HB 524-FN - AS INTRODUCEDAMENDED SESSIONBY 25-0200THE 05/02SENATE HOUSE7Jan2026... BILL 524-FN AN ACT repealing the New Hampshire vaccine association.

3021h 04/16/2026 1423s SESSION 25-0200 05/02 HOUSE BILL 524-FN AN ACT relative to disbursement of funds by the New Hampshire vaccine association.

Health, Human Services and Elderly Affairs ───────────────────────────────────────────────────────────────── AMENDED ANALYSIS This bill repealsdirects RSAthe 126-Q,New relativeHampshire vaccine association to disburse funds collected through assessments by the Newend Hampshireof vaccineeach association.fiscal year to the extent practicable.

HB 524-FN - AS INTRODUCEDAMENDED 25-0200BY 05/02THE STATESENATE OF7Jan2026... NEW HAMPSHIRE In the Year of Our Lord Two Thousand Twenty Five AN ACT repealing the New Hampshire vaccine association.

3021h 04/16/2026 1423s 25-0200 05/02 STATE OF NEW HAMPSHIRE In the Year of Our Lord Two Thousand Twenty Five AN ACT relative to disbursement of funds by the New Hampshire vaccine association.

1 Repeal.New Paragraph;

RSA 126-Q, relative to the New Hampshire vaccineVaccine association,Association; is repealed.

2Powers Effectiveand Date.Duties.

Amend RSA 126- Q:5 by inserting after paragraph II the following new paragraph:

III.

Assessments collected by the association, including funds deposited in the state vaccine purchase fund under RSA 141-C:17-a, shall be disbursed by the end of each fiscal year to the extent practicable and not to exceed 90 days thereafter.

2 Vaccine Association;

Collection of Assessments.

Amend RSA 126-Q:3, V(m) to read as follows:

(m) Collect assessments from assessable entities as calculated under RSA 126-Q:4 and annually deposit said assessments, less the association's administrative costs [annually] and reserves, with the state treasurer [to the credit of] for deposit in the vaccine purchase fund established pursuant to RSA 141-C:17-a.

At the written request of the association following a majority vote of the board of directors, any funds forwarded to the state treasurer for the vaccine purchase fund remaining unexpended for childhood vaccines, shall promptly be returned to the association.

3 Effective Date.

LBA 25-0200 Revised05/06/2026 3/5/25 HB 524-FN- FISCAL NOTE AS INTRODUCEDAMENDED BY THE SENATE (AMENDMENT #2026-1423s) AN ACT repealingrelative to disbursement of funds by the New Hampshire vaccine association.

ThisThe Office of Legislative Budget Assistant states this bill doeshas notno providefiscal funding,impact noron doesstate, itcounty authorizeand newlocal positions.expenditures or revenue.

Estimated State Impact FY 2025 FY 2026 FY 2027 FY 2028 $24 million $24 million $24 million decrease in decrease in decrease in NHVA revenue;

NHVA revenue;

NHVA revenue;

Indeterminable Indeterminable Indeterminable Revenue $0 increase in increase in increase in insurance insurance insurance premium tax premium tax premium tax revenue revenue revenue Revenue Fund(s) NH Vaccine Association revenue;

insurance premium tax revenue $24 million $24 million $24 million decrease in decrease in decrease in existing vaccine existing vaccine existing vaccine payments;

payments;

payments;

Expenditures* $0 approximately approximately approximately $194,000 in new $100,000 in $100,000 in new general fund new general general fund costs fund costs costs Funding Source(s) NH Vaccine Association revenue, state general 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 repeals RSA 126-Q, the statute establishing the New Hampshire Vaccine Association (NHVA).

The Department of Health and Human Services states that the NHVA collects payments from approximately 80 commercial payers and third-party administrators, and uses these funds to reimburse the Department for the non-governmental share (approximately 60 percent) of the state's universal vaccine purchasing program for children.

The Department anticipates annual revenue decreases of $24 million as a result of the bill.

State expenditures would decrease by the same amount, as provider sites (hospitals, federally-qualified health centers, etc) would then be responsible for privately purchasing, billing and maintaining immunization inventories for privately-insured patients under the age of 19.

The Department estimates that it will need one temporary, part-time positions to communicate these changes to providers, at a cost of $44,000 in FY26.

In addition, as the Department would no longer receive NHVA reimbursement for immunizations purchased for commercially-insured children, it would need funds to purchase vaccines during public health response activities in case of disease outbreaks, disaster relief efforts, etc.

The Department estimates these costs at $150,000 in FY26 and $100,000 annually in subsequent years.

The Insurance Department estimates that payers save approximately 30 percent off the list price of vaccines by participating in the existing program.

The Department states that if the NHVA is eliminated, health insurers may lose access to these savings, potentially leading to increased health care costs, as insurers would need to pay more for vaccines.

Additionally, insurers might experience increased administrative costs, as they would be required to process claims for the reimbursement of childhood vaccines, which is currently not necessary under the universal purchasing program.

These increased costs could exert upward pressure on premiums and, in turn, may increase the amount of insurance premium tax collected.

DepartmentsNone of Insurance and Health and Human Services