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CMS Reapproves N.H. Work Requirements

The Centers for Medicare & Medicaid Services (CMS) has reapproved New Hampshire’s request to incorporate work requirements as a condition of Medicaid eligibility for certain enrollees through its Section 1115 demonstration waiver. The waiver also will eliminate retroactive coverage for beneficiaries in the expansion population, transitioning that population into managed care.

The state’s waiver initially was approved in May, but required a second approval to extend beyond Dec. 31. New Hampshire is one of five states — joined by ArkansasIndiana, Kentucky, and Wisconsin — with approved waivers to implement work requirements.

The New Hampshire Granite Advantage Health Care Program will require nondisabled adults newly eligible for Medicaid through the state’s expansion to work or participate in other approved community engagement activities for at least 100 hours per month.

The waiver includes exemptions for certain populations, including:

  • individuals with illnesses that prevent them from working;
  • participants in a state-certified drug court program;
  • parents or caretakers for individuals requiring extensive care; and
  • parents or caretakers of a child younger than 6 years old.

America’s Essential Hospitals released a policy brief examining work and community engagement requirements in Medicaid waivers.

Contact Senior Director of Policy Erin O’Malley at or 202.585.0127 with questions.


About the Author

Rachel Schwartz is a former policy associate at America's Essential Hospitals.

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