Transcript Highlights:

• </c> a Medicaid work requirement. a Medicaid work requirement.
• So, uh part of Medicaid covered funds.
• Lipman with the now expanded title here to speak on Medicaid enhancement for children, Medicaid enhancement
• </c> uh, post delivery coverage in Medicaid. uh, post delivery coverage in Medicaid.
• </c><01:14:12.719><c> recipients</c> the percentage of Medicaid recipients the percentage of Medicaid

Summary: The committee met on January 23, 2026, to approve prior minutes and receive an update from the Department of Health and Human Services. The main presentation focused on “Project Compass,” an internal cross-department effort to prepare for changes to Medicaid and SNAP eligibility. Department staff said the goal is to maintain continuous coverage for eligible people, align policy, operations, communications, legal, finance, and eligibility work, and use the new integrated New HEIGHTS system to streamline implementation. They emphasized outreach to beneficiaries, providers, managed care organizations, and other partners, and said temporary manual workarounds had already been used to stay in compliance with fast-moving SNAP changes. Members questioned how the department would avoid repeating the costly outreach effort used in a prior Medicaid work-requirement rollout. Department officials said they are focusing on ex parte processes, sharing eligibility information across programs, and using community partners to reduce duplicate contacts and paperwork. They also said the department is monitoring the SNAP error rate closely, expects automation and a planned system contract amendment to help reduce it, and noted that current error rates are trending downward and remain below the national average. Questions were also raised about possible future SNAP restrictions on certain foods; the department said it can implement whatever the legislature directs, but that defining and administering such restrictions would be complex. The commissioner and CFO then outlined the department’s budget reduction plan. They said the department has begun implementing required “back of the budget” reductions for fiscal year 2026, using contract savings and not cutting existing services where possible. Examples included dental and home-visitation contracts, where spending was adjusted based on utilization and projected need. Officials said they had already written down a little over $15 million in prior-year encumbrances, but that this one-time source will not be available next year, making fiscal year 2027 more difficult. They also explained the difference between legally required back-of-budget cuts and lapse, and said staffing remains a major challenge because vacancies have increased and customer-facing service levels are strained. Dr. Jonathan Ballard then began an update on opioid overdose fatalities, presenting the latest medical examiner data and describing the long-term rise in deaths after fentanyl entered the illicit drug supply, with a peak in 2017 and a later increase in 2022. The transcript cuts off before his full presentation and any further committee action beyond discussion of the minutes and receipt of the department updates.

Transcript Highlights:

• First, the House budget proposed restoring the full 15 percent capital Medicaid reimbursement for the
• , at a time when Medicaid is the largest program in our state budget.
• , at a time when Medicaid is the largest program in our state budget.
• IN TERMS OF THE MEDICAID PROGRAM IT IS A VITAL PROGRAM FOR THE ELDERLY INDIVIDUALS, WITH DISABILITIES
• AND LONE NEW YORKERS, HOWEVER WE ARE CONCERNED ABOUT THE CONTINUED EXPANSION OF THE MEDICAID PROGRAM

Summary: The Joint Budget Subcommittee on Health convened as part of the 2026 Annual Budget Committee, with Senate and Assembly co-chairs introducing members, alternates, and the meeting rules. The chairs reviewed subcommittee procedures, including limits on alternates’ voting rights, no proxy participation, germane-topic restrictions, and the requirement that any report receive an affirmative majority vote from each house’s delegation. The co-chairs outlined the main health budget issues under discussion: the global cap, capital funding, hospital and safety-net hospital funding, early intervention, reproductive health, the Medical Indemnity Fund, aging issues, insurance prior authorization, EMS biomarkers, and nursing home funding. The chair emphasized the state’s responsibility to families affected by the Medical Indemnity Fund. Minority members raised support for restoring the full 15 percent capital Medicaid reimbursement for nursing homes, increasing aid for financially distressed hospitals, and addressing home care funding shortfalls. They also urged stronger measures against Medicaid waste, fraud, and abuse, warning against budget gimmicks and emphasizing long-term fiscal sustainability, including careful use of any Medicaid savings tied to the federal 1331 health program. The meeting ended with members saying they would continue consultations with each other and staff to work toward a final, on-time budget.

Transcript Highlights:

• The Trump administration increased the out-of-pocket maximum limit for Medicaid enrollees.
• Those hospitals in rural areas will have most of their patients on Medicare and Medicaid.
• or everybody lose Medicaid dollars.
• </c><00:15:24.800><c> or</c> 150,000 Minnesotans off Medicaid or 150,000 Minnesotans off Medicaid or
• </c><00:15:26.800><c> Um,</c> everybody lose Medicaid dollars. Um, everybody lose Medicaid dollars.

Summary: Senate DFL senators discussed the Health and Human Services supplemental budget on the floor, framing it as a response to federal HR 1 and related Trump administration policies that they said shift costs to states, counties, hospitals, and families. Senators Liz Bolden, Lindsey Port, Erin Murphy, Alice Mann, and Rob Kupec argued the bill is needed to backfill cuts to Medicaid and SNAP, stabilize hospitals, and prevent property tax increases and service disruptions. They said the package totals about $700 million, with more than $250 million aimed at hospital support and roughly $300 million to help counties absorb food-support cost shifts. Members described the federal changes as adding red tape and work-reporting requirements that would cause eligible people to lose coverage, with estimates cited of more than 150,000 Minnesotans losing Medicaid and about 62,000 losing individual-market coverage due to higher premiums. They also said counties would face new administrative burdens and hiring needs, and that rural hospitals, safety-net providers, and EMS systems would see more uncompensated care. One senator noted Dakota County could face an additional $11 million next year and property tax increases, while another said Minnesota hospitals could see charity care rise by more than $269 million next year. The discussion also covered specific funding in the bill, including $300 million for hospital stabilization, with $150 million for HCMC, nearly $115 million for other hospital stabilization grants, almost $18 million for community safety-net providers, and $15 million for rural EMS uncompensated care. Senators said these funds are short-term measures, not long-term fixes, and that if the state did nothing, the health care system and SNAP administration could collapse. They said they do not expect Republican support in the Senate and suggested longer-term options could include federal changes after the next election or state-level tax changes on the ultra-wealthy. No vote outcome was stated in the excerpt, but the senators indicated the bill would move forward with DFL support.

Transcript Highlights:

• In<00:17:37.880><c> Medicaid</c><00:17:38.280><c> Benefits,</c> In Medicaid Benefits, In Medicaid Benefits
• </c> million in fiscal 26 for Medicaid million in fiscal 26 for Medicaid Benefit<00:18:02.960><c> Program
• fee-for-service beneficiaries. is the growth of the Medicaid is the growth of the Medicaid system. system
• </c><00:18:33.360><c> managed</c> 27 and plan year 28 to Medicaid managed 27 and plan year 28 to Medicaid
• Medicaid state directed payments. payments. payments.

Summary: The Kentucky Senate Appropriations and Revenue Committee met with a quorum and first took up House Bill 503, the legislative branch budget, adopting a committee substitute and reporting it favorably. The chair said the Senate version fully funds defined calculations, provides 2% raises in each fiscal year for legislative employees, removes a paragraph on operating expense reductions, and includes $1 million in the first year for a judicial branch salary study. House Bill 504, the judicial branch budget, was then amended and reported favorably; changes included 2% annual raises for judicial employees, revised operating expense language, $1 million each year for county current services, retention of Boyle County fit-up language, reporting requirements for smaller capital projects, full funding for nine judges added in 2022, and removal of furlough prohibitions and certain budget implementation language. Both bills passed the committee unanimously with favorable expressions to the floor. The committee then considered House Bill 500, the executive branch budget, adopting a committee substitute before hearing a lengthy summary of major spending and policy changes. The chair described statewide 2% annual employee raises, agency base reductions with many exemptions, increased school safety and 911 funding, veterans and military funding, local government and severance-related changes, attorney general and auditor funding, pension and retirement system support, education funding changes including SEEK, postsecondary and scholarship provisions, public safety and corrections funding, and multiple capital projects. The chair also highlighted Medicaid-related provisions, including added waiver slots, increased state-directed payments, a 2.5% reduction in managed care vendor payments for plan years 2027 and 2028 with savings redirected to fee-for-service rates, and additional funding for behavioral health and public health programs. The bill was reported favorably after members explained their votes, with several noting they had only recently received the full 228-page bill and wanted more time for detailed review. Finally, the committee adopted a committee substitute for House Bill 900, an appropriation measure for government agencies, and reported it favorably. The chair said the bill remains a work in progress and that one-time funding requests from across the Commonwealth and across party lines would continue to be addressed as the process moves forward. All measures considered during the meeting passed the committee with unanimous or near-unanimous favorable votes, and the meeting adjourned after no further business.

Transcript Highlights:

• The response was that Medicaid is okay with it as well.
• Medicaid uh pretty tightly and this Medicaid uh pretty tightly and this particular<00:12:38.639><c> code
• </c> million increase in Medicaid million increase in Medicaid expenses<00:37:55.680><c> and</c><00:37
• </c> are a lot of challenges in the Medicaid are a lot of challenges in the Medicaid Program<00:38:05.079
• </c> we're very concerned about Medicaid we're very concerned about Medicaid spending<01:20:24.719><c

Summary: The committee first took up House Bill 392, sponsored by Representative Proctor, which would help the Department for Behavioral Health, Developmental and Intellectual Disabilities pay for emergency medical and psychiatric services provided to patients outside state facilities when those facilities cannot meet their needs. Proctor described it as a continuing improvement bill to address payment issues for services delivered at community-based facilities. The bill received no substantive opposition in the meeting and passed the committee with favorable expression by a vote of 15 yes, 0 no, and 1 pass. The committee then considered House Bill 580, presented by Representative Kim Moser and Elena Sweezy, which tightens oversight of peer support specialists. The bill was described as building on House Bill 505 from the prior year by reinstating supervision requirements, adding parameters around group sizes, creating a pathway for temporary peer support specialists to become fully registered after nine months, and addressing Medicaid reimbursement and accountability concerns. Members asked about reimbursement; the sponsor said Medicaid was okay with the bill and that commercial insurance coverage would be up to insurers. Representative Fleming emphasized the need for stronger financial oversight of the peer support code. The committee adopted a substitute and title amendment, then passed the bill with favorable expression. House Bill 688 was then heard, with Representative Bratcher explaining that it addresses two issues: preventing fraud in nurse licensure by giving the Kentucky Board of Nursing more discretion to review out-of-state credentials, and expanding school authority to administer certain emergency medications. He said the bill changes the board’s authority from “shall” to “may” so it can verify transcripts, curricula, accreditation, and exam passage. During discussion, Representative Sharp explained his yes vote by noting the bill also adds rescue medications such as glucagon and Solu-Cortef and allows prescribed emergency medications for known conditions in schools. The committee passed the bill with favorable expression. Finally, the committee heard House Bill 16, which would leave decisions about adding fluoride to drinking water to local governing bodies rather than maintaining a state mandate. Supporters, including Representative David Hale, Dr. Jack Call, and Cindy Batson, argued that fluoridation should be a local choice and raised concerns about cost, potential health risks, and the precautionary principle. Opponents, including Dr. Steve Robertson of the Kentucky Dental Association, defended fluoridation as beneficial for preventing tooth decay and warned that local removal decisions could increase Medicaid costs and may not reflect the broader public interest. The transcript provided does not show a final committee vote on House Bill 16 in the excerpt.

Transcript Highlights:

• SINCE 2011, FLORIDA HAS DELIVERED AND COMMUNITY SERVICE TO MEDICAID RECIPIENTS WITH INTELLECTUAL AND
• A SPECIAL KIND OF MEDICARE MEDICAID MANAGED CARE PROGRAM.
• THIS WONDERFUL PROGRAM IS A MEDICAID PROGRAM AND IF YOU CAN'T GET THROUGH THE MEDICAID ELIGIBILITY SYSTEM
• BUT IF I GO GET INTO THIS PROGRAM INTO MEDICAID ELIGIBILITY, GOING TO HURT MY MEDICARE?
• FIRST OF ALL, BEHAVIOR ANALYSIS IS A STATEWIDE MEDICAID PLAN SERVICE FOR CHILDREN UP TO AGE 21.

Transcript Highlights:

• </c> being built to Medicaid? being built to Medicaid?
• Medicaid concern consortium. Medicaid concern consortium.
• Medicaid, not Medicaid to schools, but Medicaid overall at a state level does the same.
• Medicaid, not Medicaid the same thing.
• Does Medicaid do that in terms of Medicaid to schools?

Summary: The commission met to approve the May 18, 2026 minutes and then focused on how SB 57’s special education cost study should inform HB 1099, which creates a separate study committee on residential placements and related education costs. Members discussed sending the commission’s minutes and findings to that new committee, noting the short timeline for its work and the need to be specific about unresolved issues so the new group does not duplicate the same questions. A major topic was the cost and responsibility for students placed at Spalding and similar residential programs, especially transportation and whether costs are paid through the Department of Education’s episode-of-treatment (EOT) fund, local districts, DHS, or Medicaid. Staff explained that for students with disabilities, EOT funds cover special education and transportation costs tied to the placement, while students without disabilities are handled through DHS care-management and best-interest meetings. Members raised concerns about whether some students at Spalding are receiving no schooling, whether transportation costs are substantial, and whether Medicaid reimbursement could offset some expenses. The commission also discussed confusion over district responsibility when students placed in residential programs attend school in another district, using Winnisquam as an example. Several members said the receiving district was not notified that DHHS-approved programs could bring in additional students and costs, and they suggested DHHS or its care-management entity should notify both the district of residence and the receiving district when a program is approved. The group agreed this notification issue, along with transportation funding, privacy concerns in Medicaid-to-schools billing, and the distinction between special education placements, EOT placements, and other voluntary residential placements, should be passed to the HB 1099 study committee for further work.

Transcript Highlights:

• I want to talk about the Medicaid trust fund. I guess that's I-6.
• Medicaid trust fund, we passed this legislation to try to at least keep a grasp of where we were.
• The Medicaid program will try to function with the current balances as we implement those.
• to be able to control those costs using Medicaid funds.
• So the Medicaid trust fund is a compilation of many different funds.

Committee: All ALC-PEER

Summary: The committee considered several appropriation and transfer requests, beginning with a $273,000 temporary appropriation for the Department of Labor and Licensing to cover administrative costs for its enterprise licensing platform, funded by license and application fees. It then reviewed two large Infrastructure Investment and Jobs Act requests: $280 million for the Department of Transportation for the final quarter of the fiscal year, and $195 million for the State Broadband Office to support the Arkansas BEAD broadband grant program, including an extra help position and grants to internet service providers. The broadband item drew extensive questions about awardees, contract amendments, accountability, build-out timelines, backup plans if providers default, the definition of broadband serviceable locations, and the cost per location. The State Broadband Director said no providers had requested amendments, the program would use milestone-based disbursements and a four-year build-out period, and the first tranche would serve 51,566 homes and businesses with $126.1 million in grants. Both Section B and Section C items were approved. In Section D, the committee approved a $458,000 transfer within the Department of Correction from the female work release program to the Tucker Unit water treatment plant, a $25 million transfer within the Department of Education to cover declining enrollment, teacher incentive, school recognition, and Easter Seals funding, and a $229,000 transfer for the Department of Shared Administrative Services to support two project management office positions. The education transfer prompted questions about how declining enrollment funding is calculated, how many districts receive it, and how long districts can continue to receive it; agency staff said 152 districts were on the preliminary list and the formula is based on the prior two-year average ADM compared with the previous year. The committee also gave favorable advice on a proposed $4.7 million loan for the Office of State Technology to implement ServiceNow and related IT modernization tools; agency officials said the loan would be repaid through cost recovery rates over five years and would replace an existing loan that is ending, with expected savings from consolidating applications but no precise savings estimate yet. The committee then reviewed cash fund and federal grant requests, including $200,000 for wage and hour claimant payments, $15 million for unclaimed property claims, $8,000 for a heritage program grant, and $1.1 million for a College and Career Coaches grant to expand services in rural districts. It also reviewed pay plan and budget manual items without objection. The most extensive report discussion focused on the Medicaid trust fund, where DHS and DFA officials said the balance has been declining and that the state may need to add capital back into the fund. Senators and representatives asked about the current balance, the projected year-end level, the role of the $100 million set-aside, the impact of outstanding Medicaid rules from the prior session, and whether future federal funding could help reduce long-term Medicaid costs. Officials said they are still working through more than 10 outstanding rules with CMS and do not yet have a final price tag for those changes. The meeting ended after the reports were reviewed and the committee adjourned.

Transcript Highlights:

• We get an encounter rate, which looks at the cost of providing care to not only Medicaid, Medicaid expansion
• We get an encounter rate, which looks at the cost of providing care to not only Medicaid, Medicaid expansion
• To not only Medicaid, Medicaid expansion, and uncompensated care.
• We develop so many programs, whether it's paying for education or Medicaid or Medicaid expansion, and
• for education or Medicaid or Medicaid expansion or so many things.

Committee: Joint Health Care Committee

Summary: The committee first approved the minutes and then heard a detailed annual presentation from Dr. Thomas Arnold, chair of the Maternal Mortality Review Committee, on maternal mortality trends and review findings. He explained the committee’s structure, the de-identified review process, and the distinction between pregnancy-associated and pregnancy-related deaths. He said national maternal mortality has declined from its 2021 peak, but mental health conditions, substance use, overdose, suicide, cardiovascular disease, hemorrhage, infection, and embolism remain major causes. He emphasized that many deaths are preventable, with especially high rates among non-Hispanic Black women and in the American Indian/Alaska Native population, and noted that a large share of deaths occur after 42 days postpartum. Committee members asked about suicide, domestic abuse, pregnancy testing in unexplained deaths, and the role of home births and midwife training. Dr. Arnold said the committee is adding a caseworker, exploring post-mortem pregnancy testing in suspicious cases, and working with coroners and forensic officials; he also said home births and untrained midwifery pose safety concerns and that better public education and facility-based care are important. The committee then heard from State Fire Marshal Dr. Matt Clark on cigarette ignition propensity standards and fire prevention. He recommended updating North Dakota’s cigarette ignition legislation to the current national standard and also considering legislation requiring fast-breakaway oxygen tubing, citing fatal fires involving smoking around home oxygen. He explained that his office verifies manufacturer testing and maintains certification for cigarettes sold in the state, but does not itself conduct the testing. Members asked about implementation, cost, and whether the standards apply in tribal communities; Clark said he would follow up with cost information and additional details, and that he had not seen evidence of a major issue on tribal lands but would look further. Christine Greff of the Department of Health and Human Services presented the North Dakota Stroke System of Care report. She described the statewide network of two comprehensive stroke centers, four primary stroke centers, and 30 acute stroke-ready hospitals, along with the stroke registry and quality-improvement efforts. She reported that most strokes are ischemic, that the median stroke patient age is 71.5, and that common risk factors include hypertension, dyslipidemia, obesity, and diabetes. She highlighted improvements in door-to-CT, thrombolytic treatment times, dysphagia screening, EMS pre-notification, and interfacility transfer performance, and said new priorities include hemorrhagic stroke quality measures and standardized EMS stroke screening tools. Members asked about the VA hospital’s participation, and Greff said she would pursue outreach. After a break, the committee heard testimony from Taha Khan of Vertex Pharmaceuticals as part of the prior authorization study, focused on non-opioid pain treatment. He argued that prior authorization can delay access to acute pain treatment and may push patients toward opioids, especially in the critical 24- to 72-hour post-discharge window. He cited data showing that even short opioid exposure can increase the risk of long-term use and said prior authorization is often a barrier for physicians and patients. Khan recommended open access with a quantity limit rather than prior authorization, suggesting a 14-day limit supported by the product’s data and an episode-of-care approach. Members asked about dental use, payer discussions, and cost; he said the product’s wholesale acquisition cost is about $16.10 per tablet, with patient assistance available, and that he would follow up on payer and comparison-cost questions.

Transcript Highlights:

• Medicaid. Medicaid.
• Medicaid. Medicaid.
• </c> services to those folks on Medicaid." services to those folks on Medicaid."
• </c> Medicaid programs. Medicaid programs.
• </c> provide from Medicaid. provide from Medicaid.

Transcript Highlights:

• If Medicaid is also cut, the impact on health will be irreversible.
• And as a former If Medicaid is also cut, the impact of If Medicaid is also cut, the impact of health<
• They said that the Medicaid cuts are an untruth, that sort of thing.
• We could cut Medicaid. We could have seniors homeless.
• We could cut Medicaid. We could have seniors homeless.

Summary: Sen. Erin Maye Quade, Rep. Esther Abad, and other Minnesota DFL legislators held a press event focused on responding to Trump administration and federal Republican actions that they said threaten health care, education, housing, public health, and other state services. Speakers argued Minnesota must not make “false trade-offs” between core services and should instead protect programs like Medicaid, school funding, disability services, nutrition, and public health by raising additional revenue and closing tax breaks for wealthy individuals and corporations. Rep. Abad and others outlined possible revenue options, including a fifth-tier income tax, a corporate rate match, closing tax exemptions for luxury items and second homes, a social media tax, and ending data center tax exemptions. They said these measures would not fully replace possible federal cuts, but could help mitigate harm and preserve services. Several speakers also criticized Republican opposition to tax increases and said the state should ask wealthy taxpayers and corporations to contribute more. Testimony from Olivia Dylan, a laid-off Minnesota Department of Health epidemiologist, described the impact of federal public health funding cuts and MDH layoffs on outbreak response, nursing home support, lab work, and tribal public health. Sean Leaden of SEIU Local 284 described low pay and staffing shortages among hourly school workers and said underfunding has hurt students and employees. Sen. Doran Clark and Rep. Emma Greenman framed the issue as both a budget and democracy question, arguing that federal cuts and attacks on public programs undermine self-governance and community well-being. In response to questions, speakers said Minnesota cannot fully backfill expected federal Medicaid losses, but can use state tools to reduce harm and should press Republicans to identify what services they would cut instead.

Transcript Highlights:

• So for patients who are enrolled in the Medicaid program, members of our Medicaid managed care plan,
• I didn't mean their Medicaid managed care plan.
• , sometimes as high as 75% of Medicaid membership.
• Again, it's not Medicaid, which doesn't have premiums.
• Ever since the Medicaid unwind happened, 67,000 additional kids became Ever since the Medicaid unwind

Committee: Senate Health Policy

Summary: The committee opened with roll call, welcomed members back for the first committee weeks, and heard brief personal updates from several senators before moving into agency implementation updates on recently enacted health care laws. The Agency for Health Care Administration reported on Senate Bill 64 creating rural emergency hospitals, explaining that AHCA adopted the required rules effective June 1, 2025, but that no hospitals have yet been designated. Members asked about possible hospital conversions, accreditation and survey responsibilities, and whether Florida would apply for federal rural health transformation funding; AHCA said it intends to apply and has already been working on the issue with federal officials. AHCA also reviewed the non-emergent care access plan requirement under Senate Bill 7016. The agency said hospitals with emergency departments must submit plans that help redirect non-emergent patients to appropriate care settings while complying with EMTALA, and that 83 plans had been received and 63 approved as of September 30. Members asked about data collection, managed care coordination, and the state’s health information exchange; AHCA said it has moved to a new HIE vendor and will continue monitoring implementation and possible care gaps. AHCA then updated the committee on the TEACH program, saying $6.8 million was spent in 2024-25 across 59 parent organizations and 229 facilities, with more than 1,800 students and nearly 380,000 clinical hours reimbursed. The agency said rulemaking is nearly complete, a new nursing student category and expanded facility eligibility were added, and a federal 1115 workforce waiver remains stalled after CMS signaled it will not approve new workforce demonstrations. AHCA also reviewed House Bill 121 on KidCare eligibility, explaining that implementation of the 300% poverty-level expansion remains blocked by federal litigation and waiver issues tied to premium nonpayment rules; members and public speakers urged action to close the coverage gap. Public testimony on AHCA’s presentation came from representatives of health centers and advocacy groups, who said the non-emergent care access plan has improved hospital-health center coordination and reduced repeat emergency use, and who urged implementation of KidCare expansion for children in the coverage gap. The Department of Health then presented updates on FRAM, the Sanadi screening grant program, the Health Care Innovation Revolving Loan Program, telehealth maternity care, swimming lesson vouchers, and House Bill 159 on pharmacist dispensing of HIV post-exposure prophylaxis. DOH reported strong participation in FRAM and the telehealth maternity program, 24 Sanadi grant awards in 42 counties, 4,945 swimming lesson vouchers issued last year and 2,371 so far this year, and three approved certification courses with five pharmacist certifications issued under HB 159. Committee members asked about recruitment of dentists and other providers, telehealth maternity outcomes, and why participation in the maternity program remains below expected levels; DOH said outreach and regional referral networks are expanding and more detailed outcome data will be included in the upcoming legislative report.

Transcript Highlights:

• This is true of many other entitlement programs outside Medicaid as well.
• </c> energy committee which oversees Medicaid energy committee which oversees Medicaid is<00:35:13.200
• </c> reduction in federal Medica Medicaid reduction in federal Medica Medicaid outlays<00:35:30.599><
• That's a huge hit, and to me that kind of doubles, triples the Medicaid numbers.
• </c> doubles triples the I mean that Medicaid doubles triples the I mean that Medicaid numbers<01:04:

Committee: Senate Finance

Transcript Highlights:

• ACROSS FX SIX MODULES ONLY ONE HAS BEEN IMPLEMENTED AND CERTIFIED BY THE CENTERS FOR MEDICARE AND MEDICAID
• CMS SET CERTIFICATION IS ESSENTIAL BECAUSE IT ENSURES THE STATE'S MEDICAID SYSTEM FOR THE MODULE MEETS
• ALL MEDICAID STATES ARE REQUIRED BY THE CENTERS FOR MEDICARE AND MEDICAID SERVICES TO MODERNIZE THEIR
• MEDICAID INFORMATION AND CLAIMS SYSTEMS.
• ALL DATA USED FOR CONDUCTING MEDICAID OPERATIONS IS STORED IN THE EDW.

Transcript Highlights:

• This is the Medicaid Oversight and Advisory Board.
• Um, I'm here to present on the Medicaid provisions in 119 HR1.
• At a high level, there are four key takeaways about the Medicaid provisions in HR1.
• ><c> often</c><00:08:08.720><c> shared</c> Medicaid program are often shared Medicaid program are often
• > provisions</c><00:10:45.360><c> go</c> Well, all the Medicaid provisions go Well, all the Medicaid

Summary: At its second meeting on July 30, 2025, the Medicaid Oversight and Advisory Board approved the minutes from its June 25 meeting and received housekeeping materials, including follow-up information on provider taxes, mandatory and optional Medicaid services, and the 1115 community engagement waiver. The chair noted that members should hold general questions until the end of the meeting. The main presentation came from Katherine Castanza of the National Conference of State Legislators, who gave a nonpartisan overview of Medicaid provisions in HR1. She explained that the bill contains more than 20 Medicaid-related provisions, with major changes affecting provider taxes, state-directed payments, eligibility and enrollment rules, work or community engagement requirements, and the frequency of eligibility redeterminations for expansion populations. She emphasized that five provisions account for most of the federal savings, that the fiscal effects are backloaded into the final years of the 10-year window, and that expansion states and provider payment changes make up a large share of the impact. Castanza also highlighted that the Medicaid provisions would take effect either upon enactment or before October 1, 2029, creating roughly a five-year implementation period. She noted that some states may not realize the same savings as the federal government because of financing changes and implementation responsibilities, and she cited estimates that the enacted Senate provisions could reduce hospital payments by 18.2%, or more than $660 billion over 10 years. The transcript provided does not show any votes or final actions beyond adoption of the minutes.

Transcript Highlights:

• </c><03:38:23.040><c> program</c> lower net costs to the Medicaid program lower net costs to the Medicaid
• </c> today for Claritin, I can bill Medicaid today for Claritin, I can bill Medicaid for<03:47:25.840
• In this for it to be build Medicaid.
• </c> product but yes if the Medicaid product but yes if the Medicaid beneficiary<03:57:44.640><c> came
• </c> federally CMS, the Center for Medicaid federally CMS, the Center for Medicaid Medicare<03:59:00.720

Committee: House Health, Human Services & Elderly Affairs

Transcript Highlights:

• Both of those have been around since the existence in the 90s of Medicaid coverage.
• I work for Presbyterian, not in the Medicaid side. That's a completely different line.
• Medicaid.
• I then lost my job at United when they lost the Medicaid bid.
• of some disability that Medicaid would also be the same.

Committee: House House Health & Human Services

Transcript Highlights:

• </c> gets matched by the federal Medicaid gets matched by the federal Medicaid share<00:32:55.799><c>
• I think that the Medicaid staff is bracing themselves for that.
• </c> that but I think that the um Medicaid that but I think that the um Medicaid staff<00:36:53.319><
• </c> provide services through the Medicaid provide services through the Medicaid waiver waiver waiver
• </c> explained allows states to use Medicaid explained allows states to use Medicaid funds<00:54:43.599

Summary: The Committee on Health and Human Services held an informational briefing on the Developmental Disabilities Council and related agencies. The Hawaii State Council on Developmental Disabilities outlined its 2025 legislative priorities, including a pilot project for guardian ad litem and capacity evaluations in guardianship/conservatorship cases, a supported decision-making bill, a health disparities study for people with disabilities, an ABLE savings outreach/staffing measure, a Medicaid buy-in proposal, an adult changing tables equity bill, and a resolution on fetal alcohol spectrum disorder. Council representatives emphasized that supported decision-making would complement tools like powers of attorney and medical releases, and that the health disparities study would help identify unmet needs by ZIP code and improve state data on the intellectual and developmental disability population. The Center on Disability Studies at the University of Hawaii described its role as the research and training arm within the DD system, working with the DD Council and the Hawaii Disability Rights Center. It reported activities such as interdisciplinary training, community education, technical assistance, research collaborations, the Pacific Rim International Conference on Disability and Diversity, publications, telehealth, ECHO Autism, and counseling for Maui fire survivors. The center said it leveraged about $16 million in outside funding last year and highlighted goals focused on workforce development, community capacity, research with direct participation from people with disabilities, and accessible dissemination of information. The Hawaii Disability Rights Center, the state’s protection and advocacy agency, supported the Council’s priorities, especially supported decision-making, which it said could help some people avoid guardianship while preserving liberty and reducing state resource use. The center also raised concerns about the DD system budget and urged legislators to review whether the Developmental Disabilities Division is requesting enough funding, noting possible backsliding in services and eligibility. The Developmental Disabilities Division of the Department of Health then outlined its statewide waiver program serving just over 3,500 people, its service array, and its budget request for increased waiver funding, a federal initiatives coordinator, and IT upgrades to comply with the new HCBS access rule; no votes or formal actions were taken during the briefing.

Transcript Highlights:

• This is about Medicaid for workers with disabilities.
• They're covered by Medicaid. So that is important to understand.
• I have been on the Medicaid for Workers program since it started.
• My secondary is Federal Blue Cross, and Medicaid on the Medicaid for Workers program.
• So I am so appreciative of Medicaid and Medicaid for Workers, and I really hope you guys look at this

Committee: Senate Health and Welfare

Transcript Highlights:

• </c> Medicaid population. Medicaid population.
• </c> Medicaid working with managed care. Medicaid working with managed care.
• So, I take Medicaid, my wife takes Medicaid. I understand the provider's plight.
• for Medicaid in Kentucky.
• for Medicaid in Kentucky.

Summary: The Medicaid Oversight and Advisory Board received a presentation from Dr. Stack and Commissioner Langfeld on Kentucky’s application for a federal Medicaid-related funding opportunity tied to House Resolution 1. They described a compressed six-week stakeholder process that produced more than 50 responses and letters of support, and said the application was organized around five broad priorities: maternal health, behavioral health and substance use disorder, oral health, EMS/trauma response, and chronic disease. They emphasized that the proposal was designed to align with CMS goals, use allowable funding categories, and focus on sustainability rather than a short-term grant. Commissioner Langfeld outlined five core initiatives: rural community hubs for chronic care innovation, beginning with obesity and diabetes; a maternal and infant health effort called POWER; a behavioral health and substance use model called IMPATH; an oral health initiative called Rooted in Health; and an integrated crisis-to-care EMS and trauma response effort. He said the chronic disease work would include prevention, food-as-medicine concepts, and technology tools, while the maternal health effort would expand team-based care around mothers and infants using community health workers and doulas. The behavioral health proposal would build on existing crisis intervention models, oral health would address workforce and access gaps through training, mobile vans, and telehealth, and the EMS proposal would better connect emergency response with home-based and community care. Several senators questioned whether the proposal would meaningfully address rural hospital closures or the broader rural health care crisis. Senator Meredith said the plan was not transformational and would not save rural hospitals, while Senator Berg asked how success would be measured. In response, the presenters said they would use both lagging and leading indicators, with an emphasis on rapid-cycle feedback and data use that is more actionable in real time. They also said the work could help existing models that already show promise, such as behavioral health units and dental workforce expansion, even if it would not solve the larger funding gap created by HR1. Senator Douglas asked how the proposals would motivate patients to participate in their own health care. The presenters responded that the chronic disease prevention work would focus on obesity, diabetes prevention, nutrition, and consumer-facing technology tools to help people engage in their own care, and that EMS-community health worker partnerships could identify unmet needs in the home and reduce preventable problems. The board then moved on to its next agenda item, Medicaid managed care delivery models, with Tom Stevens, Katherine North, and Dr. Patel scheduled to present.