Revision: June 6, 2025, 10:57 a.m.
Sen. Rosenwald, Dist 13
Sen. Watters, Dist 4
Sen. Prentiss, Dist 5
Sen. Reardon, Dist 15
Sen. Perkins Kwoka, Dist 21
Sen. Fenton, Dist 10
Sen. Altschiller, Dist 24
Sen. Long, Dist 20
June 4, 2025
2025-2703s
09/08
Floor Amendment to HB 2-FN-A-LOCAL
Amend the bill by replacing sections 16 through 23 with the following:
16 Education Trust Fund Appropriations Reductions; Education Freedom Accounts. The education trust fund appropriations to the department of education, in account 06-56-56560040-3446, class line 102, for education freedom accounts, shall be reduced by $9,844,091 for the fiscal year ending June 30, 2026, and by $18,344,091 for the fiscal year ending June 30, 2027. The department shall report to the fiscal committee of the general court on such reductions.
Amend the bill by replacing sections 139 to 142 with the following:
139 Business Profits Tax; Distribution of Funds. Amend RSA 77-A:20-a, I to read as follows:
I. The commissioner shall determine [41] 34.5 percent of the revenue produced by the tax imposed by RSA 77-A:2 for each fiscal year and shall certify such amounts to the state treasurer by October 1 of that year for deposit in the education trust fund established by RSA 198:39.
140 Business Enterprise Tax; Distribution of Funds. Amend RSA 77-E:14, I to read as follows:
I. The commissioner shall determine [41] 34.5 percent of the revenue produced by the tax imposed by RSA 77-E:2 for each fiscal year and shall certify such amounts to the state treasurer by October 1 of that year for deposit in the education trust fund established by RSA 198:39.
141 Tobacco Tax; Distribution of Funds. RSA 78:24 is repealed and reenacted to read as follows:
78:24 Distribution of Funds.
I. Tax revenue on all tobacco products sold at retail in this state imposed by RSA 78:2 shall be divided with 34.5 percent of that total revenue deposited in the education trust fund established by RSA 198:39 and the remaining revenue deposited in the general fund.
II. The commissioner shall certify such amount to the state treasurer for deposit in the education trust fund established by RSA 198:39. Such estimates shall be certified on June 1, September 1, December 1, and March 1 of each year.
142 Tax on Transfer of Real Property; Distribution of Funds. RSA 78-B:13, I, is repealed and reenacted to read as follows:
I. Tax revenue collected by RSA 78-B:1 shall be divided, with 34.5 percent of that total revenue deposited in the education trust fund established by RSA 198:39 and the remaining revenue deposited in the general fund.
Amend the bill by replacing sections 326 and 327 with the following:
326 Lapse Extension; Prescription Drug Affordability Board. All funds appropriated to account 05-95-95-952010-6273, the prescription drug affordability board, in the fiscal year ending June 30, 2025, shall be nonlapsing until June 30, 2027.
327 Effective Date. Section 326 of this act shall take effect June 30, 2025.
328 Prescription Drug Affordability Board; Funding; Registration Fees. Amend RSA 126-BB:8 to read as follows:
126-BB:8 Funding; General Funds and Voluntary Contributions.
I. The expenses and cost of operation of the board shall be funded by registration fees, general funds, or by voluntary contributions deposited in the board's dedicated fund.
II. There is established a nonlapsing fund to be known as the New Hampshire prescription drug affordability board administration fund, which shall be kept distinct and separate from all other funds. The fund shall be appropriated to and administered by the board. Voluntary contributions under this section shall be deposited in the fund. The board shall use the fund, consistent with the provisions of this chapter, to receive funds and to reimburse costs incurred by the board. The fund may be used to pay administrative, technical, legal support, or other costs incurred by the board under this chapter. The state treasurer may invest moneys in the fund as provided by law, and all interest received on such investment shall be credited to the fund. The dedicated fund shall be subject to the provisions of RSA 6:12-j.
III. Manufacturers, wholesalers, and distributors of prescription drugs intended for sale in New Hampshire shall register with the board and pay a biennial registration fee of not more than $1000.
IV. The office of professional licensure and certification or other state agencies shall provide the board with data requested to determine which entities are subject to the provisions of this section.
V. The aggregate level of all registration fees collected under this section by the board or other agency authorized by the board to collect said fees shall be an amount sufficient to meet the board’s expenditures, provided that such an amount shall not exceed 125 percent of the board’s biennial operating costs. The board may waive a registration fee under this section when a waiver is determined to be in the best interests of the board and the registering entity. The board’s biennial operating cost shall not exceed $500,000, excluding funds drawn from the dedicated prescription drug affordability board administration fund.
VI. If the total amount of registration fees collected in a state fiscal biennium exceeds 125 percent of the board’s operational costs, the board shall have the authority to adjust future registration fees downward.
VII. Any entity subject to this section that does not pay the registration fee within 30 days of payment due date may be subject to an interest penalty to be determined and collected by the board or other state agency authorized by the board to collect registration fees. Such interest shall not exceed 1.5 percent per month.
VIII. The board may refer an entity’s delinquent account to either the attorney general, the office of professional licensure and certification, or both for appropriate action.
IX. In the event of a shortfall during any state fiscal year, the governor is authorized to draw a warrant from funds not otherwise appropriated to fund the remaining amount of the board’s operating expenses, subject to the annual limitation on operating costs established in paragraph V. By June 30 of any fiscal year in which such shortfall occurs, the board shall reimburse the general fund for any such appropriation by lapsing an equivalent amount of registration fee revenue collected under this section.
Amend the bill by replacing section 493-494 with the following:
493 Department of Health and Human Services; Division of Public Health Services; Public-Private Health Care Workforce Recruitment and Retention Hub; Infrastructure Contracts.
I. The department of health and human services, division of public health services, rural health and primary care section shall amend its current contract with Bi-State Primary Care Association’s Recruitment Center to require the Recruitment Center to strengthen the infrastructure needed to sustain and transform community-based primary care services through the creation of a Public-Private Health Care Workforce Recruitment and Retention Hub that promotes collaboration across the continuum of care. Bi-State Primary Care Association shall administer the Public-Private Health Care Workforce Recruitment and Retention Hub and manage the sub-recipient contracts, and leverage federal, state, and private funding, and seek new funding opportunities when appropriate.
II. Bi-State Primary Care Association shall design the sub-recipient contracts to facilitate health care workforce development, recruitment, retention, support nursing preceptor and mentoring programs, provide training and technical assistance, and loan repayment opportunities. Bi-State Primary Care Association shall:
(a) Expand and implement its national outreach and marketing campaign designed to recruit qualified clinicians to New Hampshire;
(b) Collaborate with an area health education center for the purpose of creating and expanding graduate level nursing mentoring and precepting programs. The area health education center shall provide the necessary support to graduate level nursing preceptors and the health care organizations that act as training sites;
(c) Collaborate with an area health education center for the purpose of supporting the New Hampshire Needs Caregivers Program. This program shall promote, recruit, and fund training of up to 500 individuals interested in a career in health care as a licensed nursing assistant. The New Hampshire Needs Caregivers Program shall create scholarship opportunities to cover the cost of tuition for licensed nursing assistant training up to $2,600; supportive services; and assist individuals in finding courses and employment;
(d) Expand student loan repayment opportunities for clinicians with bachelors’ degrees employed by non-profit health care organizations in exchange for the agreement to work for the non-profit health care organization for 24 months for part-time employees to 36 months for full-time employees; and
(e) Collaborate with a family medicine residency program in rural New Hampshire at a teaching health center program to support the training of family medicine residents in the north country. The teaching health center program shall be accredited or eligible for accreditation by a nationally recognized accreditation agency.
494 Department of Health and Human Services; Rural Health and Primary Care Section; Appropriations.
I. Appropriation; Public-Private Health Care Workforce Recruitment and Retention Hub. The sum of $580,000 for the fiscal year ending June 30, 2026 and the sum of $580,000 for the fiscal year ending June 30, 2027 are hereby appropriated to the department of health and human services, division of public health services, rural health and primary care section for the purpose set forth in paragraph I of section 3 of this act. The governor is authorized to draw a warrant for said sums out of any money in the treasury not otherwise appropriated.
II. Appropriation; Workforce Recruitment, Advertising, and Marketing. The sum of $250,000 for the fiscal year ending June 30, 2026 and $250,000 for the fiscal year ending June 30, 2027 are hereby appropriated to the department of health and human services, division of public health services, rural health and primary care section for the purpose described in paragraph II(a) of section 3 of this act. The governor is authorized to draw a warrant for said sums out of any money in the treasury not otherwise appropriated.
III. Appropriation; Bi-State Primary Care Association Sub-Recipient Contract with an Area Health Education Center; Graduate Nursing Student Preceptors and Financial Support for Host Organizations. The sum of $300,000 for the fiscal year ending June 30, 2026 and the sum of $300,000 for the fiscal year ending June 30, 2027 are hereby appropriated to the department of health and human services, division of public health services, rural health and primary care section for the purpose set forth in paragraph II(b) of section 3 of this act. The governor is authorized to draw a warrant for said sums out of any money in the treasury not otherwise appropriated.
IV. Appropriation; Bi-State Primary Care Association sub-recipient contract with an area health education center; New Hampshire Needs Caregivers. The sum of $500,000 for the fiscal year ending June 30, 2026 and the sum of $750,000 for the fiscal year ending June 30, 2027 are hereby appropriated to the department of health and human services, division of public health services, rural health and primary care section for the purpose set forth in paragraph II(c) of section 3 of this act. The governor is authorized to draw a warrant for said sums out of any money in the treasury not otherwise appropriated.
V. Appropriation; Bi-State Primary Care Association sub-recipient contracts; Public-Private Health Care Workforce Recruitment and Retention Hub Loan Repayment Programs. The sum of $300,000 for the fiscal year ending June 30, 2026 and the sum of $300,000 for the fiscal year ending June 30, 2027 are hereby appropriated to the department of health and human services, division of public health services, rural health and primary care section for the purpose set forth in paragraph II(d) of section 3 of this act. The governor is authorized to draw a warrant for said sums out of any money in the treasury not otherwise appropriated.
VI. Appropriation; Bi-State Primary Care Association sub-recipient contract with a rural residency training at a teaching health center program. The sum of $500,000 for the fiscal year ending June 30, 2026 and the sum of $500,000 for the fiscal year ending June 30, 2027 are hereby appropriated to the department of health and human services, division of public health services, rural health and primary care section for the purposes set forth in paragraph II(e) of section 3 of this act. The governor is authorized to draw a warrant for said sum out of any money in the treasury not otherwise appropriated.
VII. Appropriation; Early Childhood and Family Mental Health Credential. The sum of $203,500 for the fiscal year ending June 30, 2026 and the sum of $203,500 for the fiscal year ending June 30, 2027 are hereby appropriated to the department of health and human services, bureau of children's behavioral health for the purpose set forth in RSA 167:3-l, IV(a)(2). The bureau shall use the funding to support the training of up to 60 clinicians per year of the biennium. The governor is authorized to draw a warrant for said sums out of any money in the treasury not otherwise appropriated.
VIII. Appropriation; Primary Care Workforce Program. The sum of $115,000 for the fiscal year ending June 30, 2026 and the sum of $115,000 for the fiscal year ending June 30, 2027 are hereby appropriated to the department of health and human services, division of public health services, rural health and primary care section, for an administrator I position for the purpose of administering paragraph I of section 3 of this act. The governor is authorized to draw a warrant for said sums out of any money in the treasury not otherwise appropriated.
495 Department of Health and Human Services; Medicaid Rates Paid to Opioid Treatment Providers; Appropriation.
There is hereby appropriated to the department of health and human services the sum of $2,000,000 for the fiscal year ending June 30, 2026 and the sum of $2,000,000 for the fiscal year ending June 30, 2027, for the purpose of increasing rates paid to providers of opioid treatment programs. Said amounts are intended to cover the cost of rate increases for both the traditional Medicaid population and granite advantage program population. The department may accept and expend any federal funds available for the purposes of this section without the prior approval of the fiscal committee of the general court. The governor is authorized to draw a warrant for said sums out of any money in the treasury not otherwise appropriated.
Amend the bill by inserting after section 573 the following:
574 Appropriation; Department of Health and Human Services; Family Planning Programs. In addition to any other sums appropriated, the sums of $339,219 in the fiscal year ending June 30, 2026 and $339,942 in the fiscal year ending June 30, 2027 are hereby appropriated to the department of health and human services, account 05-95-090-902010-5530, for the purpose of funding family planning programs. The governor is authorized to draw a warrant for said sums out of any money in the treasury not otherwise appropriated.
575 New Section; Financial Eligibility for Medicare Savings Program. Amend RSA 167 by inserting after section 4-f the following new section:
167:4-g Medicare Savings Program. The department shall administer the Medicare savings program as described in 42 U.S.C. section 1396a(a)(10)(E) in accordance with federal law and this section.
I. Financial eligibility for the Medicare savings program shall include:
(a) A resource disregard, thereby eliminating the resource test; and
(b) Income disregards so that a person with income that is no more than 185 percent of the federal poverty level is qualified as a qualified Medicare beneficiary and a person with income that is more than 185 percent and no more than 250 percent of the federal poverty level is qualified as a qualified individual.
II. The commissioner of the department of health and human services shall adopt rules under RSA 541-A relative to the Medicare savings program in accordance with the requirements of this section.
III. On or before November 1, 2026, the department of health and human services shall prepare and submit to the Centers for Medicare and Medicaid Services any amendments to the state Medicaid plan necessary for implementation of the Medicare savings program, including eliminating the financial eligibility resource test and increasing the financial eligibility income limits as provided in paragraph I.
576 Effective Date. Section 575 of this act shall take effect July 1, 2026.
2025-2703s
AMENDED ANALYSIS
REPLACE:
16. Reduces funding for education freedom accounts.
DELETE:
17. Requires scholarship organizations to accept and approve education freedom account applications on a rolling basis and sets an enrollment cap, excepting out priority guideline students from the cap.
REPLACE:
160. Requires manufacturers of certain prescription drugs to pay a registration fee and register with the prescription drug affordability board.
244. Expands access to primary health care services by directing the department of health and human services to amend its contract with the Bi-State Primary Care Association's Recruitment Center in order to expand health care workforce recruitment and retention efforts and increases funding for such programs and making an appropriation to the department of health and human services to increase Medicaid reimbursement rates for opioid treatment providers.
ADD:
263. Makes an appropriation to the department of health and human services for family planning services.
264. Directs the department of health and human services to remove asset limits and increase income thresholds for the Medicare savings program and to submit any amendment to the state Medicaid plan required for implementation.