An agenda for the future of abortion access in New Hampshire

Policy Roadmap: Ensure Access to Abortion in New Hampshire 

1. Pass proactive legislation to enshrine the right to accessing abortion in New Hampshire. New Hampshire is the only state in New England that does not have abortion rights on the books. In 2022, the Access to Abortion-care Act, which would have added the right to accessing abortion to our state laws, failed in the Senate in a 12-12 bipartisan vote. State lawmakers must take swift action in the 2023 legislative session to secure abortion rights into New Hampshire’s state statutes.

2. Amend New Hampshire’s Constitution to enshrine the right to accessing abortion in New Hampshire. New Hampshire has only two paths to amend the state Constitution: through a constitutional convention, which is offered to voters once every ten years (the last one held was in 1984); or through legislative referral, by passing a CACR through the House and Senate with 60 percent margins in both chambers. The constitutional question would then go on the ballot, requiring a 2/3 majority for passage. Either path has an incredibly high bar to reach, which is possible only through a long-term coordinated and strategic plan, which begins with – but is not limited to – significant investment from statewide and national partners, building public awareness, and electing a strong majority of pro-abortion lawmakers to the State House. 

3. Repeal current abortion restrictions. As of January 1, 2022, New Hampshire has a 24-week abortion ban – the first abortion ban in the state’s modern history. All decisions regarding abortion care should be left to the patient and their doctor – not politicians. State lawmakers should act swiftly to repeal all current restrictions from New Hampshire law, trusting patients, families, and providers in this personal and private decision-making. Abortion restrictions in New Hampshire include a 24 week ban, limited exceptions, and parental notification for minors.

4. Address disparities to abortion care based on geographic location, including for abortion later in pregnancy. New Hampshire should address gaps in abortion access in areas of the state that are served primarily by religiously affiliated hospitals and health systems. Patients must be able to access a full spectrum of health care, including abortion, contraception, miscarriage management, and gender-affirming care they need and deserve regardless of where they receive their care. New Hampshire should work to protect access for patients, regardless of patient zip code. 

5. Support policies to ensure abortion and abortion-related care is covered for all patients, regardless of insurance.  Nationally, 1 in 4 women with lower incomes seeking abortion is forced to carry an unwanted pregnancy to term because Medicaid does not cover abortion care. There are multiple paths New Hampshire could take to ensure that abortion care is available to all who need it, including allowing New Hampshire Medicaid to cover abortion and abortion-related care, investing in abortion funds, and requiring insurers through commercial health insurance plans and plans on the marketplace to cover abortion care. Allowing New Hampshire Medicaid to cover abortion and abortion-related care, for example, will decrease costs for patients with lower incomes, ensuring all patients are able to afford the care they need. Insurance companies should also be encouraged to expand protections for sexual and reproductive health including for birth control.

6. Increase the number of providers who offer abortion care. As states move to ban abortion outright, New Hampshire will likely see an increase in patients traveling from hostile regions to access care. The state should take immediate steps to protect New Hampshire health care providers from criminalization for performing legal abortion services for patients traveling from hostile states. New Hampshire should encourage more health care institutions, including OB/GYN programs and college campus health centers, to put programs in place to provide medication abortion. Additionally, by expanding and protecting telehealth parity rates and opportunities for sexual and reproductive health care, New Hampshire can help address critical care gaps in rural areas of the state.

7. Defeat anti-abortion legislation in the State House. In 2021, anti-abortion state lawmakers passed the first abortion ban in New Hampshire’s modern history. Emboldened by this success, and with the loss of federal constitutional abortion protections, anti-abortion lawmakers will continue to try and pass stricter and stricter restrictions, chipping away at access in the Granite State. We must continue to defeat all anti-abortion legislation introduced.

Funding Roadmap: Strengthen New Hampshire’s Public Health Care Ecosystem

1. Increase state funding for NH Family Planning Program (NHFPP) to reflect current health care costs. In the FY22-23 state budget, lawmakers cut funding for the NHFPP – and then the Executive Council voted against the NHFPP contracts for providers who support 79 percent of the patients in the program. In the FY24-25 state budget, state lawmakers must intentionally invest in the NHFPP. This investment should also account for the duration of time providers were excluded from the program while still providing affordable and accessible family planning services, such as cancer screenings, STI testing and treatment, and contraception.

2. Ensure family planning providers previously removed from the New Hampshire Family Planning Program (NHFPP) are able to re-enter as soon as possible. The NHFPP funds providers who offer preventative sexual and reproductive health care, such as birth control, STI testing and treatment, and cancer screenings, to Granite Staters with lower-incomes and those uninsured or underinsured. While this program does not cover abortion care, family planning providers who also offer abortion care have been excluded from this program since June 30, 2021. The New Hampshire Executive Council must reconsider and approve the NHFPP contracts for PPNNE, Lovering Health Center, and Equality Health Center – all of which have been excluded from the program due to also offering abortion care at their health centers.

3. Improve New Hampshire Medicaid reimbursement rates. Family planning providers serve as an entry point to the public health system, and New Hampshire Medicaid reimbursement rates fall well below what providers cover. One way to strengthen the public health care ecosystem throughout the state is by improving New Hampshire Medicaid reimbursement rates, which would directly impact providers specifically serving women and families with lower incomes. 

4. Maintain and increase telehealth (audio and video) rates in comparison to in-person rates. For patients throughout New Hampshire – especially in rural areas, where there is a greater distance to travel to a provider – telehealth is a vital component of their ability to access care. New Hampshire should continue to maintain telehealth rates – and increase them -- to help offset the cost of providing this critical service. 

Public Affairs Roadmap: Increase Education and Address Misinformation and Disinformation

1. Pass and implement comprehensive sexuality education that is evidence informed, medically accurate, age- and developmentally appropriate, culturally competent, LGBTQ+ inclusive, trauma informed, rights-based and sex-positive. “The full range of information provided by comprehensive sexuality education includes key components of health and well-being such as being able to communicate needs, wants, and desires; developing relationships with people; setting boundaries; and learning that you have a right to be treated with dignity and respect, no matter your identity.” Learn more at SIECUS.

2. Invest in culturally relevant, community-based organizations that serve communities that experience extreme barriers to care. New Hampshire must ensure that all communities, including immigrants, LGBTQ+, limited English speakers, BIPOC, foster youth, and people experiencing homelessness and other extreme barriers to information and care, have access to medically accurate, honest, inclusive, and comprehensive information about abortion services available in our state. 

3. Inform lawmakers and the public of the dangers of Crisis Pregnancy Centers. Crisis pregnancy centers (also called CPCs or fake clinics) are clinics or mobile vans that look like real health centers, but they have a dishonest, harmful agenda: to scare, shame, or pressure someone out of getting an abortion, and to tell lies about abortion, birth control, and sexual health. There are around 20 crisis pregnancy centers in New Hampshire; they do not provide abortion or offer a full range of health care, and they won’t give honest facts about sexual health and pregnancy options — their goal is to spread misinformation and propaganda. 

4. Educate the public on the role that the Executive Branch plays in judiciary nominees and confirmations. In New Hampshire, the Governor nominates and the Executive Council confirms judges. As the federal court is no longer a backstop, we know that the future of abortion rights is in individual states, and we must ensure that our New Hampshire courts are not hostile toward abortion rights. 

5. Prioritize advancing and supporting public safety at and around reproductive health centers. Work with local and state government and elected officials to ensure patients and staff are able to feel safe and to minimize threats and intimidation when entering and exiting health centers.

6. Maintain strong support for abortion rights in New Hampshire. Abortion is a safe, legal, common, and essential part of the full range of reproductive health. Continue to educate the public and lawmakers on the need for accessing abortion care, reducing barriers to abortion, supporting providers and abortion funds, and working together to reduce abortion stigma.  

With input from: Planned Parenthood NH Action Fund/PPNNE; ACLU-NH; NH Women’s Foundation; Joan G. Lovering Health Center; Equality Health Center; Granite State Progress; Reproductive Freedom Fund of New Hampshire