New Hampshire SB 455: relative to coverage for GLP-1 medication under the state Medicaid plan.

Bill Text

SB 455-FN - AS AMENDED BY THE SENATE

03/05/2026 0836s

2026 SESSION

 26-2204

 05/08

SENATE BILL 455-FN

AN ACT relative to coverage for GLP-1 medication under the state Medicaid plan.

SPONSORS: Sen. Prentiss, Dist 5

COMMITTEE: Health and Human Services

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AMENDED ANALYSIS

 This bill directs the department of health and human services to provide coverage for GLP-1 medication under the state Medicaid plan if such medication is medically necessary for a patient based on certain health conditions.

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 Matter which is either (a) all new or (b) repealed and reenacted appears in regular type.

03/05/2026 0836s 26-2204

 05/08

STATE OF NEW HAMPSHIRE

In the Year of Our Lord Two Thousand Twenty-Six

AN ACT relative to coverage for GLP-1 medication under the state Medicaid plan.

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

 1 New Section; State Medicaid Plan; GLP-1 Medication. Amend RSA 167 by inserting after section 3-m the following new section: 

 167:3-n State Medicaid Plan; GLP-1 Medication. 

 I. Medical assistance under the state Medicaid plan shall include coverage for GLP-1 medication if a health care provider licensed in the state of New Hampshire has determined that such medication is medically necessary for the patient and the patient meets one or more of the following: 

 (a) BMI greater than or equal to 30 kg/m² (obesity); or

 (b) BMI greater than or equal to 27 kg/m² with at least one weight-related comorbidity, including: 

 (1) Type 2 diabetes.

 (2) Hypertension.

 (3) Dyslipidemia.

 (4) Obstructive sleep apnea.

 (5) Cardiovascular disease.

 (6) Prediabetes.

 (7) Metabolic dysfunction associated steatotic liver disease. 

 II. The department of health and human services shall submit to CMS any amendment to the state Medicaid plan necessary for implementation no later than January 1, 2027. 

 2 Effective Date. This act shall take effect 60 days after it passage.

 LBA

 26-2204

 04/10/2026

SB 455-FN- FISCAL NOTE

AS AMENDED BY THE SENATE (AMENDMENT #2026-0836s)

AN ACT relative to health plan coverage of GLP-1 medications.

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

 Estimated State Impact

FY 2026

FY 2027

FY 2028

FY 2029

 Revenue

$0

$0

$0

$0

 Revenue Fund(s)

None

 Expenditures*

$0

$2 million general funds; $6.5 million federal funds

$4.3 million general funds; $14.4 million federal funds 

$4.7 million general funds; $15.9 million federal funds

 Funding Source(s)

General funds, matching federal Medicaid 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 requires the state Medicaid program to cover GLP-1 medications if determined medically necessary and if the patient meets certain criteria. The bill requires the Department of Health and Human Services to submit any necessary waiver requests to the federal Centers for Medicare and Medicaid Services by January 1, 2027, which the Department takes to mean that coverage for such medications will begin approximately on that date. The Department notes that utilization of GLP-1 drugs for weight loss has significantly increased in recent years. The Department assumes the bill will result in an expenditure increase of approximately $8.5 million in total funds in the second half of FY27 (of which $2 million will be state funds and $6.5 million will be federal funds), $18,700,000 in FY28 ($4.3 million state, $14.4 million federal), and $20.6 million in FY29 ($4.7 million state, $15.9 million federal). These calculations do not include the state share of additional administration margin or premium tax that are included in the managed care contract capitation rates. 

AGENCIES CONTACTED:

Department of Health and Human Services