Sen. Cindy Rosenwald

Maddy summarySB 478 aims to lower prescription drug costs for New Hampshire residents by regulating pharmacy benefit managers (PBMs). It bans "spread pricing" (where PBMs keep the difference between what they pay pharmacies and charge insurers), requires all manufacturer rebates to reduce consumer out-of-pocket costs or premiums, and prohibits retroactive fees on clean claims. The bill also mandates transparent pricing lists, allows audits to prevent misuse, and prioritizes the lowest net-cost drugs in formularies. These changes directly affect patients, pharmacies, insurers, and PBMs by making drug pricing more transparent and reducing hidden costs.

Maddy summarySB 583 directs New Hampshire's Department of Education to create a public education funding transparency system tracking how state education dollars are allocated, disbursed, and spent over the past decade at the school, district, and intermediate unit levels. The system must include data visualization dashboards for state officials (like the legislature and governor) and public-facing tools showing aggregate, non-identifiable funding data. Key features require the system to integrate diverse data sources, ensure strict privacy compliance (including de-identified data and small cell suppression), and support advanced analytics for forecasting and program evaluation. The bill appropriates $900,000 for system creation and $500,000 annually for maintenance starting in 2027.

Maddy summaryHB 1390 designates the apple cider doughnut as New Hampshire's official state doughnut. This ceremonial bill adds a new section to state law (RSA 3:33) recognizing the apple cider doughnut as a symbol of the state's culinary identity. It directly affects New Hampshire's official state symbols but has no regulatory, financial, or practical impact on residents or businesses. The bill takes effect immediately upon passage and does not alter any existing laws or create new requirements.

Maddy summaryHB 1744 requires health insurance companies operating in New Hampshire to submit annual reports by March 1st starting in 2026, detailing their mental health and substance use disorder coverage practices. These reports must include data on claims denial rates, average wait times for appointments, provider network availability, and compliance with federal parity laws. The insurance commissioner will review these reports and make de-identified data publicly available, while the state Medicaid program must also report annually starting in 2027 on similar metrics. This bill establishes new transparency requirements without authorizing new funding or positions.

Maddy summarySB 666 requires 60 days' advance notice for major health care ownership changes (like hospital sales or private equity acquisitions), with detailed disclosure of ownership, debt, and financial plans. The state department reviews these transactions to prevent harm to competition, costs, or care access, and can block deals that threaten consumers. It also prohibits private equity owners from interfering with doctors' clinical decisions. Additionally, a new committee will study how health insurance practices affect costs and care for the public.

Maddy summarySB 546 requires health insurance carriers offering commercial plans in New Hampshire to implement annual secret shopper audits starting January 2027. These audits, conducted by independent third parties, assess whether providers in carriers' networks are accessible and accepting new patients, following federal CMS guidelines for health benefit exchanges. Carriers must submit results by May 31 each year, with penalties for failing to report, confirming fewer than 80% of providers as in-network, or not meeting network access standards. Noncompliant carriers face fines, must reimburse enrollees for out-of-network claims, and may be required to create corrective action plans. The law directly affects all health insurers selling commercial coverage in New Hampshire.

Maddy summarySB 547 regulates pharmacy benefit managers (PBMs) in New Hampshire to increase transparency and fairness in drug pricing. The bill requires PBMs to act in the best interest of health insurance companies (their clients) and bans them from keeping profits from "spread pricing" - where PBMs charge health plans more than they pay pharmacies for drugs. It defines key terms like "affiliate" and "revenue," and mandates that PBMs pass all rebates from drug manufacturers to health plans rather than retaining them. This directly affects PBMs, health insurers, and pharmacies, aiming to address high drug costs (23% of healthcare spending) and patient cost concerns (25% skip doses due to expense).

Maddy summarySB 536 creates a new seven-member Solid Waste Facility Site Evaluation Committee to assess proposed major waste facilities beyond standard regulatory reviews. The committee, appointed by the governor with specific expertise requirements (including local conservation and waste industry knowledge), must evaluate non-regulatory impacts like noise, odor, property values, tourism effects, and economic impacts on affected communities. This applies to facilities accepting over 100,000 tons of waste annually (excluding certain food waste facilities or municipal projects), prioritizing expansions of existing landfills over new greenfield sites. The committee will issue a certificate authorizing construction after its review, replacing the current process for evaluating broader community impacts.

Maddy summarySB 551 establishes that every individual in New Hampshire has a fundamental right to reproductive health care services permitted under state law, including abortion, contraception, and pregnancy-related care. The bill prohibits state officials from cooperating with out-of-state investigations into such care, protects health care providers from professional discipline for legally provided services, and bans malpractice insurers from considering protected care when setting premiums. It also blocks enforcement of foreign court judgments related to reproductive health care and prevents extradition for legally protected activities. This law directly affects all residents of New Hampshire, health care providers, licensing boards, and state agencies handling reproductive health services.

Maddy summarySB 483 provides $15 million in state General Fund money to the Department of Health and Human Services if federal TANF funds cannot be used for child care employer grants. This backup funding would directly support New Hampshire child care employers through recruitment and benefit grants, helping them attract and retain staff. The bill triggers this state appropriation only if the federal government fails to approve or denies the use of TANF funds for this purpose by July 1, 2026. The $15 million is nonlapsing, meaning it remains available for use in fiscal year 2027 without needing annual reapproval.