New Hampshire Delays Medicaid Premiums Pending Federal Approval

New Hampshire has not implemented its new Medicaid premium system, which was due to start July 1, because it still lacks required federal approval, according to a Department of Health and Human Services spokesperson. State officials have flagged since January that the premium structure may conflict with the federal cost-sharing program created by the One Big Beautiful Bill Act (H.R. 1), which caps enrollee charges at $35 per service and takes effect in October 2028. Under the state plan, premiums would range from $60 to $270 monthly based on household size and income, up to 255% of the federal poverty level. Democratic lawmakers are citing the unresolved federal conflict to push for scrapping the premium system entirely, while Gov. Kelly Ayotte's administration has defended it as necessary to sustain generous eligibility limits.