Transcript Highlights:

• They've lost access to Medicaid.
• When enough students in a school building lose SNAP and Medicaid, it threatens the school's ability to
• When enough students in a school building lose SNAP and Medicaid, it threatens the school's ability to
• What that means is when children are on SNAP or on Medicaid, they're automatically connected to those
• I would also like to know if there are any additional barriers to CEP beyond... ...SNAP and Medicaid

Transcript Highlights:

• </c> either reimbursed once the Medicaid either reimbursed once the Medicaid application<01:40:49.520
• And this is not Medicaid.
• And this is not Medicaid.
• So, it basically, if I'm understanding... is not Medicaid. This is a revolving is not Medicaid.
• </c> for the Medicaid population. for the Medicaid population.

Committee: House Health, Human Services and Elderly Affairs

Transcript Highlights:

• It's important to note that the Medicaid number, the $1.5 billion, is basically their Medicaid assessments
• Kirk touched on Medicaid, which is approximately a $230 million increase.
• There are no Medicaid expansion components of that as it relates to just the expansion of any service
• I know that there will be a lot of discussion about Medicaid, but I would urge everybody not to jump
• You're seeing increased costs in Medicaid, and you're seeing increased costs in CHIP.

Transcript Highlights:

• That’s Medicaid eligibility quality.
• </c><01:33:51.080><c> Eligibility</c> ourselves that's Medicaid Eligibility ourselves that's Medicaid
• fraud control unit and Justice Medicaid fraud control unit and the<01:49:24.239><c> Medicaid</c><01:
• folks, or our Medicaid members.
• :38:58.639><c> on</c> to Henry Litman our Medicaid director on to Henry Litman our Medicaid director

Summary: House Finance Division III convened a work session on the DHHS budget, with the chair noting there would be no votes and that the committee would spend the day hearing from the commissioner’s office. Nathan White, DHHS Chief Financial Officer, opened with the Division of Finance/Office of Business Operations, explaining that the unit supports the department through daily financial management, AP/AR, audit work, expense projections, transfers, and procurement functions such as contracts, amendments, RFPs/RFAs, and grants management. He also described the division’s revenue and reporting work, including federal draws, CMS-64 reporting, and the public assistance cost allocation plan, and said the department had centralized rate-setting work and a small team handling Medicaid rate analysis and nursing facility rebase work. Members asked about vacancies, turnover, and budget changes. White said the division had 18 positions unfunded in the governor’s budget, reducing personal services from about $10.8 million to $9.9 million, and estimated the division’s vacancy rate at about 11 percent, below the department average. He said turnover was relatively low, with one retirement at the manager level and higher turnover mainly at lower AP-level positions. He also explained that some budget lines reflected reallocations rather than new spending, including fringe benefits centralized elsewhere and an EBT card contract moved into this unit because the staff member overseeing it works in Finance. When asked about a rent/lease increase, he said it was due to higher copier leasing costs under a statewide DAS contract. White highlighted several management and technology improvements. He said a business intelligence tool procured in 2022, using Salesforce and Excel-based data, helped DHHS better track federal revenue and maintenance-of-effort spending, reducing FY24 General Fund lapse by about 70 percent and federal/other revenue lapse by 88 percent compared with FY23; he warned that the tool is not funded in the current budget. He also described Lean Six Sigma efforts in the contracts team, training for vendors and nonprofits on procurement and indirect cost rules, and a Finance Academy to standardize policies and procedures. On the contracts side, he said the department uses Smartsheet for project management and DocuSign for electronic signatures, which cut contract execution time dramatically, but noted DocuSign is also not funded in the governor’s budget. The session ended as the committee prepared to move on to the Employee Assistance Program presentation.

Transcript Highlights:

• put that money in Medicaid fraud stat dead, we were doing that.
• You mentioned $45 million in settlement for Medicaid fraud.
• I'm looking at the Medicaid Fraud Control Unit.
• able to engage in the Medicaid system.
• They are prohibited from being a Medicaid provider.

Committee: House Appropriations

Transcript Highlights:

• </c> in order to be Medicaid reimburseable. in order to be Medicaid reimburseable.
• But the statute does not enact any change to Medicaid.
• The statute does not change to Medicaid.
• </c><00:16:47.120><c> goes</c> So, the co-occurring part, Medicaid goes So, the co-occurring part, Medicaid
• </c> wouldn't be Medicaid reimburseable. wouldn't be Medicaid reimburseable.

Committee: House Health Services

Transcript Highlights:

• What this language does is allows specific providers to build Medicaid using collaborative care codes
• What this language does is allows specific providers to build Medicaid using collaborative care codes
• What this language does is allows specific providers to build Medicaid using collaborative care codes
• </c><00:09:59.480><c> plans</c> commercial insurance and Medicaid plans commercial insurance and Medicaid
• Services as a Medicaid benefit the collaborative<00:10:07.200><c> care</c><00:10:07.399><c> model</c

Bills: HF958 , HF688 , HF702

Committee: House Human Services Finance and Policy

Transcript Highlights:

• not authorize discrimination and expressly preserves compliance with federal civil rights laws and Medicaid
• the contractual compliance, where it basically says that it's a material condition of all Idaho Medicaid
• to have this answer right now, I would just ask if you would bring for us the number of existing Medicaid
• And Medicaid is a voluntary program. No one's forced to participate with Medicaid.
• It is up to the providers to determine if they would like to participate in Medicaid, so I appreciate

Committee: House Health and Welfare

Transcript Highlights:

• If they cut housing funds, where we have a housing crisis right now, if they cut Medicaid, that would
• If they cut housing funds, where we have a housing crisis right now, if they cut Medicaid, that would
• budget they provide over a two-year period just in Medicaid about 17 billion.
• budget they provide over a two-year period just in Medicaid about 17 billion.
• budget they provide over a two-year period just in Medicaid about 17 billion.

Transcript Highlights:

• ><c> risk</c><00:05:24.880><c> of</c> Health, and lower their risk of hospitalization and costly Medicaid-funded
• needed to have really informed conversations with partners, including all of you, about additional reforms
• you, with partners, including all of you, about<00:54:18.559><c> additional</c><00:54:18.960><c> reforms
• /c><00:54:19.440><c> that</c><00:54:19.760><c> might</c><00:54:19.920><c> be</c> about additional reforms
• that might be about additional reforms that might be needed<00:54:20.319><c> for</c><00:54:20.480><c

Bills: HF4210 , HF4212 , HF4549 , HF4464 , HF4546 , HF4447

Committee: House Human Services Finance and Policy

Transcript Highlights:

• But you can see Medicaid is deemed high risk all the time by the feds.
• But you can see Medicaid is deemed high risk all the time by the feds.
• You can see that Medicaid had seven findings, which is significant.
• And so some ineligible members were left as eligible in the Medicaid system.
• It could be number of clients in Medicaid.

Summary: The meeting focused first on a legislative working group report created under House Bill 368 from the prior session on medical education in Idaho. The presenter described Idaho’s physician shortage, noting the state ranks 50th per capita in physicians and would need roughly 1,400 additional physicians to reach the national average. The group’s unanimous recommendations included maintaining current state-supported medical school seats, adding 10 new non-WAMI seats this year, expanding graduate medical education by 15 seats, prioritizing in-state training, and creating a dedicated health education coordination role to manage undergraduate and graduate placements, clinical sites, and data. Members discussed whether WAMI should also expand, the quality of WAMI graduates, the need for more clinical preceptors and residency sites, rural recruitment incentives, and whether the plan should include other health professions such as nurse practitioners and physician assistants. The presenter said the plan includes benchmarks and timelines, and estimated costs of about $350,000 for coordination, $350,000 to $485,000 for 10 new UME seats depending on placement, and $900,000 for the GME request. The committee then heard from Legislative Audit Division Manager April Renfro on the state’s 2024 single audit and related accountability work. She reported $5.4 billion in federal assistance audited, 21 major federal programs across 15 agencies, 45 findings, seven repeat findings, $2.4 million in known questioned costs, and $2 million in projected questioned costs. Major issues were concentrated at the Department of Health and Welfare, including Medicaid findings involving delayed health and safety surveys, managed care provider eligibility and roster controls, and capitation payments tied to ineligible members; Child Care and Development Fund reporting and cost-allocation errors; and repeat issues in vocational rehabilitation and low-income home energy programs. She also noted Department of Environmental Quality problems with indirect cost proposals and a duplicate grant draw, while Transportation had no findings. Members asked about accountability for repeat findings, the role of Luma in reporting errors, fraud detection, and how to prioritize corrective action; Renfro said agencies, federal management decisions, and legislative oversight all play a role, and she planned to send a prioritized list of key findings to the co-chairs. A later presentation by budget analyst Brooke Dupree introduced front-end reports in the legislative budget book, explaining state government structure, the constitutional limit of 20 executive departments, and how the Legislature uses decision units to build appropriations. She walked through the original appropriation, reappropriations, supplemental appropriations, and how those pieces roll into the current-year total appropriation, with members asking brief questions about departmental divisions and the budget model.

Transcript Highlights:

• Again, this does not include an additional reduction for public school support, the Division of Medicaid
• These additional motions, one and two, would not have any cuts in Medicaid.
• Who would not have any cuts in Medicaid or K-12, IDOC, or State Police, is that correct? Mr.
• I do want to highlight. ...that there was not going to be any additional cuts to Medicaid.
• We continue to see usage in Medicaid. We continue to see those supplementals.

Summary: The committee first received a briefing on the updated “green sheet” budget materials and how to read the FY 2027 columns, along with a review of several bills with fiscal impacts, including HB 503, HB 556, HB 559, and HB 578. Staff explained where the documents could be found online and answered questions about the timing and size of the bills’ fiscal effects, including the tax conformity bill and county jail reimbursement changes. The main business was the 2026 Idaho Budget Rescissions Act. Members debated whether to adopt the governor’s 3% rescission, add an additional 1% reduction, or add an additional 2% reduction. Supporters of deeper cuts argued the state needed structural balance, a larger ending balance, and a response to revenue uncertainty and the pending tax conformity bill. Opponents said across-the-board cuts were too blunt, could harm Medicaid, education, public safety, and other programs, and should be handled agency by agency. The committee first rejected the 1% and 2% substitute motions, then approved the governor’s 3% rescission motion on a due-pass recommendation. The committee then approved a transfer of $22,366,500 from the Public School Income Fund to the General Fund, with the motion passing after a roll call vote. It next took up statewide decisions, starting with ongoing base reductions for selected state agencies. After debate over whether the reductions should be 3%, 4%, or 5%, the committee rejected the higher-cut substitutes and approved the governor’s 3% base reduction recommendation. Members emphasized that the work groups would still have flexibility to adjust individual agency budgets later. Finally, the committee considered personnel benefit cost increases for FY 2027. Staff explained the proposed health insurance and other variable-rate adjustments, and members debated whether to use the governor’s recommendation or a DOGE Working Group recommendation that slightly changed the funding mix and total. The governor’s recommendation was defended as more consistent with prior employee-benefit review practice, while supporters of the DOGE proposal said it would tighten legislative control over funding. The governor’s recommendation was ultimately rejected, and the committee moved on after the roll call votes on the competing motions.

Transcript Highlights:

• At the current time, this is Medicaid only.
• At the current time, this is Medicaid only.
• The large fiscal note, if you can look at it, I think it's geared to Louisiana and Medicaid.
• This is not just to cover Medicaid in this bill. This is overall with private as well.
• This is not just to cover Medicaid in this bill. This is overall with private as well.

Committee: House Insurance

Summary: The House Insurance Committee met on April 15 and first considered HB 909, which would require commercial health insurance coverage for behavioral health crisis services. Representative Spell and Office of Behavioral Health interim assistant secretary Dr. Holly Howitt described the Louisiana crisis response system, the goal of reducing emergency room and 911 use, and the need to expand provider participation beyond Medicaid. A technical amendment and a stakeholder-driven amendment allowing insurers to require documentation of crisis, medical necessity, and follow-up plan were adopted, and the bill was reported as amended with support cards from several health care and local government entities. The committee then advanced HB 1151, which changes investment limits for domestic insurers, especially life insurers, by capping equity holdings and aligning the rules with solvency concerns. After questions about whether the bill would increase profits at consumers’ expense, the author and Department of Insurance staff explained it was intended to provide guardrails and keep insurers solvent; the bill was reported favorably. HB 1154, dealing with prior authorization for certain generic medications, also received technical and substantive amendments. The bill would generally eliminate prior authorization for non-opioid generics, with a $250 wholesale acquisition cost cap and physician-specialty exceptions; it was reported as amended after support testimony from the Louisiana Dermatological Society and other health groups. HB 869, which sought coverage for injectable drugs used for glucose control or weight loss, prompted extended debate over cost, obesity, and long-term savings. Several members raised concerns about premium increases and the large fiscal note, while the author argued the bill was preventive and could save money over time. Representative Jordan proposed a 25% coverage amendment, but the committee declined to take up the substantive amendment that day, and the bill was voluntarily deferred to the next meeting. Later, the committee reported HB 1196 favorably, clarifying that screening colonoscopies remain screening even if polyps are found, and HB 1176 favorably, restoring Medicare Advantage coverage for certain integrative cancer care services. The committee also heard HB 771, which would have changed Medicare coordination rules for retirees who return to state employment, but staff explained the issue is governed by federal CMS rules and preemption concerns; the bill was voluntarily deferred so the author could review the governing law. HB 751, dealing with term life insurance disclosures, was likewise voluntarily deferred after the author said more work was needed and noted concerns about existing law and consumer understanding. At the end of the meeting, the committee also deferred HB 920 and HB 1199 to the following week and briefly stood at ease before moving on to other business.

Transcript Highlights:

• For those that aren't, maybe everyone's aware, but there's a lot of concern about Medicaid right now,
• For those that aren't, maybe everyone's aware, but there's a lot of concern about Medicaid right now,
• From the House and from CMS to Massachusetts and other states regarding our Medicaid program.
• We're also convening a Medicaid summit with the Council of State Governments this June.
• Earlier, I had come up about the Centers for Medicare and Medicaid Services and a data set regarding

Summary: The Massachusetts Commission on the Status of Persons with Disabilities held its quarterly meeting virtually and in person at the State House. The commission approved the December minutes, then heard updates from the chair on planning for the next “Meeting the Moment” community forum in Lowell on March 27, focused on digital accessibility, education-to-employment transition, workforce supports, long-term services and supports, and health equity. The chair also previewed planning for the commission’s October National Disability Employment Awareness Month event and invited commissioners and advisory council members to join the planning group. The commission received an update on the advisory council orientation, which was described as well attended and productive, and then heard a detailed presentation from the Attorney General’s Office on federal litigation affecting Massachusetts. Topics included challenges to federal actions involving diversity in education, immigration and Haiti Temporary Protected Status, NIH research funding restrictions, and mental health services grants; the presenter also addressed concerns about Medicaid-related federal actions and said the AG’s office is coordinating closely with the governor’s office and other states. Commissioners asked questions about whether disability-related work could be affected by vague DEI restrictions and about the status of CMS communications on Medicaid. The meeting also featured a presentation from Undersecretary of Labor Josh Cutler and apprenticeship liaison Amara Riemann on registered apprenticeship and pre-apprenticeship programs. They described apprenticeship as paid, structured, employer-driven training with classroom instruction and wage progression, and highlighted the Bridgewater State University Excel program for neurodivergent people and people with disabilities as a model linking pre-apprenticeship to apprenticeship. Commissioners discussed how to replicate similar pathways through community colleges and disability-service providers, especially in high-demand fields. Subcommittee reports followed, including updates on disability employment, long-term services and supports, and health equity, with discussion of a projected state budget gap tied to federal changes, PCA working group recommendations, crisis standards of care, and ongoing collaboration with MassAbility and the Massachusetts Office on Disability. The meeting ended with commissioner announcements, including several awards and upcoming events, and reminders about the Lowell forum and October planning efforts.

Transcript Highlights:

• Representative Joseph continued: "And how would, for example, expanding Medicaid, which ties expanding
• Income level to lose their Medicaid, and so sometimes they don't get the hours needed, but this bill
• We sacrificed our income to meet the poverty level to qualify for Medicaid.
• things, whether it's expanding Medicaid in Florida that would help.
• We have heard things like making sure that we still have Medicaid at the federal level.

Summary: The Health Care Facilities and Systems Subcommittee met with a quorum present and took up five bills. The first, CS/HB 1119 on pediatric readiness in hospital emergency departments, would require hospitals with ERs to adopt evidence-based pediatric care policies, train staff, designate a pediatric emergency care coordinator, complete the National Pediatric Readiness Assessment, and meet minimum equipment and planning standards. Members discussed transport to the closest appropriate facility and implementation concerns, but the bill passed 16-0. The committee then approved HB 677, which would add standard fertility preservation services to the state group insurance program for employees undergoing chemotherapy, and CSHB 497, which would authorize nonprofit agricultural organization medical benefit plans for Florida Farm Bureau members, aimed at improving affordable coverage for farmers and ranchers. HB 677 passed 16-0, and CSHB 497 passed 18-0 after questions about membership, regulation, disclosures, and how the plan would compare with ACA coverage. The subcommittee also approved PCS/HB 791 on surrendered newborn infants, allowing infant safety devices at hospitals, EMS stations, and fire stations as an alternative safe-haven option. Members discussed alarms, unmanned stations, and whether churches should be included; the bill passed 18-0. Finally, HB 1529 on home health aides for medically fragile children was amended and passed 18-0. The bill seeks a federal waiver so compensation for parents serving as home health aides does not count against Medicaid eligibility, and the amendments added reporting of adverse incidents, set work-hour limits, and protected certain other benefits. The chair closed by emphasizing the committee’s role in implementation oversight and fixing problems after enactment.

Transcript Highlights:

• pro a Medicaid Minnesota has a Medicaid pro a Medicaid program<00:03:56.239><c> that</c><00:03:56.560
• It's 10% of the Medicaid program.
• onethird</c><00:15:26.560><c> of</c> Medicaid program's budget, onethird of Medicaid program's budget
• </c> overall Medicaid funding for Minnesota. overall Medicaid funding for Minnesota.
• So, uh, the first Medicaid program.

Committee: Senate Human Services

Transcript Highlights:

• </c><00:18:44.240><c> and</c> um you could um apply for Medicaid and um you could um apply for Medicaid
• and only 30 for regular Medicaid.
• Thank you. from 90 days to 60 for standard Medicaid from 90 days to 60 for standard Medicaid and<00:33
• </c><00:34:00.159><c> So</c> and only 30 for regular Medicaid. So and only 30 for regular Medicaid.
• But I think in terms of my Medicaid.

Committee: House Health, Human Services & Elderly Affairs

Transcript Highlights:

• Requires that the Medicaid Inspector General comply with standards relating to the audit and review of
• Requires that Medicaid Inspector General to comply with standards relating to the audit and review of
• There are billions of dollars every year in this Medicaid program.
• Billions wasted on the fraudulent non-emergency Medicaid transportation program.
• Billions wasted on the fraudulent non-emergency Medicaid transportation program.

Committee: Senate Finance

Summary: The Senate Finance Committee, chaired for the day by Senator John Liu, took up a long agenda of bills covering labor and benefits, corrections, health, taxation, government transparency, and public services. Early measures included increasing short-term disability benefits, adjusting a poverty-level-related earned income disregard, expanding correctional health staffing review, and authorizing the Inspector General to investigate sexual assault complaints in correctional facilities; each of these advanced to the floor. The committee also advanced bills on ovarian cancer screening access, retirement system membership changes, a trail stewardship program, live agency representative access, FOIL/open meetings fee awards, a Harriman campus development plan, court data reporting, educator conventions, park water testing, an energy storage tax abatement, a Native American Affairs office, adult changing tables in public facilities, Medicaid Inspector General audit standards, remote training certification for agency personnel, newborn Gaucher disease testing, electronic self-exclusion requests for gambling, and child daycare inspections and opioid antagonist requirements. Several bills drew discussion. The prescription drug transparency bill (Print 488A) prompted questions about possible overlap with federal Hatch-Waxman/FTC oversight and whether a New York notice requirement could slow generic-drug settlements; sponsors and staff said it was intended as a supplemental transparency measure for consumers. The court reporting bill (Print 1849A) raised concerns about mandates on local governments, but supporters said it mainly required OCA to compile data in one format. The Medicaid local-share phaseout bill (Print 5519) generated the most debate, with supporters arguing it would provide major property tax relief and should be addressed in the budget, while opponents emphasized the need to curb Medicaid fraud, waste, and abuse first. Two major fiscal oversight proposals were defeated. Print 8661, which would have required the Comptroller to hire an independent private auditing firm to review state-funded programs for fraud and abuse, was opposed despite support from some members who argued outside auditing was overdue; it failed by one vote. Print 5519 was also ultimately defeated after a recount confirmed it lacked the required majority of the full 22-member committee. Most other bills were approved and sent either to the floor or, in the case of the drug transparency bill, to the Rules Committee.

Transcript Highlights:

• Medicare and Medicaid Services condition of<01:18:45.960><c> participation</c><01:18:47.080><c> or</
• Medicaid. Alters, clarifies, and adds to Medicaid.
• Medicaid to provide reimbursement for room and board services provided by a hospice house by December
• House Bill 604, Delegate Solomon, Arbitration Reform Employees Act of 2026.
• </c> House bill 604 Delegate Solomon House bill 604 Delegate Solomon Arbitration<01:56:30.040><c> Reform

Transcript Highlights:

• The insurance companies want those costs to be shifted to Medicaid.
• It does not add cost to the Medicaid budget or to commercial plans.
• It shifts to Medicaid and onto Minnesota taxpayers.
• </c> Medicaid, and higher insurance premiums. Medicaid, and higher insurance premiums.
• </c> onto Medicaid and Minnesota taxpayers. onto Medicaid and Minnesota taxpayers.

Summary: Senators and House members held a press event in support of HF 4188, a bill addressing commercial insurance coverage for home care nursing for medically complex children who also receive medical assistance. Speakers said the issue arose after Medica and HealthPartners began imposing caps on coverage that had been provided for years under Minnesota law, and argued that the change would shift costs to Medicaid and taxpayers, create budget pressure, and force families to reduce other needed services. They emphasized that home care nursing is distinct from short-term home health visits and said the bill would prohibit quantity limits and clarify that insurers must continue covering authorized nursing care. Parents and family members described the impact on children who depend on continuous skilled nursing to remain safely at home, including one family whose child Nash has spent extensive time hospitalized and another speaker who said her niece Isabel’s care showed how many nurses, aides, and hospice workers are involved in these cases. Testimony stressed that the coverage caps could lead to more hospitalizations, ICU stays, and trauma for children and families, while costing more overall than home care. Several lawmakers, including Sen. Matt Klein and Rep. Robert Bierman, said the statute’s original intent was clear in 2010 and that the plans’ reinterpretation and the Commerce Department’s response should be corrected. Lawmakers said the Commerce and Consumer Protection Conference Committee has completed its work but is being kept open for the remaining days of session in hopes of resolving the issue this year. In response to questions, supporters said the bill is intended as a clarification rather than a new mandate, that it would simply bar caps on already-authorized home care nursing, and that they believe there is support to move it through the House and Senate before adjournment.