This bill mandates the New Hampshire Department of Health and Human Services to resubmit a Section 1115 demonstration waiver to the Centers for Medicare and Medicaid Services (CMS) by January 1, 2026. The waiver will focus on implementing 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. Starting November 1, 2025, the department is also 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 but outlines potential costs associated with these requirements, estimating approximately $8.8 million in total funds for FY 2026, with ongoing costs in subsequent years. The legislation introduces new community engagement requirements for Medicaid beneficiaries, specifically targeting individuals who are not medically frail, with an estimated 44,310 individuals subject to these requirements and 14,903 exempt under existing statutes. The Department anticipates that around 20,000 non-medically frail Granite Advantage members could lose coverage, potentially reducing annual expenditures by approximately $171,040,800. However, the bill acknowledges that some individuals may transition to other Medicaid eligibility groups, which could increase costs due to a lower federal matching percentage. Overall, the bill aims to enhance community engagement among Medicaid beneficiaries while addressing the financial implications for the state and the Department of Health and Human Services.