I have been involved in many businesses in New Hampshire over the last 30 years. Like every employer in our great state, these businesses write checks every month for our employees’ health insurance — checks that get bigger every year. We do it because we value our people, and because health coverage is one of the most meaningful benefits we can offer. It is also increasingly one of the most expensive.
When I learned that the insurance we provide doesn’t actually cover one of the most critical services a family can need — intensive, community-based mental health care for a child in crisis — I was stunned. And then I was angry.
We have a program in New Hampshire called FAST Forward. It delivers intensive wraparound services to children with serious behavioral health conditions — the kind of care that keeps a kid out of the emergency department, out of inpatient psychiatric hospitalization, and at home with their family. It works. Independent research has shown that it substantially reduces costs in the children’s behavioral health system. It saves young lives.
And private insurance — the insurance our businesses and our employees pay into — refuses to cover it.
Instead, the cost falls on New Hampshire taxpayers. The state General Fund now appropriates $2.5 million every year to cover wraparound services for privately insured children because insurance companies won’t. That figure has grown tenfold in recent years, and it has to be re-fought every budget cycle. When a family’s private plan denies the claim, Medicaid eventually picks up the tab, but only after a child’s mental health condition has deteriorated enough to require hospitalization. The insurance carrier walks away, the taxpayer pays, and the child suffers in the gap between.
I find this unsustainable for three reasons.
First, as employers and employees, we already pay for this coverage. Our premiums go up every year, and our employees’ share goes up with them. Insurance companies, like all our businesses, are entitled to make a profit, but it is perfectly reasonable to require them to cover the care our employees’ children need — care we are already paying for.
Second, when an employee’s child is in a mental health crisis and can’t get appropriate care, our employee cannot be at work. I have watched it happen. A parent navigating a broken system — calling providers, sitting in emergency departments, driving to appointments an hour away, taking calls from schools, arm-wrestling with insurance — is a parent who is not at work and productive. They are exhausted, distracted, and, rightly, focused on their child. The productivity loss is real, but the human cost is incalculable.
No parent should have to choose between their job and getting their kid the care that could save their life.
Third, this is a problem that can be easily solved. The cost of covering wraparound services, spread across New Hampshire’s privately insured population, works out to less than 25 cents per person per month. For that, we get a system where families get timely care, children stay out of hospitals, taxpayers stop subsidizing insurance companies, and our businesses stop losing good employees to a crisis our insurance plans should be covering.
The Legislature has that opportunity right now. Senate Bill 498 would require private health plans to contribute their fair share to the wraparound services New Hampshire families already depend on. It closes the loophole that lets insurance companies collect premiums while offloading their most expensive pediatric cases onto the state.
I have heard the objections. I have heard that this will raise premiums. Twenty-five cents per person per month is not a premium crisis — it is a rounding error in the annual increases we are already absorbing. What will raise premiums, taxes, and the cost of doing business in New Hampshire is continuing to pretend this problem will solve itself.
New Hampshire businesses pay for health insurance because we believe coverage matters. It is time for the coverage we pay for to actually mean something when our employees’ children need it most.
I am asking fellow business owners, and the lawmakers who represent us, to support SB 498. We are already paying, and New Hampshire taxpayers deserve an insurance market that does what it is supposed to do. Our kids deserve better.
Brad Kreick is CEO of AccessHope, past CEO of Solution Health, and a co-founder of YouthWell NH. He lives in Nashua.
