Details Of Medicaid Funding And Eligibility

By Mary Anne Broshek

I worked at the New Hampshire Department of Health and Human Services (DHHS) for 30 years and dealt with eligibility for Medicaid and all public assistance programs. I saw a number of items in Faith Clendenen’s letter in the September Beacon that I feel need to be corrected. I also want to be sure that everyone knows the help they can get in this difficult economic time.

Protecting Medicaid For Seniors

There are three Medicaid programs created solely to help seniors pay for Medicare Part A and B premiums, co-insurance, and deductibles. These programs have income and resource requirements that increase as the benefits decrease. Because these are Medicaid programs, the funding is 50% federal and 50% state. The total number of seniors in New Hampshire receiving only this help is 9,745.

In addition, there are Medicaid programs for people who are age 65 or older, for people 18 to 64 who are disabled, age 18 to 64 who are disabled and working, and for those of all ages who are blind. The total numbers receiving this Medicaid are:

65+: 8,402 (with 4,150 in nursing care)

Disabled: 15,483 (with 415 in nursing care)

Blind: 255 adults (with 14 in nursing care)

Disabled and working: 1,827

The age 65+ and disabled programs account for about 25% of the Medicaid population and about 75% of the cost. This makes them very vulnerable to budget cuts. The state-funded Catastrophic Illness Program (CIP) was suspended in the 2012/2013 New Hampshire budget. CIP was a state-funded program that provided financial assistance to adults with specific medical conditions, including cancer, hemophilia, end-stage renal disease, cystic fibrosis, spinal injury with resultant non-ambulation, and multiple sclerosis.

Must Be A Citizen

Except for emergency medical care, the only people who can receive federally-funded assistance are those who are citizens or legally-admitted aliens. Legally-admitted aliens have to wait up to five years after to coming to the US.

Nursing Care Funding

Nursing care is the most costly program. It is funded with 50% federal funds, with the remaining 50% paid by the county of residence prior to placement in the nursing home. There is a cap on how much the counties have to pay, and if the cap is exceeded, the state picks up the remaining cost.

The counties get their money from the towns and cities, so keeping individuals in their homes rather than going to a nursing home is important, both for the individual who wants to stay at home and for the budgets of towns, cities, and counties. Two programs that help keep seniors in their homes were not funded in the last budget: Congregate Housing Support Services and Respite Care for Alzheimer’s caregivers.

How To Get Help

To see if you might be eligible for help, contact Service Link at 1-866-634-9412; contact any DHHS district office; or, in the privacy or your own home, link to This site provides a screening tool for all of those 30+ programs for financial, medical, Medicare help, child care, and food stamp assistance.

Medicaid Funding

As no specifics were given, I do not know what the statement “that New Hampshire shamefully abuses its Medicaid funding is certainly true” refers to. I do know that there is a group in the Attorney General’s office dedicated to Medicaid fraud, that hundreds of cases are randomly reviewed each month as part of the federal/state quality control system, and that eligibility workers take very seriously their commitment to both public assistance clients and taxpayers. If more information is available, I would like to investigate the claim.


Democracy is built on the ability to compromise so that everyone is represented. A good quote from James A. Baker III, a former Treasury secretary, said that a grand bargain to put the country on a more responsible path would require “something that’s become a dirty word” in Washington: “Compromise.” He called for a “heroic effort” to achieve such a deal for the sake of the country’s future.

Another former Treasury secretary, Robert Rubin, sounded a similar theme. He urged today’s leaders to follow the example of the Founding Fathers, who overcame strong disagreements with each other to produce the Constitution through “principled and effective compromise.” (Both quotes come from the Concord Coalition Web site, co-founded by New Hampshire’s own Warren Rudman.)