
Stethoscope and Adhesive Note With Text Medicaid. (Via Getty Images)
Changes proposed to Medicaid under President Donald Trump’s new administration could cost the Granite State almost $500 million annually, a new study shows.
The analysis, published by the New Hampshire Fiscal Policy Institute, shows that as of December 2024 almost 13% of Granite Staters, or 186,039 people, were enrolled in Medicaid, and nearly half of the enrollees were children.
“The proposed changes could substantially impact access to health care and the financial capacity of our state to fund public services,” said Phil Sletten, NHFPI research director, in a news release.
Medicaid is the largest program New Hampshire operates based on the amount of funds invested, and under the Federal Medical Assistance Percentage (FMAP), the federal government is responsible for matching at least 50% of the program costs in New Hampshire. The amount of help a state receives from the federal government depends on its per capita income.
Medicaid in New Hampshire is also a multi-part program that includes the New Hampshire Granite Advantage Health Care Program, also known as Medicaid Expansion, or Granite Advantage in New Hampshire.
But all this could change under Trump’s rule.
One of the proposed changes to Medicaid is the elimination of the federal match (FMAP) threshold. If eliminated, the reduced match would cost New Hampshire $194 million in fiscal year 2025, outside of Medicaid Expansion, according to the NHFPI study
Several proposals have also discussed the reduction of federal contributions for Medicaid Expansion, including one that would reduce its funding from 90% to 50%. State law requires Medicaid Expansion to end if the federal government fails to match its current 90 percent obligation, or if other streams of revenue fall short of paying the state’s share of the program.
If these changes go through, the state’s share of funding for Medicaid Expansion, will go up, costing New Hampshire almost $241.9 million.
Currently, New Hampshire pays $61.2 million for the program, and if terminated, almost 60,000 Granite Staters will lose health care coverage.
“A reduced federal match rate could lead to the repeal of critical programs, leaving New Hampshire with difficult budget choices in an already challenging fiscal environment,” Sletten said.
According to the organization’s calculations, if both these changes were to happen in tandem, it would cost New Hampshire $493 million in the upcoming fiscal year.
Support Our Cause
Thank you for taking the time to read our work. Before you go, we hope you'll consider supporting our values-driven journalism, which has always strived to make clear what's really at stake for New Hampshirites and our future.
Since day one, our goal here at Granite Post has always been to empower people across the state with fact-based news and information. We believe that when people are armed with knowledge about what's happening in their local, state, and federal governments—including who is working on their behalf and who is actively trying to block efforts aimed at improving the daily lives of Granite State families—they will be inspired to become civically engaged.


What’s new and what to watch for in the upcoming ACA open enrollment period
by Julie Appleby, KFF Health News It’s that time of year again: In most states, the Affordable Care Act’s annual open enrollment season for health...

Opinion: You Can’t be Born in Rochester Anymore
If you’re looking at the potential acquisition of Catholic Medical Center by Hospital Corporation of America and wondering what that future will...

Harris proposes plan to have Medicare cover in-home care for seniors, give relief to family caregivers
Under Harris’ plan, Medicare would cover the cost of in-home health care for seniors enrolled in the program, after a medical provider has...

Harris seeks to lower drug costs for Granite Staters, building on recent progress
Harris wants to expand the $35 monthly cap on insulin costs and a $2,000 annual cap on out-of-pocket drug costs so that they apply to all Americans,...

Exclusive: Senator Shaheen introduces bipartisan bill to combat youth opioid use in schools
Senator Jeanne Shaheen (D-NH), joined by Senators Chuck Grassley (R-IA) and Laphonza Butler (D-CA), today introduced the Keeping Drugs Out of...

Everything you need to know about the new flu and COVID vaccines
Fall is coming, which not only means cooler temps and blazing leaves, but also an uptick in coughs and sniffles, and every parent’s favorite game:...