NH Medicaid Matters Statement on Federal Guidance for Medicaid Work Requirements

June 9, 2026

CONCORD, NH — On June 1, 2026, the Centers for Medicare & Medicaid Services (CMS) published its long-awaited Interim Final Rule providing guidance to states on the Medicaid work requirements included in the One Big Beautiful Bill Act (H.R. 1). Under this rule, New Hampshire will implement work requirements for adults enrolled in Medicaid expansion by January 1, 2027. NH Medicaid Matters remains deeply concerned about the more restrictive eligibility requirements embedded in this rule, including a ban on self-attestation and a limited definition of medical frailty.

Across New Hampshire, Medicaid expansion provides health insurance coverage to an average of nearly 59,000 adults every year. National estimates suggest that 14,000–29,000 Granite Staters could lose their Medicaid coverage as a result of the new work requirements and increased eligibility checks. The evidence is clear: work requirements do not increase employment — they increase administrative barriers. In fact, 75% of adult Medicaid enrollees are already working, and the vast majority of those who aren't are managing a disability, caregiving responsibilities, or another serious barrier to employment. These bureaucratic requirements will create new hurdles that cause eligible people to lose coverage through paperwork failures, not because they don't qualify.

NH Medicaid Matters calls on New Hampshire policymakers to ensure our state has the resources and flexibility needed to implement these changes without leaving anyone behind. We are actively engaging with the NH Department of Health and Human Services to better understand how New Hampshire plans to implement the work requirements and will share more detailed resources for Granite Staters as that information becomes available.

About NH Medicaid Matters

NH Medicaid Matters is a coalition of 80+ organizations who believe that our state's Medicaid program is vital to a healthy, thriving New Hampshire. We are committed to protecting this critical source of essential health insurance for hundreds of thousands of Granite Staters. Learn more at NHNeedsMedicaid.com.​

###