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Proposed changes to Medicaid could cost NH $500 M annually

Proposed changes to Medicaid could cost NH $500 M annually

Stethoscope and Adhesive Note With Text Medicaid. (Via Getty Images)

By Mrinali Dhembla

January 29, 2025

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.

Author

  • Mrinali Dhembla

    Based in Manchester, Mrinali Dhembla is Granite Post's multimedia reporter. She's previously worked as deputy editor at The Keene Sentinel, and has experience writing for many national and international publications. When not doing journalism, she likes to cook food (and eat it).

CATEGORIES: HEALTHCARE

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