Overview
- Two reports released on Tuesday, Oct. 20, 2026 project major impacts: the New Hampshire Fiscal Policy Institute estimates 23,000 to 29,000 Granite Advantage enrollees could lose coverage by 2028 while a Senate Finance Committee interim report names five contractors poised to run state eligibility systems.
- The federal rule taking effect Jan. 1, 2027 requires most non-exempt adults to document about 80 hours a month of work or qualifying activity, and New Hampshire has proposed stricter steps such as three-month verification cycles and documented proof instead of six-month self-reporting.
- Policy analysts warn that extra paperwork and more frequent verification will cause administrative churn that pushes otherwise-eligible people off Medicaid when they fail to complete complex reporting or miss documentation deadlines.
- The Senate Democrats’ report identifies Maximus, Gainwell, General Dynamics, Conduent, and Deloitte as likely vendors and highlights past problems such as glitchy eligibility systems, missed notices, billing errors, and high administrative costs in prior state rollouts.
- Advocates and providers say coverage losses would shift uncompensated care onto hospitals, could force service cuts or higher charges for insured patients, and add fiscal strain for states that may spend heavily on contractors and new IT systems.