Ayotte wades into wraparound mental health services debate

After a New Hampshire House committee voted to kick the can down the road on whether to compel insurance companies to cover wraparound mental health services for children, Gov. Kelly Ayotte was “outraged.”

“I was incredibly flabbergasted and disappointed by the House vote on this,” Ayotte told reporters in her office following the vote on Wednesday. “Insurers like Anthem keep claiming that they’re negotiating in good faith, but they’re clearly stalling because they don’t want to cover mental health coverage for children, and it’s wrong.”

Ayotte was referring to the House Commerce and Consumer Affairs Committee’s vote on Senate Bill 498, in which lawmakers recommended, 14-4, sending the bill to interim study. If the full House agrees with that recommendation, the bill would be sidelined for at least a year, ostensibly so lawmakers can study the issue further.

Wraparound services seek to connect disparate and complicated care systems, including mental healthcare, special education, and child protective services so they can work together seamlessly for those experiencing a mental health crisis. In New Hampshire, the state-run FAST Forward program offers the care. The issue has been a perennial debate for lawmakers for several years. In 2025, a similar measure (Senate Bill 128) aimed at requiring insurers to cover wraparound mental health services died in the Senate and a subsequent effort to attach the measure to the larger budget legislation failed.

Mental health advocacy groups — including the National Alliance on Mental Illness, Connected Families NH, and New Futures — have long pushed for the legislation.

The insurance companies oppose the measure, arguing that it will force them to increase premiums, and some conservative activists have characterized the coverage requirement as a hidden tax on all insurance customers. Indeed, lawmakers on the Commerce and Consumer Affairs Committee have adopted that language in arguing against the bill.

“The assessment is flat out a tax,” Rep. Carry Spier, a Nashua Democrat, said during the committee meeting Wednesday.

Ayotte, who put out a statement Tuesday before the meeting urging lawmakers to approve the measure, doesn’t buy those arguments or any of the insurance companies’ claims.

“I don’t know why any House member would listen to what they say about this,” Ayotte said.

“It’s unbelievable to me that they think that it’s more important to support the insurance companies than it is to support the children of this state when it comes to a critical issue like mental health.”

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Ayotte said this isn’t a tax; it’s “a coverage issue.”

“Anthem keeps saying that they’re negotiating in good faith,” she said. “But all it has been is a dilatory tactic, them trying to delay, to get the legislation off the table. We wouldn’t need legislation if Anthem and other insurers agreed to cover this mental health for children.”

Jim Turner, a spokesperson for Anthem, wrote in a statement to the Bulletin that the company is “disappointed in Governor Ayotte’s comments this week regarding Anthem and our position on SB 498.”

Turner said the company had met with state officials on multiple occasions to work toward a resolution and signed onto a joint letter from several insurers to Ayotte “demonstrating a shared commitment to continue working on this matter.”

Ayotte argued that the insurers “just want to give us a bunch of language that means nothing. It is not a commitment, and I find that completely unacceptable.”

Turner said the company specifically takes issue with a board the bill would establish to be in charge of assessing fees on companies in order to fund the care.

“We have been clear with all stakeholders about our concerns with SB 498,” Turner said. “It would create a nonprofit board to assess new fees on commercially insured customers. The fees would fund undefined mental health services with two Medicaid-contracted care-management entities, or CMEs. Because these CMEs provide services for Medicaid and not commercially insured members, Anthem is continuing to work in good faith with them on a path forward.”

Still, SB 498 isn’t entirely dead. The committee’s vote serves only as a recommendation. The bill will soon go to a vote of the full House, where lawmakers have the option to reject the committee’s guidance. As such, Ayotte said she’s not giving up on the issue this year.

“We’re going to continue to push this even though the committee voted it down,” Ayotte said.

“I’m not going to let up on this. We need to do the right thing.”