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For people in rural New Hampshire who rely on Medicaid rehab coverage to pay for addiction treatment, a recent clinic closure signals a difficult road ahead.
A health center serving Coös County has already shuttered one of its locations, and local providers say new federal rural health funding may not be enough to fill the gap.
What Happened in Coös County
Edward Shanshala, CEO of Ammonoosuc Community Health Services (ACHS), said that when Congress passed its recent tax cuts and spending law, he and his colleagues made the difficult decision to shut down the organization’s clinic in Franconia in anticipation of the law’s impacts.
The closure is directly tied to concerns about Medicaid, the federal-state program that covers addiction treatment and other health services for low-income individuals.
More than half of North Country Healthcare’s patients pay with Medicare or Medicaid, a figure that reflects just how dependent rural communities are on these programs to access care, including drug and alcohol rehab.
Shanshala noted that when ACHS closed the Franconia branch, it transferred staff to other locations rather than laying them off.
Patient navigators are now helping former Franconia patients find transportation to clinics in Littleton or Whitefield, which are considerably farther away.
A New Rural Fund But Is It Enough
In response to concerns from providers and advocates, Congress created the Rural Health Transformation Program. The program is expected to distribute $10 billion each year until 2030, according to the New Hampshire Department of Health and Human Services.
However, Shanshala and others in the health care industry are skeptical it will fully offset what’s being lost. He does not believe the new funding is sufficient to counteract the broader impacts on Medicaid-dependent services.
The federal government takes a different view. The Trump administration has denied the law is harmful to rural health care, arguing it does not cut Medicaid for truly eligible recipients but rather targets waste, fraud, and abuse in the program.
However, health care experts say several provisions in the bill will likely result in eligible recipients losing coverage and not being able to access rehab centers in New Hampshire.
Who Qualifies For Free or Low-Cost Medicaid Rehab Coverage
If you or a loved one is in Coös County or rural New England and worried about losing coverage, here’s what you should know:
Medicaid covers a broad range of substance use disorder services in most states, including detox, inpatient rehab, outpatient counseling, and medication-assisted treatment (MAT). Eligibility is based on income, household size, and state of residence. Even if a nearby clinic has closed, your Medicaid benefits may still be accepted at facilities farther away or via telehealth.
Medicare insurance also covers addiction treatment for eligible individuals 65 and older, or those with qualifying disabilities. This includes partial hospitalization programs, outpatient therapy, and MAT.
Community health centers like ACHS operate on a sliding-scale fee basis, meaning patients pay what they can afford regardless of insurance status. Even with the Franconia closure, ACHS continues to serve patients at other locations.
Finding Affordable Treatment In New Hampshire
The situation in Coös County underscores a broader truth: when an urban hospital closes or cuts back programs, you can go to another hospital five miles away. In rural communities, you may be driving for hours.
For people seeking addiction treatment, distance is not just inconvenient, it can be a life-or-death barrier.
You can explore Rehabs.org’s directory to find free and low-cost treatment centers nationwide. Call
800-914-7089
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to find affordable Medicaid rehab coverage options and connect with care near you.
