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<title>NH Medicaid Work Requirements: What New Hampshire Parents of Autistic Kids Need to Know (2027) | Granite Advantage Eligibility, Exemptions, Katie Beckett | Achieving Stars Therapy</title>
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<div class=gx><div class="hero hp"><input type=checkbox id=hpp class=hp-chk aria-label="Pause the hero photos"><label for=hpp class=hp-pause></label><div class=hp-reel a
ria-hidden=true><img class=s1 src="https://cdn.prod.website-files.com/65f21a701f9e963fc14601d3/6ad3cfd4f68b8eb5950b9fb2_nhwork-h1-1400.webp" srcset="https://cdn.prod.website-files.com/65f21a701f9e963fc14601d3/6ad3cfd77ea3691c28bb5c5b_nhwork-h1-700.webp 700w,https://cdn.prod.website-files.com/65f21a701f9e963fc14601d3/6ad3cfd4f68b8eb5950b9fb2_nhwork-h1-1400.webp 1400w" sizes=100vw alt="" fetchpriority=high><img class=s2 src="https://cdn.prod.website-files.com/65f21a701f9e963fc14601d3/6ad3cfdc40c9c8d83050bfe9_nhwork-h2-1400.webp" srcset="https://cdn.prod.website-files.com/65f21a701f9e963fc14601d3/6ad3cfdf40c9c8d83050c0a0_nhwork-h2-700.webp 700w,https://cdn.prod.website-files.com/65f21a701f9e963fc14601d3/6ad3cfdc40c9c8d83050bfe9_nhwork-h2-1400.webp 1400w" sizes=100vw alt="" loading=lazy><img class=s3 src="https://cdn.prod.website-files.com/65f21a701f9e963fc14601d3/6ad3cfe347c0b76f8897a89f_nhwork-h3-1400.webp" srcset="https://cdn.prod.website-files.com/65f21a701f9e963fc14601d3/6ad3cfe97fd6a69c04779181_nhwork-h3-700.webp 700w,https://cdn.prod.website-files.com/65f21a701f9e963fc14601d3/6ad3cfe347c0b76f8897a89f_nhwork-h3-1400.webp 1400w" sizes=100vw alt="" loading=lazy></div><div class=hero-inner><span class=location-badge>New Hampshire Medicaid Guide</span><h1>NH Medicaid Work Requirements: What Parents of Autistic Kids Need to Know</h1><p>Starting January 2027, some adults need 80 hours a month. Kids under 19 are not affected.</p></div></div>
<div class=quick-info><div class=info-item><div class=info-label>Starts</div><div class=info-value>January 2027</div></div><div class=info-item><div class=info-label>Who It Covers</div><div class=info-value>Granite Advantage, ages 19 to 64</div></div><div class=info-item><div class=info-label>Hours</div><div class=info-value>80 a month</div></div><div class=info-item><div class=info-label>Children Under 19</div><div class=info-value>Not affected</div></div><div class=info-item><div class=info-label>Parents</div><div class=info-value>Exempt with a child 13 or under, or with a disability</div></div><div class=info-item><div class=info-label>Renewals</div><div class=info-value>Every 6 months</div></div></div>
<div class=content>
<section><p>In July 2026 a post on r/newhampshire asked, <a href="https://www.reddit.com/r/newhampshire/comments/1v4on1b/anyone_else_find_out_theyre_going_to_lose/" rel="nofollow noopener" target=_blank>"Anyone else find out they're going to lose medicaid because the expansion wasn't renewed today?"</a> It drew 148 comments. The state's own pages tell a calmer story. Granite Advantage, New Hampshire's Medicaid expansion for adults, is changing in 2027, and the biggest change is a federal work requirement, officially a community engagement requirement.</p>
<div class=highlight-box><p><strong>The short version.</strong> The new rule is about adults in the expansion program, not children. Your autistic child's Medicaid, including Katie Beckett, is not what it targets. If you are a parent in that program, you are on the state's "not affected" list when your child is 13 or younger, or when your child has a disability. You will likely need to prove it, so keep the paperwork ready.</p></div></section>
<nav class=toc><b>On this page</b><ol><li><a href=#what>What the rule is</a></li><li><a href=#when>When it starts</a></li><li><a href=#who>Who is exempt</a></li><li><a href=#parents>Parents of autistic kids</a></li><li><a href=#renew>6-month renewals</a></li><li><a href=#kids>What stays the same for kids</a></li><li><a href=#prove>How to prove an exemption</a></li><li><a href=#faq>FAQ</a></li></ol></nav>
<section id=what><h2>What are the NH Medicaid work requirements for Medicaid expansion adults?</h2>
<p>A federal law signed July 4, 2025 (Public Law 119-21, section 71119) requires states to check that some Medicaid enrollees in the expansion group are working or engaged in their community. The New Hampshire Department of Health and Human Services (DHHS) puts it this way:</p>
<blockquote>"Starting in January 2027, Granite Advantage members between the ages of 19 and 64 may need to participate in 80 hours of work or community engagement activities each month to keep your Medicaid coverage."</blockquote>
<p>The law counts several ways to meet the 80 hours per month:</p>
<div class=table-wrap><table>
<tr><th>What counts</th><th>How much</th></tr>
<tr><td>A job</td><td>80 hours a month</td></tr>
<tr><td>Community service or volunteering</td><td>80 hours a month</td></tr>
<tr><td>A work program</td><td>80 hours a month</td></tr>
<tr><td>School or training</td><td>Enrolled at least half-time</td></tr>
<tr><td>A mix of the above</td><td>80 hours a month in total</td></tr>
<tr><td>Income</td><td>At least the federal minimum wage times 80 hours a month</td></tr>
</table></div>
<p>New Hampshire tried a state work requirement once before, at 100 hours a month. DHHS now lists that older program under archived demonstrations and says it "is not enforceable at this time." The 2027 rule is a new, federal one.</p></section>
<section id=when><h2>When do the New Hampshire Medicaid work requirements start?</h2>
<p>DHHS gives two start points:</p>
<blockquote>"For people currently covered through Granite Advantage, work requirements and 6-month redeterminations begin at their first redetermination date in 2027. For new applicants, the changes are effective immediately on January 1, 2027, which means the work requirement must be demonstrated in December of 2026."</blockquote>
<div class=table-wrap><table>
<tr><th>Date</th><th>What happens</th></tr>
<tr><td>July 4, 2025</td><td>Federal law signed</td></tr>
<tr><td>March 27, 2026</td><td>New Hampshire's SB 134 signed, adding state proof rules</td></tr>
<tr><td>June 2026</td><td>Federal rule published by CMS</td></tr>
<tr><td>December 2026</td><td>New applicants must show work or engagement for this month</td></tr>
<tr><td>January 2027</td><td>Rule starts; renewals move to every 6 months for Granite Advantage</td></tr>
<tr><td>Your 2027 renewal date</td><td>Current members are checked for the first time</td></tr>
</table></div>
<p>How many people does it touch? NHPR reported in July 2026 that, by the state's count, 47,571 Granite Advantage members "will be subject to new rules upon their first Medicaid redetermination in 2027." DHHS also notes it "is waiting for final guidance from the federal government," so details may still change.</p></section>
<figure class=pb><img src="https://cdn.prod.website-files.com/65f21a701f9e963fc14601d3/6ad3cfedcead42c8fd857553_nhwork-b1-1400.webp" srcset="https://cdn.prod.website-files.com/65f21a701f9e963fc14601d3/6ad3cff040c9c8d83050c560_nhwork-b1-700.webp 700w,https://cdn.prod.website-files.com/65f21a701f9e963fc14601d3/6ad3cfedcead42c8fd857553_nhwork-b1-1400.webp 1400w" sizes="(max-width:800px) 100vw,800px" alt="Two adults review household papers at a kitchen table" loading=lazy width=1400 height=700><figcaption>Stock photo. Renewals every 6 months mean more paperwork for adults on Granite Advantage.</figcaption></figure>
<section id=who><h2>Who is exempt? Who qualifies for an exemption from the work requirement</h2>
<p>DHHS lists who is not affected. In its words, you will not need to meet the requirement if you are:</p>
<ul>
<li>"Younger than 19"</li>
<li>"A parent, guardian, or caretaker of a dependent child (13 or younger) or someone with a disability"</li>
<li>"Someone who is medically frail, including someone who is blind or disabled, who has a substance use disorder or a disabling mental disorder, or who has a serious or complex medical condition."</li>
</ul>
<p>The federal law uses almost the same words. It excludes a "parent, guardian, caretaker relative, or family caregiver" of "a dependent child 13 years of age and under or a disabled individual."</p></section>
<figure class=ig><picture><source media="(max-width:640px)" srcset="https://cdn.prod.website-files.com/65f21a701f9e963fc14601d3/6ad497b03072eb8df8d5e781_ig-nh-who-m.png"><img src="https://cdn.prod.website-files.com/65f21a701f9e963fc14601d3/6ad497aee78e498afd266acd_ig-nh-who-d.png" alt="Does the New Hampshire Medicaid work requirement apply to you? Not affected: anyone under 19, including children on Medicaid and Katie Beckett; a parent or caretaker of a child 13 or younger; a parent or caretaker of someone with a disability; someone medically frail. May apply: Granite Advantage adults 19 to 64 without an exemption, 80 hours a month. Key dates: December 2026 for new applicants, January 2027 start, current members at their 2027 renewal." loading=lazy></picture><figcaption>Achieving Stars Therapy graphic based on NH DHHS pages and Public Law 119-21, read October 17, 2026.</figcaption></figure>
<section id=parents><h2>Parents of autistic kids: are you exempt?</h2>
<p>Most likely, yes, if you are the parent or caretaker. Here is how it lines up by your child's age:</p>
<div class=table-wrap><table>
<tr><th>Your situation</th><th>Work requirement for you?</th><th>Why</th></tr>
<tr><td>On Granite Advantage, autistic child age 13 or younger</td><td>Not affected</td><td>Parent of a dependent child 13 or younger</td></tr>
<tr><td>On Granite Advantage, autistic child age 14 or older</td><td>Likely not affected</td><td>Parent or caretaker of "someone with a disability"</td></tr>
<tr><td>You have other Medicaid, not Granite Advantage</td><td>Not this rule</td><td>Most changes apply only to Granite Advantage</td></tr>
<tr><td>Your child is on Medicaid or Katie Beckett</td><td>Not for your child</td><td>Children under 19 are not affected</td></tr>
</table></div>
<p>The age 14 row needs care. The federal rule defines a disabled individual as someone who "meets the Americans with Disabilities Act definition of disability," and adds that a person "need not be eligible for Medicaid or other Federal programs on the basis of a disability" to count. The ADA rules it points to go further. They say it "should easily be concluded" that certain conditions limit a major life activity, and the list includes this line: "Autism substantially limits brain function." So the parent of an autistic teen has a strong case. The state still has to verify it, so keep your child's diagnosis report and any IEP or 504 plan where you can find them.</p></section>
<section id=renew><h2>Medicaid eligibility redeterminations every 6 months</h2>
<p>The second change is about paperwork. DHHS says: "Beginning in January 2027, eligibility for people who currently have Medicaid through the Granite Advantage Health Care Program will be reviewed every 6 months instead of each year." Each review is a chance to lose coverage over a missed letter, so watch the mail and keep your contact details current with DHHS.</p>
<p>If you apply for Medicaid as a new adult applicant from January 1, 2027, the check happens at application. That is why DHHS says new applicants must show the work requirement in December 2026.</p></section>
<section id=kids><h2>What does not change for children's Medicaid eligibility</h2>
<p>DHHS says plainly that "these changes will not affect everyone covered by Medicaid - most of the changes only apply to people who have Medicaid coverage through the Granite Advantage Health Care Program."</p>
<p>Children's Medicaid "provides health and dental coverage for children under age 19," and the Katie Beckett option (Home Care for Children with Severe Disabilities) is for "severely disabled children under age 19." Neither is Granite Advantage. Medicaid's children's benefit, called EPSDT, covers screening, diagnosis and treatment for "eligible Medicaid beneficiaries under age 21."</p>
<p>For a family whose child gets ABA through the New Hampshire Medicaid program, the work rule is a question about the parent's coverage, not the child's therapy.</p></section>
<figure class=pb><img src="https://cdn.prod.website-files.com/65f21a701f9e963fc14601d3/6ad3cff347c0b76f8897acf5_nhwork-b2-1400.webp" srcset="https://cdn.prod.website-files.com/65f21a701f9e963fc14601d3/6ad3cff9f68b8eb5950ba876_nhwork-b2-700.webp 700w,https://cdn.prod.website-files.com/65f21a701f9e963fc14601d3/6ad3cff347c0b76f8897acf5_nhwork-b2-1400.webp 1400w" sizes="(max-width:800px) 100vw,800px" alt="A mother works on a laptop on the sofa while her daughter plays nearby" loading=lazy width=1400 height=700><figcaption>Stock photo. Caring for a child with a disability is one of the listed exemptions.</figcaption></figure>
<section id=prove><h2>How to prove your exemption</h2>
<p>Expect to show papers. New Hampshire's own law on this, SB 134 (signed March 27, 2026), says the state "shall verify all exemptions and shall not accept self-attestation from individuals seeking exemptions." A medically frail exemption needs a statement from a listed professional, such as a physician or a licensed psychologist.</p>
<ol class=steps>
<li><strong>Find your renewal date.</strong> Current members are first checked at their 2027 redetermination.</li>
<li><strong>Gather proof you are the parent or caretaker.</strong> A birth certificate or guardianship papers.</li>
<li><strong>Gather proof of your child's age or disability.</strong> For a child 14 or older, the autism diagnosis report, IEP or 504 plan.</li>
<li><strong>Open every letter from DHHS.</strong> If the state finds you out of compliance, federal law gives you 30 calendar days from the day you receive the notice to respond.</li>
<li><strong>Ask for help early.</strong> Call the Department of Health and Human Services or use NH EASY before your renewal month, not after.</li>
</ol></section>
<section><h2>Where Achieving Stars Therapy fits</h2>
<p>Achieving Stars Therapy is an ABA provider, not a benefits office, and it cannot decide anyone's Medicaid eligibility. What it can do is keep your child's therapy steady while the adult rules change. It provides BCBA-led <a href="https://www.achievingstarstherapy.com/in-home-aba-therapy-new-hampshire">in-home ABA therapy in New Hampshire</a> for children 18 months to 15 years and accepts NH Medicaid.</p>
<p>It serves <a href="https://www.achievingstarstherapy.com/location/states/aba-therapy-new-hampshire">every town in New Hampshire</a>, from <a href="https://www.achievingstarstherapy.com/location/city/aba-therapy-manchester-nh">Manchester</a> to the Seacoast. The team checks benefits for free before the first session.</p></section>
<section id=faq><h2>Frequently Asked Questions</h2>
<details class=acc><summary>Will my autistic child lose Medicaid because of the work requirement?</summary><div><p>No. DHHS lists anyone "younger than 19" as not affected. The rule is about adults on Granite Advantage.</p></div></details>
<details class=acc><summary>Does Katie Beckett change in 2027?</summary><div><p>The work rule does not apply to Katie Beckett. That option is for children under 19, and the changes mostly apply to Granite Advantage adults.</p></div></details>
<details class=acc><summary>Is New Hampshire Medicaid expansion ending?</summary><div><p>Not according to the state's pages as of October 17, 2026. DHHS describes the program changing in 2027, with work requirements and 6-month renewals, not ending.</p></div></details>
<details class=acc><summary>My child is 14. Am I still exempt?</summary><div><p>Very likely, as the caretaker of "someone with a disability." The federal rule uses the ADA definition, and the ADA regulations list autism as a condition that "substantially limits brain function." Keep your child's diagnosis report ready, because the state must verify exemptions.</p></div>
</details>
<details class=acc><summary>What counts as community engagement?</summary><div><p>Community service, a work program, school at least half-time, or a mix that adds up to 80 hours a month. Earning at least the federal minimum wage times 80 hours also counts.</p></div></details>
<details class=acc><summary>Does the rule change my child's ABA coverage?</summary><div><p>The rule is about adult eligibility. Children's Medicaid and Katie Beckett are separate, and ABA for an eligible child still runs through the children's benefit.</p></div></details>
</section>
<section><h2>Sources</h2><ol class=src>
<li><a href="https://www.dhhs.nh.gov/programs-services/stay-covered-new-hampshire/medicaid-work-requirements-what-you-need-know" rel="nofollow noopener" target=_blank>NH DHHS, Medicaid Work Requirements: What You Need to Know</a></li>
<li><a href="https://www.dhhs.nh.gov/programs-services/stay-covered-new-hampshire/stay-covered-nh-information-people-medicaid" rel="nofollow noopener" target=_blank>NH DHHS, Stay Covered NH</a></li>
<li><a href="https://www.dhhs.nh.gov/programs-services/stay-covered-new-hampshire/6-month-eligibility-renewals-certain-adults" rel="nofollow noopener" target=_blank>NH DHHS, 6-month renewals</a></li>
<li><a href="https://www.dhhs.nh.gov/programs-services/medicaid/medicaid-waivers-demonstrations" rel="nofollow noopener" target=_blank>NH DHHS, Medicaid waivers and demonstrations</a></li>
<li><a href="https://www.dhhs.nh.gov/programs-services/medicaid/nh-medicaid-medical-assistance-eligibility/nh-medicaid-medical" rel="nofollow noopener" target=_blank>NH DHHS, Medicaid eligibility for children</a></li>
<li><a href="https://www.govinfo.gov/content/pkg/PLAW-119publ21/html/PLAW-119publ21.htm" rel="nofollow noopener" target=_blank>Public Law 119-21, section 71119</a></li>
<li><a href="https://www.govinfo.gov/content/pkg/CFR-2025-title28-vol1/xml/CFR-2025-title28-vol1-sec35-108.xml" rel="nofollow noopener" target=_blank>28 CFR 35.108, ADA definition of disability</a></li>
<li><a href="https://www.govinfo.gov/content/pkg/FR-2026-06-03/html/2026-11094.htm" rel="nofollow noopener" target=_blank>CMS interim final rule, Federal Register, June 3, 2026</a></li>
<li><a href="https://bills.nhliberty.org/bills/2026/SB134" rel="nofollow noopener" target=_blank>SB 134 (2026) enrolled text, bill tracker copy</a></li>
<li><a href="https://www.nhpr.org/health/2026-07-20/medicaid-work-requirements-nh-granite-advantage" rel="nofollow noopener" target=_blank>NHPR, July 20, 2026</a></li>
</ol></section>
<p class=disclaimer>Sources read October 17, 2026. DHHS says details may change with federal guidance. General information, not legal advice. For your own case, contact NH DHHS.</p>
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<h2>Keep Therapy Steady: In-Home ABA in New Hampshire</h2>
<p>Free benefits check. BCBA-led, in-home, NH Medicaid accepted.</p>
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