Revision: June 23, 2026, 12:08 p.m.
HB 1584-FN - VERSION ADOPTED BY BOTH BODIES
12Feb2026... 0324h
05/14/2026 1427s
05/14/2026 1960s
05/14/2026 1959s
4Jun2026... 2089CofC
4Jun2026... 2178EBA
2026 SESSION
26-3239
05/08
HOUSE BILL 1584-FN
AN ACT 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.
SPONSORS: Rep. Potenza, Straf. 19; Rep. Kofalt, Hills. 32; Rep. Layon, Rock. 13; Rep. Mazur, Hills. 44
COMMITTEE: Health, Human Services and Elderly Affairs
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AMENDED ANALYSIS
This bill:
I. Directs the department of health and human services to include in certain materials relative to childhood immunization requirements a statement indicating that medical and religious exemptions to such requirements are available under state law.
II. Requires pharmacies to make efforts to notify consumers of their right to request the lowest available price for prescription drugs.
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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Matter which is either (a) all new or (b) repealed and reenacted appears in regular type.
12Feb2026... 0324h
05/14/2026 1427s
05/14/2026 1960s
05/14/2026 1959s
4Jun2026... 2089CofC
4Jun2026... 2178EBA 26-3239
05/08
STATE OF NEW HAMPSHIRE
In the Year of Our Lord Two Thousand Twenty-Six
AN ACT 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.
Be it Enacted by the Senate and House of Representatives in General Court convened:
1 New Paragraph; Notice of Medical and Religious Exemptions. Amend RSA 141-C by inserting after section 20-f the following new section:
141-C:20-g Notice of Medical and Religious Exemptions.
I. Any printed or electronic materials relative to required childhood immunizations in RSA 141-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: "Medical and religious exemptions are available under New Hampshire law." The department shall include a website link on an existing webpage detailing the current immunization exemptions under New Hampshire law.
II. The department of health and human services may adopt rules under RSA 541-A to implement this section.
2 New Subdivision; Drug Pricing Options. Amend RSA 318 by inserting after section 47-m the following new subdivision:
Drug Pricing Options
318:47-n Notice of Drug Pricing Options.
I. Every pharmacy licensed in this state shall make reasonable efforts to notify consumers of their right to request the lowest available price for a prescription drug. Such notice may include, but is not limited to, verbal instruction from pharmacy staff, signage at check out, or printed material available for consumers to read.
II. A pharmacy shall, upon request of a consumer, inform the consumer of available pricing options for a prescription drug, including the consumer’s cost under the consumer’s insurance plan, the pharmacy’s usual and customary cash price, and any available coupons, discounts, or rebate programs.
I. Section 1 of this act shall take effect 90 days after its passage.
II. The remainder of this act shall take effect January 1, 2027.
26-3239
05/26/2026
HB 1584-FN- FISCAL NOTE
AS AMENDED BY THE SENATE (AMENDMENT #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.
FISCAL IMPACT:
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Estimated 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 of this bill requires the Department of Health and Human Services to provide notice of medical and religious exemptions from immunization requirements. In response to an earlier 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:
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.
Section 9 requires pharmacies to make reasonable efforts to notify consumers of their right to request the lowest available price for prescription drugs, and to further notify them of available pricing options. This section is not anticipated to have a fiscal impact.
AGENCIES CONTACTED:
Department of Health and Human Services