Progress Made on Medicaid Work Requirement Deal

Print More


CONCORD — House and Senate negotiators made some progress Tuesday on work requirements in the Medicaid expansion program.

Under proposed changes, the work, school, training or community service requirement would be waived for about 20,000 participants that Health and Human Services Department officials have been unable to contact about the prerequisites approved by lawmakers last year in reauthorizing the program.

The penalties for failure to meet the 100-hour a month work requirement are scheduled to go into effect this summer.

The Granite Advantage program serves about 50,000 low-income adults, many of whom work, and some others who are exempt.

A proposed amendment would suspend the requirement until sometime during the next biennium in order to allow the department to contact all participants.

Sen. Jeb Bradley, R-Wolfeboro, said Tuesday department officials have done all that could have been expected of them to contact program participants and called the failure to reach the 20,000 recipients the biggest issue lawmakers have to address.

He called it the elephant in the room, and said he wants to find a way to protect the health-care coverage for 50,000 residents.

The plan presented by Sen. Cindy Rosenwald, D-Nashua, would exempt parents with children 12 years old and younger, and those in treatment and recovery from the opioid epidemic, which she called the state’s biggest public health crisis.

But the proposed change to Senate Bill 290 would no longer exempt grandparents who care for their grandchildren, although Rep. Lucy Weber, D-Walpole believes they should be included noting many of those children’s parents suffer from addiction.

The change would allow participants in frail health to self-report their condition instead of needing a physician’s certification, but Bradley objected to that change.

He said that was his biggest issue with Rosenwald’s proposal, noting there is nothing in federal law that allows someone to “self-attest” to the condition.

Health and Human Services Commissioner Jeff Meyers said allowing a person to attest to frail health was in state law governing the program and nothing in federal law or rules prevents it, but also do not prohibit states from requiring a physician to certify the condition.

Bradley said most of the changes are not “show-stoppers” for him but asked for clarification on several provisions.

The conference committee of House and Senate negotiators meets against Wednesday at 9 a.m. to continue to try to reconcile differences between House and Senate versions of the bill.

Gov. Chris Sununu and other Republicans have said they consider the work requirement part of the expanded Medicaid deal agreed to last year by Republicans and Democrats.

They say if folks receiving that health-care benefit do not show they have worked they should not keep their health-care coverage.

Nationally, work requirements are under fire and litigation is now underway.
A similar provision to New Hampshire’s in Arkansas resulted in tens of thousands of participants losing their health-care coverage.

The original bill would eliminate the requirement if more than 500 or more recipients lose coverage because of the provision or if health-care providers experience an increase in uncompensated care costs.

The deadline for reaching an agreement is Thursday.

The House and Senate will vote on the agreement June 27.

Garry Rayno may be reached at

Comments are closed.