Merrimack County hears warnings on rising health costs; approves change to ancillary benefits

Kirsty Karpowicz, a benefits consultant with Boreslow, told the Merrimack County Board of Commissioners on Oct. 22, 2025, that national and regional medical and prescription‑drug cost trends are driving unusually large health‑insurance renewals and that the county’s own recent catastrophic claims have left fully insured carriers unwilling to quote the county’s business.

Karpowicz said national prescription trends and “specialty” drugs are producing the largest increases, and that medical trend — the factor carriers use to project how much a procedure or service will cost next year — is running near double digits in many places. She said New Hampshire trends and public risk‑pool activity show sharper increases than the national median and cited the state’s municipal pools as evidence of volatility.

The consultant told commissioners the state began the year with three public risk pools — the Health Trust (Anthem), SchoolCare (Cigna) and the New Hampshire Interlocal Trust (Harvard Pilgrim). She said the smallest pool, the Interlocal Trust, closed earlier in the year, and that SchoolCare issued a large assessment in September after its actuaries projected a negative reserve position. Karpowicz said the Health…