Relative to work requirements under the state Medicaid program.
The implementation of SB134 could potentially reshape eligibility for Medicaid under the Granite Advantage program. By instituting work requirements, the bill suggests a shift towards a more employment-focused framework for assistance, mirroring federal trends. This could lead to changes in the demographic coverage of Medicaid recipients in New Hampshire, especially among those who may be unable to meet the work-related criteria. The bill is expected to bring increased responsibility and conditions for beneficiaries, which could affect overall enrollment rates.
SB134-FN proposes amendments to the New Hampshire Granite Advantage Health Care Program by directing the Department of Health and Human Services to resubmit a Section 1115 demonstration waiver to the Centers for Medicare and Medicaid Services (CMS). The bill stipulates that this waiver shall enforce community engagement and work requirements as a condition for eligibility under the state Medicaid program. This legislative move aims to comply with evolving federal regulations and to reinforce eligibility criteria that necessitate work involvement from beneficiaries.
However, the proposed bill has sparked concerns regarding its feasibility, particularly related to the uncertainty of federal endorsement and guidelines for such work requirements. The Department of Health and Human Services anticipates potential complications arising from federal approval processes, including public hearings and compliance with forthcoming federal criteria. Critics of the bill may point to the risks of disenfranchising vulnerable populations who may not meet the new conditions for Medicaid eligibility, as well as logistical issues presented by the current staffing challenges within the Department.
Fiscal implications have also been raised; while the bill does not allocate funding or authorize additional positions, the Department projects indeterminable increases in expenditures exceeding $2.5 million in FY 2026 and 2027 for implementing changes. This includes potential costs arising from adjustments to Medicaid management systems and staff training related to the new requirements, indicating that the financial impact could be significant as the bill progresses.