Medicaid agency: DHHS / Division of Medicaid Services
New Hampshire Medicaid is administered by the Department of Health and Human Services (DHHS) through its Division of Medicaid Services; it has run statewide risk-based managed care, Medicaid Care Management (MCM), since 2013, currently through three MCOs (AmeriHealth Caritas New Hampshire, NH Healthy Families, a Centene subsidiary, and WellSense Health Plan) whose current contracts took effect September 1, 2024, with vendor and trade press describing a term running through August 2029 though DHHS has not published a contract document confirming that end date. CHIP is delivered as Expanded Children's Medicaid within the same MCM system rather than as a separate program. New Hampshire's expansion program, Granite Advantage Health Care Program, operates under a state statute, RSA 126-AA, whose legislative sunset was extended in 2023 to December 31, 2030; the program's original federal Section 1115 demonstration expired December 31, 2023, and New Hampshire's current 1915(b) and 1915(c) waivers and recent state plan amendments do not name a federal authority covering the expansion population in its place. Federal community engagement (work) requirements take effect on the standard national January 2027 timeline for Granite Advantage members ages 19-64; New Hampshire's own enabling legislation for the requirement was referred to interim study in March 2026, setting aside floor action for the remainder of the session.
CMS's most recent managed care enrollment data, report year 2024, shows New Hampshire's Medicaid Care Management program delivered through three comprehensive MCOs (AmeriHealth Caritas of New Hampshire, New Hampshire Healthy Families, and WellSense Health Plan) with a combined 181,676 members, consistent with the nationwide unwinding of pandemic-era continuous Medicaid enrollment. A separate dental-only Prepaid Ambulatory Health Plan, NH Smiles Adult Dental Program, covered 89,662 members in the 2024 report year.
Long-term services and supports run outside the three MCM MCO contracts, delivered fee-for-service through four Section 1915(c) home- and community-based waivers administered by DHHS's Division of Long-Term Supports and Services: the Choices for Independence (CFI) waiver for older adults and adults with physical disabilities who meet a nursing facility level of care, the Developmental Disabilities (DD) waiver, the In Home Supports (IHS) waiver for children with developmental disabilities, and the Acquired Brain Disorder (ABD) waiver. The DD and ABD waivers are both partway through a renewal cycle covering 2026 through 2031.
Not integrated into managed care
Behavioral health runs capitated within the same three MCM MCOs rather than through a separate carve-out vendor; each MCO's contract covers medical, pharmacy, and behavioral health (mental health and substance use) services together. New Hampshire separately runs a Section 1115 demonstration focused specifically on behavioral health access, the Substance Use Disorder / Serious Mental Illness and Serious Emotional Disturbance Treatment and Recovery Access demonstration, most recently approved for a five-year term running through June 30, 2029.
Carved in
Adult dental coverage runs separately from the three MCM MCOs' own contracts, through New Hampshire Smiles, a statewide dental plan authorized under its own Section 1915(b) waiver. DentaQuest administers the benefit in partnership with Northeast Delta Dental and Solvere Health, and it launched April 1, 2023.
Pharmacy runs through a split, multi-vendor structure. Prime Therapeutics State Government Solutions administers the fee-for-service pharmacy benefit, and each MCO otherwise manages pharmacy through its own contracted PBM: AmeriHealth Caritas New Hampshire through its own PerformRx, and WellSense Health Plan through Express Scripts. New Hampshire Healthy Families' PBM arrangement is not named on its own materials. DHHS has a pharmacy benefit management RFP in process that raises the possibility of moving to a single statewide PBM across all three MCOs rather than each contracting separately.
Non-emergency medical transportation is subcontracted through each MCM MCO rather than a single statewide broker. Medical Transportation Management (MTM) has administered NEMT for New Hampshire Healthy Families since September 2020 and also serves as WellSense Health Plan's transportation partner; AmeriHealth Caritas New Hampshire instead uses Coordinated Transportation Solutions (CTS).
Conduent operates New Hampshire's Medicaid Management Information System, the NH MMIS Health Enterprise Portal.
246 agency updates tracked for New Hampshire. Available with Pro.
See them with ProNew 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.
New Hampshire's System Review Committee finalized recommendations to reform the state's oversight of developmental disability care, following a Bulletin investigation that found hundreds of abuse and neglect incidents in the taxpayer-funded, privately-run care network. Key proposals include a centralized complaint intake system, a single designated lead agency for investigations, a 24/7 reporting hotline, a new 'inconclusive' finding category for investigators, a public education campaign on reporting obligations, and unannounced facility visits. The recommendations target the state Department of Health and Human Services, which currently splits oversight across multiple siloed offices including Medicaid Program Quality, Adult Protective Services, and Licensing and Certification. No implementation timeline was specified in the recommendations released Thursday.
New Hampshire saw 4,868 fewer residents enrolled in ACA Marketplace plans in 2026 compared to 2025, an 8% decline, following the December 2025 expiration of Enhanced Premium Tax Credits. Nationally, enrollment dropped from 21.8 million to 19.2 million. The analysis by KFF used effectuated enrollment data, which reflects both non-enrollment and coverage loss due to non-payment of premiums. The decline coincides with broader federal Medicaid cuts under the One Big Beautiful Bill Act and new state Medicaid premium requirements in New Hampshire, raising concerns among community health providers about access to primary care and emergency department utilization.
State records show 21 confirmed cases of sexual, physical, or emotional abuse and 30 deaths occurred in New Hampshire's state-run intellectual and developmental disability care system from January through June 2026. The system, which contracts with private agencies to serve people with disabilities including autism and cerebral palsy, received 280 reports of abuse, neglect, or exploitation during this period; state investigators deemed 75 credible, with 88 investigations still incomplete. The data indicates continued systemic problems nine months after a media investigation documented widespread abuse and neglect in the program, which serves Medicaid-funded LTSS beneficiaries.
The National Association of Medicaid Directors published a case study on New Hampshire's approach to integrating Medicaid and public health operations. The partnership focuses on intentional collaboration, aligned priorities, and sustained leadership engagement between state Medicaid and public health agencies to improve population health outcomes. The case study provides operational lessons for other states seeking to strengthen coordination between their Medicaid programs and public health departments, addressing a growing priority as states work to address social determinants of health and prevention through Medicaid financing.
12 active waivers tracked for New Hampshire. Available with Pro.
See them with ProNo active solicitations currently tracked for New Hampshire.
6 managed care contracts tracked for New Hampshire. Available with Pro.
See them with Pro14 bills tracked for New Hampshire. Available with Pro.
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