State tracker

New Hampshire — Medicaid Coverage Retention

Applies Last updated 2026-06-03 · confidence: high

New Hampshire is subject to federal Medicaid community-engagement/work-requirement implementation beginning January 1, 2027, unless modified by future federal or state guidance.

Procurement / RFP activity

None identified

No public RFP for work-requirement communications/outreach identified as of 2026-06-03. (Note: RFP-2026-DMS-04-COMMU "Community Reentry Navigator and Communications Services" appears in NH DHHS listings but is scoped to reentry-from-incarceration services under the state's Section 1115 demonstration, NOT H.R.1 community-engagement/work-requirement member outreach. The general MES procurement RFP-2026-DMS-01-EBINT (Enterprise Business Intelligence 2.0, due Jan 21, 2026) is Medicaid-systems integration, not work-requirement-specific.)

Procurement portal: NH DHHS Contracts & Procurement Opportunities (dhhs.nh.gov/doing-business-dhhs/contracts-procurement-opportunities) and the NH state procurement portal apps.das.nh.gov/NHProcurement; federal solicitations would appear on SAM.gov · Implementation funding: ~$1.7M total funds in FY2026 to modify eligibility/IS&T systems plus ~$340K/yr ongoing O&M beginning FY2027 (75% federal / 25% state). KFF/state estimates put total NH implementation near $6M, the low end among states. Funded via existing-vendor system modifications, not a standalone communications procurement.

Latest detail

NH plans to implement H.R.1 community-engagement (work) requirements for its Granite Advantage expansion population, with compliance tracking expected to begin December 2026 and enforcement by Jan 1, 2027; DHHS was required to resubmit a Section 1115 waiver to CMS on/before Jan 1, 2026. NH is one of only two states (with Indiana) whose legislation mandates QUARTERLY compliance checks, and it also checks compliance monthly between renewals — a notably stricter posture. System changes are being handled through modifications to existing infrastructure (the state's MMIS is operated by Conduent under an extended contract) rather than a new competitive eligibility-system RFP, consistent with the modest ~$1.7M FY26 cost and the short federal timeline. As of early June 2026 the federally required member-outreach window (June 30–Aug 31, 2026) had not yet generated a public, separately-procured communications/advertising solicitation; legislative debate over implementation details continued into 2025–2026.

Medicaid expansion status	Expanded
Implementation status	Planning for implementation; state must have requirements in place by Dec 31, 2026 (tracking starts ~Dec 2026, enforcement Jan 1, 2027). Awaiting federal guidance on exemptions/verification.
Who may be affected	Yes — expansion adults
Reporting frequency	Pending state guidance
Reporting method	Pending state guidance
Renewal cadence	Every 6 months for expansion adults (H.R.1)
Notice timing	Pending state guidance
Self-attestation allowed?	Pending state guidance
State system / vendor	Pending state guidance
Major Medicaid MCOs	Pending state guidance
Languages likely needed	Pending state guidance

Key exemption categories to monitor

80 hours/month of work, job training, education, or community service — or qualifying monthly income.
Targets many ACA Medicaid expansion adults (19–64); non-expansion states largely have no such group.
Federal enforcement: January 1, 2027 (states implement; some earlier).
New: expansion adults redetermine every 6 months (not annually).
Commonly-defined exemptions: pregnancy/postpartum; medically frail; primary caregiver; disability; SUD treatment; certain students; tribe (AIAN); short-term hardship. Exact definitions set by CMS rule and each state.

Short-term hardship exemptions to track

Short-term hardship exemptions — adoption pending state guidance.

Member communication risk

Risk detail pending.

What MCOs & state partners should do now

Segment affected members
Identify likely exemptions
Send plain-language multilingual notices
Deploy SMS/email/IVR reminders
Track retention outcomes

Operating in New Hampshire?

The member-notice window is open now and closes August 31, 2026. Complete a Coverage Retention Readiness Audit while there is still time to act — we build CMS-compliant, plain-language, multilingual outreach to keep eligible New Hampshire members enrolled.

Request a Coverage Retention Audit

Frequently asked

Who is subject to Medicaid work requirements in New Hampshire?

Many ACA Medicaid expansion adults ages 19–64 who do not qualify for an exemption. Final scope is set by CMS rule and state implementation.

When do New Hampshire Medicaid work requirements start?

Federal enforcement begins January 1, 2027 (some states may implement earlier). Member notices are expected in the federally-required window of June 30–August 31, 2026.

What exemptions are available?

Federal baseline categories include parent/caretaker of a child under 14, pregnant/postpartum, disabled/medically frail, American Indian/Alaska Native, and those already meeting SNAP/TANF work rules. Short-term hardship exemptions and exact definitions are set by CMS rule and state implementation.

Sources

This page tracks publicly available implementation information and is updated as New Hampshire publishes guidance. State-specific rules are evolving. Not legal or eligibility advice.