New Hampshire stands at a crossroads. A nationwide legal crisis, an unfolding technological revolution, and our state’s unique position have given us a monumental opportunity. If state legislators protect Rep. Lisa Mazur’s HB 701 this week, New Hampshire could become a national leader in biotechnology.
America’s recent wave of so-called “right-to-try” laws—meant to allow dying patients to access experimental treatments—has failed. Because they addressed narrow regulatory issues without allowing patients to waive civil liability, federal and most state right-to-try laws have been used by almost no one.
Yet Americans have never needed “right-to-try” laws more. Thanks to AI-based genome sequencing, CRISPR-Cas9, and viral vectors, we now stand on the precipice of a revolution in gene therapy. Treating terminal illness with individualized gene-editing may soon be a matter of building upon fundamental concepts we already understand.
Enter New Hampshire—one of the most politically-innovative and liberty-oriented states in the country. Our population centers are a short drive from the Boston metropolitan area, the world’s largest biotechnology hub. Boston-area innovators recently administered a promising gene therapy to Lucas Toro, a young boy with Duchenne muscular dystrophy, who is now showing positive results.
What would happen if New Hampshire became the best legal regime in the country for experimental treatments—a kind of Delaware of clinical trials—for dying patients? That’s the question raised by Rep. Mazur’s HB 701. Drawing on the insights of patient advocates like Dr. Bess Stillman, Mazur has proposed removing the remaining state regulatory obstacles, allowing patients to waive civil liability through a process of informed consent, and attracting biotech innovation to the Granite State.
In recent months, New Hampshire legislator and inspirational cancer hero Michael Yakubovich has emerged as another key leader of the fight to pass the bill, with many suggesting that the new law should be named after him.
Michael’s heroic example has been a powerful catalyst. Since I became involved in New Hampshire politics in 2020, I have never seen such a broad and passionate coalition for any single bill. At the Senate HHS hearing on HB 701, a crowd of patients championed the bill—with only one commercial lobbyist testifying in opposition.
Among New Hampshire groups, HB 701 has been supported by Cornerstone—the church-based Christian advocacy group I represent—as well as Americans for Prosperity New Hampshire, the Josiah Bartlett Center for Public Policy, the Hanover-based Center for Modern Health, the Concord-based NH Rare Disorders Collaborative, and the New Hampshire Liberty Alliance. In fact, the bill has been championed by seemingly every wing of the New Hampshire libertarian movement, prominently including tech entrepreneur and activist Jeremy Kauffman.
Nationally, the bill has been endorsed by the Goldwater Institute, the Alliance for Longevity Initiatives (“A4LI”), and a variety of small research foundations—such as the L-CMD Foundation and the TNPO2 Foundation—often run by mothers of children with rare genetic illnesses.
After passing the New Hampshire House on consent, HB 701 unanimously passed the Senate HHS committee in a strong form.
Unfortunately, unless it is fixed by a legislative “committee of conference” this week, the bill will not do anything.
In its current form—the result of a Senate floor amendment—the bill’s protections would be limited to patients who are already lingering on the verge of death: those who will die “in the near future.”
This requirement would bottleneck the bill, making it even less protective than the FDA’s cumbersome “compassionate use” protocol, which does not require imminent death. The current bill would also be less protective than the useless federal right to try law, which also does not require death “in the near future.” Needless to say, any statute even less protective than federal law would leave innovators, providers, and patients with no incentive to come to New Hampshire.
A requirement of imminent death would also exclude, on its face, all or most patients we want to help. Babies dying of rare genetic illnesses may be on track to die when they are 6 to 9 years old—or, as is so often the case, their life expectancy may be unknown.
Adults with well-understood diseases would fare little better. Dr. Bess Stillman’s late husband, Jake, lived with throat cancer for years; he did not receive a 6-month diagnosis until after his cancer had metastasized throughout his body and his tongue had been cut out.
In the week leading up to the Senate’s last floor vote, Yakubovich and other advocates of HB 701 proposed various compromises to try to avoid this “near future” requirement—drawing on regulations and policies from the Social Security Administration, the FDA, and other agencies. As a result, the legislature’s “committee of conference” this week, which will hash out the final form of the bill, already has workable options to choose from.
Dying children, spouses, fathers, and mothers around the country are yearning for a jurisdiction like the one New Hampshire may soon become. The state senators and representatives on the committee of conference, which will meet on Monday, are listed publicly on the bill docket on the General Court’s website. Ask these legislators to raise the flag of life above the Granite State and lead our state and country into the future of medicine.
