The federal government last month approved the state’s request to require some recipients to spend at least 100 hours a month working, going to school or participating in community service. There would be exemptions for parents of young children, people with disabilities and others, and those who fall short could make up hours the next month. But changes made by the Centers for Medicare and Medicaid Services would limit the availability of that safety net, and would not allow someone who works more than 100 hours one month to carry over the extra to another month.
“That makes no sense. That’s a disincentive to work. What did the Trump administration say? Work exactly 100 hours with precision each and every month, if not you may lose your health insurance coverage,” said state Sen. Dan Feltes, D-Concord. He accused the administration of disrespecting state lawmakers.
“That’s not the New Hampshire way,” he said. “That’s not what we negotiated in a bipartisan way here in the state of New Hampshire.”
The rest of the Joint Legislative Committee on Administrative Rules agreed, voting unanimously to object to the interim rules drafted by the Department of Health and Human Services. But Commissioner Jeffrey Meyers said he is allowed to adopt rules over the committee’s objections.
“Our state statute clearly provides that we are to implement the program in accordance with the terms and conditions of the waiver issued by CMS, and we’re going to continue now to implement the program,” he said. “We’re not stopping any of our efforts with respect to education, outreach and readiness to turn the program on March 1.”
With a March 1 start date, June would mark the first month that participants would have to provide proof of employment or other “community engagement” activities. Those who don’t meet the requirements would be notified by July 10, and would have the rest of the month to make up for any deficiencies, Meyers said.
“No one under my plan can be suspended from coverage until August of 2019,” he said.
New Hampshire expanded its Medicaid program under the Affordable Care Act in 2014 to include adults making up to 138 percent of the poverty level. The state initially used federal money to put participants on private insurance, but in reauthorizing the program this year, changed to a managed care model and added the work requirements.
The department has notified the 53,000 current enrollees about the changes by mail and plans to call all of them starting in January, Meyers said.
But critics questioned the expense associated with both that outreach and implementation of the work requirements overall.
While supporters argue that work requirements helps participants achieve self-sufficiency, critics argue they also jeopardize health care for hardworking people who may be struggling with child care, transportation and other issues while working low-wage jobs with fluctuating hours.
“Our question is really whether we want to pay taxpayer dollars on red tape that will result in people losing health care?” said Dawn McKinney, policy director for New Hampshire Legal Assistance.