With Change in Fed Policy, N.H. Lawmakers Likely to Attach Work Requirement to Medicaid

Jan 11, 2018

In new guidelines released by the Trump Administration, states including New Hampshire will now be allowed to impose work requirements on some recipients of Medicaid.

A letter sent to state Medicaid directors Thursday by the Centers for Medicare and Medicaid Services says work requirements are designed to improve recipient health by “incentivizing work and community engagement.”

During the Obama years, states including New Hampshire tried and failed to get the federal government to approve a work-requirement on “able-bodied” adults who qualify for Medicaid expansion through the Affordable Care Act. With the reversal, New Hampshire’s most recent application--filed last August--is likely to gain approval.

Under New Hampshire’s request, applicants for the health insurance program, along with falling under certain income thresholds, must either hold a 20-hour a week job, be enrolled in a job training course, or pursue career-related education to be approved. Individuals in a drug-court program or with children under the age of 6 are exempted, as well as those who provide certification from a physician regarding a temporary “illness or incapacity.”

The rules would only apply to people who apply for health coverage through the state’s expanded Medicaid program, which currently covers roughly 50,000 residents.

It’s not clear when the state may receive final approval. New Hampshire is one of ten states that has submitted a work requirement waiver to the Centers for Medicare and Medicaid Services.

State lawmakers are currently debating whether to extend the Medicaid expansion program beyond the end of 2018, when it is due to sunset.

Gov. Chris Sununu called the CMS announcement great news for New Hampshire. He says it will allow the state to better control the costs of Medicaid programs and help more people enter the workforce.