New Hampshire becomes fourth state to impose Medicaid work rules

The CMS on Monday gave New Hampshire the green light to impose work rules for some adult Medicaid recipients. It's the fourth state to win approval for that requirement.

The state's Medicaid 1115 waiver will require adult beneficiaries between the ages of 19 and 64 to participate in 100 hours of "community engagement activities" a month to maintain eligibility for coverage. Community engagement is defined as having a job, being enrolled in school, participating in job skills training, or performing some sort of community service.

"Today's announcement by the CMS … is a transformative step towards a more thriving workforce," Gov. Chris Sununu said in a written statement. "Work requirements help lift able-bodied individuals out of poverty by empowering them with the dignity of work and self-reliability while also allowing states to control the costs of their Medicaid programs—we are committed to helping more people get into the workforce, as it is critical not only for individuals but also for our economy as a whole."

In 2014, New Hampshire's Medicaid expansion program expanded to include those earning up to 138% of the poverty level. But state Republicans have always asked for a work requirement. The Obama administration denied that request in 2016.

New Hampshire joins Arkansas, Indiana and Kentucky in implementing the work rules. Waivers in six other states are pending approval.

Virginia Gov. Ralph Northam's administration in February concluded that adding work rules to its Medicaid program would cost an extra $100 million in administrative expenses by the second year of implementation.

"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," CMS Administrator Seema Verma said in a released statement. "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."