HB 1584 — directing the department of health and human services to provide notice of medical and religious exemptions from immunization requirements and relative to notice of drug pricing options.

CHAPTER 328 HB 1584-FN - VERSIONFINAL ADOPTEDVERSION BY BOTH BODIES 12Feb2026...

CHAPTER 328 HB 1584-FN - VERSIONFINAL ADOPTEDVERSION BY BOTH BODIES 12Feb2026...

1328:1 New Paragraph;

Any printed or electronic materials relative to required childhood immunizations in RSA 141-C:20-a141- C:20-a produced by the department of health and human services and distributed in connection with school and child care enrollment on or after the effective date of this section shall include the following statement:

2328:2 New Subdivision;

3328:3 Effective Date.

LBACHAPTER 26-3239328 05/26/2026 HB 1584-FN-1584-FN FISCAL- NOTEFINAL ASVERSION AMENDED- BYPage THE2 SENATE- (AMENDMENTApproved: #s 2026-1427s, 2026-1960s, and 2026-1959s) AN ACT directing the department of health and human services to provide notice of medical and religious exemptions from immunization requirements, relative to income eligibility for the New Hampshire child care scholarship program and reallocating certain revenues to fund the program, and relative to notice of drug pricing options.

FISCALJuly IMPACT:15, 2026 Effective Date:

EstimatedI. State Impact FY 2026 FY 2027 FY 2028 FY 2029 Revenue $0 $0 $0 $0 Revenue Fund(s) None Expenditures* $0 Indeterminable Indeterminable Indeterminable Funding Source(s) General Fund, Education Trust Fund Appropriations* $0 $0 Indeterminable Indeterminable Funding Source(s) General Fund, Education Trust Fund *Expenditure = Cost of bill *Appropriation = Authorized funding to cover cost of bill METHODOLOGY:

Section 1 ofeffective thisOctober bill13, requires2026 theII. Department of Health and Human Services to provide notice of medical and religious exemptions from immunization requirements.

InRemainder responseeffective toJanuary an1, earlier2027 version of this language, the Department assumed that in the first year of implementation, it will need a part-time medical health services specialist to communicate the changes to the several hundred impacted providers.

The cost for this position was estimated to be $43,500.

It is unclear whether the position will still be needed to comply with the simplified requirement contained in this bill.

For this reason, the cost of this section is indeterminable.

Sections 2-8 amend RSA 167:83, II(r) by directing the Department of Health and Human Services to find families eligible for the child care scholarship program if their gross monthly income is less than or equal to 95 percent of the state median income (SMI).

Currently, the statute in question merely establishes the program as a departmental responsibility, and does not reference SMI with respect to eligibility criteria.

The bill makes the new eligibility standards contingent upon available funding, and restricts the following revenue sources to provide for child care scholarships:

· 50 percent of any surplus tobacco tax revenues above those estimated in the annual revenue plan;

· 50 percent of any surplus Liquor Commission profits above those estimated in the monthly revenue plan;

· 50 percent of any surplus beer tax revenues above those estimated in the monthly revenue plan;

· 50 percent of any surplus revenues collected from video lottery terminals (VLT), above those estimated in the monthly revenue plan;

and · 2 percent of certain revenues received by the Lottery Commission.

(The bill specifies revenues attributable to horse and dog racing, games of chance, bingo/Lucky 7, fantasy sports, sports betting, and video lottery terminals.) The revenue sources identified above are currently deposited into the general and education trust funds.

The bill states that no transfers to the childcare scholarship program shall take place before July 1, 2027.

As the first four sources refer to revenue above plan, the amounts that may be available for the childcare scholarship program are currently indeterminable.

The fifth component, certain revenues received by the Lottery Commission, is unique in that the bill requires two percent of all such revenues to be transferred to the childcare scholarship program, regardless of whether those revenues exceed plan.

Although it cannot be known how much revenue will be generated by the Lottery Commission in FY28 and beyond, the operating budget for FY27 assumes that approximately $164 million will be received from the sources identified in the bill.

Assuming this number is accurate in future years, the Lottery component would generate approximately $3.28 million per year for the childcare scholarship program.

This would indirectly be a cost to the general and education trust funds, as these are where such revenues are currently deposited.

With respect to the non-Lottery revenue sources, the bill contains several inconsistencies regarding the determination of surplus revenues above plan.

Section 2 refers to a surplus above the yearly revenue plan, sections 3 and 4 refer to surpluses above the monthly revenue plan, and section 5 refers to a surplus above an unidentified period's revenue plan.

With respect to possible costs, the Department of Health and Human Services states that it currently provides child care scholarships for households with income at or below 85 percent of the SMI.

The SMI for a family of four is $146,582 annually.

Therefore, the families who will become newly eligible for child care scholarships as a result of this bill are those between $124,595 (85 percent of SMI) and $139,253 (95 percent of SMI) annually.

Based on available census data, the Department concludes that approximately 6,090 children will newly qualify for the child care scholarship as a result of this bill.

At an average cost of $4,770 per year, the bill will therefore result in a total annual cost of approximately $29 million should all eligible children be provided benefits.

In addition, the Department assumes that nine new positions (one business administrator, one business system analyst, and seven social services specialists) will be needed to handle the increased caseload, at an annual cost of $560,000 in the first year of the program's expansion, increasing slightly in subsequent years as step increases are provided.

Finally, the Department anticipates needing a one-time change to the New Heights eligibility system, at a cost of $1,145,000 in the first year of the program's expansion.

As noted above, the bill makes the new eligibility criteria contingent upon available funding.

Total costs, therefore, are indeterminable and will depend on the amount of revenue received from the sources identified above.