HB 524 repeals RSA 126-Q, which is the statute creating the New Hampshire Vaccine Association (NHVA). The bill would eliminate the association’s role in collecting payments from commercial insurers and third-party administrators to help fund the state’s universal childhood vaccine purchasing program. Under current law, the NHVA reimburses the state for the non-governmental share of vaccine costs for privately insured children, allowing providers to access vaccines through the centralized program rather than purchasing and billing them individually.
If enacted, the bill would shift privately insured children’s vaccine purchasing and billing responsibilities away from the NHVA system and back to provider sites, such as hospitals and federally qualified health centers. The fiscal note estimates about a $24 million annual reduction in NHVA revenue and a corresponding decrease in vaccine-related expenditures, while also anticipating new general fund costs for outreach and for vaccine purchases during public health response activities. The Insurance Department notes that insurers could lose access to current vaccine purchasing discounts and face higher administrative costs, which could increase premiums and potentially raise insurance premium tax revenue.
Impact
The bill would repeal the statutory framework for the New Hampshire Vaccine Association and remove the legal basis for its funding and reimbursement structure. That would affect the state’s universal vaccine purchasing program for children, especially the portion serving privately insured patients under age 19, and would require providers and insurers to adjust how vaccines are purchased, billed, and inventoried. It would also likely shift some costs from the NHVA-funded system to private insurers, providers, and potentially the state general fund for outbreak and emergency vaccine needs.
Sentiment
The available voting history suggests the bill was controversial and closely divided. On March 6, 2025, one recorded vote to table the bill failed 175-198, and a recorded OTP vote passed 189-181, indicating narrow support and substantial opposition. No committee transcript is available, but the fiscal note shows both potential savings and significant operational and cost-shifting concerns, which likely contributed to the split sentiment.
Contention
The main point of contention is whether repealing the NHVA would reduce state involvement and eliminate a payer-funded mechanism for vaccine purchasing, or instead increase costs and administrative burdens elsewhere in the system. Supporters appear to favor ending the association, while opponents are likely concerned about losing vaccine price discounts, disrupting the universal purchasing program, and shifting costs to insurers, providers, and the state. Another disputed issue is the fiscal effect: the bill reduces NHVA revenue and vaccine payments, but may increase insurance premium tax revenue if premiums rise.