Connor McLaughlin

1. Work requirements, even with exceptions for behavioral health, SUD treatment, pregnancy, etc. will act as a barrier to care. The legislation would require proof of meeting the work requirement or an exception on a monthly basis. The state would be better off killing Medicaid expansion than wasting time on something like this. 1A. Georgia has work requirements and requires proof each month. Only 5% of eligible individuals meet the work requirement (5,500 enrolled with work requirements out of 110,000 possibly eligible). Its going so badly in Georgia, the Georgia legislature has directed the Georgia Medicaid department to move to annual proof. 2. The cost to implement work requirements is not in the budget and the cost to implement is in the millions. That means it is not just implementing work requirements it also means cutting other services and coverage to pay for work requirements. Any savings from lower enrollment will not be seen until the next budget and the savings will be minimal. 2A. Providers are already financially stressed enough. Is a work requirement worth another Medicaid rate cut? 3. NH is finally seeing a return on the millions of dollars and resource hours it has invested in combating the opioid crisis (overdose deaths down 35% in 2024 compared to 2023). Now is not the time to derail that hard work. 4. When NH previously tried to implement work requirements, 1/3rd of the Medicaid expansion population would have had coverage terminated if the Courts did not step in and rule NH's law to be unconstitutional. SB134 is the same law, by the way ... 5. Work requirements will increase NH's uninsured rate. Uninsured doesn't mean you don't need health care. It means less preventative care and an increase in emergency and higher acuity care because care will not be accessed at the right time and in the right setting. For emergency departments and hospitals it means EDs and hospitals will cover 100% of the cost to provide that care as uncompensated care. Or we could just leave Medicaid as it is and have the federal government cover 90% of those health care costs.