Amber MacQuarrie

Amber MacQuarrie, a day care provider in Manchester, qualifies for expanded Medicaid but knows very little about how to comply with new work requirements that took effect June 1.

CONCORD — State officials have been unable to connect with about 20,000 people enrolled in New Hampshire’s expanded Medicaid program who might be required to comply with new work requirements or lose their health insurance.

As a result, legislation was amended by a House-Senate conference committee on Thursday to grant Health and Human Services Commissioner Jeffrey Meyers broad powers to exempt people from the work requirement, which Republicans in the state Legislature had demanded be included in the expanded Medicaid program.

The amendment will still have to be passed by the full Senate and House and signed into law by Gov. Chris Sununu, who has supported the work requirement. He told reporters on Wednesday that the state is doing everything it can to reach the target population, but time is running out as a July 7 deadline approaches.

“The department (Health and Human Services) has done a very good job in their attempts to reach out to this population,” Sununu said. “But there are still 20,000 out there. It is a big number and something we have to be aggressive about getting down and making sure these folks enter the program like they are supposed to.”

The new work or community engagement requirement kicked in as of June 1, requiring anyone covered by expanded Medicaid, known as Granite Advantage, to complete 100 hours of work or approved community activities each month to maintain medical coverage, unless they are exempt due to medical frailty or other circumstances listed in the law.

Meyers says the department has been able to determine that about 22,000 of the 50,000-plus enrolled in Granite Advantage are exempt from the work requirement for various reasons.

“For the month of June, that leaves about 27,000 others,” he said. “About 7,400 of that 27,000 are in compliance because we have wage information that confirms that, which leaves about 20,000.”

Outreach efforts by the state and its vendors included letters and phone calls, as well as texts, emails, in-person information sessions, videos, local meetings with beneficiaries, community organizations and providers, and interactions with DHHS client services staff.

DHHS spent $100,000 on a contract with a company called Maximus Health to help with the outreach. When asked if the agency was satisfied with the company’s efforts, Meyers said, “Of course we are.”

“They made more than 50,000 calls,” he said.

The problem, according to Meyers, is that many calls went unanswered, and in cases where Maximus was able to reach people, they weren’t always willing to cooperate. Many of those who were reached declined to provide their Medicaid ID number over the phone.

“We did the outreach, but if people on the other side for whatever reason don’t want to talk we can’t force them into a conversation,” he said.

A federal judge in March blocked work requirements that the Trump administration authorized for Arkansas and Kentucky. A group of plaintiffs, including New Hampshire Legal Assistance, has appealed to the same judge to block the work requirement in the Granite State as well.

Republican Sen. Jeb Bradley, chief architect of the expanded Medicaid compromise with Democrats, said he would support the changes to the work requirement in the final version of SB 290, given the uncertainty surrounding coverage for 20,000.

“When you look at the 20,000, I’m sure there are a lot who are working the requisite number of hours or they have one of the exemptions, so I suspect the number is far less than 20,000 at end of day,” he said. “I see this as a way of preserving the work requirement, but also ensuring that commissioner Meyers has the tools to make sure we can effectively implement it.”

The provisions of SB 290 expire on July 2021, after which a new legislature will have to decide how to proceed, assuming the work requirement survives legal challenges.

Everyone in the Granite Advantage program has until July 7 to report their hours worked, qualified activities or reasons for an exemption.

“We have a plan for pulling all that together, entering it into our system every day,” said Meyers. “We will then determine how many are in compliance and how many are not, and then I will be able to make a judgment about whether or not people need to be exempted until they can be reached or for any period of time, up to July 2021.”

Monday, December 09, 2019