Healthcare

SB 134 requires New Hampshire's Department of Health and Human Services to resubmit a federal waiver application to CMS by July 1, 2025, seeking approval to enforce work requirements as a condition of Medicaid eligibility under the Granite Advantage program. The bill also mandates annual reports to the legislature starting November 1, 2025, detailing the waiver status and implementation progress. This bill does not change current Medicaid rules, as work requirements are not currently in effect; it only sets a process for the state to seek federal approval to potentially implement such requirements. The bill has no immediate cost but may lead to future expenses if the waiver is approved and implemented.

HB 1811 repeals all state-mandated vaccination requirements for children in New Hampshire, removing legal obligations for schools and childcare agencies to require immunizations or maintain related records. The bill eliminates provisions for religious and medical exemptions, attendance rules during outbreaks, and reporting requirements to health authorities. It replaces mandatory vaccination with advisory recommendations from health officials, stating schools and agencies cannot deny enrollment based on vaccination status. This directly affects parents, schools, childcare providers, and public health officials by ending the state’s enforcement of childhood immunization rules. The bill takes effect 60 days after passage.

HB 1596 raises New Hampshire's cigarette and little cigar tax from $1.78 to $2.80 per pack of 20, increasing revenue for state funds. It appropriates $18 million annually to New Hampshire's university system to restore higher education funding to 2024 levels. The bill also stops collecting premiums for two health programs: the Children's Health Insurance Program and the NH Granite Advantage health care program. These changes take effect July 1, 2026, with tobacco tax revenue funding the university appropriation and education trust fund.

This bill requires schools to obtain written parental consent for each new medical service provided to students enrolled in the Medicaid to schools program. It defines "each new service" as any new Medicaid diagnostic code (ICD code), meaning consent must be renewed for each distinct health service. The bill directly affects students receiving school-based Medicaid health services and their parents or legal guardians. Schools must implement this consent process starting January 1, 2026, and the state must submit annual reports on program costs and participation to legislative committees.