Transcript Highlights:

• <00:08:08.639> McCumber HR1 signed sincerely Kevin F.
• McCumber HR1 signed sincerely Kevin F. McCumber clerk.
• table the bill HR1 to provide for<00:08:39.039> reconciliation<00:08:39.919> pursuant<
• They are so desperate to spear smear HR1 They are so desperate to spear smear HR1 and<02:04:40.320
• HR1 so that more wins can be delivered HR1 so that more wins can be delivered to<02:07:29.440> the

Keywords: U.S. House of Representatives Floor Proceedings on Wednesday, July 2, 2025, 1012, house, all

Transcript Highlights:

• So that might be HR1, resolution one. >> Sorry, just one more.
• <00:26:50.960> So beautiful is they they call it HR1.
• So beautiful is they they call it HR1.
• So that<00:26:52.640> might<00:26:53.360> HR1 that might HR1 that might HR1 resolution<
• Um, it was another way, but HR1 was the congressional bill number and One Beautiful Bill Act was the

Keywords: 928, house, all

Summary: The committee first approved the draft minutes of its May 16, 2025 meeting, with one correction removing Representative Dry from the attendance list because she was present as a guest rather than an appointed member. The committee then received a Department of Health and Human Services update from Commissioner Lori Weaver, who focused on the rural health transformation grant process. She said the department has been gathering stakeholder input since July, issued a request for information on September 22, and is working toward an end-of-October draft and a November 3 deadline, with a grant writer request expected to go before Governor and Council at no cost to the state. The bulk of the meeting centered on federal changes affecting SNAP and Medicaid. Karen Heert explained that the federal law changes commonly referred to as the “Big Beautiful Bill” or HR1 will affect SNAP eligibility and state costs, including a shift in administrative cost sharing from 50/50 to 75/25 beginning in October 2026 and a possible state share of benefits if New Hampshire’s error rate is too high. She said the program affects about 43,000 households, that New Hampshire’s federal fiscal year 2024 error rate was 7.57% versus a national rate of 10.93%, and that the state must get below 6% to avoid liability. She also said DHS is preparing remediation steps, auditing cases, and seeking technology and staffing support, including a grant for automation and training. Henry Litman then described Medicaid changes under HB2 and the new federal law. He said New Hampshire returned to pre-pandemic eligibility verification rules on July 1, including a 10% income compatibility standard and reduced ex parte renewals, which has increased manual work and contributed to a drop in enrollment from about 185,000 in late June to about 178,000 in early September. He also reviewed new child premiums, pharmacy copays, Granite Advantage premiums, and possible Medicaid work requirements, noting that DHS is working with CMS on implementation details and may use a state plan option rather than an 1115 waiver because it would be less expensive and faster. Members asked several questions about the SNAP error-rate rules, the distinction between administrative and client errors, the effect of unpaid copays, and the timing and legal risk of the Medicaid work requirement; no votes were taken on those policy issues.

Transcript Highlights:

• okay<00:25:46.679> moving<00:25:46.919> on<00:25:47.039> to<00:25:47.279> hr1
• adopted thank you okay moving on to hr1 adopted thank you okay moving on to hr1 136<00:25:48.799

Keywords: 910, house, all

Summary: The House Committee on Transportation met on April 1 and first took up HR 63 HD1 and HCR 70 HD1, which urge the Department of Transportation to facilitate and accelerate adoption of sustainable aviation fuels to help decarbonize Hawaii’s transportation sector and meet climate goals. Testimony was mixed: supporters included representatives of Island Energy Services, Par Hawaii, Alaska/Hawaiian Airlines, Life of the Land, and the Hawaii Renewable Fuels Coalition, who said aviation emissions are a major challenge for Hawaii and that further research and development of renewable fuels is needed. Opponents, including the Environmental Caucus of the Democratic Party of Hawaiʻi and Energy Justice Network, argued the resolutions would undermine the state’s greenhouse-gas reduction commitments, rely on non-carbon-free fuels, and could create land, water, and biosecurity concerns. One member, Rep. Moroka, said his concern was the word “accelerate” because of potential damage from improperly stored biofuels. The committee voted to pass HR 63 HD1 and HCR 70 HD1, with Rep. Moroka voting no and the remaining voting members in favor. The committee then heard HR 136 and HCR 142, which urge the Hawaii Tourism Authority and the Department of Transportation to expand the airport greetings program to display kākau art in all neighbor island airports. The only noted testimony was written comments from the Hawaii Tourism Authority, and there was no additional oral testimony or discussion. The committee voted to move the measures out as is, and the recommendation was adopted without opposition. The meeting adjourned after both sets of measures were approved.

Transcript Highlights:

• We also need to take care of our rural hospitals because the HR1, excuse me, the beautiful bill as Senator
• We also need to take care of our rural hospitals because the HR1, excuse me, the beautiful bill as Senator
• We also need to take care of our rural hospitals because the HR1, excuse me, the beautiful bill as Senator
• We also need to take care of our rural hospitals because the HR1, excuse me, the beautiful bill as Senator
• We also need to take care of our rural hospitals because the HR1, excuse me, the beautiful bill as Senator

Keywords: 918, senate, all

Summary: Senate DFL leaders held a press conference focused on affordability, federal cuts, and end-of-session negotiations. Senators Heather Gustafson, Erin Maye Quade, Liz Boldon, Grant Hauschild, and Majority Leader Erin Murphy highlighted prior DFL accomplishments such as universal school meals, North Star Promise, paid family and medical leave, property tax relief, the child tax credit, and Social Security tax cuts, while arguing that House Republicans have not shown enough urgency on current affordability issues. A major theme was the impact of federal policy on Minnesota, especially cuts to Medicaid and SNAP, rising health care and energy costs, and cost shifts to counties and local governments. The senators said the state is spending heavily to backfill federal cuts and protect Minnesotans from higher costs, with particular concern for rural communities, hospitals, EMS, food shelves, and county property taxes. Hauschild emphasized that rural counties and seniors would bear added burdens from federal mandates, while Murphy said the Senate is trying to put money directly into people’s pockets through rental assistance, heating assistance, food support, and targeted property tax relief. The leaders also discussed a Senate Tax Committee proposal for about $100 million in direct property tax refunds, and Murphy said the Senate’s position on HCMC funding is the strongest, while also needing support for rural hospitals and providers statewide. In response to questions, she said the Senate hopes to reach a global deal before the weekend and by Sunday midnight, described the Senate’s proposals as public and already passed, and said some items, including rental relief for people affected by an ICE operation, still have support and may move in the House. No votes were taken at the event.

Transcript Highlights:

• Starting on January 1, 2027, HR1 will require adults without dependents receiving health coverage to
• HR1's eligibility provisions does introduce quite a few of different pieces to how we do quite a few
• educational or databases that reflect student enrollment because it is one of the exemptions identified in HR1
• were in the roundtables that we did over the interim as we were kind of preparing for the impacts of HR1
• Our estimate on based on the increase in workload and to implement HR1 in the most compassionate manner

Summary: The Assembly Budget Subcommittee on Accountability and Oversight held a hearing on how H.R. 1’s new federal work and community engagement rules will affect Medi-Cal and CalFresh, especially for Californians with behavioral health needs, people experiencing homelessness, and justice-involved individuals. The Legislative Analyst’s Office outlined the scope of the changes, including Medi-Cal work requirements beginning in January 2027 and CalFresh changes beginning in June 2026, and estimated large potential coverage losses if people cannot document exemptions or comply with reporting rules. State departments said they are still awaiting some federal guidance but are already building implementation plans, data matching, outreach campaigns, and system changes to reduce disruption and automatically identify exemptions where possible. Department of Health Care Services and Department of Social Services officials described efforts to use existing data, CalSAWS, and cross-program coordination to streamline exemption screening, including for medical frailty, serious mental illness, substance use disorders, and student status. They said outreach will include text messaging, webinars, county training, and community-based partners, while also acknowledging that many people will still need direct worker contact. County representatives stressed that the new rules will create major administrative burdens, require significant new staffing, and could lead to coverage loss if counties are not adequately funded. They urged the Legislature to release the $20 million in current-year General Fund for CalFresh implementation and to consider a much larger county augmentation next year. Assembly members pressed the administration on outreach strategy, county funding, consistency across counties, and how to avoid harming eligible people through overly aggressive implementation. They also asked about coordination with universities, CDCR, and community-based organizations, and about how exemptions would be documented for mental health and substance use conditions. Department officials said they are working with counties, education institutions, and correctional agencies, and that they are trying to align Medi-Cal and CalFresh rules where possible, but not all federal definitions match. Public commenters from legal aid, counties, labor, and public hospitals warned that work requirements do not increase employment, will worsen food insecurity and health outcomes, and will strain county systems unless the state provides more funding and support.

Transcript Highlights:

• Given the HR1 federal impacts on all things in your operation, do you have... ...a special team lined
• Do you have a team lined up, or can you establish a team that is really watching closely on HR1?
• You establish a team that is really watching closely on HR1 impacts on states and, in particular, our
• systems might be able to adjust SNAP dollars as we were trying to balance the exact same team working on HR1
• So we are laser-focused on HR1 because of the people-centeredness of what we do.

Summary: The committee heard a lengthy update on Washington child welfare from Casey Family Programs and DCYF. Dr. David Sanders said Washington has sharply reduced out-of-home care and increased kinship placements, but he flagged concerns about low screening-in rates, long stays in foster care for many children, and a recent rise in repeat maltreatment and child fatalities, especially among infants. He urged more focus on infants and young children, better coordination among child protection, health care, and law enforcement, and more proactive review and investigation practices. Members asked for disaggregated data on children lingering in care, fatalities, and causes such as fentanyl exposure. DCYF said it has increased relative placements and guardianships, but also reported a concerning rise in 2025 critical incidents, mostly near-fatalities involving children age three and under, many opioid-related. The department described responses including safe child consults for opioid cases, more training, hotspot analysis, and proposed investments in peer support, public health nurses, community referrals, and an updated safety framework. Members also discussed whether a broader commission on child abuse prevention would be useful, and DCYF said it was open to that idea. The committee then received a DSHS reorganization update from Secretary Angela Ramirez, who described the “Reimagined” plan to consolidate four administrations into three new ones, with the stated goals of reducing silos, improving customer experience, and making transitions between services smoother. She said the agency is seeking statutory changes and CMS approval to align the new structure, and members asked about preparing for federal HR1 impacts, especially SNAP. Ramirez said DSHS is monitoring those impacts closely and emphasized the need for accurate data and cross-agency coordination. Finally, DSHS’s Behavioral Health and Habilitation Administration updated the committee on residential habilitation centers and implementation of Substitute Senate Bill 5393, which phases out Rainier School by June 30, 2027 and limits new admissions. Officials reported current census and staffing levels at the state’s RHCs, said Rainier has had some residents transition to supported living or adult family homes, and explained that emergency and permanent rulemaking was needed to implement the law. They also said Rainier was recently cited by federal surveyors for not meeting the active treatment requirement for two residents, and that the facility has 90 days to return to compliance before possible payment penalties or further remedies. Members pressed for details on the citation, the meaning of active treatment, the assessment process for admissions, and whether Rainier could be repurposed for other services; DSHS said it is working on corrective action and will follow up in writing.

Transcript Highlights:

• We'll also plan to continue offering HR1 specific webinars and We'll also plan to continue offering H.R
• And the impacts of HR1, when those begin to hit, there will likely be additional uninsured individuals
• We also urge the legislature to consider funding pressures on counties due to HR1, as well as to reject
• finally, we urge you to integrate the over 9,000 certified Medi-Cal peer support specialists to do HR1
• We appreciate your comments on the challenges that counties are facing with HR1 and other policy changes

Summary: The subcommittee heard presentations from the Department of State Hospitals (DSH), the Commission for Behavioral Health, and the Department of Health Care Services (DHCS) on budget proposals and implementation updates. DSH outlined its proposed 2026-27 budget, including funding for patient operating expenses, IST solutions savings, conditional release program costs, LPS bed allocation changes, electrical infrastructure projects at Napa and Patton, SB 380 transitional housing feasibility work, and expanded dental services at Metropolitan and Patton. DSH also reported that it has met court-ordered IST treatment benchmarks in the Stiavedi v. Clinton case, with average time to initiate treatment down to about five days and pending placements reduced to roughly 250, while noting that Proposition 36 could increase referrals and SB 1323 may divert some individuals earlier into community-based treatment. Members asked about rising outside hospitalization costs, Medicare enrollment, the timing and structure of capital projects, and whether IST solution funds are being fully used; DSH said the savings reflect slower-than-expected ramp-up of community programs and that the Central California FACT replacement program is still on track for January 2027 activation. The Commission for Behavioral Health described its role under the Behavioral Health Services Act (BHSA), including data, evaluation, grantmaking, technical assistance, and transparency work. It highlighted the new statewide Innovation Partnership Fund, a five-year, $20 million-per-year program with small and large grant categories; the first RFA drew strong interest, with more than 400 questions and over 1,000 bidders’ conference participants. The Commission also discussed a proposed extension to spend down about $4.1 million remaining for the Alcove Youth Drop-in Center grants so sites can finish implementation and Stanford can complete the final evaluation. Members asked about grant duration, whether projects can be renewed, what qualifies as innovation, and whether the fund could support service delivery rather than awareness campaigns or training; the Commission said awards are expected to be three-year contracts and that proposals must be new or meaningfully expanded approaches that support BHSA priority populations. DHCS reviewed major behavioral health changes under CalAIM and BH Connect, including peer support, mobile crisis, contingency management, traditional health care practices for tribal members, updated specialty mental health access criteria, and new substance use treatment standards based on ASAM’s fourth edition. DHCS reported strong contingency management results, with more than 13,000 members served and 95% testing negative for stimulant use during treatment, and said 21 Indian health care providers have been approved to offer traditional health care practices. It also described BH Connect initiatives such as the $1.9 billion access reform and outcomes incentive program, workforce investments, evidence-based practice expansion, IMD participation by four counties, and transitional rent services. On BHSA implementation, DHCS said it is not tracking individual county contract cuts but is monitoring county plans and statewide outcomes, while stakeholders raised concerns about local prevention and service gaps. DHCS also outlined its H.R. 1 implementation strategy, including outreach, streamlined renewals, exemptions for disabled, substance use, and medically frail individuals, and proposed clinic navigator and outreach funding; it said it has not yet produced a focused estimate of H.R. 1 impacts on behavioral health populations. The discussion ended with DHCS noting that B-CHIP bond funding has supported 437 infrastructure projects, creating 546 new or expanded facilities and more than 9,500 residential beds across the state.

Transcript Highlights:

• So the last part of this issue was some questions about HR1 implementation and specifically the impacts
• And the impacts of HR1, when those begin to hit, there will likely be additional uninsured individuals
• And the impacts of HR1, when those begin to hit, there will likely be additional uninsured individuals
• Finally, we urge you to integrate the over 9,000 certified Medi-Cal peer support specialists to do HR1
• Finally, we urge you to integrate the over 9,000 certified Medi-Cal peer support specialists to do HR1

Summary: The subcommittee heard budget and policy updates from the Department of State Hospitals, the Commission for Behavioral Health, and the Department of Health Care Services. DSH described its proposed 2026-27 budget of $3.2 billion, including savings tied to IST solutions, higher patient-driven operating costs, and a small increase in caseload projections. Officials said the department has met court-ordered IST treatment benchmarks, with wait times reduced from a pandemic peak of 1,953 pending placements to about 250, and average treatment initiation now around five days. Members asked about the effects of Proposition 36 and SB 1323, rising outside hospitalization costs, Medicare enrollment, and whether IST solution funding was being overbudgeted; DSH said referrals are slightly down overall, aging and medically complex patients are driving outside care costs, and the IST solution savings reflect slower-than-expected program activation rather than a service gap. The department also outlined proposed funding for CONREP cost increases, a new county-by-county LPS bed allocation model, electrical infrastructure upgrades at Napa and Patton, SB 380 transitional housing feasibility work, and additional dental staffing and space at Metropolitan and Patton. The Commission for Behavioral Health reviewed its role in the Behavioral Health Services Act transition and its new Innovation Partnership Fund. Staff said the commission is shifting from county-level innovation oversight to a statewide grant strategy, with the first $20 million RFA drawing strong interest and awards expected in mid-June. Members asked how “innovation” would be defined, whether grants could be renewed after the initial three-year contracts, and how the state would ensure the money supports real service delivery rather than general outreach or training. The commission also sought a liquidation deadline extension for the Alcove youth drop-in center grants so remaining funds can be spent before they revert, allowing sites to finish implementation and support the final evaluation. DHCS provided an overview of CalAIM and BH Connect implementation, including updated specialty mental health access criteria, new ASAM-based substance use treatment standards, contingency management, traditional health care practices for tribal members, workforce investments, evidence-based practice expansion, IMD participation, and transitional rent services. The department also addressed BHSA implementation, saying it does not track specific local program cuts but will monitor county three-year plans, performance measures, and outcomes as counties shift to the new funding structure. On H.R. 1, DHCS said it is preparing outreach, eligibility simplification, and exemption strategies to reduce Medi-Cal coverage losses, including clinic navigators, a statewide outreach campaign, and possible employment supports through a future waiver. The department also reported that BH-CHIP bond funds have supported 437 infrastructure projects, creating 546 facilities and more than 9,500 residential beds, with additional outpatient capacity and tribal investments. Finally, DHCS outlined a proposed 988 trailer bill to create a statewide designation process for 988 centers and mobile crisis teams, with implementation no earlier than October 1, 2027.

Transcript Highlights:

• We really believe that without funding, the agency's capacity, HR1 workload increases will erode our
• The initiatives for the Income Support Division that are related to HR1 are highlighted in...
• The administrative budget is primarily around staffing and support for HR1 system implementation.
• There's also a gap in system upgrades for HR1.
• We have, in addition to all of these coverage losses related to HR1, premiums have gone up.

Keywords: 996, all

Transcript Highlights:

• to<00:23:32.720> our<00:23:32.919> last<00:23:33.679> reso<00:23:34.919> hr1
• see none moving to our last reso hr1 see none moving to our last reso hr1 147<00:23:38.120> establishing

Keywords: 910, house, all

Summary: The House Committee on Housing met on March 21, 2025, first taking testimony on several resolutions related to housing policy and building codes. HCR 1/HR 1 urged HHFDC to continue working with the City and County of Honolulu to transfer roads in the Villages of Kapolei; the committee noted one supportive testimony from HHFDC. HCR 66/HR 60 sought action by the State Building Code Council to authorize point access block, or single-stair, residential construction up to six stories; testimony included support from Housing Hawaiʻi Future and the Grassroots Institute of Hawaiʻi, and opposition from the AIA Hawaiʻi State Council. HCR 67 asked state and county officials to develop a comprehensive strategy for updated building codes; Grassroots Institute testimony was in support and AIA Hawaiʻi State Council was in opposition. HCR 78 addressed housing credits under Act 31, clarifying that qualifying projects approved before July 1, 2031, would remain eligible after repeal; HHFDC and Na Uho testified in support. HR 147 proposed a legislative working group to oversee DHHL’s use of Act 279 funds; DHHL supported the measure, along with one individual supporter who was not present. No public testimony was offered beyond those submissions, and the committee moved to decision-making after a short recess. In decision-making, the committee adopted the chair’s recommendation to pass HCR 1/HR 1 as is, with several members excused. HCR 66/HR 60 was also passed as is after discussion emphasizing the potential for lower construction costs, more design flexibility, and better ventilation from single-stair buildings. HCR 67 was passed with amendments, including removing the housing committee chairs from the recipient list and adding language calling for reinstating and adequately funding the State Building Code Council so it can carry out its mandate. HCR 78 was passed as is, and HR 147 was passed as is after brief supportive comments about DHHL accountability. The meeting then adjourned.

Transcript Highlights:

• One<01:29:44.239> provision<01:29:45.360> of<01:29:45.679> HR1 One provision of
• HR1 One provision of HR1 was<01:29:47.760> to<01:29:48.239> increase<01:29:48.719> the
• that makes uh this bill important, HR1 that makes uh this bill important, and<01:31:20.239> that<
• But HR1 changed aspects of SNAP funding, and the department now has to backfill that $4.4 million on
• But HR1 changed aspects of SNAP program.

Keywords: 1189, house, all

Transcript Highlights:

• > health transformation program grew out health transformation program grew out of<00:07:34.479> HR1
• Included in HR1 was the rural health transformation program.
• Included in HR1 was the rural health Included in HR1 was the rural health transformation<00:28:45.520
• Included in HR1 was the rural health transformation program.
• HR1 may help us expand our it be this.

Bills: HF1925

Keywords: nurse licensure, multistate license, healthcare, public safety, interstate compact, nursing regulation, 1183, house

Transcript Highlights:

• I'm here to present on the Medicaid provisions in 119 HR1.
• Um, but if provisions in 1119 HR1.
• HR1 HR1 about<01:10:05.360> the<01:10:05.600> potential<01:10:05.920> for<01:10
• And that is a fact available for anyone to read in HR1. center predicts.
• to read in in HR1. to read in in HR1.

Keywords: 00:00:22 - Call to Order and Roll Call 00:03:00 – Approval of June 25, 2025 Minutes 00:03:22 - Update on Federal Changes to the Medicaid Program 01:03:44 - State Directed Payments, Provider Taxes, and the Rural Health Transformation Fund: How Medicaid Changes Could Impact Kentucky Hospitals 01:29:42 – Public Comments 01:45:25 – Announcements 01:46:19 - Adjournment, 958, all

Summary: The Medicaid Oversight and Advisory Board met on July 30, 2025, approved the June 25 minutes, and received a presentation from Katherine Castanza of the National Conference of State Legislatures on Medicaid provisions in H.R. 1. The presentation outlined more than 20 Medicaid-related provisions, emphasizing that the largest federal savings come from work/community engagement requirements, changes to provider taxes, limits on state-directed payments, more frequent eligibility redeterminations for expansion populations, and related eligibility/enrollment changes. She said the fiscal effects are backloaded, with most reductions occurring in the later years of the 10-year window, and noted potential significant impacts on hospital payments and state financing. She also described new funding opportunities, including a $50 billion rural health transformation fund and a new home and community-based services waiver with associated grants. A substantial portion of the discussion focused on Kentucky’s pending community engagement 1115 waiver and how it would interact with the new federal requirements. Board members asked whether the waiver had been approved, what the cabinet’s contingency plan would be if CMS does not approve it, and what the timeline is for compliance. Cabinet representatives said the waiver has not yet been approved by CMS, remains under public comment, and that the state will wait for CMS guidance before moving forward; if needed, the state would amend the waiver or submit a new one. They said the work requirement must be in place by January 1, 2027, with a possible extension to 2028. Castanza also explained that expansion adults with incomes between 100% and 138% of the federal poverty level would face new cost-sharing requirements beginning October 1, 2028, and that eligibility redeterminations would move from annual to every six months starting January 1, 2027. She then walked through provider tax changes, including a moratorium on new provider taxes beginning October 1, 2026, and a phased reduction in the hold-harmless threshold for existing taxes beginning January 1, 2028, with exemptions for nursing facilities and ICF/IID providers. Board members questioned the timing and likely impact on Kentucky, and Castanza responded that the effect would depend on each tax’s current rate and would phase in over time.

Transcript Highlights:

• HR1. HR1. That<05:18:45.920> is<05:18:46.320> false. That is false. That is false.
• We're ending it in HR1. We're ending it in HR1.
• We all know the Democrats opposed HR1. We all know the Democrats opposed HR1.
• <05:35:55.520> McGovern's it advances HR1. And Mr. McGovern's it advances HR1. And Mr.
• what the Democrats voted against in HR1. what the Democrats voted against in HR1.

Keywords: U.S. House of Representatives Floor Proceedings on Wednesday, June 11, 2025, 1012, house, all

Transcript Highlights:

• And hundreds of thousands of Minnesotans will lose health care and food support because of HR1.
• and food support lose health care and food support because<00:03:46.560> of<00:03:46.799> HR1
• <00:03:48.239> Property<00:03:48.640> taxes<00:03:49.040> are because of HR1
• Property taxes are because of HR1.

Keywords: 1183, house

Transcript Highlights:

• As many of you know, HR1 contained a six-month redetermination requirement that impacts the Medicaid
• HR1 does contain many exclusions, including Native Americans, pregnant and postpartum women, parents,
• Madam Chair, Senator Gonzales, HR1 exempts it. This proposal currently as written contains...
• HR1 exempts it. This proposal currently as written contains no exemptions.

Bills: HB2408, HB2434, HB2725, HB2728, HB2729, HB2730, HB2731, HB2732, HB2733, SB1192, SB1398, SB1399, SB1494, SB1557, SB1813, SB1821

Keywords: nursing board, regulatory actions, disciplinary actions, expungement, healthcare professionalism, controlled substances, prescription monitoring, opioid crisis, healthcare regulations, patient safety, prescription drugs, opioids, healthcare, pain management, utilization controls, AHCCCS, Department of Economic Security, social services, welfare programs, vocational rehabilitation

Transcript Highlights:

• the federal of this committee, the federal government<00:12:35.839> passed<00:12:36.639> HR1
• /c><00:12:37.839> uh<00:12:37.920> the<00:12:38.079> federal government passed HR1
• And so the the bars represent from HR1.
• This chart on the federal fiscal estimates have lost federal funding from HR1.
• This chart on the federal fiscal estimates have lost federal funding from HR1.

Keywords: 918, senate, all

Summary: The Senate Rules and Administration Select Subcommittee on Federal Impacts on Minnesotans and Economic Stability met on February 20, 2026, to hear from Minnesota Management and Budget State Budget Director Anna Mingi about federal funding changes affecting the state budget. Before testimony began, Senator Rasmusson objected to a draft committee report that had been prepared in advance of the hearing, arguing it was inappropriate to summarize testimony before it occurred. The chair responded that nonpartisan staff had prepared the draft from Mingi’s submitted presentation and could revise it after the hearing if needed. Director Mingi explained that federal dollars make up more than one-third of state spending and support about 650 federal awards totaling over $23 billion this year, with more than $15 billion supporting state entitlement programs. She said the federal funding environment had changed significantly since January 2025 through executive orders, pauses, terminations, new grant conditions, delayed awards, and the July 2025 passage of H.R. 1, the federal reconciliation bill. Her main focus was H.R. 1’s effects on health care and food assistance, including work requirements for some adults, changes to eligibility for legal non-citizens, limits on retroactive Medicaid coverage and directed payments, new limits on provider taxes, and SNAP changes that shift some benefit and administrative costs to the state and counties. She estimated H.R. 1 would reduce federal funds to state-administered programs by about $327 million in the current biennium and $1.6 billion in the next, with additional costs to hospitals, counties, and other partners beyond the budget horizon. Members asked follow-up questions about whether the estimates were relative to the forecast and whether federal Medicaid funding would still rise over time. Mingi said the estimates were based on the November forecast baseline and that Medicaid federal dollars would likely continue growing overall, though the law still creates significant losses relative to prior projections. Senator Rasmusson emphasized that point in remarks to the committee. The discussion then shifted to federal grant pauses and cancellations: MMB’s tracker showed about six awards on hold totaling roughly $491 million, 13 confirmed cancellations across areas including clean energy, education, food assistance, and public health, and additional threatened or litigated cuts not included in those totals. Mingi identified two canceled violence-prevention-related grants, including a FEMA public safety grant and a justice reinvestment grant, and noted that CDC had recently moved to cancel or seek cancellation of several Minnesota public health grants, including a $65 million public health infrastructure award.

Transcript Highlights:

• However, any conversation around mitigating HR1 or federal policy more globally must balance addressing
• for this year contain additional reductions and confirm the federal administration's plans to apply HR1
• I just wanted to say that California hospitals were already under severe financial strain before HR1,
• Now with HR1, we're even in a worse situation.
• Consumers will bear the brunt of the impacts of HR1, and we can't protect household and state budgets

Summary: The hearing began with testimony from Let California Kids Hear and supporters urging action on pediatric hearing aid coverage. Advocates said California has repeatedly failed to enact a workable solution over the past eight years and argued that children need early access to sound to support development. The proposal discussed would limit the coverage mandate to the large-group market, which advocates said would cover roughly 70% to 80% of affected children and avoid the exchange-related cost issue that contributed to prior vetoes. Supporters, including parents, audiologists, and children’s health groups, backed the proposal, and the chair expressed sympathy and support while noting hope for a federal solution for exchange plans. The Department of Finance then gave opening remarks about the state’s structural deficit and the need to balance new investments against projected out-year shortfalls. HCAI followed with a broad overview of its programs, including CalRx insulin and naloxone initiatives, reproductive health grants, the Office of Health Care Affordability, hospital seismic compliance, workforce programs, and the diaper access initiative. Members asked about geographic targeting of workforce funds, the behavioral health workforce pipeline, and the status of the 21st Century Nursing Initiative, which HCAI said had reverted funds. The committee also discussed a proposed transfer of the Data Exchange Framework and Office of the Patient Advocate to HCAI, new reporting on long-term care staffing and health coverage waiting periods, and a Behavioral Health Services Act workforce proposal that would use BHSA funds to support training, stipends, and technical assistance while offsetting $100 million in General Fund spending; members and LAO questioned the offset and asked for more detail, and the item was held open. HCAI also presented the Rural Health Transformation Program, explaining that California received $233.6 million in federal funds for the first year and had to revise its proposal so that $35 million in provider payments would be tied to specific transformative activities rather than general financial relief. The program will fund rural care model redesign, workforce development, and technology/infrastructure improvements, with grants to be rolled out on a tight timeline and subject to CMS approval. Members asked about the size of California’s award, the use of funds for maternity care, labor and delivery access, dialysis, tribal set-asides, and the role of a technical assistance contractor. The department said the program will use supply-and-demand workforce modeling to target funding and that all funds must be obligated by October 30. Finally, the Department of Managed Health Care outlined its budget and two major bill-related proposals: SB 41 on PBM reform and SB 306 on prior authorization transparency. DMHC said SB 41 would require PBM licensure, ban spread pricing, require rebate pass-through, and regulate pharmacy network practices, while SB 306 would require reporting on prior authorization and create a list of services exempt from prior authorization. DMHC requested additional positions and funding to implement both measures.

Transcript Highlights:

• We've already had some under HR1.
• under HR1. under HR1. >> Thank<02:25:25.920> you.
• <02:25:43.120> and conversations this year about HR1 and conversations this year about HR1
• HR1 makes two major relates to SNAP.
• Secondly, HR1 also makes states Secondly, HR1 also makes states responsible<02:26:10.040> for<

Keywords: 1187, senate, all

Transcript Highlights:

• With the cuts in HR1, that will both impact SNAP access in Minnesota.
• So with the cuts in HR1 food to access.
• <01:23:23.760> is administrative cost share that HR1 is administrative cost share that HR1
• We're expecting that next year the impact of HR1 on our levy, just HR1, is going to be 5.4%.
• We're expecting that next year the impact of HR1 on our levy, just HR1, is going to be 5.4%.

Keywords: 1187, senate, all