Doing the Math on HB 1283: What's the REAL Cost to the State of NH?

While proponents of HB1283, “End of Life Options” have not discussed the costs associated with this bill, there are plenty of potential and indirect costs to plan for and to consider.  For example:

Legal challenges: 

In states where physician-assisted suicide is legal, like California, legalizing physician-assisted suicide could lead to legal challenges and lawsuits, which can run up substantial legal fees and expenses for the state. Disability groups are claiming California's assisted suicide law discriminates : NPR .

State-subsidized death: 

Looking at trends in OR, the number of residents participating in physician-assisted suicide has greatly increased over the years – and so have the number of participants who do not have private health insurance.  Throughout the first ten years of ‘Death with Dignity’ in Oregon, the large majority of participants (up to 88%) were privately insured. In the past eight years, however, that trend has reversed. In 2021, only 21% of those who died by assisted suicide had private insurance and the vast majority, 79%, had government insurance, Medicare or Medicaid. This is double the state average of adults with government insurance. 60274 (oregonlegislature.gov)

Additional training and resources:

Implementing and regulating physician-assisted suicide would require additional resources, including training for healthcare providers and pharmacies, and developing protocols and guidelines for implementing End-of-Life Options. In some cases a patient may need to be evaluated to make sure they are mentally capable of making the decision.  In other cases, patients who want to participate in physician-assisted suicide will “shop” for the physician who will sign off – involving more medical costs.  (Not to mention mental health help for physicians and other healthcare providers who are administering these deadly drugs).  These administrative costs will impact the state budget.

Oversight to prevent abuse: 

People with disabilities, veterans and others vulnerable to suicide would be negatively impacted by HB1283.   Therefore, monitoring and enforcement efforts, which might include establishing review boards, conducting investigations, and implementing quality assurance measures would likely be necessary.  All of these come with associated costs.

Education and public awareness: 

Educating healthcare professionals, patients, and the general public about the implications of physician-assisted suicide is standard in many other states. This includes raising awareness about patients' rights, discussing end-of-life care options, and addressing ethical considerations. The state of NH would need to incorporate funding of public education campaigns and outreach initiatives into their budget. 

The question becomes – do we want to, as a state, spend money helping people die or helping people live?