As many as 29,000 people across New Hampshire could lose their Medicaid coverage by 2028, according to a new report from the New Hampshire Fiscal Policy Institute covered by NHPR. The projection adds the Granite State to a growing list of states warning of major coverage losses tied to federal health policy changes.
Medicaid covers roughly one in five Americans, including low-income families, children, pregnant women, seniors in nursing homes, and people with disabilities. In New Hampshire, the program is a lifeline for hundreds of thousands of residents — and a major funder of the state's community health centers, rural hospitals, and substance-use treatment programs, which depend heavily on Medicaid dollars.
The institute's warning comes as states digest the fallout from congressional Medicaid cuts and the scheduled expiration of enhanced Affordable Care Act premium tax credits at the end of 2025. Analysts project millions nationwide could lose coverage or face sharply higher premiums in the coming years, with hospitals absorbing more uncompensated care — a cost that ultimately lands on insured patients and state budgets.
For New Hampshire, the stakes go beyond the newly uninsured: community health centers that serve Medicaid patients operate on thin margins, and coverage losses could force service cuts in the state's most vulnerable communities. Advocates say the findings should sharpen state planning around outreach, simplified renewals, and safety-net funding now, while there is still time to blunt the impact.
The report also underscores a broader national pattern: with federal support shrinking, states are being left to decide how much of the gap they can fill themselves. New Hampshire lawmakers will face those choices in upcoming budget sessions, weighing the cost of state-funded coverage protections against competing priorities. Health policy experts say the states that act early — investing in enrollment assistance and renewal systems before the losses hit — tend to fare better than those that wait for the termination letters to go out.