Proposed Budget for
Fiscal Years 2026 & 2027

Proposed budget changes included in the House of Representatives' budget:

The following is a list of budget changes the House proposed for fiscal years 2026 and 2027. Please note that this is not a comprehensive list of all recommended changes. We are highlighting the changes that will have the most significant impact on services and resources. 

Please keep in mind that the budget process is not yet complete. Next, the budget will go to the Senate, and the public will have another opportunity to share their thoughts and concerns.

Be sure to take a moment to review the explanation of the budget phases on our advocacy page. 

Included in HB2 amendment 1488h, passed the House on April 10, 2025.

• The Department of Health and Human Services shall reduce all Medicaid provider rates by 3% effective January 1, 2026.
  • Both the Governor and House apply "carry forward" funding to the total funds allocated to the disability service system.
    • “Carry forward” are funds allocated for services not utilized for various reasons, most commonly the unavailability of a workforce.
  • The rate reduction eliminates access to matched federal funding.
  • Although we avoided the implementation of a formal waitlist, the loss of funding impedes the service system's ability to provide services. 
  • The House Finance Committee has retained organizational footnotes in the Governor’s State Budget proposal, allowing the DHHS to request additional funds through the Joint Legislative Fiscal Committee if spending exceeds the budgeted amounts.

 

• Payment for recreational and socialization services [for individuals with a Developmental Disability] shall be limited to [$600] $595 per individual.
• This change was recommended to increase access to recreational funding by eliminating the requirements to report this resource as taxable income.
• Additionally, the legislature wants to create a charitable fund to manage this resource. The fund will be administered by the Department of Health and Human Services and will be eligible to accept donations and proceeds from charitable gaming.

 

• Extends a prior appropriation for the pilot program for young adults with developmental disabilities.
  • The pilot project will assess concepts before a comprehensive rollout of a redesign program. The pilot program shall gather data to evaluate positive or negative consequences for the beneficiary population, family, and extended support services. Topics shall include, but not be limited to, mandated and proposed changes to the waiver system, revised rate and reimbursement models, system upgrades and integration, billing and reimbursement changes, and budget and service level changes. 

 

The following were changes recommended by the Governor and advanced by the House.

• Authorizes the Department of Health and Human Services to accept additional federal funds, with fiscal committee approval for the Medicaid to schools program if necessary.
• Revises criteria for pharmacists filling name-brand and generic drug prescriptions under the Medicaid program
• Any funds appropriated to the division of Medicaid services for the biennium ending June 30, 2025, shall not lapse until June 30, 2027, and shall be treated as restricted revenue to fund expenditures for Medicaid care management. The Department of Health and Human Services is authorized to accept and expend any matching federal funds without prior approval of the fiscal committee of the general court. 
  • This allows DHHS to spend funds previously allocated for Medicaid services without requiring additional authorization, carrying forward funding from the previous budget. 
• Revises criteria for pharmacists filling name-brand and generic drug prescriptions under the Medicaid program.
  • Brand-name prescriptions must be provided and not substituted for generic brands if the prescription is noted by brand name and on the Medicaid preferred prescription list.
• The Department of Health and Human Services shall file a Medicaid state plan amendment on or before January 1, 2026, to increase the prescription drug copay amount to $4, subject to federal limitations
  on cost sharing and eligibility limitations. 
• The Department of Health and Human Services shall file a Medicaid waiver and state plan amendment, if necessary, on or before July 1, 2026, to institute premiums, subject to federal limitations on cost sharing and eligibility limitations, for individuals participating in the Granite Advantage Health Care Program who have income at or above 100 percent of the Federal Poverty Limit.
• Department of Health and Human Services; Medicaid Program; Premiums Established. The Department of Health and Human Services shall file a Medicaid state plan amendment on or before January 1, 2026, to institute premiums, subject to federal limitations, for households with children enrolled in Medicaid with income at or above 255 percent of the federal poverty limit. 
• Department of Health and Human Services; Medicaid Eligibility. To restore income verification for Medicaid redetermination to pre-public health emergency income verification standards for the biennium ending June 30, 2027, the Department of Health and Human Services shall allow the federal public health emergency Social Security Act Section 1902e(14)(A) waiver authorities to expire effective June 30, 2025

 

Next, the budget will go to the Senate, where we will have the opportunity to advocate to fully fund the disability service system. 

• Sources:
  https://gc.nh.gov/bill_status/billinfo.aspx?id=1188&inflect=2
• https://gc.nh.gov/bill_status/pdf.aspx?q=amendment&id=2025-1488H
• https://gc.nh.gov/lba/budget/operating_budgets/2026-2027/House_Finance/FULL%20House%20Budget%20briefing%204-8-25.pdf
• https://gc.nh.gov/bill_status/pdf.aspx?q=amendment&id=2025-1474H
• https://nhfpi.org/blog/house-finance-committee-state-budget-reduces-funding-by-about-643-million-from-governors-proposal-leaves-113-million-for-rainy-day-fund/?fbclid=IwY2xjawJmVBVleHRuA2FlbQIxMQABHkk-5pBWnzmQV-g9-Oji3gmYY5Ma5CEtvlUF1OfW1yWRJmHxXU5bwCmPdOVw_aem_HHiDcEms8fxzfZ3GbV6SoA

Proposed Medicaid changes included in the Governor's budget before it moved on to the House of Representatives:

The following list does not include all changes, just those most relevant to the people we serve. If you have any questions about other potential changes or feel they should be included in the list, please email Shawnna Bowman at SBowman@cbinnh.org.

HB 2 includes but is not limited to:

• Authorizes DHHS to accept additional federal funds for the Medicaid to School program with authorization from the Fiscal Committee of the general court.
• Any funds appropriated to the division of Medicaid services for the biennium ending June 30, 2025, shall not lapse until June 30, 2027, and shall be restricted revenue to fund expenditures in Medicaid care management. The Department of Health and Human Services is authorized to accept and expend any matching federal funds for the purposes of this section without prior approval of the fiscal committee of the general court.
• Revised criteria for pharmacists filling name-brand and generic-brand prescriptions under the Medicaid program.
• Directs DHHS to increase prescription drug co-pays to $4.00, subject to federal limitations on cost sharing and eligibility limitations.
• Directs DHHS to establish income-based premiums, subject to federal limitations, to participate in the Granite Advantage Health Care Program with an income at or above 100% of the federal poverty level.
• Directs DHHS to establish income-based premiums, subject to federal limitations, for families with children in the Medicaid program whose income is at or above 255% of the federal poverty limit.
• Directs DHHS to enforce pre-pandemic income standards to access Medicaid by June 30, 2027.

 

Source:

https://www.das.nh.gov/budget/

 

 

 

Join us for a Budget Webinar

Join us and others from around the state as Jim Monahan of the Dupont Group and Marissa Berg of CSNI present a webinar on April 21^st at 4:00 pm, reviewing the budget process so far and how it impacts Developmental Services.

 Topics will include how the state budget is developed, what was in each budget iteration to this point, how it would affect people with disabilities, and what you can do about it. It will be recorded and made available on the CSNI website. We will not be taking any questions, but will provide additional resources for families to learn more.

Pre-register here: https://zoom.us/webinar/register/WN_2XQofjziQDeUqeo6aO8d9Q

 

The following video is a press conference hosted by New Futures on the potential impact the proposed budget will have on social services. 

 

Current Status of the Budget for DD/ABDIHS Waiver System

Created and distributed by CSNI

Please click on the images below for a closer look.

 

 

The following resources can help you stay up to date on Federal Legislation impacting Medicaid:

• Ancor Medicaid Resource Center
• Ancor Advocacy Tool Kit