New Hampshire's Senate Primary: What Health Care, Veteran Support, and Democracy Actually Require

New Hampshire goes to the polls today to pick nominees for retiring Sen. Jeanne Shaheen's seat, a race that could tip control of the Senate. But buried in the primary fight is a question the whole country needs to answer: What does healthcare actually cost, and who should pay for it?

On the Democratic side, Chris Pappas, the moderate congressman, is facing off against Karishma Manzur, a medical scientist backing Medicare for All. It's the kind of choice that feels like it divides Democrats, but it's really about two different approaches to the same human problem: keeping people alive without bankrupting them.

The Real Cost of Doing Nothing

Medical debt is the #1 cause of personal bankruptcy in America. That's not ideology. That's math. People are choosing between insulin and rent. Families are skipping doses because they can't afford refills. The question isn't whether we have a healthcare problem. It's how we fix it.

Manzur's pitch, Medicare for All, is one answer. Pappas represents a different approach: keep the current system, make it work better, hold insurance companies accountable. Both candidates want to get money out of politics, which matters, because healthcare policy has been written by the drug and insurance industries for forty years.

What matters isn't the label. It's whether people get care.

Why the Republican Side Matters Too

Former Sen. John Sununu is favored to win the GOP nomination, with Donald Trump's backing. He's running against Scott Brown, who lost to Shaheen twice. But what neither major-party nominee is likely to do is acknowledge a hard truth: every country that spends less per capita on healthcare than we do, Germany, France, Japan, Canada, Australia, covers everyone. We're the only wealthy nation that doesn't. We're also the only one where the threat of medical debt keeps people from going to the doctor.

Voting Rights and Democracy Itself

There's a second reason this primary matters. Manzur has made "getting money out of politics" central to her campaign. That's Common Ground, the machinery of democracy itself. When healthcare policy is written by lobbyists instead of evidence, when campaign donations come from drug companies instead of voters, no policy actually works. You can't fix healthcare if the system that writes healthcare law is broken.

New Hampshire has not voted for a Republican president since 2000, yet Republicans have held the governor's office since 2017. The state's 1st Congressional District has switched parties five times in eighteen years. That's not a sign of a healthy democracy. That's a sign of a district gerrymandered or shaped by money and incentives that don't serve voters.

Veterans Deserve Better Than Talking Points

Maura Sullivan, one of the leading candidates in the 1st Congressional District Democratic primary, served at the Department of Veterans Affairs and the Pentagon during the Obama administration. That matters. Veterans are the people we ask to bear the hardest costs of policy. They deserve more than lip service. They deserve a government that invests in the VA the way we talk about investing in defense, as a moral obligation to people who sacrificed.

That means healthcare that doesn't require them to fight bureaucracy. Mental health services without waiting lists. Job training that actually leads to work. These aren't partisan things. They're what we owe.