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Tens Of Thousands Of N.H. Residents Are At Risk Of Losing Medicaid Coverage. Here's What They Need To Know.

The federal public health emergency is expected to conclude at the end of this year. When it does, a key health insurance protection that affects tens of thousands of Granite Staters will also end.

Since March of 2020, the state has been largely blocked from terminating Medicaid coverage for people insured through the program. But when the federal public health emergency ends, New Hampshire residents who use the program could lose their coverage. NHPR's Ed Brouder spoke with health and equity reporter Alli Fam about it.

Key takeaways

  • With the public health emergency in effect, Granite Staters on Medicaid have not needed to prove to the state they are eligible to keep their coverage.
  • Medicaid enrollment topped 222,000. The N.H. Department of Health and Human Services estimates that around 70,000 people have their coverage only because the emergency protections are in place. Many of these people could still be eligible for coverage, but need to send the state missing information or complete their overdue redetermination forms.
  • The department has been sending notices to people who are at risk of losing coverage to people on pink paper.
  • Medicaid numbers in New Hampshire are increasing substantially. Compared to January 2020, standard Medicaid participation has gone up 14%, and Granite State Advantage, or Medicaid expansion, has gone up around 50%.

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Ed Brouder: So, Medicaid is a state and federal program that provides health insurance for low-income and other populations. What protections has the public health emergency afforded people enrolled there?

Alli Fam: Yeah, I mean, so basically it has meant that people do not need to prove to the state that they are eligible for their coverage like they usually do. So, typically Medicaid enrollees would have to redetermine their coverage every year — basically prove that they're still eligible. And there can be other information, like income, that they have to certify much, much more frequently as well. And so right now, they don't have to do that. And the goal of this has been to keep people insured in the midst of a health crisis and not have people losing health insurance during this real public health risk.

Ed Brouder: So, how many people are we talking about who've been allowed to keep their coverage through the pandemic?

Alli Fam: Right, so officials estimate that roughly 70,000 people are on Medicaid right now solely because of these protections, and total enrollment is over 222,000. But I mean, I do want to note the system hasn't been perfect. I mean, some people say they actually were removed from Medicaid during the pandemic. I've spoken to a young woman in Pembroke, Lidia Yen, who lost her coverage, had no idea, and got stuck with a medical bill that she thought was covered.

The Department of Health and Human Services says people like her can get their coverage back and be reimbursed for medical expenses they footed during that period, but that process can be quite a bit of work, as it has been for Lidia Yen, who still hasn't gotten her coverage resolved.

Ed Brouder: Ok, so some cases of people losing coverage despite these protections in place during the pandemic. Overall, though, has this actually translated into more people being covered?

Alli Fam: It absolutely has. I mean, we've seen Medicaid numbers here in New Hampshire really increase during the pandemic. You know, if we compare today's numbers with those in January of 2020, so standard Medicaid participation has gone up around 14% and Granite State Advantage, that is Medicaid expansion, has gone up around 50%.

And one of the things that these protections have really reduced is churn. That is gaps in coverage for people who may temporarily lose their coverage because they don't recertify on time or they don't get the correct documentation into the department.

Ed Brouder: Right. So once the public health emergency ends, people will have to submit all that documentation again to stay on Medicaid, correct?

Alli Fam: Yes, but they should do it sooner rather than later. And the state has been trying to get the word out about this now because, basically, what they do not want to see happen is everyone submits documentation all at the same time and people end up with coverage gaps, even if they're eligible, because of the administrative overload. And so, as the state is processing this information, they are also looking to see if people may qualify for a different program.

For example, if someone initially qualified for Medicaid coverage based on income, but now maybe they have a disability or they're pregnant or fall into kind of another category of people who are often eligible for coverage that would maybe allow them to continue it.

Ed Brouder: Well, how has the state been letting people know about this?

Alli Fam: Yeah, so the state is trying to be proactive. They've sent out notices to people in the mail. If you're wondering, 'have I gotten one of these?,' it is on a hot pink piece of paper. They've also been meeting with health providers and community members who work with people on Medicaid to basically help those providers help the people they work with and really just try to minimize those gaps in coverage.

If people have questions on this, they can email the department directly at or call at (603) 271-4344.

Julia Furukawa is the host of All Things Considered at NHPR. She joined the NHPR team in 2021 as a fellow producing ATC after working as a reporter and editor for The Paris News in Texas and a freelancer for KNKX Public Radio in Seattle.
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