Gov. Ayotte plans to rein in spending by instituting a work requirement for persons receiving Medicaid. The New Hampshire Senate promoted her plans when it passed SB134 on party lines, 16-8, on March 6. The idea is as old as the Poor Law of Queen Elizabeth I and is found most recently in the Trump-MAGA playbook, Project 2025. In 2019, New Hampshire attempted a Medicaid work requirement only to have Gov. Sununu end it after spending $130,000 because it proved to be onerous and difficult to implement. A court order closed a similar program in Arkansas in 2018.

The work requirement ignores two realities. First, contrary to conservative thinking, most people want to work. An analysis in 2023 found that 71% of working-age adults on Medicaid were either in school or working full or part-time. Second, the same analysis found that an additional 12% were either caregivers or part-time workers enrolled in school or work training programs. Other factors – blindness, poor health, lack of transportation, the absence of a job in a tight market, caregiving responsibilities and no internet or computer access – make employment difficult if not impossible. In view of these realities, the governor, House and Senate should shift from placing new burdens on an already vulnerable population to raising money. They can do that by reviving previously canceled revenue sources and finding new ones.

Kent Hackmann

Andover