Medicaid Expansion in New Hampshire and the State Senate’s Proposed Changes 

New Hampshire Fiscal Policy Institute Issue Brief - April 3, 2018

Medicaid Expansion in New Hampshire and the State Senate’s Proposed Changes 

New Hampshire’s Medicaid expansion is an important program with impacts on the state’s public health and economy. The New Hampshire Health Protection Program, the state's version of Medicaid expansion, provides health coverage to approximately 52,000 low-income people in the Granite State.

More than 90 percent of program expenses have been funded by the federal government since the program began in 2014. Since that time, hundreds of millions of federal dollars have helped provide medical care for Granite Staters and contributed to the state economy, both through payments to medical providers and helping ensure a healthy, productive workforce, and assisting the state’s efforts to combat the ongoing opioid crisis.

Federal dollars coming to New Hampshire through expanded Medicaid included $608.7 million for enrollee coverage in the first two State fiscal years of program operation. Going forward under current federal law, for every one dollar New Hampshire pays for expanded Medicaid coverage, the federal government will contribute at least nine dollars. Without legislative action, the current program will expire at the end of December 2018.

Therapeutic Marijuana Satellite Dispensary in Cheshire Co.

SB 388 is a bill to allow for satellite therapeutic marijuana satellite dispensaries.  I introduced a floor amendment that would allow a therapeutic marijuana satellite dispensary in Cheshire Co.  The bill passed the Senate with bi-partisan support.  I’ve been contacted by constituents stating they drive 2 hours to Lebanon only to find they can’t fill their prescribed amount.  They’ve said it’s easier to buy the marijuana on the street.  Remember, medically prescribed marijuana treats diagnosed illnesses such as cancer, chronic pain and PTSD (shown below), and is an alternative to stronger drugs like opioids.

Now, we need to prepare for testimony in the House of Representatives.  This means people in Cheshire County that would gain from a dispensary 30 minutes from their home need to testify or send written comments to the committee.  Please contact me ( so we can coordinate a presentation for the House of Representatives, Health and Human Services and Elderly Affairs Committee hearing.

Qualifying Medical Conditions

As of August 27, 2017, the list of qualifying medical conditions for the therapeutic use of cannabis is established by law in RSA 126-X:1, IX(a), as follows.

“Qualifying medical condition” means “the presence of:

  1. (A) Cancer, glaucoma, positive status for human immunodeficiency virus, acquired immune deficiency syndrome, hepatitis C, amyotrophic lateral sclerosis, muscular dystrophy, Crohn's disease, multiple sclerosis, chronic pancreatitis, spinal cord injury or disease, traumatic brain injury, epilepsy, lupus, Parkinson's disease, Alzheimer's disease, ulcerative colitis, Ehlers-Danlos syndrome, or one or more injuries or conditions that has resulted in one or more qualifying symptoms under subparagraph (B); AND
    (B) A severely debilitating or terminal medical condition or its treatment that has produced at least one of the following: elevated intraocular pressure, cachexia, chemotherapy-induced anorexia, wasting syndrome, agitation of Alzheimer's disease, severe pain that has not responded to previously prescribed medication or surgical measures or for which other treatment options produced serious side effects, constant or severe nausea, moderate to severe vomiting, seizures, or severe, persistent muscle spasms;

  2. "Qualifying medical condition" also means:
    (A) Moderate to severe chronic pain. 
    (B) Severe pain that has not responded to previously prescribed medication or surgical measures or for which other treatment options produced serious side effects.
    (C) Moderate or severe post-traumatic stress disorder.



March for Our Lives Rally | March 24, 2018

March for Our Lives Rally | March 24, 2018


Senator Kahn’s Comments Delivered to March for Our Lives Rally March 24, 2018


Thank you organizers of Keene’s March for Our Lives rally.  We join 800 other rallies against gun violence and in favor of government taking actions to limit gun violence

For the past 3 weeks I’ve been in the thick of the debate over granting Local School Board’s the ability to control firearm possession in a Safe School Zone.  It took time for those in favor of the change to get organized and initially nearly all the letters were against any prohibitions on gun possession.  Some gun rights advocates acknowledged doing nothing was not an option either, but their gesture was hollow.  When asked what do you think we can do, there was no there, there, no replies.  Then those who favor safe school zones, which include rule making over gun possession, began flooding the mail boxes pleading the case for local control. After all, isn’t that what NH government is based upon, local control. 

There are 4 high schools in my state senate district, every school board is holding discussions about violence in schools.  The closest Republicans could come to accepting local control is that every NH school is required to have a safety plan.  That’s true.  But otherwise the arguments stuck on guns make us safer, school shooting have occurred where safe school zones were in place, where signs are posted.  If you were going to shoot people wouldn’t you pick a place where it is posted “this is a gun free zone.”  That the reason NH schools are safe is because we allow guns in schools.  

Whoa.  Let’s bust some myths.  School shooting do happen in NH; ask the students who were in the Walpole elementary school cafeteria 7 years ago and witnessed a classmate bring a gun into the cafeteria, who shot himself in the head in an attempted suicide.  Ask the students who were sheltered in place after hearing a gun-shot ring out through their hallways.  Of the terror they felt, of the trauma they relive during every school safety drill, after every reported school shooting.  The trauma is real. And their cry for action is real. 

Because we’re missing the point in the debate over school safety.  It isn’t about gun possession.  The debate is about control over the learning environment to help students keep their focus on learning and a teacher’s focus on teaching.  And when you feel unsafe you can’t focus in that environment.  You, our students and teachers and parents, become victims and isn’t that what the NH Senate passed the other day, Marsey’s Law, to protect victims of crime.  Shouldn’t we be protecting students and teachers from relapsing trauma resulting from school violence.

We rely on local control in all other ways.  The state doesn’t set learning standards, by course, by grade level, or for graduation, that’s a matter of local control.  The state doesn’t mandate what test is given to assess students, that’s a matter of local control.  The state doesn’t say how much should be spent on a student’s education, that’s a matter of local control.  We even say schools must have a safety plan and that’s a matter of local control.  But school boards can’t establish rules about firearm possession in a safe school zone.  That’s what the NH Senate said this week. 

What might local control mean.  Certainly, school resource officers and police officers that keep our community safe would be allowed to carry arms in schools.  Maybe some school boards would allow school personnel certified to carry arms to possess them as well.  Would we face up to the fact that school children face trauma every day-- in witnessing violence, in home neglect, in food and income insecurity, in being the outsider, in fear of attacks.  Shouldn’t we provide resources in our schools to treat mental instability and case manage for neglect and isolation.   But the NH Senate with guidance from the Governor cut off that debate.

What will we do instead?  Follow the plan of our federal government, and form a commission, study the problems.  What did the student from Margory Stoneman Douglas HS, Emma Gonzalez, say to Marco Rubio?  We Call BS.  Well Mr. Governor, Mr. President, We Call BS. 

Other states are moving forward with what works: 

·      universal background checks for gun sellers, employees and buyers

·      Red Flag tests to take guns away from people and homes where potential violence can occur

·      Raising the minimum age for purchase and ownership of firearms to 21

·      Limiting possession of semi-automatic assault type weapons. 

Nobody is asking a government official to form a study commission.  It’s a form of delay, to which we say, we call BS.

It’s a matter of life and death.  38,658 people died from guns this past year—including suicides and violent crimes. That’s 105 people a day. 

As John Kennedy said in his inauguration address, time has come to pass the torch to a new generation:  The post 9-11 generation is demanding we control gun violence.  You should demand change.  Get registered to vote because it may be the most effective way to achieve change--to tell those that oppose legislation that would limit gun violence that my action is a reaction to your inaction.