Medicaid expansion has provided health care coverage to NH workers, supported the economy – New Hampshire Bulletin

First Published in the New Hampshire Bulletin, May 17, 2023

Medicaid expansion has improved access to health care for New Hampshire’s workers and residents with low incomes while supporting the overall economy, based on NHFPI research published earlier this year.

Over 219,000 Granite Staters have received health coverage through Medicaid expansion at some point. In Medicaid expansion’s first five years in New Hampshire, the uninsured population dropped by 42 percent.

Since the program’s implementation in 2014, Medicaid expansion has provided key support for the Granite State’s workers and workforce. Evidence from other states suggests Medicaid expansion enrollees have an easier time finding employment, and that access to health care coverage through Medicaid expansion helps workers keep their jobs.

Services and supports accessed through the program provide many Granite Staters with the immediate and preventative care their families need to live healthy and active lives. During the COVID-19 pandemic, Medicaid expansion helped workers impacted by pandemic-related employment losses keep coverage during a public health emergency.

Granite Staters in communities across New Hampshire have had greater access to health care through Medicaid expansion, and enrollment rates are higher in rural regions of the state. In rural communities, Medicaid expansion has not only increased access to health care coverage, but has also infused federal dollars into local economies and helped stave off the closure of small, rural hospitals.

Rural hospitals provide local accessibility to critical, lifesaving medical services and important preventative care for their communities. Research shows rural hospital closures are associated with declines in local employment, and may negatively impact per capita incomes, regional population growth, and labor force participation. By covering more residents in rural areas, Medicaid expansion can play an important role in helping to ensure more vital health care services remain available, while supporting local economies and workforces.

Medicaid expansion has improved access to health care services for many families and individuals who otherwise would not have been able to afford such services. Key supports and services provided by the program include access to mental health, substance misuse, preventative, and emergency room care.

In increasing access to these important care needs, Medicaid expansion has been associated with reduced mortality and better health outcomes. Among households nationwide, research shows Medicaid expansion has lowered medical debt, reduced eviction risk, improved food security, and had an overall positive effect on financial security.

For the state budget and economy, Medicaid expansion can help build in financial resiliency. The federal government pays for 90 percent of the services funded by Medicaid expansion, which has directly contributed $3.2 billion to the state economy in the first seven years. In 2022 alone, New Hampshire received $502 million in federal dollars through Medicaid expansion, with the higher enrollment resulting from the pandemic leading to more federal dollars flowing to New Hampshire.

The program can also lead to key savings in the state budget by offsetting other costs the state would have paid, including the costs of uncompensated care at hospitals treating uninsured individuals, enrollment of residents in other parts of Medicaid, and providing medical care to the state’s incarcerated residents.

Through Medicaid expansion, New Hampshire has helped ensure more Granite Staters with low incomes have better access to critical health care services and improved health outcomes. Medicaid expansion helps bolster household financial security and reduces eviction risk, research indicates, while infusing federal dollars into local economies and contributing to key savings in state budgets.

Through support to Granite State workers, who are the backbone of a strong economy, Medicaid expansion has helped New Hampshire invest in a more equitable, inclusive, and resilient economy.

The New Hampshire Fiscal Policy Institute is a nonprofit, independent policy research organization based in Concord and focused on the state budget, New Hampshire’s economy, and policies affecting Granite Staters, particularly those with low and moderate incomes. For the research supporting this information and to read more about Medicaid expansion, see NHFPI’s Issue Brief, The Effects of Medicaid Expansion in New Hampshire, available at