Providing support for local planning and infrastructure needs, similarly to those supplied through the state’s Housing Opportunity Planning (HOP) Grant Program, can help address local challenges.

Improve Homelessness Services and Rental Support: As New Hampshire moves towards the longer-term goal of more affordable housing, offering increased support for Granite Staters with the highest need is crucial. Panelists emphasized the need for better services for individuals experiencing homelessness, as well as increasing more affordable housing for cost-burdened renters with low incomes.

High Cost of Rurality

Support Anchor Institutions: In rural communities, where services may be harder to access, supports for key place-based institutions can have positive effects. Schools, hospitals, child care centers, and libraries are anchor institutions that help stabilize rural communities, said panelist and Coos County Child Care Director Network consultant Airole Warden. Panelist and New Hampshire Children’s Health Foundation Director of Research and Community Impact Alisa Druzba identified the value of supporting educational institutions and integrating health services into school settings.

Help Businesses and People Afford Risks and Leverage External Resources with Local Infrastructure: Housing costs have risen faster in rural northern and western parts of New Hampshire than in the southeast, and incomes have not increased proportionately. All panelists identified the need for locally-grown and locally-informed solutions, paired with external resources when possible, that could help people access resources in a sustainable manner, whether for housing repairs or to start a business. Panelist and Executive Director at the Hannah Grimes Center for Entrepreneurship Julianna Dodson noted that local entrepreneurs often need external assistance to compete in a global marketplace. Warden indicated much of New Hampshire’s aging housing available in a tight market needs costly rehabilitation. Druzba identified lead poisoning prevention in older houses, while costly, is a solution that helps address several challenges simultaneously..

Upstream Solutions and Strategic Changes in Thinking: Rural areas can creatively stretch resources further, but intentional coordination and planning is required, the panelists said. Warden and Dodson both identified a need for more training and employment opportunities in local areas to help build and support the future workforce, while Druzba noted investments in children, particularly disconnected youth, are effective for long-term success. Dodson also emphasized thinking of systemic change through leverage points, and Druzba identified the value of efforts to reduce poverty and increase incomes.

Looking Ahead

Throughout all four panel discussions, experts emphasized the interconnectedness of New Hampshire’s challenges. Strengthening one system, whether it would involve improving health care or increasing affordable housing, helps strengthen the other systems across the state. Continued collaboration, increased investment, and heightened support are important for addressing ongoing challenges and building a better future for all Granite Staters. As the state moves into the upcoming year and next Legislative session, the solutions discussed by conference panelists can provide insight into addressing immediate challenges and building longer-term stability for all residents.