CHOURASIA FOR NH

On May 14, SB 498, a New Hampshire Senate bill concerning mental health coverage for children 18 and younger, came before the House after passing the Senate. It was among the most widely discussed bills of the day. It passed only as interim study by a 188-164 division vote, and a subsequent motion to reconsider later in the day failed 162-183 on a roll call vote. Earlier, the House Commerce Committee had also recommended interim study by a 14-4 vote.

As a member of the Commerce Committee and a supporter of the bill, I helped bring it to the House floor in hopes of gaining enough support for passage. In the week leading up to the vote, I discussed the bill’s merits with many colleagues and was encouraged by the growing support. I was also among the first representatives to speak in favor of the bill on the House floor. Although the bill ultimately fell short by a narrow margin, we were encouraged that our efforts significantly narrowed the gap and brought the measure close to passage.

This bill was supported by New Futures and NAMI (National Alliance on Mental Illness), both nonpartisan organizations focused on improving the health and well-being of all Granite Staters. Gov. Kelly Ayotte and the New Hampshire Insurance Department had voiced strong support of the bill, which holds insurance companies accountable for protecting coverage for children’s mental health care.

As many of you know, the mental health crisis, especially among children 18 and younger, is a growing concern for our state, and adequate, responsible mental health coverage with proper access and capacity for these children is the need of the hour. This is part of our state’s healthcare cost and access problems, which the New Hampshire Forum, a bipartisan statewide civic engagement group, identified as one of the top six priorities facing Granite Staters.

SB 498 establishes a fair and sustainable funding model for the FAST Forward program, a mental health Tier 3 wraparound care management program that provides community-based, family-centered care for youth facing serious emotional and behavioral challenges before a situation escalates, which could lead to costly emergency room visits, hospitalizations and out-of-home placements. Currently, private insurance does not cover FAST Forward, even for its own members. As a result, children often go without care until their conditions worsen, sometimes to the point where Medicaid becomes the only option. If the child does not qualify for Medicaid, state general funds cover the cost.

SB 498 addresses this issue by requiring shared accountability between public and private payers. Simply put, it requires private insurers to cover mental health services for their own members. The bill would save the state more than $2.5 million annually in taxpayer funds, not including additional savings from reduced emergency visits and psychiatric hospitalizations through earlier intervention.

A common concern about expanding insurance coverage is the impact on premiums. I addressed this during my House floor speech. Using available data, the estimated cost was just 24 cents per member per month. To be fair, I also asked Anthem representatives for their estimate during the Commerce Committee hearing. Anthem later provided a figure of $1.25 per member per month. Even at that amount, it is a small price to pay to save taxpayers millions of dollars while improving mental health services for our children.

Although the bill passed only as interim study, it will be revisited by the House Commerce Committee in fall 2026. Given the awareness and support generated over the past month, I am optimistic that we can build consensus and advance a meaningful solution to New Hampshire’s mental health crisis in the near future.