For children with complex medical needs, uncertainty governs everyday life.
Fragile Futures examines the stark realities facing these children and their families. They grapple with reduced life spans, limited mobility, delayed development, sudden hospitalizations and a never-ending slew of doctors’ appointments, prescriptions and therapies, all punctuated by one giant question mark about what the future holds — and how they will meet the inevitable challenges heading their way. Rachel Wachman’s reporting explores home care funding reductions amid federal Medicaid cuts, delves into young adults seeking solutions as they age out of the school system, and captures the acute mental health tolls on parent caregivers.
From the stories of individual families to the voices of healthcare professionals and politicians, Wachman’s project chronicles the experiences of some of the most vulnerable Granite Staters while illuminating gaps in the system of services intended to support them.
About the project
This investigation by the Concord Monitor in partnership with USC Annenberg Center for Health Journalism’s Impact Fund for Reporting on Equity in Health and Health Care found that:
- Federal policy shifts: The cuts were triggered by Medicaid restrictions in the One Big Beautiful Bill Act (H.R. 1) and an end to pandemic-era recertifications, leading insurers to implement cost controls.
- No notice: Insurers eliminated hours without explanations, prompting state intervention to mandate 30-day advance notice and review.
- Financial peril: A loss in care hours directly cuts family earnings, in some cases by up to half, while increasing out-of-pocket medical costs.
- Threatened institutionalization: Without adequate home nursing or LNA hours, families face becoming unable to care for medically complex children safely at home.
- Temporary relief: Reinstated hours were only a short-term fix, leaving families fearing renewed cuts to their care and income as temporary extensions lapse.
THE PARTNERSHIP
This project was reported in partnership with the USC Annenberg Center for Health Journalism’s 2026 Impact Fund for Reporting on Equity in Health and Health Care and the Center’s Engagement Initiative.
CONTACT US
If you have personal experiences or thoughts to share about home care, medical complexities, Medicaid or more, we invite you to submit a letter to the editor or reach out to Rachel Wachman at rwachman@cmonitor.com or 603-369-3304.
Follow the series
Fragile futures: ‘It was just gone’ — For medically complex kids, families face looming uncertainty of care
Medically complex children’s families in New Hampshire face financial and caregiving instability due to sudden cuts in Medicaid-funded home nursing hours, sparking state intervention and grassroots advocacy.
Families with home nursing face medical supply challenges
New Hampshire families advocating for medically complex children are reporting shortages and delays in essential Medicaid-covered durable medical equipment supplied by various managed care organizations.
State mandates written notice for changes to home care plans for medically complex children
New Hampshire’s Department of Health and Human Services has mandated that managed care organizations provide formal written notice before modifying home care plans for individuals under age 21 following recent service reductions.
State steps in to restore home care hours for medically complex children
New Hampshire officials and advocates are working to restore Medicaid nursing hours for medically complex children after managed care organizations implemented reductions earlier this summer.
For families with medically complex children, home care is ‘necessary’. Cuts to nursing hours put this in jeopardy.
Families across New Hampshire formed the advocacy group NH Families for Home Nursing to protest significant cuts to Medicaid-funded home care hours under the Katie Beckett Program.
