Brief Calls on U.S. District Court to Strike Down New Hampshire’s Medicaid Work Experiment

A “friend of the court” brief signed by public health deans and scholars calls on the U.S. District Court for the District of Columbia to strike down a New Hampshire experiment that would require Medicaid recipients to work at least 100 hours per month or lose their health coverage. The brief calls New Hampshire’s Medicaid work experiment “arbitrary, capricious, an abuse of discretion and contrary to law.”

“New Hampshire’s demonstration threatens coverage for thousands of poor people. Its lack of any reasonable basis is especially striking in New Hampshire, whose unemployment rate, even among older workers, is virtually nonexistent,” said Sara Rosenbaum, JD, one of the health policy scholars represented by the brief. She is the Harold and Jane Hirsh Professor of Health Policy and Law at the George Washington University Milken Institute School of Public Health (GW Milken Institute SPH). “Like Arkansas and Kentucky, the New Hampshire program lacks the requisite elements of sound social policy research; the administration has unlawfully deployed experimental authority simply to strip the poor of health insurance.”

The brief argues that the Trump Administration’s approval of the New Hampshire Granite Advantage work program ignored the harm that will result if the project is enacted. Milken Institute SPH researchers Leighton Ku, PhD, MPH, and Erin Brantley, MPH, estimate potential coverage losses of between 15,000 and 23,000 Medicaid recipients in the first year alone.

New Hampshire’s proposed work requirements are the harshest to date, the brief’s authors write. New Hampshire has one of the nation’s lowest unemployment rates and an economy with a large number of seasonal and part-time work. Officials will require at least 25 hours per week of work, with an increasingly limited opportunity to make up for any deficit before coverage ends and will not provide additional training or help searching for jobs. New Hampshire’s work experiment also targets beneficiaries through the age of 64, despite evidence that 70 percent of low-income adults ages 50 and older already are in only fair-to-poor health.

The brief argues the Trump Administration has ignored how the work requirements will impact community health centers. Milken Institute SPH researchers Peter Shin, PhD, MPH, and Jessica Sharac, MS, MPH, estimate that loss of health care coverage among patients of community health center patients could reduce patient capacity by 2,500, which translates into nearly 11,000 fewer patient visits per year.

The amicus brief can be accessed here. The deans and scholars were represented by Edward T. Waters, Phillip A. Escoriaza, and Christopher J. Frisina of the Washington, D.C. law firm of Feldesman Tucker Leifer Fidell, LLP.