SB 455-FN - AS AMENDED BY THE SENATE
03/05/2026 0836s
2026 SESSION
26-2204
05/08
SENATE BILL 455-FN
AN ACT relative to coverage for GLP-1 medication under the state Medicaid plan.
SPONSORS: Sen. Prentiss, Dist 5
COMMITTEE: Health and Human Services
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AMENDED ANALYSIS
This bill directs the department of health and human services to provide coverage for GLP-1 medication under the state Medicaid plan if such medication is medically necessary for a patient based on certain health conditions.
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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Matter which is either (a) all new or (b) repealed and reenacted appears in regular type.
03/05/2026 0836s 26-2204
05/08
STATE OF NEW HAMPSHIRE
In the Year of Our Lord Two Thousand Twenty-Six
AN ACT relative to coverage for GLP-1 medication under the state Medicaid plan.
Be it Enacted by the Senate and House of Representatives in General Court convened:
1 New Section; State Medicaid Plan; GLP-1 Medication. Amend RSA 167 by inserting after section 3-m the following new section:
167:3-n State Medicaid Plan; GLP-1 Medication.
I. Medical assistance under the state Medicaid plan shall include coverage for GLP-1 medication if a health care provider licensed in the state of New Hampshire has determined that such medication is medically necessary for the patient and the patient meets one or more of the following:
(a) BMI greater than or equal to 30 kg/m² (obesity); or
(b) BMI greater than or equal to 27 kg/m² with at least one weight-related comorbidity, including:
(1) Type 2 diabetes.
(2) Hypertension.
(3) Dyslipidemia.
(4) Obstructive sleep apnea.
(5) Cardiovascular disease.
(6) Prediabetes.
(7) Metabolic dysfunction associated steatotic liver disease.
II. The department of health and human services shall submit to CMS any amendment to the state Medicaid plan necessary for implementation no later than January 1, 2027.
2 Effective Date. This act shall take effect 60 days after it passage.
26-2204
11/15/25
SB 455-FN- FISCAL NOTE
AS INTRODUCED
AN ACT relative to health plan coverage of GLP-1 medications.
FISCAL IMPACT:
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Estimated State Impact | ||||||
| FY 2026 | FY 2027 | FY 2028 | FY 2029 | ||
Revenue | $0 | Indeterminable Increase (range not provided by agency) | Indeterminable Increase (range not provided by agency) | Indeterminable Increase (range not provided by agency) | ||
Revenue Fund(s) | General Fund | |||||
Expenditures* | $0 | $0 | $0 | $0 | ||
Funding Source(s) | General Fund | |||||
Appropriations* | $0 | $0 | $0 | $0 | ||
Funding Source(s) |
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*Expenditure = Cost of bill *Appropriation = Authorized funding to cover cost of bill | ||||||
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Estimated Political Subdivision Impact | ||||||
| FY 2026 | FY 2027 | FY 2028 | FY 2029 | ||
County Revenue | $0 | $0 | $0 | $0 | ||
County Expenditures | $0 | Indeterminable | Indeterminable | Indeterminable | ||
Local Revenue | $0 | $0 | $0 | $0 | ||
Local Expenditures | $0 | Indeterminable | Indeterminable | Indeterminable | ||
METHODOLOGY:
This bill requires commercial health insurance carriers to provide coverage for glucagon-like peptide-1 receptor agonist (GLP-1) medications for individuals with a body mass index (BMI) of 40 or higher, or for those with a BMI of 35 or higher with at least one qualifying comorbidity such as Type 2 diabetes, hypertension, coronary artery disease, sleep apnea, high cholesterol, or severe osteoarthritis.
The Insurance Department notes this bill expands the eligible population for GLP-1 medications beyond the current commercial coverage model, which largely mirrors Medicare’s eligibility criteria. Expanding eligibility would likely increase total claims for this class of drugs, which may lead to higher overall premiums. Increased premiums could result in higher Insurance Premium Tax revenue to the state.
To estimate the fiscal impact precisely, the Department indicates additional analysis of NH Comprehensive Health Information System (CHIS) claims data would be required to model the expanded eligible population. Because of significant overlap among conditions such as obesity, diabetes, hypertension, and hyperlipidemia, the marginal increase in eligible participants and resulting premium impact cannot be determined. However, the Department reports that as of June 30, 2025, gross expenditures for commonly prescribed GLP-1/GIP drugs exceeded $650 million statewide and are projected to surpass $1 billion by the end of plan year 2025. Based on potential induced demand of 10 to 20 percent, increased expenditures of $100 to $200 million are possible. The Department is able to provide a range if needed.
The Department of Administrative Services states the bill will have no impact on the State Employee and Retiree Health Benefit Plan, as the RSA amended applies to fully insured commercial health insurance plans and does not apply to self-funded health benefit plans like the State Employee Health Benefit Plan.
AGENCIES CONTACTED:
Insurance Department and Department of Administrative Services
| Date | Amendment |
|---|---|
| Feb. 18, 2026 | 2026-0836s |
| Date | Body | Type |
|---|---|---|
| Feb. 11, 2026 | Senate | Hearing |
| March 5, 2026 | Senate | Floor Vote |
March 16, 2026: Introduced (in recess of) 03/12/2026 and referred to Commerce and Consumer Affairs HJ 8
Feb. 26, 2026: Ought to Pass with Amendment #2026-0836s, MA, VV; OT3rdg; 03/05/2026; SJ 5
Feb. 26, 2026: Committee Amendment # 2026-0836s, AA, VV; 03/05/2026; SJ 5
Feb. 26, 2026: Committee Report: Ought to Pass with Amendment # 2026-0836s, 03/05/2026; Vote 5-0; CC; SC 8
Feb. 5, 2026: Hearing: 02/11/2026, Room 100, SH, 01:00 pm; SC 5
Nov. 21, 2025: Introduced 01/07/2026 and Referred to Health and Human Services; SJ 1