Transcript Highlights:

• We've enhanced activities that generate more revenue for the Medicaid program, like collecting certain
• And financing of our own Medicaid program.
• In many cases, PBMs will not allow the Medicaid recipient to go to a local pharmacist.
• Medicaid controls the budget.
• Some of these plans have decided not to offer commercial insurance anymore and just do Medicaid.

Summary: The committee first heard Senate Bill 1414 by Sen. Polsky on congenital cytomegalovirus (CMV) education. The bill would require the Department of Health, working with medical experts, to create and distribute CMV educational materials to expectant and new parents or caregivers through hospitals, birth centers, and OB/GYN practices. An amendment removed a section that would have required instruction for medical professionals, and the amended bill was reported favorably as a committee substitute. The committee then took up a block of confirmations. Appointees on tabs 2 through 7 were recommended favorably in one vote, and Chavon Harris was separately confirmed as Secretary of the Agency for Health Care Administration after extensive questioning. Senators praised her leadership and experience, while others raised concerns about Medicaid redeterminations, the state’s CORE modernization project, Hope Florida, and a DCF anti-marijuana ad campaign; Harris said she would follow up on some issues and defended the agency’s work on transparency, managed care oversight, and access to care. Her confirmation was recommended favorably, with Sen. Berman noting opposition. Several health-related bills were then heard and advanced. SB 186 by Sen. Garcia expanded epilepsy training requirements for school personnel, including charter school bus drivers, and was reported favorably. SB 902 by Sen. Garcia, after amendments narrowing dental workforce provisions and allowing certain seizure rescue medication delegation to family home health aides, was reported favorably; testimony focused on medical marijuana regulation, practitioner accountability, and concerns about park and child-care proximity restrictions. SB 196 by Sen. Sharif created a uterine fibroid research database with privacy protections and was reported favorably after emotional testimony from a patient and supporters. SB 688 by Sen. Rodriguez would reestablish licensure of naturopathic doctors; it drew both support and skepticism about diagnosis and treatment boundaries, but was reported favorably. SB 1574, Maddie’s Law, would add biliary atresia screening to newborn screening and was strongly supported by parents describing a delayed diagnosis; it was reported favorably. SB 878 on clinical laboratory personnel, SB 1092 on podiatric medicine and certain cellular/tissue-based products, and SB 1032 on medical marijuana registry timelines and veteran fee waivers were also reported favorably, while SB 1032 drew debate over longer renewal/supply periods. The committee then began SB 1760 on Medicaid oversight and program transparency, with the sponsor describing the bill’s creation of a joint legislative oversight committee and a legislative actuary.

Transcript Highlights:

• Medicaid recipient.
• This next rule does two things in the Medicaid program.
• This next rule does two things in the Medicaid program.
• Our system does allow for that, so that is not a problem within either the Medicaid rules or the Medicaid
• to Medicaid clients.

Summary: The committee reviewed a series of Arkansas Medicaid and Department of Health rules, many implementing 2025 acts. Early items covered presumptive eligibility and Medicaid policy updates, including adding a definition of fictive kin for foster children and changing the disability onset age for ABLE accounts from 26 to 46. Another rule clarified that continuous glucose monitors may be billed by both pharmacies and durable medical equipment providers, with committee members questioning prior authorization timing, system lag, and a fiscal impact estimate of about $3 million over two years; the rule was reviewed, but members requested additional cost breakdowns. Other Medicaid-related rules addressed an RSV vaccine administration fee increase, an ET3 telemedicine exemption for ambulance treat-triage-transport services, a dental rate increase under Act 1025, expanded physical therapy access, and the Healthy Moms, Healthy Babies package covering doulas, lactation consultants, remote monitoring, and expanded prenatal testing. Most were reviewed without objection after brief discussion or no questions.

Transcript Highlights:

• I'm the Deputy Secretary for Medicaid.
• Find out and have individuals call to find out how many Medicaid patients a provider will take.
• For this amendment, the Centers for Medicare and Medicaid Services awarded the agency $209 million to
• service to individuals and Medicaid Within general revenue and trust funds, under the Medicaid service
• to individuals and Medicaid long-term care budget entities, to address projected surpluses.

Summary: The Legislative Budget Commission considered 21 budget amendments, most of them routine authority adjustments tied to federal grants, Medicaid payment programs, and trust fund realignments. The Department of Education received $14.751 million for a Preschool Development Grant to support early learning system improvements, workforce credentialing and training, IT modernization, and related early childhood certification work. The Department of Veterans Affairs shifted $2.2 million within its trust fund to cover higher nursing home occupancy, replace contract nursing with OPS staff, and meet rising operating costs. The Department of Health moved about $9.1 million to support Disability Determinations, where roughly 140,000 cases were pending or in process, and said the change would help reduce backlog and avoid a deficit. The Agency for Health Care Administration presented multiple amendments for Medicaid-related programs, including $766 million for indirect medical education, $1.9 million for managed care network adequacy audits, $209 million for the Rural Health Transformation Program, and several large supplemental payment programs for hospitals and physicians; members asked about CMS approval delays, provider access, and how rural funds would be distributed. The commission also adopted an amendment realigning KidCare funds, placing a $32.1 million surplus into reserve, though several members objected that the state had not yet implemented the 2023 KidCare expansion and that children remained on a wait list. Another Medicaid amendment placed a $376 million surplus into reserve after updated estimating conference projections. Other agencies also received approvals. FDLE received $16.26 million to buy counter-unmanned aircraft systems equipment such as radar and RF sensors to detect and mitigate drone threats. The Department of Juvenile Justice received $1.6 million for the Florida Scholars Academy and a Social Services Block Grant realignment, with staff confirming corrective action had been taken after prior audit findings about allowable SSBG spending. The Division of Emergency Management received federal pass-through authority for FIFA World Cup security and counter-UAS funds, both controlled by the Miami host committee, and members noted the state had little direct oversight over how those local grants would be used. The Department of Commerce received $148.4 million for Community Development Block Grant Disaster Recovery work, with questions focused on the split between housing, infrastructure, and administrative costs. The Department of State received $408,377 for arts and culture federal grant obligations. All amendments were adopted, generally without objection, after brief questioning and no public testimony.

Transcript Highlights:

• I'm the Deputy Secretary for Medicaid.
• For this amendment, the Centers for Medicare and Medicaid Services awarded the agency $209 million to
• Under the Medicaid services to individuals and Medicaid long-term care budget entities to address projective
• services to individuals and Medicaid...
• Within general revenue and trust funds, under the Medicaid services to individuals and Medicaid long-term

Summary: The Legislative Budget Commission met to consider 21 budget amendments, beginning with the Department of Education’s request for $14.751 million in federal grant authority for the Preschool Development Grant. Members asked whether any funds would support VPK or provider payments; the department said the money is for birth-to-kindergarten early learning work, including IT modernization, workforce credentialing, training, and streamlining director certification. The amendment was adopted without objection. The commission then approved amendments for the Department of Veterans Affairs to shift $2.2 million within its trust fund to cover higher nursing home occupancy and reduce staffing agency use, and for the Department of Health to realign about $9.1 million for disability determinations amid a backlog of roughly 140,000 cases. The Agency for Health Care Administration presented multiple Medicaid-related amendments, including $766 million for indirect medical education, $1.9 million for managed care network adequacy audits, $209 million for the Rural Health Transformation Program, and several large supplemental payment programs for KidCare, hospitals, physicians, cancer hospitals, nursing IME, and public hospital payments. Members questioned network adequacy, rural access, and the KidCare surplus and expansion; the KidCare realignment drew debate, with some members objecting because the 2023 eligibility expansion has not been implemented, but the amendment passed on a roll call vote. Other amendments adopted included FDLE’s $16.3 million for counter-UAS detection and mitigation equipment, DJJ’s $1.6 million for Florida Scholars Academy and a Social Services Block Grant realignment, and emergency management pass-throughs for FIFA World Cup security and counter-drone funding to the Miami host committee. The Department of Commerce received $148.4 million for disaster recovery under the CDBG-DR program, with questions about the split between housing, infrastructure, and administrative costs. The Department of State also received $408,377 for arts and culture grant authority. Most amendments were adopted without objection, and the commission adjourned after completing the agenda.

Transcript Highlights:

• Chairman and members of the Senate Medicaid Committee.
• Senate Bill 2674 is about access to care, hospital stability, and fairness in how Mississippi's Medicaid
• procedures is significantly below Medicare and below most southern states. in how Mississippi's Medicaid
• in how Mississippi's Medicaid program<00:01:04.640><c> pays</c><00:01:04.960><c> for</c><00:01:05.119
• to gain meaningful allowing Medicaid to gain meaningful long-term<00:02:57.120><c> savings.

Summary: The Senate Medicaid Committee heard testimony on Senate Bill 2674, which would increase Mississippi Medicaid reimbursement for outpatient vagus nerve stimulation (VNS) procedures used to treat drug-resistant epilepsy. Dave Weinberger of LivaNova said current Medicaid rates are far below Medicare and most neighboring southern states, creating financial pressure on hospitals and causing some to stop offering the procedure. He argued the therapy provides durable clinical benefits and long-term savings for Medicaid, and said the bill would align Mississippi’s rates with Medicare’s 2026 outpatient rates and with other states. Weinberger said the bill would set reimbursement at $45,000 for CPT 64568 and $35,000 for CPT 61885, and framed the measure as improving access, hospital stability, and fairness for vulnerable patients. Committee members did not ask questions during this hearing, though the chair noted the bill had been double referred and would go to appropriations, with a more detailed hearing scheduled for the next day. After discussion, a motion was made that the title was sufficient and the bill do pass. The committee approved the motion, and the bill was reported out of committee.

Transcript Highlights:

• </c> Medicare reimburse Medicaid Medicare reimburse Medicaid reimbursement<00:38:26.960><c> rates</c>
• </c><01:00:48.640><c> facing</c><01:00:49.040><c> a</c> Medicaid even though we're facing a Medicaid
• </c> Medicaid, or buying a marketplace plan. Medicaid, or buying a marketplace plan.
• </c> for the non-federal share of Medicaid for the non-federal share of Medicaid for<01:56:51.760><c>
• </c> anymore and they apply for Medicaid. anymore and they apply for Medicaid.

Committee: Senate Health and Human Services

Transcript Highlights:

• Medicaid impact. Also, these premium increases. So I thank you for working this out.
• So this is just allowing for us to look at options outside of just the Medicaid.
• Or Medicaid, Medicare, or any other type of coverage that meets basic standards.
• Our population is about 2,500 and 14,920 individuals are on Medicaid.
• McKinley County has a population of about 72,000, with 47,388 individuals on Medicaid.

Committee: Senate Senate Health & Public Affairs

Transcript Highlights:

• get Medicaid pay reimbursement.
• business and finance, Medicaid, you all wrote in one.
• Uh, we're going to try to give you the committee Medicaid 101, if you would, on how we pay for Medicaid
• </c> to give you um the committee Medicaid to give you um the committee Medicaid 101<00:09:08.720><c>
• </c> for Medicaid for Medicaid and<00:09:15.040><c> how</c><00:09:15.200><c> the</c><00:09:15.440><c>

Committee: Joint Medicaid

Transcript Highlights:

• Medicaid and Healthcare Partnership.
• We have expertise on the Medicaid program and Medicaid billing, and I think that one of the things that
• to bill for Medicaid medically necessary services.
• They are subject to all of the Medicaid regulations and policies.
• Medicaid program, but this is not entirely accurate.

Bills: SB623 , SB1266 , SB1310 , SB1373 , SB1580 , SB1952 , SB2032 , SB2269 , SB2544 , SB2653 , SB2796

Committee: Senate Health & Human Services

Transcript Highlights:

• Medicaid. So this is to help catch more fraud.
• He's been a longtime advocate now. ...for criminal justice reform and trying to improve public safety
• We've talked about bail reform; we're further criminalizing it.

Bills: SB31 , SB33 , SB20 , SB217 , SB264 , SB269 , SB650 , SB681 , SB528 , SB502 , SB740 , SB916 , SB995 , SB10 , SB2581 , SB2570 , SB3031 , SB24 , SB379 , SB1171 , SB1121 , SB1120 , SB1061 , SB1036 , SB1019 , SB890 , SB11 , SB868 , SB1188 , SB1254 , SB2778 , SB2543 , SB2443 , SB1333 , SB1259 , SB1401 , SB1404 , SB2139 , SB2165 , SB2237 , SB2268 , SB1202 , SB1198 , SB1212 , SB1451 , SB1470 , SB1498 , SB965 , SB1547 , SB1667 , SB1818 , SB1902 , SB2129 , SB2078 , SB2069 , SB1737 , SB1589 , SB1318 , SB387 , SB1150 , SB1574 , SB2127 , SB3034 , SB860 , SB1278 , SCR5 , SCR32 , SB4 , SB23 , SB1762 , SB34 , SB60 , SB706 , SB1814 , SB1220 , SB523 , SB565 , SB1253 , SB840 , SB764 , SB2383 , SB2155 , SB1535 , SB1423 , SB1566 , SB1804 , SB1728 , SB1816 , SB1952 , SB75 , SB2068 , SB1455 , SB213 , SB627 , SB2037 , SB670 , SB896 , SB917 , SB1184 , SB971 , SB1255 , SB1261 , SB1283 , SB991 , SB1733 , SB21 , SB231 , SB739 , SB1252 , SB1371 , SB646 , SB3 , SCR27 , SB552 , SB1405 , SB1948 , SB243 , SJR1 , SB31 , SB33 , SB20 , SB217 , SB264 , SB269 , SB650 , SB681 , SB528 , SB502 , SB740 , SB916 , SB995 , SB10 , SB2581 , SB2570 , SB3031 , SB24 , SB379 , SB1171 , SB1121 , SB1120 , SB1061 , SB1036 , SB1019 , SB890 , SB11 , SB868 , SB1188 , SB1254 , SB2778 , SB2543 , SB2443 , SB1333 , SB1259 , SB1401 , SB1404 , SB2139 , SB2165 , SB2237 , SB2268 , SB1202 , SB1198 , SB1212 , SB1451 , SB1470 , SB1498 , SB965 , SB1547 , SB1667 , SB1818 , SB1902 , SB2129 , SB2078 , SB2069 , SB1737 , SB1589 , SB1318 , SB387 , SB1150 , SB1574 , SB2127 , SB3034 , SB860 , SB1278 , SCR5 , SCR32 , SB546 , SB647 , SB648 , SB1493 , SB1709 , SB2001 , HB5669 , HB3115 , HB5655 , HB5675 , HB5689 , HB5690 , HB5653 , HB3228 , HB2802 , HB45 , HB1318 , HB5560 , HB2894 , HB4344 , HB2775 , HB33 , HB 12 , HB148

Keywords: SB 31, Life of the Mother Act, Texas abortion law, medical emergency, reasonable medical judgment, pregnancy complications, maternal health, life-threatening condition, ectopic pregnancy, spontaneous abortion, miscarriage, unborn child, abortion exception, abortion ban, physician liability, health care liability claim, aiding and abetting, Texas Medical Board, State Bar of Texas, continuing medical education

Transcript Highlights:

• HB 1668 relating to Medicaid.
• </c> HB 1668 relating to Medicaid. HB 1668 relating to Medicaid.
• </c><00:10:50.080><c> buy-in,</c> about when we had the Medicaid buy-in, about when we had the Medicaid
• </c> to pay for the Medicaid? That's correct. to pay for the Medicaid? That's correct.
• So, it is for Medicare Medicaid.

Committee: Senate Health and Human Services

Summary: The Health and Human Services committee hearing opened with notice that the meeting was being streamed and could reconvene later if technical problems forced an abrupt end. The chair also announced a one-minute testimony limit and proceeded through several bills, taking mostly written and oral support testimony and asking limited questions. No votes were taken in the portion provided. HB 1626, relating to youth penalties, drew strong support from the Office of Hawaiian Affairs, youth advocates, the ACLU, the Department of Education, and others. Testifiers said financial sanctions on youth are ineffective, disproportionately burden Native Hawaiian youth, and function as poverty penalties; they urged replacing fines with community service, restorative practices, and ʻāina-based programs, and eliminating uncollectible legacy debt. The chair moved on after no member questions. HB 1643, relating to pharmacy, was discussed with support from the Hawaii Pharmacists Association, Kaiser, the Board of Pharmacy, independent pharmacies, and PBM representatives. Testimony focused on amendment language, audit procedures, HIPAA concerns, and the need for flexibility for small island pharmacies. HB 1668, relating to Medicaid, received broad support from disability advocates and the Department of Human Services; witnesses said CMS had already approved the underlying state plan amendment removing income and asset limits for certain workers with disabilities, but they wanted the protection codified in law to preserve it long term. The chair asked whether codification was necessary and was told it would not be harmful and would help ensure continuity if federal policy changed. The committee then heard HB 1550 on drug paraphernalia and syringe access, with support from Shipta and the Department of Health; testimony emphasized preserving flexibility for the statewide syringe access program to respond to emerging drugs like xylazine. HB 1974, relating to health, was presented as a planning measure for hearing loss; testifiers said Hawaii lacks a comprehensive hearing-loss plan and that the bill would fund a state planning process, not direct services. HB 1858 on vital statistics drew support from clinicians and medical organizations, who said better data on spontaneous fetal deaths is needed and that the term used in the bill is standard medical and CDC terminology. HB 1871 and HB 1966 also received support, with HB 1966’s EMS special fund prompting discussion about the cigarette-tax revenue source; the chair questioned the nexus to EMS, and the Department of Health said the revenue currently funds the special fund and there is no alternative funding stream.

Transcript Highlights:

• and other opportunities that may enable them to become eligible and/or maintain eligibility for Medicaid
• and other opportunities that may enable them to become eligible and/or maintain eligibility for Medicaid
• Senate Bill 28, Senator McCray, Arbitration Reform for State Employees Act of 2026, favorable with two
• But he was big on, you know, different programs to help in prison reform prisons.
• But he was big on, you know, different programs to help in prison reform prisons.

Summary: The Senate reconvened with a quorum present and then proceeded through committee reports, largely adopting favorable reports and amendments without objection. Early measures included SB 530, which funds grants for multigenerational social connection programs for older adults; SB 731, clarifying the legal status of the Maryland Statewide Independent Living Council; SB 809, directing a feasibility study on a caregiver infrastructure program; SB 860, creating an Aging Resilience Fund with reporting and budget protections; SB 910, requiring insurance reimbursement for services provided by graduate-level clinical interns under supervision; and SB 972, making several Baltimore City alcoholic beverages licensing changes. Each of these bills was advanced to third reading after committee amendments were adopted. The Finance Committee also advanced SB 555, establishing a Dementia Services and Brain Health Program and a provider resource toolkit for dementia care; SB 757, creating a Maryland Local Sourcing Portal to connect businesses with local sources for tariff-impacted goods; SB 772, creating an employment training and opportunity database to help people qualify for or maintain Medicaid and SNAP; SB 792, requiring hospitals to adopt and train staff on immigration-enforcement policies consistent with Attorney General guidance; SB 869, establishing a workforce training pilot program through Commerce and community colleges; SB 905, creating an advanced manufacturing grant program through TEDCO; and SB 974, changing who may serve as inspector for the Caroline County Board of License Commissioners. Most of these bills were reported favorably with technical or narrowing amendments and then ordered printed for third reading. Budget and Taxation advanced SB 28, which would create binding arbitration for state employee collective bargaining impasses and include a proposed constitutional amendment requiring funding in the Governor’s budget; SB 466, expanding a physician preceptor tax credit and adjusting training-hour requirements; and later SB 704, concerning estate tax treatment for qualified agricultural property transferred to an LLC. SB 557, a gaming-related bill, was laid over until the end of the evening at the majority leader’s request. In the Education, Energy, and the Environment report, the committee advanced SB 35 on a state natural science museum designation, SB 166 on shellfish aquaculture permit sanctions, SB 189 on municipal drainage inlet safety requirements prompted by a child’s death, SB 242 on civil relief for service members and spouses, SB 266 on local regulation of invasive trees and tree-of-heaven, and SB 267 on a corporate rental-property registry and local housing application review process. SB 267 drew a brief question from the minority leader, who asked whether prior opposition remained and how the amended bill differed; the sponsor said the opposition had gone away and described the bill as now focused on a responsible-owner registry and an administrative review process.

Transcript Highlights:

• </c> State's Medicaid State's Medicaid director<01:32:14.360><c> good</c><01:32:14.480><c> morning</c
• </c> you know when it comes to the Medicaid you know when it comes to the Medicaid reimbursements<02:
• </c><02:33:35.200><c> application</c> the filing of the Medicaid application the filing of the Medicaid
• </c> center for Medicare and Medicaid center for Medicare and Medicaid services<03:00:22.200><c> which
• </c><03:22:31.960><c> and</c> as well as New Hampshire Medicaid and as well as New Hampshire Medicaid

Committee: Senate Health and Human Services

Transcript Highlights:

• </c><00:33:39.720><c> unwind</c> experienced it with the Medicaid unwind experienced it with the Medicaid
• </c> people who are eligible for um Medicaid people who are eligible for um Medicaid are<00:33:54.679
• </c> I think the Medicaid I think the Medicaid Program<00:38:47.680><c> early</c><00:38:48.040><c> entry
• </c><00:40:00.040><c> is</c> someone who is eligible for Medicaid is someone who is eligible for Medicaid
• helps families access Medicaid.

Committee: Senate Health and Human Services

Transcript Highlights:

• from Medicaid.
• Medicaid, in contrast, accounts for 89%.
• They calculate our staffing needs based on the size of our state Medicaid budget.
• More Medicaid dollars being paid for services means more staff needed to investigate fraud.
• We investigate and prosecute Medicaid provider fraud.

Bills: HF2783 , HF2603 , HF2846 , HF2354 , HF1836 , HF2713 , HF1198 , HF1389

Committee: House State Government Finance and Policy

Transcript Highlights:

• Will KidCare cover it and Medicaid? >> You're recognized.
• This is Senate Bill 1060 on Medicaid Oversight.
• We have a slightly different system; we don't pay for Medicaid directly, we have a managed Medicaid system
• We have a law that states it's less than 5% of Medicaid to a $41 billion program.
• First, there is no attempt to undermine our current managed Medicaid process.

Transcript Highlights:

• We have Brian Meyer, Deputy Secretary for Medicaid, here to present amendment EOGB 2026-0831.
• My name is Brian Meyer, Deputy Secretary for Medicaid, and I'd like to thank you for this opportunity
• I do know that there are a lot of supplemental payments on the Medicaid side that cover uncompensated
• I also know the next amendment is another program that addresses Medicaid shortfall.
• Bad debt, also we're reading that here, Medicaid and Children's Health Insurance Program, and I'm very

Summary: The Legislative Budget Commission met with a quorum present and considered two Agency for Health Care Administration budget amendments related to Medicaid supplemental payments. The first amendment, EOGB 2026-0831, authorized $2.1 billion in budget authority for the Low-Income Pool to support safety-net providers with uncompensated charity care. Members asked about the timing of AHCA’s submission to CMS and whether the program addressed hospital shortfalls for insured patients and CHIP-related concerns. AHCA said approvals have generally been slower under the current federal review process, and the amendment was adopted without objection. The second amendment, EOGB 2026-0875, placed $7.9 billion in reserve for Florida’s Directed Payment Program for Hospitals pending final CMS approval. Senators and representatives questioned the role of hospital attestations regarding hold harmless agreements, whether any agreements had to be unwound, and how long final approval might take. AHCA said all hospitals had submitted attestations, no unwinding was known to be necessary, and approval was expected soon. Members also raised concerns about cancer hospitals, including Moffitt and the University of Miami, not participating in the directed payment program. AHCA responded that those institutions participate instead in a separate Florida Cancer Hospital supplemental payment program, which had already been approved. Both amendments were adopted without objection, and the commission then adjourned.

Transcript Highlights:

• Medicaid blows all of that out of the water.
• stay on Medicaid?
• stay on Medicaid?
• Medicaid has been considered a mandatory program, so as long as Medicaid continues to kind of keep the
• The Medicaid changes I mentioned are significant.

Committee: Senate Senate Committee on Intergovernmental Affairs

Summary: The committee heard testimony from Doug Howe of the Mass Taxpayers Foundation and Evan Horowitz of Tufts on the fiscal effects of federal policy changes, especially the OB3 reconciliation law, federal shutdown risks, and Massachusetts budget planning. Howe outlined a framework of direct and indirect federal impacts on the state budget, capital program, and grant funding, emphasizing uncertainty around Medicaid, SNAP, LIHEAP, immigration, NIH funding, and federal tax changes. He said OB3 is expected to reduce federal health spending in Massachusetts by about $3 billion annually when fully implemented, with an estimated 250,000 to 300,000 people losing coverage, and could shift up to $400 million in annual SNAP costs to the state if Massachusetts’ error rate remains above the federal threshold. He also discussed the governor’s proposal to delay conformity with certain federal tax changes and to expand the pass-through entity tax to offset revenue losses. Members questioned the witnesses about SNAP error rates, unemployment insurance, the use of the stabilization fund, and whether the state should adopt a Maryland-style delay in implementing federal tax changes. Howe argued the stabilization fund should not be used to backfill permanent obligations, but could be used for temporary crises, and said the state should improve data-sharing and administrative systems so eligible residents do not lose MassHealth or other benefits because of paperwork barriers. He also said unemployment insurance remains a major problem and that a broader fix should include benefit, tax, and possibly state contributions. Horowitz took a more aggressive view on using reserves for urgent needs like SNAP, argued the state should harden its budget against volatility, and warned that Massachusetts is increasingly exposed to stock-market-driven revenue swings and to a possible income tax ballot question that could significantly reduce revenues. No votes were taken; the hearing was informational, and the chair asked both witnesses for follow-up written recommendations, especially on system integration and accountability.

Transcript Highlights:

• Almost all of it is coming from Medicaid services.
• So Medicaid has a larger need than originally anticipated for general revenue this year.
• The second highest is related to the Medicaid program.
• Human services, largely driven by Medicaid...
• So Medicaid, if we had a bad recession, Medicaid would be affected by it.

Summary: The committee met to hear Amy Baker’s presentation on Florida’s constitutionally required long-range financial outlook for fiscal years 2026-27 through 2028-29. Baker said the forecast reflects slower but still positive economic growth, continued above-average personal income growth, rising wages, and population growth that is increasingly driven by in-migration as Florida’s senior population expands. She highlighted weakening housing-related revenue, especially documentary stamp taxes, softer consumer sentiment, and the expectation that Florida will pass 25 million residents by 2030, with nearly a quarter of the population age 65 or older. Baker said the outlook largely retained the March 2025 general revenue forecast, but the Legislature’s 2025 session actions significantly improved near-term funds available by redirecting or freeing up money, including contingency appropriations and reversions. She noted total state reserves are just under $15 billion, or about 30% of general revenue, and that the budget stabilization fund is at its constitutional maximum. The main spending pressures in the outlook were critical needs, led by a new emergency preparedness and response fund transfer and Medicaid growth driven mainly by medical inflation and behavioral analysis costs in managed care, not by caseload growth. Other high-priority needs were also identified, and Baker said the first year shows a projected surplus, but years two and three show shortfalls, meaning fiscal strategies will still be needed. Members questioned Baker about the accuracy of the forecast, Medicaid managed care costs, the emergency preparedness fund, federal funding assumptions, and whether recent federal legislation was reflected in the numbers. Baker said the outlook is a good representation of the total picture, though the Legislature will likely adjust it as conditions change, and that more information on federal changes would come in later estimating conferences. Senator Trumbull asked about the governor’s veto of $750 million, and Baker said it simply returned to unallocated general revenue rather than being spent or added to the budget stabilization fund. The chair closed by warning members to expect a difficult budgeting process and noting that the committee would adjourn without further action.

Transcript Highlights:

• Restricted funds were increased by about $55 million for FY26 for Medicaid benefits program support.
• Um my question, sir, um relates to Medicaid funding.
• And I’m just wondering why the Medicaid budget seems to be that amount short.
• </c> Medicaid funding. Medicaid funding.
• </c> includes $220 million less for Medicaid includes $220 million less for Medicaid benefits<00:32:39.679

Committee: House Appropriations & Revenue