New Hampshire is operating its statewide health insurance exchange through a partnership with the federal government. While the launch of the exchange did little to change the competitive landscape in the state in 2014 (only one carrier participated), the exchange became highly competitive with four new carriers joining. However, after a short two years, both Minuteman Health and Community Health Options have withdrawn from the New Hampshire exchange market leaving consumers to choose from three carriers. New Hampshire was the fourth state to implement a work requirement under its Medicaid waiver expansion that goes through 2023, though it was blocked by a federal judge and will likely never be implemented. The state will also shift Medicaid recipients off of exchange plans and into managed Medicaid. Anthem controls the exchange and commercial market share, while UnitedHealthcare dominates the Medicare Advantage market.

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