Transcript Highlights:

• And that's really due to the changing population for Medicaid expansion.
• And that's really due to the changing population for Medicaid expansion.
• Chair, we have done value-based purchasing and Medicaid for a while.
• value-based kind of payment structure in our Medicaid program.
• Chair, I think that's it for Medicaid specifically.

Committee: Senate Appropriations - Human Resources Division

Summary: The Senate Appropriations HR Division met with all members present to review the medical services portion of the HHS budget. Sarah Aker, Executive Director of Medical Services, walked the committee through several budget items, including HCBS cost-to-continue adjustments, the DD bed assessment, expansion of value-based purchasing, targeted rate increases for home health and QSP services, and the cross-disability waiver. Members generally supported the targeted increases for home health and QSP, and Aker explained that the cross-disability waiver funding would support startup work, service design, and infrastructure ahead of a planned July 1, 2028 implementation. The committee spent significant time on rate-setting and provider payment issues. Members discussed ambulance rate rebasing, with several senators expressing concern that the proposed increase was too high relative to peer states; the committee ultimately moved toward reducing that item to $1 million rather than zero so it could be revisited in conference committee. They also discussed a House-added critical access hospital networking grant and similarly leaned toward reducing it to $1 million. Aker explained the department’s value-based purchasing plans, including use of a vendor selected through RFP, and clarified how the department’s existing Medicaid managed care and hospital value-based programs work. A major portion of the meeting focused on long-term care and basic care payments, including a House-added extension of the $5 per day basic care add-on and a proposed shift in nursing facility incentive grants toward a withhold-based model. Senator Mathern indicated he would bring an amendment to delay or modify the withhold change, and Aker said the department would prefer language that directly addresses whether a withhold may be implemented. Members also discussed 1915(i) services, FMAP changes, the Medicaid legacy system modernization carryover, and a House-added legislative intent section on medical assistance. The committee adjourned for the morning with plans to return later to continue Human Services budget work and revisit unresolved items in conference committee.

Transcript Highlights:

• The decreases primarily stem from federal government cuts to Medicaid eligibility and related Medicaid
• and Medicaid behavioral health.
• And then a $66.6 million decrease in Medicaid.
• Medicaid-covered adults.
• They will no longer qualify for Medicaid.

Committees: Senate Senate Finance , Senate House Appropriations & Finance

Transcript Highlights:

• Look at Medicaid.
• ><c> time,</c><01:38:31.920><c> the</c><01:38:32.159><c> state</c> Medicaid.
• Once upon a time, the state Medicaid.
• Numerous recent polls and studies show strong bipartisan support for redistricting reform, including
• I'm here to speak in favor of HB 1487 as a measured common sense reform that strengthens New Hampshire's

Committee: House Election Law

Transcript Highlights:

• Medicaid is fully funded, although Medicaid is funded in many, many different places in the budget.
• that's in Medicaid.
• Medicaid has had some good years.
• Numbers in Medicaid.
• Medicaid is funded in many, many spots.

Committee: Senate Finance

Transcript Highlights:

• </c> all Medicaid programs. all Medicaid programs.
• Each state runs their own Medicaid<01:13:36.880><c> program</c> Medicaid program Medicaid program uh<
• Government shutdown, is Medicaid closed? And no, Medicaid is open, Medicaid is funded.
• So, um, no, Medicaid medicines.
• </c> the Medicaid program. the Medicaid program.

Summary: The House Committee on Human Services held an informational briefing on the impacts of federal funding cuts, inflation, labor shortages, and chronic underfunding on Hawaii’s nonprofit social safety net. Hawaii Community Foundation opened with a story about a federal worker family relying on food pantry support, then described a “perfect storm” facing human services nonprofits: historically high demand, rising costs, staffing challenges, federal cuts, and state and county contracts that do not cover true service costs. The foundation said it has reactivated its Hawaii Resilience Fund, launched strengthened service grants, and is tracking policy changes and data to help nonprofits respond. Trey Gordner of UHERO presented research on the vulnerability of Hawaii’s nonprofit sector, explaining a framework that assessed political, financial, and structural risk. He said about 8,200 501(c)(3) nonprofits are active in Hawaii, but only about 200 receive direct federal funds; 74 grants to 59 organizations were flagged as politically at risk, totaling about $126 million in unpaid obligations. He said about 68 of the direct-funding recipients rely on federal funds for more than 20% of annual revenue, and that human services nonprofits are among the most exposed subsectors because they serve vulnerable populations and depend heavily on federal support. Catholic Charities Hawaii and the Hawaii True Cost Coalition said community-based organizations were already under strain before the current crisis, with most contracts not covering full costs and many groups depending on private philanthropy to fill gaps. They reported that half of surveyed organizations expect to reduce programs, more than a third may decline future contracts, and some are waiting months for reimbursements. Examples included reduced shelter admissions, fewer case management hours, and cutbacks in kūpuna services. The coalition urged higher contract rates, regular inflation and cost-of-living reviews, and timely reimbursement; no votes or formal actions were taken. Partners in Development Foundation described the loss of Native Hawaiian education funding as especially damaging, saying the federal Department of Education has zeroed out support that creates a roughly $46 million gap, including about $20 million for early childhood programs. The speaker shared a family story from the Nā Pono program to illustrate how early learning services support both children and parents, and warned that the organization’s federal funds make up 72% of its budget. The briefing ended with a call for continued emergency funding and longer-term structural changes to sustain nonprofits statewide.

Transcript Highlights:

• In Washington State, we refer to our Medicaid program as Apple Health.
• As the Medicaid plan. And I don't hear that argument.
• Our focus with the bill is the support of the state's Medicaid system.
• Our focus with the bill is the support of the state's Medicaid system. members.
• One thing I sometimes hear is that Medicaid enrollees are freeloaders.

Summary: The Ways and Means Committee met on January 20, 2026, hearing several bills related to retirement systems, school employee health coverage, port district pensions, environmental fee accounts, developmental disability services, legislative budget transparency, and a new Apple Health employer assessment. Early in the meeting, the committee heard SB 5834, which would make permanent a temporary expansion allowing certain retirement trust fund earnings to pay broader administrative expenses, and SB 5835, which would raise the lump-sum retirement allowance threshold for Plan 2 members from $50 to $250. Both bills were presented by Department of Retirement Systems staff and supported by the department, with questions focused on the scope of the administrative-expense language in SB 5834 and the technical nature of SB 5835. The committee then entered executive session and moved three bills without recommendation to the Rules Committee: Substitute SB 5249, allowing kit homes as emergency housing; Substitute SB 5053, allowing certain counties to include school district boundaries when forming a public facilities district; and Substitute SB 5203, directing state agencies to develop a wildlife habitat connectivity strategy and creating related accounts. After returning to public hearing, members heard SB 5883 on SEBB eligibility for school employees in their second school year of employment. Supporters, including labor representatives and individual school workers, said the bill would reduce coverage gaps and improve recruitment and retention, while school district officials and administrators argued it would create an unfunded mandate, increase costs, and add administrative burden. No action was taken on the bill. The committee also heard SB 5905, which would exclude certain port district employees from PERS if they are covered by the federal Railroad Retirement Plan or a collectively bargained defined benefit pension plan. Port representatives, labor stakeholders, and the Department of Retirement Systems described it as a narrow technical fix to avoid duplicate pension coverage and retroactive liabilities, and the bill drew support. SB 6151 would create dedicated accounts for Ecology fee revenue tied to laboratory accreditation and landfill methane work; Ecology and county representatives supported the measure as a way to reinvest fees in the programs that generate them. SB 6163 would require the Individual and Family Services waiver for developmental disability services to be budgeted at maintenance level; advocates said it would stabilize services and prevent waitlists, and no opposition was heard. The final two bills were SB 6177, which would require LEAP’s budget website to display additional budget detail such as carry-forward data, program and subprogram expenditures, and balance sheets for all public accounts, and SB 6173, which would create an Apple Health employer assessment on larger private employers with workers enrolled in Medicaid expansion coverage. SB 6177 was framed as a transparency measure, while SB 6173 drew extensive testimony both in support and opposition: supporters said it would help offset expected Medicaid losses after federal work requirements take effect and stabilize the health safety net, while opponents argued it would be an unfunded tax, create administrative and legal complications, and could discourage hiring or reduce hours. The committee heard no final votes on the public hearing bills, and staff reminded members that signature sheets would be held for 24 hours under Senate rules.

Transcript Highlights:

• more difficult by removing funding from Medicaid.
• So they're leaving and they'd automatically go on to a state program such as Medicaid.
• The penalty for not complying could be cuts to our Medicaid... Mr. Chairman, that is correct.
• The penalty for not complying could be cuts to our Medicaid.
• Where in Medicaid, if that cut were to happen, is that cut to basic Medicaid or where to Medicaid bans

Committee: House Health and Welfare

Transcript Highlights:

• But what is the differentiator there between expansion compared to traditional Medicaid?
• And so they're not taking Medicaid like they were.
• This committee provided $25 million to go towards Medicaid.
• This committee provided $25 million to go towards Medicaid.
• We've given them money to Medicaid services, not necessarily because we wanted to.

Summary: The committee met briefly to clarify priorities for available funding, with the chair noting that JFAC had already removed funding for one SRO-related item and that the committee would need to decide how to proceed. Senator Kevin Cook was invited to outline several potential behavioral health and Medicaid-related uses of funds, emphasizing that he was not lobbying but providing information on costs and impacts. Much of the discussion focused on three behavioral health services that had been cut: Assertive Community Treatment (ACT), Adult Peer Support Services, and Healthy Connections. Senator Cook and Department of Health and Welfare Medicaid administrator Sasha O’Connell described ACT as an evidence-based team service for people with severe mental illness, noting it had been cut under the governor’s holdback and that restoring it would cost about $1.3 million for the remainder of FY 2026 and $4.1 million in FY 2027. Peer support was described as a trained recovery-based service, with estimated costs of $2 million for FY 2026 and $6 million for FY 2027. Healthy Connections, which had ended due to statute rather than department action, was estimated at $1.5 million to finish FY 2026 and $6.3 million for FY 2027. O’Connell explained that the cuts were driven by budget holdbacks and limited options under state and federal law, and that ACT had been moved into the Magellan Medicaid contract to leverage federal matching funds. Members asked about the Medicaid match, the number of people served, and why these services were not included in earlier Medicaid funding decisions. Several members and Senator Cook argued that ACT in particular reduces costs and risks by preventing hospitalizations, jail stays, and law enforcement crises, and cited letters and personal examples supporting the program. The committee did not take final action, but members expressed support for ACT and discussed whether statutory changes or another meeting would be needed before any funding decision.

Transcript Highlights:

• Medicaid expansion, which would otherwise prohibit this.
• rolls, of people being dropped off the Medicaid rolls arbitrarily.
• Of people being dropped off the Medicaid rolls arbitrarily.
• Who wants to go to still be qualified and want to still be on Medicaid.
• The Medicaid error rate and the SNAP error rate are very concerning.

Summary: The House first established a quorum after several members were absent, then moved into bills for perfection. House Bill 261, dealing with anti-Semitism in public schools and higher education, drew extensive debate. The sponsor described rising anti-Jewish incidents and said the bill would require educational institutions to adopt nondiscriminatory policies, use the IHRA definition as a guide, and treat failures to address harassment as Title VI issues. An amendment from the gentleman from Pulaski was adopted to clarify that protected First Amendment speech, religious expression, and political viewpoints would not be reported or cataloged. Supporters said the bill was needed to protect Jewish students; opponents argued it singled out one group, could chill speech about Israel and Palestine, and created unequal reporting requirements. The House ultimately ordered the bill perfected and printed as amended. The chamber then took up House Bill 2384 on housing affordability and building codes. The sponsor said the bill would lower housing costs by rolling back energy-code mandates to 2009 standards, setting clearer permitting timelines, and allowing certain multifamily buildings to use a single staircase. Supporters argued current codes raise costs, discourage builders, and contribute to Missouri’s housing shortage. Opponents raised concerns about local control, preemption of municipal energy standards, and public safety, especially the single-stair provision; the sponsor responded that the design has been used safely in other states and cities. A Pulaski amendment requiring municipalities with online ordinances to keep only one hard copy available was adopted, and after debate the previous question was moved and approved. The House then adopted the committee substitute and ordered the bill perfected and printed. House Bill 1766, addressing personal property tax, was also perfected and printed. The sponsor said the bill would apply Hancock/CPI-style tax limitations to personal property tax growth, arguing that rapidly rising vehicle values had created a windfall for political subdivisions and unfairly increased taxpayer burdens. Supporters said the bill would slow growth without eliminating it, while opponents argued local governments need revenue to keep up with inflation and that the measure would reduce resources for schools and other services. Finally, the House began consideration of House Joint Resolution 154, which would place into the Missouri Constitution a Medicaid work requirement mirroring federal policy. The sponsor said adults ages 19 to 64 would need to work, volunteer, participate in a work program, or attend school for 80 hours a month to remain eligible, and the discussion began with questions about whether the constitutional change was necessary and how documentation requirements would work.

Transcript Highlights:

• Also worked with Medicaid and providers to expand access to services for Medicaid members in 2014.
• traditional Medicaid waiver, Unlike traditional Medicaid waiver, eligibility<01:07:32.480><c> is</c>
• </c> qualify for waiver based Medicaid qualify for waiver based Medicaid eligibility<01:11:13.520><c>
• </c> partnership with DCBS and with Medicaid partnership with DCBS and with Medicaid to<01:14:22.400>
• </c> possibilities in the Medicaid toolbox. possibilities in the Medicaid toolbox.

Committee: Joint Families & Children

Transcript Highlights:

• uh, the department, so for example, we would have the Department of Human Services investigating Medicaid
• for example, Department of Human Services has primary responsibility to investigate fraud in the Medicaid
• </c> the Medicaid program. That's their job. the Medicaid program. That's their job.
• So only if Medicaid fraud if necessary.
• fraud they have to revert refer Medicaid fraud they have to revert refer it<00:15:51.759><c> to</c><

Committee: Senate State and Local Government

Transcript Highlights:

• I know at the end of last session, we set aside $100 million for Medicaid.
• Do we have something similar to that within fee-for-service Medicaid?
• Every Medicaid state has to offer them.
• One was an increase for Medicaid fees for the pediatric portion.
• Medicaid. Go to them. Tell them that's where the money is. Go and talk to them.

Committee: All ALC-ADMINISTRATIVE RULES

Summary: The Administrative Rules Subcommittee of the Arkansas Legislative Council reviewed several agency rules and requests. It approved without objection an Insurance Department amendment implementing Act 261’s holding company system requirements, two State Board of Election Commissioners rules on poll watchers/provisional voting and certified election monitors, and a Treasurer of State rule removing DEI-related membership requirements to comply with Act 938. The committee also held over for a month a Department of Education request related to excluding a rule from reporting requirements so it could be discussed further with the Department of Commerce. A major portion of the meeting focused on the Department of Human Services’ request to be excluded from rulemaking for Acts 567, 568, 967, and 1025. DHS said federal CMS guidance created comparability and other issues for the Medicaid-related dental and diagnostic lab provisions, making it difficult to implement the acts as written by their effective dates. DHS outlined possible paths, including broader adult dental coverage, waivers, or splitting the dental rate increase from the special-needs cap increase. The Arkansas State Dental Association disputed DHS’s approach, arguing Act 1025 is workable, that the pediatric rate increase should move forward separately, and that DHS should continue pursuing the law rather than stop rulemaking. Committee members questioned both sides extensively about CMS correspondence, waiver timelines, fiscal impact, and whether the acts could be severed. After testimony from DHS, the Dental Association, and a public commenter, the committee adopted a motion not to exclude DHS from reporting requirements for Acts 567, 568, 967, and 1025, meaning DHS must continue the normal rulemaking/reporting process. The committee then accepted the Division of Higher Education’s report, which recommended repealing three of its 32 rules and keeping the remaining 29 in effect. It also received routine written updates on older and newer rulemaking items and filed the monthly updates without further action.

Transcript Highlights:

• And just the application, the the the time that it takes to get Medicaid in place.
• sheriff cost Medicaid? >> Patients so share of cost is actually not a full Medicaid program.
• They have to go on for Medicaid program which is an WA or MTD MTV.
• It every client on the waiver program was put under mtd Medicaid. That is protected Medicaid.
• And we've had some issues with Medicaid, but we're grateful for the services.

Transcript Highlights:

• </c> Medicaid Fraud Unit. Medicaid Fraud Unit.
• >> Yes, Medicaid provider fraud. That's what the Medicaid Fraud Control Unit does.
• </c> subpoena power beyond Medicaid fraud? subpoena power beyond Medicaid fraud?
• </c> Medicaid fraud. Medicaid fraud.
• Um so like Medicaid provider.

Committee: Senate Judiciary and Public Safety

Transcript Highlights:

• We've also had some reports on pieces of the Medicaid budget.
• and putting it back in Medicaid.
• and putting it back in Medicaid.
• That doesn't mean I won't come back with something on Medicaid expansion also.
• The bill that I am drafting actually takes Medicaid, makes it...

Summary: The committee first heard reports from the House and Senate Health and Welfare chairs on budget issues and related policy concerns. Senator Van Orden said the department’s non-Medicaid budget had been presented and that members were focused on scrutinizing public health contracts, avoiding broad across-the-board cuts, and preserving essential services. She also said she was not in favor of moving 988 suicide crisis hotline services into the behavioral health managed care contract at this time, while Representative Tanner noted prior intent language had only required a cost-benefit analysis and that any change would need more detail. Representative Van der Woude said the House committee was committed to a bill holding back about $21 million for RESHAB, with audit and oversight provisions, and raised concerns about rural health fund oversight, provider rate reductions, and Medicaid expansion spending. Members then questioned the chairs about possible policy changes to reduce costs, including reviewing programs not in Idaho Code, restoring provider rates if revenues improve, and adding work requirements or enrollment caps to Medicaid expansion. Van der Woude said he was drafting a bill that would let Medicaid expansion expire and restart with work requirements and a cap, and he said he would support an asset-based waiver request for people with substantial assets. Several members raised concerns about the human impact of cuts, especially in adult dental and developmental services, while others emphasized the need for clearer evaluation tools and better return-on-investment data for programs. Van der Woude explained that RESHAB funding concerns stemmed from unclear assessment standards and the loss of a prior evaluation tool in litigation, and Senator Wintrow cautioned that a straight $21 million reduction could harm services and providers. The committee then heard from House Agricultural Affairs Chair Gerald Raymond, who reviewed agriculture-related budget items and emphasized the importance of dedicated funds, research, and invasive species prevention. He highlighted funding for quagga mussel prevention, Mormon cricket control, Japanese beetles, and carnal bunt response through a deficiency warrant, and said prevention at boat check stations is cheaper than treatment. He also discussed the University of Idaho dairy/cafe project, saying the facility was nearing completion and expected to have about 400 cows milking by the end of the summer. Members asked about the impact of recent cuts on check stations, and Raymond said his committee had not yet discussed that issue but would consider it, and that the Snake River Basin study had mostly been left to the resource committees. The meeting ended with notice that work groups would meet immediately after adjournment and that budget-setting would begin the next day, with the committee reconvening at 7:15 a.m. and the full committee at 8:00 a.m.

Transcript Highlights:

• But for the operating budget, there was some discussion earlier about Medicaid and supporting Medicaid
• There, of course, is the Health Care Authority and Medicaid.
• Medicaid program.
• We're looking at pieces here of the Medicaid program.
• They're pulling from Medicaid funds in Wisconsin.

Committee: House Tobacco Settlement Revenue Oversight Committee

Transcript Highlights:

• I know we have people already dropping off of Medicaid.
• Are these not already billable through Medicaid?
• Medicaid, prior, you could get these services through Medicaid.
• Warning about what New Mexico should prepare itself for Medicaid.
• we try to sort out how we use Medicaid wisely.

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:

• Redmond, up next on the agenda is RS-33-456, Medicaid presumptive eligibility.
• Hospital presumptive eligibility is a Medicaid program that...
• It says in the statement, ...determined to be qualified for Medicaid.
• And there's charts to see whether they're going to qualify for Medicaid or not.
• What I like about this is that it's not saying that they can't enroll people in Medicaid.

Committee: House Health and Welfare

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.