NH Dems decry Medicaid premium increases

Low and moderate-income families on public assistance programs eventually will have to pay up to $300 monthly for their health insurance premiums, a critical move that state budget writers took in June 2025 to balance their two-year state budget.

State Democratic leaders, including gubernatorial nominee-to-be Cinde Warmington of Concord, pounced Wednesday on the target date of July 1 in the state budget to make these premium changes.

“Our most vulnerable families will feel the pain and face the increased prices of Kelly Ayotte’s and Donald Trump’s reckless Medicaid cuts. Families that can no longer afford health coverage will be left entirely without health care, and providers will find it harder than ever to continue providing care as they struggle to keep their doors open,” Warmington said in a statement.

“Granite Staters deserve a governor who is committed to making health care more accessible and more affordable, and I’ll reverse these costly premiums when I get to the corner office.”

But the Ayotte administration said the Department of Health and Human Services (DHHS) is still awaiting approval from the Trump administration to adopt the premium hikes.

“No new Medicaid premiums have gone into effect today as DHHS is awaiting final guidance from the federal government before implementing any changes,” said Ayotte spokesman John Corbett.

“Governor Ayotte has fought to protect New Hampshire’s Medicaid program and preserve some of the highest eligibility levels in the country, including coverage for children. The State will work to implement Medicaid changes while ensuring families facing financial hardship do not lose access to care or coverage.”

Once the federal Centers for Medicare and Medicaid Services gives New Hampshire its requested waiver, the state budget calls for recipients on the Medicaid program to pay 5% of their income for health care coverage:

• Children’s Health Insurance Program: Families with children in CHIP would pay if they made at least 255% of the federal poverty level, which is roughly $72,500 a year. The 5% premium would be about $300 a month or $3,600 a year and,

• Granite Advantage: The premium would be charged to low-income adults in the Medicaid expansion program who made at least 100% of the federal poverty level, which for a single person is about $16,000 annually. The 5% translates to about $66 a month or $800 a year in client payments.

Drug copayments would go up from $1 or $2 to $4 for Medicaid expansion recipients

All other clients in Granite Advantage who make less than the federal poverty level would see copayments for prescription drugs rise from $1 or $2 to $4 for each medication.

Once adopted, DHHS officials said the premiums would apply to about 8,600 families, or about 10% on the CHIP program.

In Granite Advantage, the premiums would apply to 12,000 clients, or about 20% of that population.

Ayotte first proposed the change as part of her proposed budget. At the time she said in a tight fiscal period that this was necessary to avoid restricting eligibility for anyone on the federal Medicaid program.

When Ayotte signed that budget, 18 states already required some Medicaid recipients to pay monthly premiums, including Massachusetts and New York.

New Hampshire had been offering for free the CHIP benefit to families that make up to 323% of the federal poverty level, which in 2025 was the fifth highest eligibility standard in the country.

Federal law permits states to go further than Ayotte did as they can charge premiums of up to 5% for families on Medicaid that make at least 150% of the poverty level, which is $48,200 for a family of four.

New Hampshire Democratic Party Chairman Ray Buckley said the Medicaid premium increases will be a major issue in this race for governor.

“Kelly Ayotte chose to balance her budget on the backs of the most vulnerable Granite Staters. Her new health care premiums are another bill Granite Staters simply cannot afford,” Buckley said.

“No one should have to choose between seeing a doctor, filling a prescription, or putting food on the table, but that’s exactly the choice Kelly Ayotte has created."

House Majority Leader Jason Osborne, R-Auburn, defended the upcoming changes.

“Only Ray Buckley would complain about affordability while his party pushes a $1 billion income tax to strip thousands from Granite Staters. True affordability comes from responsible stewardship, such as asking individuals to pitch in a reasonable $2 a day toward their taxpayer subsidized healthcare,” Osborne said.

“In 22 other states, these same families wouldn’t even qualify for public assistance. The truth is, New Hampshire remains incredibly generous. Ray can keep running his fictional narratives and stay in the minority, we’ll keep running the state responsibly.”

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