N.H. Medicaid Work Requirement Cost At Least $4.4 Million in Federal, State Funds

Oct 11, 2019

More than $4 million in state and federal money was spent rolling out a Medicaid work requirement in New Hampshire that was later struck down by a federal judge.

The numbers, which come from state estimates provided to the Government Accountability Office, are the first estimate of the total cost of the now defunct program.

The report shows New Hampshire spent $4.4 million in mostly federal money implementing the work requirement and planned to spend at least another $1.6 million “for evaluation activities from 2019 through 2025.”

The program would have required tens of thousands of Medicaid expansion beneficiaries in New Hampshire to prove to state officials they were meeting a monthly quota of work hours or other qualifying activities. The state struggled to make contact with the majority of those who were mandatory for the program, despite making thousands of robo-calls and even going door-to-door.

The GAO report criticizes the Centers for Medicare and Medicaid Services for allowing states to implement Medicaid work requirements without submitting estimates for administrative costs in advance.

“The cost of administering demonstrations, including those with work requirements, is not transparent to the public or included in CMS's assessments of whether a demonstration is budget neutral,” the report reads.

New Hampshire's Medicaid work requirement was struck down by a federal judge in July. That decision is being appealed by the Trump administration.