Transcript Highlights:

• any given time, we have about 1,400 to 1,500 students in the residential programs, but we serve probably
• Thank you. you and you defend yourself and you wound but don't kill this person and cause them seriously
• It caused some serious bodily injury. The guy went to the hospital that day.
• The neighbors primarily is probably the primary scenario where I can imagine a known person.
• Temporary injunctions do not operate to cause the loss of firearm rights.

Summary: The Criminal Justice Committee met with a quorum present and temporarily postponed SB 156. The committee first considered the confirmation of Matthew Walsh as Secretary of the Department of Juvenile Justice. Walsh described his background in law enforcement, social work, and juvenile justice, and outlined DJJ priorities including recruitment and retention, staff wellness, collaboration with DCF and other agencies, aging facilities, and expanding educational and vocational opportunities for youth. Members asked about his social work training, lockout youth, bed space, recidivism, and the Florida Scholars Academy. The committee voted unanimously to favorably report his confirmation. The committee then took up SPB 704, a committee bill extending the public records exemption for conviction integrity unit reinvestigation information. Senator Martin explained that the exemption was originally created to protect active innocence reviews and should continue past its current sunset date. With no opposition or debate, the committee voted unanimously to report the bill favorably as a committee bill. Next, the committee considered CS for SB 32, as amended, which creates an injunction for protection against serious violence by a known person and adds it to the statewide injunction verification system and related enforcement provisions. Senator Sharif said the bill is intended to give judges a faster tool to protect victims who have reported serious violence to law enforcement, while supporters said it addresses cases where victims are harmed before a repeat-violence injunction can be granted. Eric Friday of Florida Carry opposed the bill, warning it could be misused against self-defense situations and create problems in cases already covered by existing injunction laws. After debate, the committee voted unanimously to report the bill favorably. The committee then considered SB 210, which extends public records protections to petitions for injunctions for protection against serious violence by a known person, including dismissed petitions and identifying information before service. There was no opposition, and the committee voted unanimously to report SB 210 favorably before adjourning.

Transcript Highlights:

• of the aisle that thinks we need to go a little further, and that we're starting today where we probably
• I can probably alleviate some of the uncertainty the support of this amendment may have.
• for emergency shelter and assistance, I can provide you with some assurances that that party is probably
• amends the bill in Section 6 by inserting after the word show in line 125 the following: 'that their cause
• Put in an eligibility requirement for the emergency shelter program, provided that the cause or the need

Keywords: 995, all

Summary: The House considered House No. 57, a $425 million supplemental appropriations bill for fiscal year 2025 to fund the emergency shelter/emergency housing assistance system and related activities. The bill, as described by the chair of Ways and Means, included major policy changes requested by the Governor: immediate residency verification at intake, limits on eligibility, required criminal history disclosures and CORI checks, a reduced maximum shelter stay from nine months to six months with hardship waivers, temporary respite sites for 30 days, and a cap on system capacity. Supporters argued the changes were needed to preserve the right-to-shelter system amid fiscal strain and federal inaction; opponents said the bill still did not go far enough or, in some cases, went too far and risked harming families and children. The House debated and voted on numerous amendments, mostly focused on tightening eligibility or changing shelter operations. Several Republican amendments to reduce funding, impose a one-year residency requirement, require broader background checks, limit eligibility to homelessness caused within Massachusetts, and require cooperation with ICE were rejected, often after roll call votes. A point of order was sustained on multiple amendments as beyond the scope of the bill, including proposals affecting court officers, law enforcement, and ICE-related provisions. The House also rejected amendments to cut the appropriation from $425 million to $200 million and to add other restrictions on eligibility and administration. Some amendments were adopted. A redrafted Amendment 27, offered by Rep. Decker, was adopted 25-25 on a tie vote and expanded protections to children under age six and added related hardship/extension language. A subsequent amendment by Rep. Consalvo was adopted unanimously to add disability-related protections and extend benefits in certain cases. Another amendment by Rep. Finn was adopted to modify language about seeking federal reimbursement, and Amendment 9 was adopted to require competitive bidding for certain service funds. After debate and roll call, the bill was passed to be engrossed by a vote of 126-26. The House then observed a moment of tribute for Doug Selfick and adjourned to meet again Monday at 11 a.m.

Transcript Highlights:

• some areas, the things I'm here to talk to you about today are some of the things that are going to cause
• even, I want to give you a little bit of an explanation of some of the things that are going on that caused
• But it causes a little bit of a low start or a slow start in spending those dollars.
• So we just finished one, probably two years ago.
• That was here before. $350,000 is probably a rounding error for us.

Keywords: 914, all

Transcript Highlights:

• c><00:11:56.320> drink and they eat and they probably drink and they eat and they probably drink
• Representative NAB said he thinks things have changed probably since this was enacted.
• Representative NAB said things have changed probably since this was enacted.
• Representative NAB said things have changed probably since this was enacted.
• Representative Darby, I see you. things have changed probably since this things have changed probably

Keywords: 928, house, all

Summary: The committee began with housekeeping about report deadlines and bill scheduling, noting that reports should be submitted as soon as possible, ideally by Friday night, so they can be reviewed and filed on time. The chair explained the process for Democratic and Republican reports, reviewed the timing sheet for early bills, and said the committee was trying to stay on schedule to avoid hearings during vacation week. He also shared his contact information for questions. The committee then moved into executive session on 10 bills. On HB 13, relative to OHRV operation on certain highways in Windsor, the committee voted unanimously to retain the bill after the prime sponsor asked that it be held for possible local action. On HB 127, extending the closing date of OHRV trails on the Connecticut River headquarters property from September 30 to Columbus Day, members debated economic benefits for Pittsburgh versus concerns about local control, conservation easements, and hunting impacts. The committee voted 11-5 ought to pass; the chair noted it would not go on consent and would have a fiscal note. On HB 174, increasing the maximum weight of a utility terrain vehicle to 3,500 pounds unladen dry weight, supporters argued the change could help accommodate electric vehicles and heavier equipment, while opponents raised concerns about undefined terms, enforcement, private landowner rights, and unintended consequences. The committee voted 8-7 ought to pass. On HB 203, requiring C-COT approved personal flotation devices while on New Hampshire state waters, the committee heard a split between members who emphasized personal responsibility and those who said the bill would improve safety and education and could reduce drowning deaths. The motion to ITL failed 11-5, meaning the committee rejected the motion to kill the bill and advanced it instead. The transcript then moved on to HB 332, allowing for the establishment of a village district, but the discussion of that bill was not included in the provided excerpt.

Transcript Highlights:

• And, just like I said, there's probably 50 people on these calls every week.
• Chair, Representative, it's probably 250 miles from the southern border. Okay, Mr.
• We need probably a billion to a billion and a half more.
• Now, there was some cause of that because there were some bad actors involved with that.
• Mental health issues are the number one cause of maternal mortality events in Arizona.

Bills: HB2063, HB2271, HB2416, HB2478, HB2593, HB2692, HB2813, HB2992, HB2993, HB4044

Keywords: corrections oversight, appropriation, independent office, public safety, funding, firefighters, insurance rates, workers' compensation, firefighter cancer reimbursement, rate deviations, cost analysis, premiums, border security, drug trafficking, human smuggling, law enforcement funding, Arizona, immigration, education reform, K-12

Transcript Highlights:

• A smart device is a cause for disruption and distraction to students; all said yes.
• This causes cascading effects to our environment and for everyday families.
• I think I'm the guy you should probably have a lot of questions for.
• The first time we probably laid this bill out, I was elected in 1996.
• So that's probably our biggest concern.

Bills: HB2963, HB3005, HB3287, HB3288, HB3289, HB3290, HB3344, HB3712, HB3862, HB3874, HB4196, HB4308, HB4901, HB4984

Keywords: digital equipment, repair rights, manufacturers, maintenance, consumer rights, construction contracts, payment regulations, public works, dispute resolution, audit procedures, construction, trust funds, mechanic's lien, contractor, subcontractor, residential properties, disputes, payment obligations, accountability, payment disputes

Transcript Highlights:

• What if a delay causes a flare-up? That kind of uncertainty isn't just stressful.
• One didn’t, and it caused us delays similar to what Doug has described.
• And I probably, the lawyer in me, probably went way too deep on some of these...
• The lawyer in me probably went way too deep on some of these things.
• And it caused a little, I mean, just to be honest, caused a little bit, you know, in some of the smaller

Summary: The Assembly Health Committee met on April 22 and took up a special order of bills focused largely on prior authorization and utilization management in health care. The chair framed the discussion as part of a broader legislative effort to reduce delays and barriers to care, especially in behavioral health, chronic disease management, cancer treatment, and rehabilitation services. AB 384 by Assembly Member Connolly would prohibit prior authorization for inpatient mental health or substance use emergency admissions and related physician care; supporters said it would prevent dangerous delays in crisis care, while insurers and health plans warned about fraud, abuse, and ambiguity around residential treatment facilities. The bill was moved on a due pass as amended motion and passed the committee on a party-line style vote, with Republicans largely absent or not voting. The committee then heard AB 510 by Assembly Member Addis, which would require health plans, upon request, to provide a peer reviewer of the same or similar specialty when a treating provider appeals a prior authorization denial or modification. Supporters argued that specialty-matched review would make appeals fairer and more clinically informed; opponents said the requirement was too rigid and that timelines and electronic submission rules needed changes. After discussion about the need for timely, specialty-specific review, the bill was approved on a due pass as amended motion and placed on call. AB 539 by Assembly Member Schiavo would extend prior authorization approvals to one year or the duration of the physician’s prescribed treatment for chronic conditions; supporters cited repeated denials and treatment interruptions, while opponents raised concerns about overbreadth, fraud, and the need for shorter validity periods. The bill was also passed as amended and placed on call. The committee next considered AB 669 by Assembly Member Haney, which would bar concurrent and retrospective review for the first 28 days of medically necessary substance use disorder treatment and limit prior authorization for related outpatient medications. The bill was presented with a powerful personal story from Ryan Matlock’s mother about her son’s death after an insurer cut off treatment early; supporters said the measure would keep patients in care long enough to stabilize, while opponents argued it would reduce oversight and could allow lower-quality or non-evidence-based care. The bill was moved on a due pass as amended motion and placed on call. Finally, AB 512 by Assembly Member Harabedian would shorten prior authorization response times to 24 hours for urgent requests and 48 hours for non-urgent requests; supporters said delays can worsen outcomes, while opponents warned the timelines were unrealistic and could increase administrative burdens and safety issues. The bill was approved as amended and placed on call. AB 574 by Assembly Member Mark Gonzalez was then heard; it would allow up to 12 medically necessary physical therapy sessions for a new episode of care without prior authorization, with supporters emphasizing stroke and neurological recovery and opponents warning of reduced oversight and unnecessary care. The transcript ends during testimony on AB 574, before final action is shown.

Transcript Highlights:

• IF YOU ARE LIKE ME, PROBABLY SOMETIME DURING HER LIFE ESPECIALLY AFTER COLLEGE OR WHATEVER YOU RENTED
• AND THAT'S PROBABLY FIVE, SIX, SEVEN UNITS PER AD.
• ON AUGUST 22nd, 2006, PASCO COUNTY SCHOOL BUS DRIVER CAUSED A CRASH BY PULLING OUT IN FRONT OF CAR THAT
• SOME OF US WE PROBABLY DID NOT EVEN LIKE EACH OTHER BUT WE LEARN HOW TO COME TOGETHER AND WORK TOGETHER
• AND DESIGNATES CONDUCT VEXATIOUS IF ALL OF THIS LITIGATION OR RELITIGATION VALIDITY DETERMINATION CAUSE

Keywords: 999, senate, all

Transcript Highlights:

• Yeah. that that probably probably probably the<01:10:35.120> budget<01:10:35.679> as<01
• to use their house rule that is causing to use their house rule that is causing multiple<05:18:19.680
• So this is probably okay but I Right.
• And probably we're expecting more funds later this year.
• Well, Probably would be three residents.

Keywords: 10am HB 1 & HB 2, 928, house, all

Summary: The committee of conference on HB 1 and HB 2 reviewed comparison documents and worked through a long list of House and Senate positions, agreeing on some technical or already-enacted items while setting aside others for later discussion. Early on, members agreed to delete a House Bill 2 section tied to a bill already passed into law, and a representative explained a technical amendment to the EFA provisions clarifying enrollment-cap repeal language and compulsory attendance rules for EFA students. That amendment was discussed but a vote was postponed because not all members were present. The committee also noted that the overall EFA budget numbers had already been settled separately. Several items were either agreed to or held for further negotiation. Members agreed to delete sections already covered by other enacted bills, including BTLA-related language, and to accept a technical amendment changing "municipalities" to "political subdivisions" in a section affecting funding eligibility. They also agreed on some items involving workers’ compensation second injuries, certain pilot-program language, and some sections related to state loan repayment and other technical corrections. In contrast, they set aside or disputed items involving site evaluation, lottery-related provisions, opioid abatement, the Commission on Aging, Granite Advantage premium costs, renewable energy/offshore wind funding, special education funding, and several education trust fund and unique-fund provisions. The committee spent substantial time on policy disputes. The House side argued against keeping money in dedicated Fish and Game funds rather than increasing the main Fish and Game fund, while the Senate side defended its approach and raised concerns about fee impacts, including one tied to the fishing license. The members also discussed a housing appeals board proposal, with one member suggesting a possible compromise that would preserve some function while shifting duties and possibly sunsetting the arrangement later; the contracts for the positions were noted as running through June 30, 2028 and June 30, 2029. Another extended discussion concerned the child advocate records-access section, which one side wanted removed as policy that should go through the normal bill process, while another member asked to hold it and suggested a possible middle-ground, time-limited approach. Later, the committee agreed to remove sections already handled in other bills, including House sections 254 and 255, and discussed but did not resolve disputes over liquor licensing functions, cannabis-related language, cost containment, special education, and several fee and fund provisions. The Senate explained its position on the governor’s commission language, saying opioid abatement trust funds could not be used for that purpose and that the commission should continue to be funded through 5% of gross liquor profits; it also described renaming the body the Commission on Addiction Treatment and Prevention and expanding its scope to include problem gambling. The meeting ended with several major items still open for later negotiation.

Transcript Highlights:

• That caused the emotional pull for more legislation to be done.
• opinion in 2022 that stated that on-the-ground violence and lawlessness at the Arizona border was caused
• I suspect that there was probably a drafting issue on the part of Ledge Council on this one, right?
• Credo for a while now, and I know that he's good at his word, and I think that probably tomorrow he'll
• It probably doesn't get rid. All right, members, with your votes...

Bills: HB2665, HB2904, HB2917

Keywords: manslaughter, suicide encouragement, assisted suicide, online harassment, social media, text messaging, directed communication, minor suicide, youth suicide prevention, criminal liability for speech, online bullying, free speech, homicide, class 2 felony, Cade's Law, Arizona criminal law, sovereignty, border security, health crisis, drug cartels

Transcript Highlights:

• That causes real hardship for parents who have to front the money for materials and services and then
• Abraham Lincoln said, “If you want to win a cause, you've got to make your friends...” ...you've got
• to make your friends, people your friends, to win your cause.
• Senator Pizzo probably articulated it as good as anyone could, and thank you for your comments, sir.
• We'll probably keep painting that battleship for as long as any of us are here.

Summary: The Senate Appropriations Committee met with a quorum present and took up two bills. The first, SB 250 on rural communities by Senator Simon, was described as a broad rural development package creating an Office of Rural Prosperity, a Renaissance grant program, housing and transportation investments, added funding for rural education consortiums, and health care initiatives for rural areas. Senator Harrell asked about overlap between road funding programs, and the sponsor explained that eligible counties could receive both SCRAP and FARM funding. Several organizations waived in support or spoke in support, and the bill was reported favorably by unanimous vote. The committee then heard SB 318, the committee substitute for educational scholarship programs by President Gates. The bill was presented as a response to Auditor General findings about the rapid growth and administration of Florida’s school choice and scholarship programs. It would separate Family Empowerment Scholarship funding from the FEFP, require more frequent student enrollment verification, lower scholarship funding organization administrative fees, require return of overpayments, create a student ID system, establish a $250 million stabilization fund, require annual audits, and direct DOE to recommend future program administration through competitive procurement. Gates also offered five amendments, including technical changes to eligibility documentation and a substantive amendment requiring a DOE report on future administration and competitive selection; all five amendments were adopted. During debate and public testimony, senators and witnesses discussed accountability, software solutions, reimbursement delays, monthly attestations, and impacts on public schools and families. Supporters and opponents alike raised concerns about bureaucracy, fraud prevention, special education services, and whether the bill would help or burden parents. Gates said the bill aimed to fix tracking and payment problems without capping the program, and he noted the IEP timeline would be aligned with public school timelines. After debate, the committee reported CS for SB 318 favorably by unanimous vote, and then adjourned.

Transcript Highlights:

• The proposal But with protocols that seem to cause many disruptions in care.
• We must also address the root causes of pharmacy closures and unfair business practices.
• I think some of what you're probably, if I'm understanding correctly, some of your concerns, I think.
• it's probably more the purview of the FDA as opposed to the board.
• I think that it's probably enforced by the FDA.

Summary: The joint Assembly and Senate business committees held a sunset review hearing on the California State Board of Pharmacy, with board leadership describing the board’s consumer-protection role and its priorities around access, enforcement, and updating pharmacy law. The board emphasized a proposed shift toward a standard-of-care model for pharmacists, arguing it would reduce rigid protocol requirements and improve access to services such as HIV PrEP/PEP, contraception, and naloxone. Board representatives also discussed pharmacy deserts, possible fee waivers for pharmacies in underserved areas, concerns about payer practices contributing to closures, continuing education audits, and a request to restore more flexibility in licensure decisions and probationary monitoring for applicants with certain criminal histories. A major focus of the hearing was the board’s ongoing compounding regulations, especially the treatment of sterile versus nonsterile compounding and substances such as glutathione and methylcobalamin. The board said the proposal was not a ban on those substances and described the rulemaking as grounded in federal law, USP standards, and public comment, noting the process had gone through multiple modified texts and hearings. Testimony from stakeholders was sharply divided: pharmacists, veterinarians, firefighters, naturopathic doctors, and patient advocates warned the rules were restricting access to compounded medications and harming patients and first responders, while the California Medical Association, psychiatric physicians, and PhRMA raised concerns that the board’s proposals could expand pharmacist authority beyond training, affect physician practice, or create safety risks. Other public comments addressed pharmacy technician ratios, remote processing, flavoring medications, hospital-specific regulation, budget and enforcement transparency, and whether the board should add members with community compounding or pharmacy technician expertise. Committee members also asked about the board’s oversight priorities and the rationale for its standard-of-care proposal. Board staff explained that consumer protection includes education, licensing, policy, and enforcement, with the highest-priority enforcement cases being those posing imminent public harm. After public testimony concluded, the chairs thanked participants and adjourned the sunset review hearing, announcing an immediate transition to the joint informational hearing on the Department of Cannabis Control.

Transcript Highlights:

• > of<01:15:32.080> my That's probably five pages of my That's probably five pages of my
• Yeah, snow removal definitely, but uh probably that's probably on you. I rented it.
• <01:53:30.400> that's definitely, but uh probably that's definitely, but uh probably that's
• <02:12:52.800> significant it can really cause significant it can really cause significant
• Catholic Charities as you probably know. Catholic Charities as you probably know.

Keywords: 1191, senate, all

Transcript Highlights:

• If you see me suddenly get up and run out of the room, it's probably so I don't want to disrupt these
• They probably have a better answer than I would. Any other questions from the committee?
• <02:05:36.559> an the culture being not ready causing an the culture being not ready causing
• <02:08:20.760> understand know are going to probably understand know are going to probably
• <02:21:11.600> is would say that the benefit probably is would say that the benefit probably

Keywords: 928, house, all

Summary: The committee first heard House Bill 119-FN, which would allow rental companies registering a rental fleet to choose New Hampshire as their base jurisdiction under the International Registration Plan. The DMV witness said the state already has this capability under the IRP and did not support the bill, adding that no additional staffing should be needed. Committee questions focused on whether the bill would change where registrations are done, what implementation would require, mileage tracking, decals, and inspection requirements. A representative of the Motor Transport Association also said the bill was unnecessary because the option already exists, while noting some related truck-registration and property-tax issues. The chair then closed the public hearing on HB 119-FN with no further speakers. The committee next heard House Bill 612, which would let youth operators renew up to 30 days before turning 21 and receive a temporary license so they can transition to a standard horizontal license without an extra DMV trip. The sponsor and DMV director strongly supported the bill, describing a long-standing problem where early online renewals can trigger another vertical youth license, forcing a duplicate transaction and fee after the birthday. The DMV said the change would reduce confusion and workload, and estimated a one-time system update cost of $48,000. Members asked about whether the proposal was effectively a 30-day extension, how law enforcement would view the temporary status, and whether the system could handle printing and mailing the new horizontal license; the director said the DMV could manage it and that the bill was the best approach. The chair closed the hearing after no one else testified. Finally, the committee heard House Bill 209, which would exempt new vehicles from inspection in the second year after purchase, effectively allowing two years before the next inspection. The sponsor argued the bill would save taxpayers money and reduce unnecessary trips for owners of new vehicles. Supporters said newer vehicles are already maintained through warranties and routine service. Opponents, including the New Hampshire Auto Dealers Association and a service manager from a dealership, argued the bill was not limited to truly new cars, would weaken safety by delaying inspections on vehicles that can still develop tire, brake, and other defects, and could raise costs for everyone else if inspection volume drops. The Motor Transport Association clarified that commercial motor vehicles remain subject to annual federal inspection requirements. No vote was taken in the transcript, and the hearing remained open with testimony continuing.

Transcript Highlights:

• is some building bonds being paid off, and the biggest thing that causes an increase is approval of
• For individual districts, the biggest thing that causes a big drop in their levy from year to year is
• That probably had a fair amount to do with family eligibility.
• You'll probably see this when you turn the page.
• You'll probably see this when you turn the page.

Keywords: 1183, house

Transcript Highlights:

• She probably and cross the tees.
• <01:48:08.719> problems class except the kid causing problems class except the kid causing
• Many of you probably served with her.
• Many of you probably served with her. Many of you probably served with her.
• . direct and that has caused problems.

Keywords: 1183, house

Transcript Highlights:

• Um, if you know what you're doing, you're probably safe.
• Any... causing damage to, you know, outside of causing damage to, you know, outside of the<00:12:48.240
• <00:14:52.880> If<00:14:53.040> you doing, you're probably safe.
• If you doing, you're probably safe.
• <00:14:55.920> So, probably maybe at risk. So, probably maybe at risk.

Bills: SB2671, SB2902

Keywords: permit processing, permitting reform, county permits, development permits, building permits, land use, construction delays, housing development, infrastructure development, county workforce, differential pay, salary incentive, performance bonus, recruitment and retention, expedited hiring, vacancy rates, permit backlog, government modernization, county mayor, county council

Summary: The Senate Committee on Energy and Intergovernmental Affairs heard two measures. SB 2671, relating to essential permitting positions, drew no oral testimony beyond written comments from the Department of the Attorney General and the Office of Planning. The chair said the bill was intended to make government more efficient and reduce red tape in the permitting process. SB 2902, relating to renewable energy, received testimony from the Division of Consumer Advocacy, the Climate Change Mitigation and Adaptation Commission, the Public Utilities Commission, Kauai Island Cooperative, Bright Saver, and 350 Hawaii. Supporters described the bill as a way to expand access to plug-in or balcony solar, lower electricity bills, improve resilience, and broaden access for renters and apartment residents. Several testifiers urged amendments to avoid limiting the measure to condominiums, to remove condominium board approval language, and to eliminate utility or PUC registration requirements. The PUC said registration could help with safety, linemen protection, and circuit hosting-capacity concerns, and noted that improper installation or oversizing could create problems. After a brief recess, the committee voted to recommend both bills for passage with amendments and deferred each to April 19, 2042. The recommendations were adopted without objection.

Transcript Highlights:

• It's probably not more than 20 to 30 cents a day.
• It's been around, probably well, not quite as long as me, but getting there.
• Probably costs a radiology center $25.
• Crazy Probably just in the House. We've done all these compacts.
• In these cases, violence is the cause of their homelessness.

Keywords: 996, all

Transcript Highlights:

• Probably the best for a long-term standard out of all of these is geothermal and hydro.
• So if they were looking for rules, they would probably go to the federal rules first.
• And I think the waste is probably the biggest problem.
• Probably within the next five years, fusion will be a real deal.
• So that's not causing more emissions anywhere else. That is subtracting.

Bills: SB78, SB235, SB22, SB310

Keywords: nuclear energy, renewable energy, sustainability, carbon emissions, energy regulation, microgrid, zero carbon resources, Public Regulation Commission, energy generation, electric utilities, motor vehicle manufacturers, licensing, dealers, franchise agreements, consumer protection, water supply, sewage improvements, environment, funding, Mora County

Transcript Highlights:

• But regardless, we're probably going to start seeing at a minimum about 80,000 people not being able
• We'll probably see some counties that don't have individual market coverage, which is going to be really
• CMS no longer has the ability to give any good-cause waivers.
• It's probably increased a little bit since then.
• Either one of them is probably illustrative.

Summary: The committee first received an update on the effects of HR1 and related federal Medicaid and marketplace changes from Governor’s Office and Health Care Authority staff. Presenters said the most immediate coverage losses are expected in the individual market beginning in January, with premium increases and an estimated 80,000 people potentially unable to afford coverage. They warned that larger Medicaid impacts will follow over the next year and beyond, including tighter eligibility checks, work requirements, reduced retroactive coverage, limits on state-directed payments and provider taxes, new cost-sharing, and changes affecting certain non-citizen adults. They also said the state plans to seek a waiver or extension for work requirements and will continue to analyze impacts, including on rural providers and Planned Parenthood-related services. Members asked about the effect on nursing homes, rural hospitals, and how the state can help providers and enrollees navigate the new requirements; staff said timelines and a state-specific implementation chart are being developed. The committee then heard a report on the International Medical Graduate Work Group and Washington’s efforts to create pathways for internationally trained physicians. Testimony described the clinical experience license, the clinical evaluation assessment tool, grant funding for IMG support organizations, and a new hardship waiver process enacted this year. National presenters said many states have adopted similar pathways because of physician shortages, but Washington and Tennessee are among the few states that have actually issued licenses so far. They recommended clear guardrails, an employment offer before application, ECFMG certification, supervised practice, and data collection to avoid exploitation and protect patients. Members asked about state-to-state variation, retention of IMGs, and whether Washington should pursue dedicated residency or preceptorship options; presenters said the key next step is moving successful participants from supervised experience to a durable long-term license. The final topic was implementation of Washington’s Apple Health doula benefit and the statewide doula hub and referral system. Senator T’wina Nobles highlighted the state’s $3,500 per-birth Medicaid reimbursement rate for doulas and the importance of the hub for referrals, training, and billing. Health Care Authority staff said the benefit launched January 1, 2025, and covers prenatal intake, labor and delivery, postpartum visits, and telehealth-supported services. They reported 336 state-certified doulas, 134 enrolled in Apple Health, 287 unique clients served, and 641 claims paid so far. Testimony emphasized doulas’ role in improving birth outcomes, reducing unnecessary interventions, and addressing racial disparities in maternal health, while noting that implementation is still early and ongoing.