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UNH Report on New Hampshire’s Medicaid Work and Community Engagement Requirements Cites Disruption for Community Organizations and Beneficiaries

CONCORD, N.H. – The Institute for Health Policy and Practice at the University of New Hampshire recently published a report titled, The Community Response to Medicaid Work and Community Engagement Requirements: Lessons from New Hampshire.”


As part of New Hampshire’s Medicaid expansion program, the state implemented an individual compliance obligation for each beneficiary to remain eligible for health insurance. Called work and community engagement requirements (WACER), It was foreseeable that the WACER program’s impacts would extend to community organizations supporting these beneficiaries.


Doctor-1149149_960_720New Hampshire was used as a case study to test the hypothesis that community organizations would be burdened by the WACER for several reasons, including that these organizations serve as resources for and provide care to Medicaid beneficiaries who are subject to the WACER.

The research concluded that the preparation and implementation process for New Hampshire’s approved WACER program was costly and confusing for community organizations. The process was exacerbated by the WACER’s uncertain future and simultaneous changes to the Medicaid program that also impacted beneficiaries and community organizations. “Community organizations realized many uncompensated costs associated with the WACER implementation, and many additional potential costs and impacts were avoided only because the program was suspended before full implementation,” says report co-author, Lucy Hodder, JD, Director of Health Law and Policy at IHPP, Franklin Pierce School of Law.

The research was funded by the Robert Wood Johnson Foundation (grant #76038). The views expressed do not necessarily reflect those of the Foundation.

For questions, please contact Bridget Drake, Bridget.Drake@unh.edu

The Institute for Health Policy and Practice (IHPP) is an applied research institute located within the College of Health and Human Services at the University of New Hampshire. IHPP conducts and disseminates high-quality, cutting-edge applied research and policy work that enables health system partners to implement evidence-based strategies to improve population health.