This bill mandates the New Hampshire Department of Health and Human Services to resubmit a Section 1115 demonstration waiver to the Center for Medicare and Medicaid Services (CMS) by January 1, 2026. The waiver pertains to the enforcement of community engagement and work requirements as conditions for eligibility in the Granite Advantage Health Care Program. Prior to submission, the proposed waiver must receive approval from the fiscal committee of the general court. Additionally, starting November 1, 2025, the department is required to provide an annual report to key legislative leaders and the governor regarding the status of the waiver application and the implementation of community engagement requirements.

The bill does not allocate funding or authorize new positions, and it is expected to incur indeterminable expenditures exceeding $2.5 million in FY 2026 and FY 2027. The Department of Health and Human Services has indicated that the implementation of community engagement and work requirements is contingent upon CMS approval, which is complicated by the current federal administration's stance and potential Congressional actions. The bill also highlights the need for public hearings and a comment period before the waiver can be submitted, indicating that the timeline for compliance may be affected by the availability of federal criteria and guidance.