The House Committee on Health, Human Services and Elderly Affairs voted 11–6 to advance SB134FN as amended, a bill that directs the state to implement federal Medicaid community-engagement (work) requirements for the Granite Advantage program rather than seek an 1115 waiver.

Supporters said aligning state law with federal statute avoids rework and preserves federal funding. "We have the option to do the work requirements under a state plan amendment," Henry Lippmann, the state's Medicaid director, told the committee, adding that a state-plan approach "is very important for us to meet timeframes that are in the law and for the budget for the state.”

Sponsor Representative Brett Coval introduced Amendment 3093H, which replaces the earlier waiver-centered approach, suspends overlapping state statute while federal rules apply, shortens a proposed look-back period from three months to one month for verifying participation, and requires documentary or third-party verification rather than relying on unverified self-attestation.

Opponents said the changes will create extra paperwork and barriers for people who need coverage. "What this whole overriding scheme is going to do is... prohibit many people who desperately need this support," Representative Schultz argued, citing elderly and disabled Granite Staters who may struggle with app-based verification and form submissions.

Lippmann warned of fiscal consequences if beneficiaries shift from Granite Advantage to regular Medicaid because of eligibility hurdles: "If it's only at 5% of the people that go in that direction, it could cost us $8,000,000 annually. And if it's up to 10%, it could be $16,000,000 annually." He said the department is preparing outreach and tools, including optional CMS-developed apps and ex parte verification where agency records exist.

The amendment also corrects a federal-code cross-reference to 1396A9A18 and ties exemptions to the federal statute's definitions, a change sponsors said was necessary to keep the state program eligible for federal funding when federal regulations take effect. Committee members asked for clarity on the frequency of exemption recertification, with sponsors indicating verification is expected at least quarterly in the current draft.

The committee voted 12–5 to adopt Amendment 3093H and then 11–6 on the bill as amended. Members who opposed the bill said they would press for further changes on the floor; supporters said failing to act now would risk losing federal dollars and program continuity. The committee did not vote on final enactment; the bill moves to the next stage of the legislative process.