Medicaid work requirements · New Hampshire

Medicaid work requirements in New Hampshire: who is subject and who loses coverage (2027)

Data snapshot 2026-06-03 · part of These 5 Million People Are About to Lose Their Medicaid — But They Don't Have To

New Hampshire expanded Medicaid, so the federal work requirement that takes effect January 1, 2027 applies to its expansion adults. About 56,968 of them (6.8% of an expansion pool of 60,900) will have to prove 80 hours a month of work, school, or service, or an exemption, to keep coverage.

This model's bottom-up estimate is that 19,288 people in New Hampshire lose coverage by 2034: 17,579 of them still eligible but lost to paperwork and reporting failures, and 1,709 not meeting the requirement. Nationally the same model gives 5,461,400, against CBO's 5,200,000.

Whether those eligible people keep coverage depends on the state's ability to renew them automatically (ex parte) from data it already holds. New Hampshire scores 71 of 100 on this model's ex parte capability index, a low band; its eligibility system is NH EASY.

Key figures

Model v2-2026-06-03. "Strict" counts adults whose ACS record shows them subject with no observable exemption; "permissive" allows the broader exemption reading.
MeasureNew Hampshire
Expansion stateYes
Subject to the requirement via waiverNo
Expansion pool (adults 19 to 64)60,900
Adults subject, strict definition56,968
Adults subject, permissive definition55,829
Share of expansion pool subject6.8%
Projected coverage loss by 203419,288
Hardship exception statusAdopting
Early implementerNo
Ex parte capability score (0 to 100)71 (low)

Who is subject in New Hampshire

Of the 56,968 subject adults, 32% already work 80 or more hours a month and 59% are not working. 31% have a child under 14 at home. Among those not working, 61% report a disability and 11% are caregivers.

ACS PUMS 5-year 2020 to 2024, subject adults only.
CharacteristicShare of subject adults
Age 19-2412%
Age 25-3424%
Age 35-4420%
Age 45-5414%
Age 55-6430%
Not working59%
1 to 19 hours a month1%
20 to 79 hours a month7%
80 or more hours a month (meets the bar)32%
Not working: Disabled61%
Not working: Caregiver11%
Not working: Postpartum0%
Not working: Student2%
Not working: Other26%

Why eligible people lose coverage

Of the 19,288 projected to lose coverage in New Hampshire, 17,579 meet the requirement or qualify for an exemption but fail to document it. 5,387 of those are working people who cannot prove their hours through data the state can see, and 12,192 qualify for an exemption the state does not detect automatically.

Bottom-up model v8.0-2026-05-30; documentation-failure buckets compound over the 14 six-month renewal cycles through 2034.
GroupProjected to lose coverage
Multiple part-time jobs (aggregation failure)1,694
Variable shifts / on-call work1,198
Self-employed (other)1,053
Full-time students not auto-verified352
Volunteering / job training347
Seasonal: agriculture, hospitality, food service286
Cash-paid construction & trades263
Gig / courier (DoorDash, Uber, Lyft, Instacart)194
Medically frail without auto-match5,071
Caregivers of a disabled adult2,477
Parent caregivers of children ≤13 without auto-match2,088
Kinship caregivers (non-parent) of children ≤131,069
SUD treatment not flagged in claims data469
American Indian / Alaska Native (tribal exemption)412
Other categorical exemptions (foster, AYA cancer, SNAP/TANF)294
Recent incarceration (data-match gap)277
Pregnancy / postpartum data lag37

Can the state renew people automatically?

The ex parte capability index blends the state's observed automatic-renewal rate (76% in CMS eligibility-processing data), the wage, disability, and other data sources it can query, and its history of churn. New Hampshire's composite score is 71 (low band). A low score means more eligible people will be dropped for paperwork unless the state changes its process before January 1, 2027.

ComponentScore
Composite71
Observed ex parte76
Core capability62
Data sources65
Historical churn70

How subjects overlap across exemption categories

Each subject adult sits in exactly one cell. Categories: Working ≥ qualifying hours / income; Parent caregiver of child ≤13; Medically frail; Full-time student.
CombinationAdultsShare
None of the four20,13135.3%
Medically frail12,96622.8%
Working ≥ qualifying hours / income9,23916.2%
Working ≥ qualifying hours / income + Parent caregiver of child ≤136,19110.9%
Parent caregiver of child ≤133,0815.4%
Working ≥ qualifying hours / income + Full-time student1,4912.6%
Full-time student1,3892.4%
Working ≥ qualifying hours / income + Medically frail9111.6%

Counties in New Hampshire

Subject adults concentrate: Hillsborough County (16,476), Rockingham County (12,898), and Merrimack County (6,199) account for 62% of the state's subject population.

All 10 counties in New Hampshire with subject adults, sorted by count. County figures are model allocations of the state estimate by ACS tract characteristics.
CountyAdults subjectSubject rateProjected lossPoverty rateWorking-age population
Hillsborough County16,4766.2%5,5787.0%264,170
Rockingham County12,8986.7%4,3675.0%192,068
Merrimack County6,1996.6%2,0997.0%94,055
Strafford County5,4956.6%1,8609.0%82,986
Grafton County4,1957.7%1,42010.0%54,496
Cheshire County3,3507.5%1,1349.0%44,906
Belknap County2,7297.3%9249.0%37,396
Carroll County2,5049.0%8488.0%27,806
Sullivan County1,8077.2%61212.0%25,212
Coos County1,3157.4%44512.0%17,870

State brief and methodology

Estimates, not counts. The model rakes to CBO's national subject total and allocates by ACS microdata; state agencies hold the administrative data that would replace these figures.

Sources

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