New Hampshire delays work requirement compliance deadline

CONCORD, N.H. (AP) — New Hampshire is delaying implementation of new work requirements for Medicaid recipients after fewer than a third of those subject to the rules were in compliance last month.

In reauthorizing the state's expanded Medicaid program last year, lawmakers added rules requiring most recipients to spend at least 100 hours a month working, going to school or participating in community service.

June was the first month for which participants had to document their hours, but of the nearly 25,000 people subject to the requirements, only 8,000 complied.

The state was scheduled to send letters to the other 17,000 people this week notifying them that they were in danger of losing coverage, but instead is delaying implementation until the end of September, Health and Human Services Commissioner Jeff Meyers said.

In the meantime, workers from his agency and the Department of Employment Security have begun going door to door in high-enrollment neighborhoods in Manchester, Nashua and Laconia to ramp up outreach efforts.

The state already has spent more than $130,000 on letters, phone calls, text messages, public information sessions and information tables set up outside grocery stores and other retailers. Republican Gov. Chris Sununu called the door-to-door push the most comprehensive effort in the country.

"No other state has taken the effort, and the pains, if you will, of making sure we're engaging in this population as aggressively as we can in terms of making sure they have the information," he said. "Making sure we get this right is absolutely paramount, so the idea giving ourselves another 120 days to move forward on this and get the implementation where we need it to be, it's not just fair to the system, but it's fair to individuals."

In Arkansas, where courts have blocked the work requirements, state officials also used letters, calls, social media and advertising for outreach but did not go door to door. One of the insurance carriers serving the program, did make such an effort, according to the Department of Human Services.

While supporters argue that work requirements help participants achieve self-sufficiency, critics say they could jeopardize health care for hardworking people who may be struggling with child care, transportation and other issues while working low-wage jobs with fluctuating hours.

Such requirements are being challenged in court in several states, including New Hampshire, where New Hampshire Legal Assistance and two national organizations filed a federal lawsuit this year on behalf of low-income residents.

Dawn McKinney, policy director for the New Hampshire group, said Monday that while she appreciates the implementation delay, neither that nor the door-to-door effort will resolve the problem.

"I don't think we can outreach our way out of this situation," she said. "We hope our state leaders will come to the realization that there isn't a way to do this where it will work or be legal."

The ability to delay implementation was a provision of a bill Sununu signed Monday. Championed by Democrats and opposed by Republicans, it also expanded exemptions and made other changes to ensure participants wouldn't lose coverage.

"It should not have taken Republicans and Governor Sununu this long to try to do the right thing," Senate Majority Leader Dan Feltes, D-Concord, said in a statement. "The Sununu administration has failed to adequately implement this work requirement over the last year, another 120 days will not make a difference. This is simply a political maneuver to save face in light of ongoing litigation."

Associated Press writer Andrew DeMillo in Little Rock, Arkansas, contributed to this report.