Demonstrators in New York in 2017, protesting against Republican Medicaid proposals.
Credit: LightRocket /Getty

Comments close soon on New Hampshire’s new Medicaid waiver application. The Granite State is one of several states to already have a work requirement approved, and they want to continue it, which is what understandably gets the most attention.

But New Hampshire is also making another change to their Medicaid expansion plan, one that helps signal the end of an era for the program, the quiet death of what was once thought to be a promising conservative alternative to a conventional Medicaid expansion.

New Hampshire wants to end its Medicaid premium assistance program.

Premium assistance — alternatively known as the private option when it comes to Medicaid expansion — has almost been erased from the earth. Now that Republican-led states have an administration that will approve Medicaid work requirements, they don’t seem as interested in funneling expansion enrollees to the private market.

A quick refresher: Premium assistance — which has been around in Medicaid for decades, but we’re focusing […]

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