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DHHS outlines redetermination 'return to regular eligibility' and estimates fiscal impact
Summary
Department of Health and Human Services told House Finance Division III officials that federal redetermination flexibilities tied to the COVID public health emergency will end in June, creating additional redeterminations. DHHS estimates general fund savings from closures but also modeled population churn and costs.
House Finance Division III heard Feb. 21 that New Hampshire is continuing the transition from continuous federal Medicaid coverage rules used during the COVID-19 public health emergency toward regular, pre-pandemic redetermination processes and that the department has modeled both enrollment churn and fiscal impact.
Henry Littman, Medicaid director, explained the department used federal flexibilities to ease the workload of re‑establishing eligibility for roughly 238,000 cases that accrued during the public health emergency. Those flexibilities are available to states through June of this year, Littman said. He told the committee the state has expanded ex‑parte renewals (automatic renewals using administrative data) but expects ex‑parte renewals to decline by roughly 2,000 individuals per month when flexibilities end. "We're expecting about half of those individuals…won't stay open," David Chorney, deputy Medicaid director, said, summarizing earlier modeling.
DHHS presented fiscal estimates tied to the modeled decline in enrollment. From the department's budget perspective, returning to regular redetermination processing was reflected as a net reduction (savings) in the governor's operating budget of approximately $5,700,000 in general funds in state fiscal year 2026 and approximately $11,400,000 in general funds in state fiscal year 2027; federal matching dollars were shown as equivalent amounts in the budget documents presented to the committee. Nathan White, DHHS chief financial officer, described those figures as the department's budgetary assumptions tied to enrollment declines that would occur when continuous‑coverage flexibilities expire.
Committee members pressed DHHS for estimated counts of people who could be affected and how many redeterminations remained outstanding. Littman said he did not have an exact figure at-hand but that modeling assumptions included the approximate ex‑parte decrease and observed historical reenrollment rates. The department noted that Medicaid is continuously open — meaning people who lose coverage can reapply without waiting periods — and staff said the state had done proactive outreach during the unwind and that about 11,000 people closed over a 12‑month period due to outreach efforts.
Why it matters: Changes in redetermination procedures affect enrollment levels and therefore state and federal Medicaid spending and individuals' access to care. Committee members asked for more granular breakout tables showing which populations are most affected by redeterminations and requested that the department provide updated counts and the assumptions underlying the financial estimates.
Ending: DHHS said it would provide additional data on expected counts by program and more detail on modeling assumptions to the committee.
