Victory for Medicaid Recipients in New Hampshire

On July 29, 2019, NCLEJ and co-counsel National Health Law Program and New Hampshire Legal Assistance won a victory that protects Medicaid recipients in New Hampshire from harsh work requirements. A federal judge vacated the U.S. Department of Health and Human Services’ approval of New Hampshire’s section 1115 Medicaid waiver project that would have drastically cut Medicaid coverage and undermined the efficacy of New Hampshire’s Medicaid program. As in a handful of other states, the federal government had given New Hampshire permission to condition Medicaid coverage on work requirements and to eliminate 3-months’ retroactive coverage. “In short, we have all seen this movie before,” stated Judge James E. Boasberg, who has vacated similar projects in Arkansas and Kentucky.

National Center for Law and Economic Justice Senior Attorney Travis England said, “New Hampshire’s plan would have disproportionately harmed low-income people living with chronic health conditions, so today’s decision affirms that the purpose of Medicaid is to make medically necessary health services accessible to those who would otherwise not be able to afford them. Medicaid work requirement waivers are arbitrary and capricious, and Judge Boasberg’s decision should send yet another signal to the Trump Administration that they cannot dismantle Medicaid by taking coverage away from people who are unable to meet work rules.”

National Health Law Program Legal Director Jane Perkins said, “We are pleased with Judge Boasberg’s decision and the speed with which he made it. Seventeen thousand limited-income people in New Hampshire were facing termination, so this opinion vacating the project will not only maintain their health insurance coverage, but allow them to go about their lives without the fear of losing coverage hanging over their heads. Coverage matters because it enables people to live, work, and participate as fully as they can in their communities.

“Judge Boasberg’s decision makes clear that federal agencies must engage in reasoned decision making, which is not what happened here,” Perkins continued. “Rather than consider the Medicaid Act’s aim of furnishing medical assistance, Secretary Azar continued to double down on his consideration of other aims for Medicaid – goals that we have argued will achieve the administration’s stated aim of exploding the ACA’s Medicaid expansion.”

“New Hampshire Legal Assistance has long opposed conditioning Medicaid on work and we are so pleased with today’s federal court decision,” added New Hampshire Legal Assistance Policy Director Dawn McKinney. “Judge Boasberg cited even greater coverage-loss concerns than Kentucky’s and Arkansas’s, given New Hampshire’s harsher mandate for more hours and applying that to a larger age range. We especially applaud the four Medicaid recipients, from various parts of New Hampshire, who filed this lawsuit to make sure that thousands of Granite Staters would not lose precious health coverage.”