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Could Work Requirement in NH Medicaid Expansion Be Illegal?

Gov. Chris Sununu signed the Medicaid expansion bill just last week, and it already faces new hurdles. (Office of Gov. Sununu)
Gov. Chris Sununu signed the Medicaid expansion bill just last week, and it already faces new hurdles. (Office of Gov. Sununu)
July 2, 2018

CONCORD, N.H. — Last week, Gov. Chris Sununu signed a bill to continue New Hampshire's Medicaid program for another five years, but it includes a new work requirement which may not be legal.

On Friday, a similar policy failed the litmus test in Kentucky — the first state to attach a work requirement to Medicaid coverage. The Trump administration's Center for Medicare and Medicaid Services approved it, but it was blocked by a federal judge for not factoring in how many people would lose coverage.

The decision raises similar questions about work requirements in the Granite State, according to Dawn McKinney, policy director at New Hampshire Legal Assistance.

"They're contrary to federal law. The Medicaid Act is a health program, not a work program, and we are concerned about moving forward with the work requirements in New Hampshire,” McKinney said. “And the judge's decision to stop Kentucky from moving forward validates our concerns around the legality of doing so."

State lawmakers also will be watching to see if the ruling in Kentucky has an impact. The Medicaid expansion is expected to provide health coverage to about 52,000 people in New Hampshire.

Another concern is how a work requirement would be verified and the administrative roadblocks it could create, with new deadlines and paperwork jeopardizing coverage for applicants. According to McKinney, just trying to document that a resident meets the number of work hours needed is a problem - even for a large percentage of people on Medicaid who are already working or who live in working households.

"Anytime you add an administrative hurdle — whether it's filing paper, providing identification or pay stubs or any sort of administrative hurdle — is going to cause some people to lose coverage who are, in fact, eligible and are in need of health coverage,” she said.

New Hampshire's change in Medicaid eligibility is set to take effect in January. McKinney said there's a lot to be done between now and then - and given the Kentucky court decision, she said that should include a careful review of the work requirement mandate.

Linda Barr, Public News Service - NH