New Hampshire Health Insurance 2026

New Hampshire has a relatively small but stable ACA marketplace with 20–40 plans statewide. Anthem is the dominant carrier, with Harvard Pilgrim and Ambetter providing competition primarily in the Manchester and Nashua areas. Silver premiums average $455–$475/month for a 40-year-old before subsidies. Northern and rural New Hampshire have limited plan options and specialist access challenges. New Hampshire uses Healthcare.gov for marketplace enrollment. The state's proximity to Boston means many residents access care from Massachusetts providers, affecting network design.

New Hampshire expanded Medicaid in 2014 through a unique private-carrier model (New Hampshire Health Protection Program), contracting with commercial insurers to provide Medicaid expansion coverage. The program has enrolled over 70,000 residents and has been made permanent. New Hampshire initially had a work requirement attached to its expansion program, but this was blocked by federal courts. The state has no state-based exchange. New Hampshire's historically libertarian political culture has made coverage expansion a recurring political debate, but the expansion has maintained bipartisan support due to its private-sector model.