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N.H. Medicaid expansion work requirement approved by Washington

  • A sign showing the amount of people Medicaid helps in individual cities and towns at a rally to support the re-authorization of the bill on Wednesday, May 2, 2018. GEOFF FORESTER



Monitor staff
Monday, May 07, 2018

Federal authorities have approved New Hampshire’s request to add a work requirement to the Medicaid expansion program, the governor’s office announced Monday, clearing away a major barrier for reauthorization of the program.

In a letter to the state released Monday afternoon, the U.S. Centers for Medicare and Medicaid Services Administrator Seema Verma said the agency will greenlight a waiver sent by the state last year. The waiver means individuals between the ages of 19 and 64 will need to participate in at least 100 hours a month of “community engagement activities” – which can include employment, community service or job training.

The mandate includes numerous exceptions, including for people with children up to age 12 and those with disabilities.

In a statement, Gov. Chris Sununu praised the development from Washington.

“Today’s announcement by CMS authorizing New Hampshire’s Medicaid work requirements is a transformative step towards a more thriving workforce,” he said. “We appreciate the hard work that Administrator Verma has put into New Hampshire’s waiver and we are pleased to have the most robust work requirement in the nation.”

The approval brings to an end to one of the largest open questions for the program, which was approved by the New Hampshire House last week and is expected to be passed by the Senate on Thursday.

First authorized in 2014, New Hampshire’s Medicaid expansion program extends the traditional Medicaid program to those earning up to 138 percent of the poverty level. But since its inception, Republicans have pressed to add a work requirement as an incentive to move recipients off the program.

The stakes were high. In 2017, the Legislature added a mandate to the budget trailer bill that held that the federal government must approve a work requirement waiver by April 30, 2018, or the program would shut down. That deadline was extended by lawmakers to May 30 earlier this year.

The decision represents the fourth time the federal agency has approved a state work requirement, after Kentucky, Indiana and Arkansas. And it’s a marked turn from decisions made by the Obama administration, which refused to grant a similar waiver request by New Hampshire in 2016.

In her own statement, Verma heralded that shift, linking the work requirement waivers to the Trump administrations broader philosophy on employment.

“I congratulate Governor Sununu’s commitment to join me in improving the lives of Medicaid beneficiaries by creating a crucial link to work and community engagement,” Verma said. “The Trump Administration has helped create one of the strongest job markets in our nation’s history and we want to make sure able bodied, working age adults receive the necessary skills to join our growing workforce.”

(Ethan DeWitt can be reached at edewitt@cmonitor.com, or on Twitter at @edewittNH.)