The House, Thursday, March 6, 2025

Deputy Speaker Steven SmithThe bill is on second reading and open to amendment. Rep. Read is recognized to speak on her amendment.

Rep. Ellen Read (D - Rock 10)Thank you, Mister Speaker. I'm going to say what I said a year ago in so far as that it will be a surprise to absolutely no one who knows me or even knows of me that I am a huge, vocal, passionate supporter of socialized medicine, of healthcare as a human right, of Medicare for all. But much of the opposition to the underlying bill here is the perception that it's an attack on Medicaid, an attack on medical coverage for the poorest of the poor for desperately needed medical services. So, this amendment makes the Medicaid question a non-issue because it moves dollar for dollar the savings that the department will receive in not covering non therapeutic neonatal circumcision to a vision screening, a pediatric vision screening program that almost every other state has and that has had broad support in this chamber for several years. So, I want to talk about why moving that coverage from one procedure to another or to another program is appropriate. Non therapeutic neonatal circumcision is not considered medically necessary by any medical organization in the world, including this country, including this state. No medical organization in the world considers it medically necessary. You understand that, right? Because 80% of the world is not circumcised by default and we don't circumcise any male mammal. We don't circumcise horses, dogs, cats, sheep, goats and none of them seem to have widespread problems. In fact, only one in 11,000 adult intact men have a need for a circumcision later in life. Some in this country, some medical organizations consider neonatal non therapeutic circumcision a preventative measure, but while only one in 11,000 intact men need circumcision later in life, one in 20 people will need an appendectomy, one in 7 will need their tonsils out. We do not remove the appendices of infants because they might need that surgery later. We do not remove the tonsils of infants. We don't remove any healthy tissue from an infant because they might have an infection later in life. On the other hand, one in 6 circumcised infants experience pain and excessive bleeding, one in 20 experience a serious infection and many thousands experience, like the cause of this bill going in last year, lifelong debilitating conditions such as urinary problems, recurring infections, disfigurement and sexual disfunction and in this country where 1.4 billion male babies are circumcised, about 100 little boys, one day old infants, end up dying from complications because of a circumcision. So, while those organizations may say there are some, we think, maybe benefits and perhaps the benefits might outweigh the risks, I would encourage people to ask the parents of those 100 baby boys who died whether the benefits outweigh the risk or ask the adult men who have permanent disfigurement and dysfunction whether the benefits outweigh the risks. It is the only non reconstructive, non therapeutic cosmetic procedure that we cover with taxpayer dollars. I know that culturally it's hard to move past the things that we have always considered to be normal. The expectation that we know how to predict the world helps us feel in control of the world that is not controllable. But think of this, the exact analogous procedure in a female child, the removal of the clitoral hood, is not paid for by taxpayer dollars. It is not covered under any kind of insurance. It is actually illegal, and you will be sent to prison because on a logical level, when we get beyond what's comfortable and normal and culturally acceptable, on a logical level, we know that the genital cutting of a tiny baby infant, one day old or a few hours old is wrong. We know that. So, although I passionately support single payer healthcare, I don't support this coverage anymore than I would support any other cosmetic procedure on an 8-hour old infant or anymore than I would support any procedure that could harm a baby. Surgery on a tiny piece of healthy flesh for no other reason than cultural expectation. However, I hope while it may be controversial whether there is medical benefits to it or not, I hope it's not controversial that vision is legitimate medical healthcare. In fact, all those organizations that don't think that non therapeutic neonatal circumcision is medically necessary, they think that vision care is legitimate healthcare. So, this amendment moves those savings, dollar for dollar, into a pediatric vision screening program which has been before this House multiple times, which most states have. The vast majority of states have Medicaid pay for a pediatric vision screening program because children don't know that their vision is messed up because it's the only vision they ever had so they don't realize that not seeing the blackboard or the screen is not normal. So, they don't self report that they have vision problems. As I said, most states have this. This same exact language in this amendment is the bill from the last term. It was retained in 2023. It was interim studied in 2024. DHHS was fine with it. They said that the money was fairly small. It turns out miraculously about the same amount that they will save from circumcision, which is about $100,000 or less. My side of the chamber was unanimously in support of this vision screening program the last two years. The other side was split, but there was broad support. So, passing this amendment will remove the question of whether or not it's about Medicaid and attacking social services and attacking services for the poor and make it purely what the underlying bill is about, circumcision. So, please support the amendment.

Deputy Speaker Steven SmithThe question is on the adoption of floor amendment (0768h). Are you ready for the question? All those in favor, say Aye; those opposed, Nay. The motion fails. Now on the main motion of Ought to Pass. Rep. Nagel is recognized to speak against the committee report.

Rep. David Nagel (D - Belk 6)Thank you, Mister Chairman. I'd like to begin by thanking all of the people that were involved in this discussion. Multiple stakeholders over hours and hours both in session and beyond and it was really interesting and made me think a lot and that's an important thing. Therein lies the problem with this bill. This is an incredibly complex issue and that's why I can't support the Ought to Pass motion. Basically, what it does is it reduces a very complex biopsychosocial issue to a purely biomedical one. That overly reduction is non patient centered thinking which is a trend we are trying to get away from in healthcare both in medical education and in public policy. I'm going to share an illustrative personal story because this is a really important medical concept. No, I'm not going to talk to you about my circumcision. For 20 years, I raced all over the country and even all over the world. It was great. I thought I would do it forever. Then all of a sudden, I was training once, and I felt my knee pop and I knew I tore cartilage. You know, I knew what it was and I went to see my friend who is an orthopedic surgeon, and he immediately looked at me and said you need surgery. I looked at him and I said you're treating me as a knee and not as a person. I immediately thought of the millions of different biological, psychological, social functional issues that played a role in my making a complex medical decision. I know I don't look like a physical wreck, but I also have a herniated disc. I also have carpal tunnel in both hands and both my knees are bad, and I've chosen to not have surgery, and I guarantee you that most people I raced with would have chosen to have surgery and I bet a lot of you out there would have chosen the same. What all these things have in common with circumcision is that they are all elective and they all require a whole person patient centered analysis. Different people make different choices. For those who choose surgery, interesting, Medicaid covers all of those elective things. So, circumcision has been around for a long time. I did my research and the first recorded one I could come up with was 4,000 years ago. Since that timeframe there has been billions, billions of circumcisions performed on males. I tried to find why. There is no unifying reason why. Every culture has a different reason, but in each of these cultures, it is really important to them. The magnitude of this suggests that we, as a people, find value in circumcision for a variety of reasons. In the United States, 70% of males now are circumcised. Their satisfaction rate is 90%. Contrast that with uncircumcised males who only have a satisfaction rate of 80% with their status. Interestingly, one study found that 83% of women prefer a male who is circumcised. Says nothing about who is attached to the genital but that is what they said. One of the things that we do know is that if you're going to have this done, the risk benefit ratio favors doing this in the newborn and there is clear evidence for reductions in a variety of things that the previous speaker already alluded to. Complications happen, but they are rare and the severe complications that we were told about are extremely rare. The minute the baby leaves the newborn nursery, that may explain that when Florida enacted a similar ban, they actually found that their Medicaid costs rose. They did not go down, they went up and the reason why is because when you do it later, it is dramatically more expensive. One other thing that I found that was interesting is some people brought the cost issue into this. Does anybody want to guess what the reimbursement to an OB or whomever to do a Medicaid circumcision in this state is? It's actually a little less than $50, which is not enough to cover costs, and it is most definitely not enough to cover opportunity cost, meaning the time that they could spend doing something else. With that said, I interviewed a couple of OB practices. They all said the same thing. We do it because it is patient choice, and we feel obligated to respect the wishes of our patient. Concluding, circumcision for complicated reasons remains an important part of the American healthcare paradigm. Until there is a major paradigm shift, third party payment payers such as Medicaid should respect the recommendations of the American Academy of Family Physicians and cover this procedure. I would recommend at this time, until that day happens, that we oppose the Ought to Pass motion. Thank you.

Deputy Speaker Steven SmithRep. Berch is recognized to speak against the committee report.

Rep. Paul Berch (D - Ches 6)Thank you, Mister Speaker. So, lets talk about circumcision and Medicaid. This is a bill designed to remove circumcision from Medicaid coverage in New Hampshire. Circumcision, like many procedures covered by Medicaid, is considered by the medical profession as beneficial, as recommended, but not mandatory. The professional groups that deal with procedures like circumcision are the American Academy of Pediatrics, not surprising, and the American College of Obstetricians and Gynecologists. Both have issued a policy statement that states that for newborn male circumcision, the health benefits outweigh any risks, and such benefits include prevention of UTIs, penile cancer, and transmission of some sexually transmitted infections such as HPV and HIV. If you want to reduce HPV, a very serious disease in our society today that affects women and men, support circumcision. Complications, unlike what we may have heard earlier, complications are infrequent according to the medical profession. Usually, quite minor and serious complications are very rare. In addition to concluding that newborn male circumcision is a medically beneficial procedure, the medical profession also says, and this is part of both what the academies say, that third party payments are warranted. That means Medicaid. So, question, does or should Medicaid cover beneficial, recommended, but not mandatory procedures? Actually, it's a significant part of what Medicaid does. Now, we all know that Medicaid is state administered, and it varies from state to state so let's talk about what New Hampshire covers that are beneficial but not mandatory like circumcision. Dental care, vision care, chiropractic services, hearing aids, physical therapy, podiatry services, mental health counseling, smoking cessation programs, weight loss programs and bariatric surgery. I could go one with more. So, all of these are in the same category as circumcision. This bill separates out from all of those kinds of programs, only one program, circumcision. It is a recommended procedure. It's a beneficial procedure. There is no medical argument in support of this bill. Let's also talk about the results if this bill passes. We know that circumcisions are performed across the entire spectrum of males in New Hampshire, but it is clearly associated with Jewish and Muslim practice. I am not arguing, and I will say it again, I am not arguing the difference should be paid by the state to the religious or cultural practices of any religion or any group. I am not arguing that. However, I am saying that the passage of this bill that sets circumcision apart from all the other beneficial but not mandatory procedures does send a message. I hangs a sign that says Jews and Muslims are not quite as welcome in New Hampshire as others. Many will not see that sign, but you can be sure that Muslims and Jews will. The Democratic Chair in Cheshire County is a Muslim. We don't usually talk about bills. We do some administrative talk, and he does his work, and I do mine. On this bill, he reached out to me, probably the first bill in five years and asked me to do what could be done to have it defeated. We don't need to pass this bill. It's a miniscule program. The reimbursement, as we heard, is about $50 per claim. We should not pass this bill. What we need to do is treat our neighbors as we would wish them to treat us and to follow good medical advice. Thank you.

Deputy Speaker Steven SmithRep. Soti is recognized to speak in support of the committee report.

Rep. Julius Soti (R - Rock 35)Thank you, Mister Speaker. I'm going to be brief because I know this is a broad and extensive topic. I going to clear up some myths right here and right now of what circumcision is and is not. Circumcision is when 40 to 50% of our erogenous tissue, also knows as the foreskin, is cut off from a baby boy's penis. This is medically not necessary. It cures exactly nothing. This erogenous tissue was put there for a reason. It is there to protect the head of the penis, and it is there to enhance sexual pleasure. 80% of the male population on the planet who are unaltered and intact can attest to this. Some of the myths also are that Christianity adopted circumcision, but it has not. It is a Jewish religious ceremony. It is part of the Covenant.

Deputy Speaker Steven SmithThe member will suspend for a minute. There should be one person speaking and he's at the well. Continue.

Rep. Julius Soti (R - Rock 35)It is part of the Jewish Covenant. Abraham was supposed to sacrifice his son, but in the last minute, God said no, instead we will sacrifice some sexual pleasure to bring him closer to God by cutting the penis. Christianity never, or rather, Muslims have this as part of their tradition, but they do not, the time intervals vary when they do it. Christians do not. Saint Paul made it very clear in the first century that circumcision would not be part of Christianity. Probably a great marketing move because I don't think come to Jesus, cut a piece of your penis off would have been a big seller. Next myth is that it's a good old American tradition. It is not. The men pictured on the wall behind me were not circumcised.

Deputy Speaker Steven SmithThe House will be in order. We all have to get through it. That's not at the current speaker, the whole thing. Continue please.

Rep. Julius Soti (R - Rock 35)Circumcision didn't become a thing in the US until the late 1800s and it peaked in 1970, and it's been on the decline ever since. It was in the late 1800s when the medicine was more like snake oil than science. Circumcision was promoted as a wonder cure for everything, and we are still wondering what it is curing because all of it has been debunked. It was during this time that it was promoted by puritanical prudish quacks who saw sex as the root of all evil. Circumcision was meant to be painful, and it is. It was meant to diminish sexual pleasure by cutting off an erogenous tissue. They also had some versions for women which included some sort of acid as well. Luckily for women, that never caught on. Which brings us to this bill where I would as the House today why we, the state, are paying to diminish sexual pleasure of poor people. I'll finish there. I will answer questions. I'm totally comfortable in my skin.

Deputy Speaker Steven SmithOh, dear Lord. Rep. Wheeler, you may inquire.

Rep. Jonah Wheeler (D - Hills 33)There's a lot of times in this body where I feel like I'm in high school, but none more than when the entire body laughs, laughs, laughs at every time the word penis is mentioned, but that's okay. Thank you, Representative, for taking my question. I was looking into history. I love history. I like to be well informed as I can on these issues and I found a doctor from San Diego who was cited in many medical journals, including Boston's, Maryland's and others. His name is Peter Raymundo. Would you believe, Representative, in his medical journal written in 1894 that was used for quite a long time. He cited circumcision and its benefits, one of them being from our observations and experiences and such case, we feel fully warranted in suggesting the wholesale circumcision of the negro race so as an efficient remedy in preventing the predisposition to discriminate raping. They wanted to use circumcision as a way to circumcise the entire negro race to prevent them from raping white women. Would you believe that was the justification used for circumcision back then? That was in the medical journal.

Rep. Julius Soti (R - Rock 35)Yes, I would. That was one of the quacks that was promoting circumcision back in the late 1800s.

Deputy Speaker Steven SmithRep. Granger has requested a roll call. Is that sufficiently seconded? It is sufficiently seconded. This will be a roll call vote. Members take your seats. The question is on the majority committee report of Ought to Pass on HB 94. Rep. Berch is recognized for a parliamentary inquiry.

Rep. Paul Berch (D - Ches 6)Thank you, Mister Speaker. If I know that according to the American Academy of Pediatrics and the American College of Obstetricians and Gynecologists that circumcision is beneficial surgery and its health benefits outweigh it's risks in that it helps to prevent UTIs, penile cancer and transmission of sexually transmitted infections such as HPV and HIV and that complications are infrequent, generally very minor. And if I know that Medicaid in New Hampshire and elsewhere every day pays for many beneficial but mandatory procedures and that the payment for Medicaid from Medicaid for circumcision is approximately $50. And I know that the medical profession supports third party payments for circumcision because of its medical benefits. And finally, if I believe that the passage of this bill will make Jews and Muslims feel less welcome in the Granite State, would I press the red button to vote against the OTP so that another motion can be made? Thank you, Mister Speaker.

Deputy Speaker Steven SmithRep. McFarlane is recognized for a parliamentary inquiry.

Rep. Donald McFarlane (R - Graf 18)Thank you, Mister Speaker. Mister Speaker, if I know that we rightly condemn female genital mutilation as abhorrent, yet some of my honorable colleagues would force taxpayers to fund genital cutting when it happens to boys. And if I know that this bill does not ban circumcision but simply says that the government should keep its hands off where they don't belong. And if I know that routine circumcision has no medical justification and that countries which don't routinely circumcise have lower rates of these infrequent, as the member from Westmoreland puts it, infections and complications, than we do. And if I know that we Americans can and should make female orgasms greater again. And finally, Mister Speaker, if I know that taxation is theft then would I now vote to cut unnecessary spending in the bud by pressing the green button?

Deputy Speaker Steven SmithThe House will be in order. Cooperate. I'm standing between you and your lunches and I'm comfortable. The question is on the majority committee report of Ought to Pass on HB 94 and this is a roll call vote. If you are in favor, press the red; opposed, press the green. Voting stations are open for 30 seconds. Have all members present had an opportunity to vote? The House will attend to the state of the vote. 184 in the affirmative. The House will be in order. 184 in the affirmative, 183 in the negative, the committee report is adopted.

Rep. Eileen Kelly (D - Merr 8)I'd like to make a motion, Mister Speaker.

Rep. Eileen Kelly (D - Merr 8)Mister Speaker, I would like to make a motion to lay HB 524-FN on the table and I request a division vote.

Deputy Speaker Steven SmithOkay, just asking for a division vote? The motion is to lay HB 524 on the table. Rep. Granger requests a roll call. Is that sufficiently seconded? It is. This will be a roll call vote. Members take your seats. The motion is lay HB 524 on the table. Rep. Weber is recognized for a parliamentary inquiry.

Rep. Lucy Weber (D - Ches 5)Thank you, Mister Speaker. Mister Speaker, if I know that the New Hampshire Vaccine Association is a very popular program that reduces costs by 30%, increases efficiency and increases access for those who want vaccines without coercing anybody else to have them. And if I know that it is therefore a very parent friendly program because it allows parents to choose exactly what kind of treatments they want for their children, would I now vote to table this bill so we can go on to a more productive debate?

Deputy Speaker Steven SmithRep. Kofalt is recognized for a parliamentary inquiry.

Rep. Jim Kofalt (R - Hills 32)Thank you, Mister Speaker. If I know that taxpayers deserve answers as to why the New Hampshire Vaccine Association has repeatedly refused to reimburse the state for the nearly $1 million cost of our vaccine program. And if I know that the false claims about this bill, that this bill would negatively impact New Hampshire families, deserve a response on this House floor, so that we can decide this bill on its merits. And, finally, Mister Speaker, if I know that the New Hampshire Vaccine Association suffers from a disturbing lack of transparency and accountability and that tabling this bill would obscure the issue even further by preventing debate, would I then press the red button to defeat this motion so that we can continue with the floor debate? Thank you, Mister Speaker.

Deputy Speaker Steven SmithThe question is whether to lay HB 524 on the table. This is a roll call vote. If you are in favor, press the green button, opposed, press the red. Voting stations are open for 30 seconds. Have all members present had an opportunity to vote? The House will attend to the state of the vote. 175 in the affirmative; 198 in the negative, the motion fails. Back to the main motion of Ought to Pass. Rep. LaMontagne is recognized to speak against the committee report

Rep. Jessica LaMontagne (D - Straf 17)Thank you, Mister Speaker. I rise against the Ought to Pass motion on HB 524, which would repeal the New Hampshire Vaccine Association. The association is a non-profit organization established decades ago to save money and to ensure every child has access to vaccines. It is a great example of a public private partnership that works well. It combines money from 90 commercial insurers with federal vaccines for children funds to seamlessly purchase and distribute vaccines across the state to more than 200 pediatric and family practices. It is not a tax as some have suggested. It is more like a voluntary buying club that reduces the cost of vaccines for everyone by 30%. It decreased overhead for private practices so they don't have to carefully maintain their own inventories nor directly bill insurers for every shot. It ensures that every child who enters the doctor's office or clinic can get the recommended vaccines at no cost. There is no evidence that there is any fraud at the New Hampshire Vaccine Association. Not a single insurer nor medical provider spoke in favor of its repeal and in fact, they staunchly defended the New Hampshire Vaccine Association. DHHS opposes this bill. It does not cost the state anything. In fact, if its repealed, it will cost the state money because DHHS will then have to maintain an inventory of vaccines to maintain in case of an outbreak. The system works and does not need fixing. So, what is the point of this bill? Dissolving the New Hampshire Vaccine Association will result in fewer children being vaccinated in the Granite State. This will result in outbreaks of preventable diseases as we have seen happening the US where vaccinations rates have declined. Vaccines have saved more lives than any other medical intervention in history. If you don't believe that, I have one word for you, polio. Do you think polio is not a problem anymore? There have been recent cases of paralytic polio in unvaccinated communities. This is a tragedy I know something about personally. My husbands father contracted polio in the 1955 epidemic in Massachusetts. He was a healthy 34-year-old, WWII vet who came home from work on a Friday afternoon feeling like he had the flu, and he never walked again. He had one of the worst cases of the most severe form of polio to survive. The cruel irony is that all 4 of his children, including my husband were vaccinated the year before, but they hadn't rolled out the vaccine for adults yet. The children were fine, but Bruce did survive while many died and he lived another 21 years paralyzed from the neck down, most of the time in an iron lung because the disease destroyed his voluntary nervous system and he could not breath without it, an iron lung. I knew him as a child, as our families were close, and I still remember overcoming my fear as a little girl of the man in the machine with just his head sticking out. Despite his paralyzes, he played a powerful role as a father and a member of his community, and his family was grateful that he survived. Still my husband might have been happier to have a more normal childhood where he could hike with his father in the Whites and play ball and not be changing his bed pan. Let us not go backward with the progress we've made in vaccines and please vote no on Ought to Pass.

Deputy Speaker Steven SmithRep. Kofalt is recognized to speak in support of the committee report.

Rep. Jim Kofalt (R - Hills 32)Thank you, Mister Speaker. Let me say first and foremost, this bill has nothing to do whatsoever with the merits of vaccines or the lack thereof. It's not about more vaccines or fewer vaccines. In fact, the NIH did a study and found the compulsory bulk purchase programs for vaccines do not impact vaccination rates. So, the New Hampshire Vaccine Association is probably something that most of you don't know a lot about. I didn't know a lot about it until I started to research this bill and the more, I learned the more questions I had. This is a non-profit organization created by the legislature in 2002 under RSA 126-Q. But the New Hampshire Vaccine Association is not like any other non-profit organization. For one thing, it has the power to levy assessments. I would call those taxes because they are compulsory payments levied against the insurance carriers. They are not optional. They are not voluntary. In fact, the statute contains provisions saying that the state can revoke licenses of insurance carriers that fail to make payment. They can also levy fines and penalties for late payment or non payment so it's not voluntary. Secondly, I find it very interesting that the New Hampshire Vaccine Association members, directors, employees and agents are shielded from all liability. They are immune from liability under the statute for all of their operations. The New Hampshire Vaccine Association asserts that because it is a separate non-profit organization, it is not subject to our right to know law, 91-A and they have objected to even such simple measures as posting their zoom meetings, their monthly meetings online. They said it would be burdensome to do so. So, zoom has a feature that you can livestream and turn on very easily and livestream to YouTube and its posted and maintained online. So, I think the assertion that this is overly burdensome is hyperbole. So, what we see is an organization created under state law that is unlike any other non profit I'm aware of and that suffers from a disturbing lack of transparency and accountability. So, what does the vaccine association do? Well, every year they work with the Department of Health and Human Services to estimate the number of vaccines that are going to be required for insured children in the state. They collect money or assessments from the insurance carriers, and they provide those funds for bulk purchase of vaccines. Now this only covers insured children. So insured children are covered for vaccines under the Affordable Care Act. Insurance carriers are required to pay 100% of those costs. There is no copay. So, if this bill doesn't pass, families get those vaccines without any kind of copayment. If this does pass, families get those vaccines without any kind of copayment. Let's talk about uninsured children. This doesn't affect them. Vaccines for uninsured children in Medicaid are purchased or acquired through a federally funded program called Vaccines for Children. So ostensibly, the program by assessing money from the insurance carriers and engaging in this bulk purchase of vaccines is ostensibly saving money, but does it really and at what cost? The bills opponents have cited costs of $200 to $400 per dose, depending on the vaccine. That is an MSRP. It's a little like the MSRPs on car ads. Nobody actually pays it, but by negotiating a 30% discount on that presumably they are passing that onto the insurance carriers. It's interesting, however, that not a single insurance carrier showed up at the bill hearing to testify against this bill. Only 6 states have compulsory vaccine bulk purchasing programs like New Hampshire. Most of them date back many, many years and most states have rejected such programs as being too costly and needlessly cumbersome. So, although I am yet to be convinced it is possible that insurance carriers are saving a bit of money. If that is the case, then they are doing that at a cost to New Hampshire taxpayers. Every year, the Department of Health and Human Services incurs cost close to $1 million for running the vaccine program. For fiscal year 25, that cost is estimated to be $941,303.61. Every year they submit a request to the New Hampshire Vaccine Association to pay 60% of that cost because 60% of the vaccines purchased are covered under the New Hampshire Vaccine Association program. The vaccine association, in 2018, issued a letter stating that they had no intention of ever paying this. They don't believe the statute authorizes it, so they are not covering it. That leaves taxpayers holding the bag. As I said before, those who argue that this affects vaccination rates in any way are wrong. The NIH studied compulsory programs like this and said that they were, "ineffective in increasing vaccination rates," and recommended that, "policy makers seeking to increase vaccination rates would do well to consider other policies such as addressing provider practice issues and vaccine hesitancy." So, finally I'd like to circle back to the false claims that this bill would negatively impact families. There was an editorial that appeared recently in one of our newspapers in New Hampshire stating that the vaccine association, "Removes access and financial barriers for parents who want their child to be immunized." That is not the case. They don't pay anything for the vaccine when they go to the doctor today and if this bill is passed and become law, they won't pay anything for it tomorrow or a year from now or five years from now. The claim that any child would have any less vaccine coverage is patently false. HB 524 would not result in any new costs for families, it would simply eliminate a bureaucracy that serves no legitimate purpose and that suffers from a disturbing lack of transparency and accountability. Mister Speaker, I urge my colleagues to support this bill so that we can get transparency and accountability for New Hampshire taxpayers and get government out of this business. Thank you, Mister Speaker.

Deputy Speaker Steven SmithRep. Granger requests a roll call. Is that sufficiently seconded? Oh sure, everybody wants it. This will be a roll call vote. Members take your seats. The question is on the majority committee report of Ought to Pass on HB 524. Rep. LaMontagne is recognized for a parliamentary inquiry.

Rep. Jessica LaMontagne (D - Straf 17)Thank you, Mister Speaker. If I knew that there was no credible evidence of any kind of fraud presented about the vaccination association. And if I knew that not a single insurance company came to support this bill and that many medical providers came to oppose the bill. If I knew the public spoke overwhelmingly against this bill. And if I know that dissolving the vaccine association will make it harder for children to be vaccinated in the state. And if I know that this will result in lower vaccination rates and potentially outbreaks, would I press the red button so that a better motion may be brought forward?

Deputy Speaker Steven SmithRep. MacDonald is recognized for a parliamentary inquiry.

Rep. Wayne MacDonald (R - Rock 16)Thank you, Mister Speaker. Mister Speaker, if I know that while well intentioned, New Hampshire Vaccine Association is not a cost-effective program, and it would be more efficient for vaccine providers to purchase and control their own vaccine inventories to meet the needs of the patients they serve. And, Mister Speaker, if I know that this bill will not increase the cost to parents through deductibles or copays because federal law requires that all vaccines for children be provided at no cost to the parent. Mister Speaker, if I know these things, would I then press the green button and vote Ought to Pass?

Deputy Speaker Steven SmithThe question is on the majority committee report of Ought to Pass on HB 524. This is a roll call vote. If you are in favor, press the green button. If you are opposed, press the red button. Voting stations will be open for 30 seconds. Have all members present had the opportunity to vote? The House will attend to the state of the vote. 189 in the affirmative, 181 in the negative, the committee report is adopted.