SB 543 New Hampshire Senate · 2026 Regular Session

relative to long-term care eligibility and making an appropriation therefor.

SB 543 establishes provisional eligibility for Medicaid nursing facility services in New Hampshire, directly affecting long-term care applicants and nursing facilities. The bill requires the Department of Health and Human Services to grant temporary coverage within 90 days of application submission if a facility agrees to comply with program terms, without waiting for full application completion. This provisional status lasts up to 18 months or until a final eligibility decision, with facilities receiving payments during this period and required to reimburse funds if final approval is denied. The bill appropriates $1 for the 2026-2027 biennium to fund this program and creates two new positions within the department to manage it (per RSA 167:8).
Bill status failed 4 of 5 stages cleared
Introduction
Nov 2025
Committee Review
Apr 2026
Senate Passage
Jan 2026
House Passage
Apr 2026
Governor
Introduced Nov 24, 2025 Last action Apr 23, 2026
Maddy AI version diff · 1 comparison

What changed between versions

Introduced As Amended by the Senate · 2 edits
MINOR
The Senate amendment dramatically reduced the appropriation from $1,500,000 to $1, effectively eliminating the funding while preserving the bill's legislative framework. Additionally, the Crotched Mountain Rehabilitation Center was removed from the list of facilities for which counties are shielded from provisional eligibility reimbursement liability.
Scope change
The bill's practical scope was significantly narrowed: the funding was gutted (from $1.5M to $1), and one named facility (Crotched Mountain) was removed from county liability protections, potentially shifting financial exposure to counties for that facility's provisional eligibility costs.
FISCAL

The appropriation amount was reduced from $1,500,000 to $1, essentially eliminating the funding for provisional eligibility expenses while keeping the authorization language in place.

SCOPE

The Crotched Mountain Rehabilitation Center was removed from the list of facilities for which counties are not liable for provisional eligibility appropriations and payments under RSA 167:18-a, I(b). This may expose counties to reimbursement liability for that specific facility unless it is already covered under the broader 'state institutions' category.

Floor votes · House Apr 23, 2026

How they voted

9495
Passed · 34 other
Total votes 223
Apr 23, 2026
D Democratic108
92 Nay 16
85% Nay
I Independent2
1 Yea 1
50% Yea
R Republican113
93 Yea 3 Nay 17
82% Yea
Vote distribution
All Yea All Nay Mixed No data
Full legislative history

Actions timeline

Total actions
12
Key actions
5
Committee
5
Apr 23, 2026
House · Passed
House Vote: pass (94-95-34)
house
Apr 15, 2026
Lower · Passed
Minority Committee Report: Ought to Pass
lower
Apr 15, 2026
Committee
Majority Committee Report: Inexpedient to Legislate 04/15/2026 (Vote 10-8; RC)
lower
Feb 26, 2026
Introduced
Introduced (in recess of) 02/19/2026 and referred to Health, Human Services and Elderly Affairs HJ 5 P. 124
lower
Jan 29, 2026
Upper · Passed
Committee Amendment # 2026-0109s, AA, VV; 01/29/2026; SJ 2
upper
Jan 29, 2026
Upper · Passed
Ought to Pass with Amendment #2026-0109s, MA, VV; OT3rdg; 01/29/2026; SJ 2
upper
Jan 20, 2026
Upper · Passed
Committee Report: Ought to Pass with Amendment # 2026-0109s, 01/29/2026; Vote 5-0; CC; SC 3
upper
Nov 24, 2025
Introduced
Introduced 01/07/2026 and Referred to Health and Human Services; SJ 1
upper
1 primary · 6 co-sponsors

Sponsors