New Hampshire SB 134: relative to work requirements under the state Medicaid program.

Bill Text

SB 134-FN - AS AMENDED BY THE SENATE

03/06/2025 0401s

2025 SESSION

 25-1122

 05/09

SENATE BILL 134-FN

AN ACT relative to work requirements under the state Medicaid program.

SPONSORS: Sen. Pearl, Dist 17; Sen. Lang, Dist 2; Sen. Murphy, Dist 16; Sen. Innis, Dist 7; Sen. McGough, Dist 11; Sen. Gannon, Dist 23; Rep. Osborne, Rock. 2; Rep. Moffett, Merr. 4; Rep. Edwards, Rock. 31

COMMITTEE: Health and Human Services

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ANALYSIS

 This bill directs the department of health and human services to resubmit the 1115 demonstration waiver to CMS regarding community engagement and work requirements under the state Medicaid program. The bill also directs the department to provide an annual report to the legislature regarding the status of implementation.

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Explanation: Matter added to current law appears in bold italics.

 Matter removed from current law appears [in brackets and struckthrough.]

 Matter which is either (a) all new or (b) repealed and reenacted appears in regular type.

03/06/2025 0401s 25-1122

 05/09

STATE OF NEW HAMPSHIRE

In the Year of Our Lord Two Thousand Twenty Five

AN ACT relative to work requirements under the state Medicaid program.

Be it Enacted by the Senate and House of Representatives in General Court convened:

 1 New Hampshire Granite Advantage Health Care Program 1115 Demonstration; Renewed Application to CMS. 

 I. On or before January 1, 2026, the department of health and human services shall resubmit to the Center for Medicare and Medicaid Services (CMS) a Section 1115 demonstration waiver to the state Medicaid plan relative to enforcing community engagement and work requirements as a condition of Granite Advantage eligibility. Prior to submitting the Section 1115 waiver to CMS, the department shall submit the proposed waiver to the fiscal committee of the general court for approval.

 II. Beginning November 1, 2025 and annually thereafter, the department shall provide a report regarding the status of the waiver application and implementation of the community engagement requirements in RSA 126-AA:2, III, to the senate president, the speaker of the house of representatives, the senate clerk, the house clerk, and the governor 

 2 Effective Date. This act shall take effect upon its passage.

 LBA

 25-1122

 4/16/25

SB 134-FN- FISCAL NOTE

AS AMENDED BY THE SENATE (AMENDMENT #2025-0401s)

AN ACT relative to work requirements under the state Medicaid program.

FISCAL IMPACT: This bill does not provide funding, nor does it authorize new positions.

 Estimated State Impact

FY 2025

FY 2026

FY 2027

FY 2028

 Revenue

$0

$0

$0

$0

 Revenue Fund(s)

None

 Expenditures*

$0

Indeterminable (See below)

Indeterminable (See below)

Indeterminable (See below)

 Funding Source(s)

General and Other Funds

 Appropriations*

$0

$0

$0

$0

 Funding Source(s)

None

 *Expenditure = Cost of bill *Appropriation = Authorized funding to cover cost of bill

METHODOLOGY:

This bill directs the Department of Health and Human Services to resubmit the 1115 demonstration waiver to the federal Centers for Medicare and Medicaid Services (CMS) regarding community engagement and work requirements under the state Medicaid program. The bill also directs the Department to provide an annual report to the legislature regarding the status of implementation.

The Department indicates that community engagement and work requirements are not currently a condition of Granite Advantage eligibility. In 2021, CMS withdrew approval of the 1115 waiver establishing the community engagement requirement and implementing the community engagement requirements would be contingent on CMS approval. The Department states that due to the change in administration at the federal level and a new Congress working on budget reconciliation in which work requirements are part of the conversation, there is a level of uncertainty relative to what Congress or CMS may require through regulations and guidance for implementing work requirements. The number of individuals under the NH Granite Advantage Health Care Program who would be subject to the community engagement work requirement would depend on the number of individuals qualifying for exemptions and what portion of the estimated 65% of working individuals would meet the requirements. The Department provided the following fiscal information regarding implementation of SB 134 as amended:

 Estimated Costs (Total Funds)

FY 2026

FY 2027

FY 2028

 Systems Upgrades, Modifications and Maintenance

$1,700,000 

$340,000 

$340,000

 Personnel Costs

1,798,000

$1,903,000 

$1,952,000

 Call Center Costs

4,800,000

$4,800,000 

$4,800,000

 Memorandum of Understanding with New Hampshire Employment Security

$357,800 

$357,800 

$357,800

 1115 Waiver Evaluation

$100