2026-223 IP Rule He-W 837

The New Hampshire Department of Health and Human Services has filed an initial proposal dated August 14, 2026, to readopt with amendment the rules governing the Granite Advantage Health Care Program, He-W 837.01 through He-W 837.05, originally effective June 5, 2019 (Document #12796). The Granite Advantage program provides Medicaid coverage to adults eligible under Title XIX of the Social Security Act, Section 1902(a)(10)(A)(i)(VIII), as established under RSA 126-AA. The amendments implement federal work requirements for Medicaid established under Section 71119 of Public Law No. 119-21. The proposed amendments reduce the community engagement hour threshold from 100 hours to 80 hours per calendar month for applicable individuals not meeting an exclusion or exception. The rules introduce a restructured framework distinguishing between "specified excluded individuals" who are permanently exempt from requirements and "applicable individuals" who may qualify for time-limited exceptions. Specified excluded individuals include former foster care children, American Indians and Alaska Natives, parents and caretakers of dependent children age 13 or under or disabled individuals, veterans with a 100% VA disability rating, medically frail individuals (defined by reference to 42 CFR 435.554(c)(5)(i) and including those with SUD, disabling mental disorders, or physical or developmental disabilities that impair activities of daily living), TANF work-compliant individuals, SNAP participants not exempt from SNAP work requirements, drug and alcohol treatment program participants, inmates of public institutions, and pregnant women and those in their 12-month postpartum continuous eligibility period. Time-limited exceptions from demonstrating compliance are available for applicable individuals who, during any part of the month, were under age 19, entitled to Medicare Part A or enrolled in Medicare Part B, enrolled in a mandatory categorically needy eligibility group, or were a specified excluded individual. Short-term hardship exceptions cover individuals receiving inpatient hospital, nursing facility, ICF/IID, or inpatient psychiatric services; individuals or their dependents who must travel outside their community for serious or complex medical services unavailable locally; individuals in counties subject to a presidentially declared emergency or disaster under the NEA or Stafford Act; and individuals in counties where the unemployment rate equals or exceeds the lesser of 8 percent or 1.5 times the national unemployment rate. Verification procedures are also amended. The department is required to first attempt verification using its eligibility system and electronic data sources. Self-attestation is accepted for pregnancy, American Indian and Alaska Native status, and former foster care children who aged out in another state. Medical frailty exclusions not verifiable through the eligibility system require a licensed medical professional certification. Certain exclusions, including permanent veteran disability, former foster care status until age 26, and American Indian and Alaska Native status, are not subject to reverification. The qualifying activities list includes unsubsidized and subsidized employment, on-the-job training, at-least-half-time enrollment in higher education or career and technical education programs, job search and readiness assistance under programs including WIOA, and participation in SNAP work programs under Section 6(o)(1) of the Food and Nutrition Act of 2008.