Revision: May 4, 2022, 4:39 p.m.
SB 407-FN - AS AMENDED BY THE HOUSE
02/24/2022 0801s
21Apr2022... 1591h
4May2022... 1926h
2022 SESSION
22-3089
05/04
SENATE BILL 407-FN
SPONSORS: Sen. Prentiss, Dist 5; Sen. Bradley, Dist 3; Sen. Rosenwald, Dist 13; Sen. Perkins Kwoka, Dist 21; Sen. Whitley, Dist 15; Sen. Hennessey, Dist 1; Sen. Watters, Dist 4; Sen. Kahn, Dist 10; Rep. M. Murray, Hills. 22; Sen. Cavanaugh, Dist 16; Sen. Sherman, Dist 24; Sen. Gannon, Dist 23; Sen. D'Allesandro, Dist 20; Sen. Soucy, Dist 18; Rep. Nordgren, Graf. 12
COMMITTEE: Health and Human Services
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AMENDED ANALYSIS
This bill directs the department of health and human services to submit a state plan amendment to temporarily expand postpartum coverage under Medicaid, establishes a quarterly reporting requirement, and makes an appropriation to the department for the purpose of funding the postpartum health care services for a 12 month period. The program expansion is repealed March 31, 2027.
The bill also requires public employers, private employers, and postsecondary education institutions that receive public funds to accept an employee or student's request for exemption from a vaccination or other inoculation procedure on medical, religious, or right of conscience grounds.
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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Matter which is either (a) all new or (b) repealed and reenacted appears in regular type.
02/24/2022 0801s
21Apr2022... 1591h
4May2022... 1926h 22-3089
05/04
STATE OF NEW HAMPSHIRE
In the Year of Our Lord Two Thousand Twenty Two
Be it Enacted by the Senate and House of Representatives in General Court convened:
1 Title. This act shall be known and may be cited as the "Healthy Moms, Healthy Babies Act of 2022".
2 New Paragraph; Medicaid Enhancement for Children and Pregnant Women. Amend RSA 167:68 by inserting after paragraph III the following new paragraph:
IV.(a) Pursuant to the state option under the American Rescue Plan Act of 2021 to expand maternity care under Medicaid and section 1902(e)(16) of the Social Security Act (42 U.S.C. section 1396a(e)), the commissioner of the department of health and human services shall submit, no later than August 15, 2022, a Medicaid state plan amendment to the federal Centers for Medicare and Medicaid Services to establish and implement 12 months of continuous coverage for the entire postpartum period. This benefit shall be available to anyone who received medical assistance under the state plan for all pregnancy-related and postpartum medical assistance available under the state plan.
(b) The purpose of the program shall be, through ensuring continuous coverage for a 12-month postpartum period, to increase identification and mitigation of preventable pregnancy related and pregnancy associated morbidity and mortality, including those related to substance use disorder and mental illness.
(c) The medical assistance provided for a pregnant or postpartum woman under this section shall, consistent with Section 1902(e)(16) include all items and services covered under the state plan that are not less in amount, duration, or scope, or are determined by the Secretary to be substantially equivalent, to the medical assistance available for an individual described in subsection (a)(10)(A)(i); and be provided for the individual while pregnant and during the 12-month period that begins on the last day of the individual’s pregnancy and ends on the last day of the month in which such 12-month period ends.
(d) On January 1, 2023, the commissioner shall begin submitting quarterly reports to the oversight committee on health and human services, the legislative committees with jurisdiction over health and human services, and the governor regarding the department's progress in obtaining and implementing the state plan amendment. The quarterly reports shall include the department's plans for reducing administrative burdens for enrollees and the department’s efforts to expand access and participation to voluntary, evidence-based maternal home visiting programs, pursuant to subparagraph (a). Reports submitted under this paragraph shall also be posted on the department's website.
(e) The department shall include in its biennial request for appropriations under RSA 9:4, not less than $200,000 for each fiscal year, for the purpose of providing the postpartum health care services required under this paragraph.
3 Appropriation. The sum of $200,000 for the biennium ending June 30, 2023 is hereby appropriated to the department of health and human services for the purpose of expanding postpartum health care services under the state Medicaid plan as provided in section 2 of this act. The governor shall determine if any discretionary funds appropriated in the American Rescue Plan Act of 2021, Public Law 117-2, or any other federal funds, can be used for this purpose, and the commissioner shall expend such federal funds for this purpose. Any remainder shall be appropriated from the general fund. The governor is authorized to draw a warrant for the general fund portion of such sum from any money in the treasury not otherwise appropriated.
4 Prospective Repeal. RSA 167:68, IV, relative to Medicaid coverage of postpartum health care services for a 12-month period, is repealed.
5 Legislative Findings. The general court finds that:
I. It is the longstanding public policy of New Hampshire to protect the rights of its citizens to live free; and
II. The state of New Hampshire has affirmed in statute the natural, essential, and inherent right to individual bodily integrity. Therefore, citizens shall have the right to choose what, if any, substances are injected into their bodies, including without limitation, any mandated vaccine.
6 New Subdivision; Labor; Protective Legislation; Exemption from Vaccination Mandates. Amend RSA 275 by inserting after section 77 the following new subdivision:
Exemption from Vaccination Mandates
275:78 Exemption from Vaccination Mandates; Public and Private Employers.
I. Any public or private employer that receives public funds from the federal or state government or any subdivision thereof, whether such funds are in the form of payment for contractual services, grants, or in any other form however denominated, and irrespective of the amount or level of such funding, and mandates any vaccine, inoculation, or immunization procedure, shall offer an employee the opportunity to submit a request for a medical, religious, or right of conscience exemption.
II. An employee's written request for exemption shall simply state: “I, (employee name), hereby submit a request for a medical, religious, or right of conscience exemption from the mandated vaccination or inoculation. [employee signature and date]”. Such request for exemption shall be granted. The employer may then work with the employee to see if an agreement for a reasonable accommodation can be reached.
III. If any provision of this section or its application to any person or circumstances is held invalid, such invalidity shall not affect other provisions or applications of this section that can be given effect without the invalid provision or application, and to this end the provisions of this section are severable.
7 New Chapter; Exemptions from Vaccination Mandates in
Postsecondary Educational Institutions. Amend RSA by inserting after chapter 200-N the following new chapter:
CHAPTER 200-O
EXEMPTIONS FROM VACCINATION MANDATES IN
POSTSECONDARY EDUCATIONAL INSTITUTIONS
200-O:1 Exemptions from Vaccination Mandates; Postsecondary Educational Institutions.
I. Any postsecondary educational institution that receives public funds from the federal or state government or any subdivision thereof, whether such funds are in the form of payment for contractual services, grants, or in any other form however denominated, and irrespective of the amount or level of such funding, and mandates any vaccine, inoculation, or immunization procedure, shall offer each student the opportunity to submit a request for a medical, religious, or right of conscience exemption.
II. A student's written request for exemption shall simply state: “I, (student name), hereby submit a request for a medical, religious, or right of conscience exemption from the mandated vaccination or inoculation. [student signature and date]”. Such request for exemption shall be granted. The school may then work with the student to see if an agreement for a reasonable accommodation can be reached.
200-O:2 Severability. If any provision of this chapter or its application to any person or circumstances is held invalid, such invalidity shall not affect other provisions or applications of this chapter that can be given effect without the invalid provision or application, and to this end the provisions of this chapter are severable.
I. Section 4 of this act shall take effect March 31, 2027.
II. The remainder of this act shall take effect upon its passage.
22-3089
Revised 1/19/22
SB 407-FN- FISCAL NOTE
AS INTRODUCED
FISCAL IMPACT: [ X ] State [ ] County [ ] Local [ ] None
|
| |||
| Estimated Increase / (Decrease) | |||
STATE: | FY 2022 | FY 2023 | FY 2024 | FY 2025 |
Appropriation | $200,000 | $0 | $0 | $0 |
Revenue | $0 | $0 | $0 | $0 |
Expenditures | Indeterminable | $200,000 - $1,000,000 state general funds; indeterminable matching federal funds |
$200,000 - $1,000,000 state general funds; indeterminable matching federal funds
|
$200,000 - $1,000,000 state general funds; indeterminable matching federal funds
|
Funding Source: | [ X ] General [ ] Education [ ] Highway [ X ] Other - Federal matching funds | |||
METHODOLOGY:
This bill requires the Department of Health and Human Services to submit a state plan amendment expanding postpartum coverage under Medicaid. The Department notes that currently, the state provides Medicaid coverage to pregnant women with incomes up to 196 percent of the federal poverty level (FPL) for 60 days postpartum, which would be extended to 12 months under the bill. In addition, the Granite Advantage Program currently covers individuals with incomes up to 138 percent of the FPL. Accordingly, the Department states the bill will effectively provide 10 months' worth of postpartum coverage for those between 138 percent and 196 percent of the FPL. As of December 2021, the Department was awaiting guidance from the federal Centers for Medicare and Medicaid Services (CMS) regarding the availability of an enhanced Federal Medical Assistance Percentage (FMAP) for these services. Depending on the FMAP available and the number of individuals eligible for the extended coverage, the Department estimates an annual increase in state general fund expenditures of $200,000 to $1,000,000 per year.
This bill contains an appropriation of $200,000 in FY 2022. If federal funds are available under the American Rescue Plan Act of 2021 (ARPA), those shall be used first, with state general funds used for the remainder.
AGENCIES CONTACTED:
Department of Health and Human Services