Transcript Highlights:

• You know, we we look at child carees.
• </c><01:12:21.199><c> I</c> strengthening our systems of care. I strengthening our systems of care.
• They have to provide quality care day after day. Physical care that's grueling.
• Physical care that's grueling. Is day. Physical care that's grueling.
• </c> healthc care is a privilege. healthc care is a privilege.

Summary: The committee first handled routine business, including roll call and approval of the prior meeting minutes, with one member abstaining because of absence and one member opposing. The main informational items were a Department of Health and Human Services update on the rural health transformation grant and a public health briefing on vaccines, followed by a quarterly budget and staffing update and an annual report from the Permanent Subcommittee on Alzheimer’s Disease and Other Related Dementias. Commissioner Lori Weaver reported that the department submitted the rural health transformation grant application on November 4, described it as reflecting input from communities and providers statewide, and said CMS review and budget negotiations would follow before final approval on December 31. She said the grant could support hiring as long as administrative costs stay within the 10% cap, and that the governor’s office will oversee administration with HHS. Ian Watt then testified that New Hampshire remains committed to vaccine access, including through the universal purchase program and annual respiratory virus guidance for flu, RSV, and COVID-19. He said the state continues to use evidence-based review for vaccine policy, noted the CDC’s change regarding the combined MMRV vaccine for the first dose in young children, and said New Hampshire’s school vaccine mandates remain at nine for schoolchildren and 10 for child care, with statutory exemptions still in place. Department staff also said there have been no supply or funding problems affecting childhood vaccine access. Nathan White, the department’s CFO, reviewed the DHHS budget and vacancy trends. He said DHHS makes up a large share of the state budget, that about 31% of its budget is general funds subject to lapse, and that lapse projections are difficult because much of the budget is driven by utilization rather than personnel. He reported current projected general fund lapse of just under $20 million, compared with about $39 million in the statewide surplus statement, and explained that only about a third of DHHS general funds can actually lapse because of statutory restrictions. He also said the department has about 400 unfunded positions, contributing to roughly a $30 million general fund reduction across the biennium, and that the hiring freeze has pushed vacancy trends upward while critical direct-care positions are being prioritized. The Alzheimer’s subcommittee reported six meetings this year, presentations on state services, silver alerts, brain health awareness, and palliative/hospice care, and work toward a new state Alzheimer’s plan. The subcommittee is developing a needs-assessment survey for people living with dementia, caregivers, and service providers, with the goal of using the results and other data sources to inform the plan. Its recommendations focus on integrating Alzheimer’s and dementia materials into chronic disease and aging outreach, embedding brain health into systems of care, adding cognitive health measures to BRFSS, and continuing partnerships with statewide organizations. Members also discussed recent research and prevention efforts, and the committee noted that a separate bill is being pursued to include Alzheimer’s and dementia in existing public health awareness campaigns.

Transcript Highlights:

• I actually take care of the kids that we're talking about and have taken care of patients with meningitis
• We have Cindy Bishop with the Child Care Association, and we have Jonathan Pierce with the Child Care
• The Child Care Association of Louisiana is the largest and oldest child care organization in the state
• As a licensed child care provider, I am responsible every day for meeting comprehensive, Child care provider
• And we, as child care providers, are my program, the school, And we as child care providers are my program

Committee: House Education

Summary: The committee first heard HB 1079 by Rep. Boudreaux, which would allow charter schools to give enrollment preference to children who attended a licensed early learning center operated by the charter school or under an articulation agreement. An amendment expanded the preference to include children of active-duty military members, foster children, and children in court-ordered custody situations, and a second amendment clarified that the preference is permissive. Supporters said the bill would improve continuity from preschool to kindergarten and encourage more early learning centers. The committee adopted the amendments and reported HB 1079 as amended. The committee then took up HB 737 by Vice Chair Amedee, which would remove the state requirement that students show proof of meningococcal vaccination for school or post-secondary entry. The author argued the bill aligns state law with updated CDC guidance and preserves parental choice and physician consultation, while opponents, including pediatricians, public health advocates, and meningitis survivors, warned that removing the requirement would lower vaccination rates and increase the risk of severe illness or death. After extensive testimony and questions, the committee voted 4-8 against the motion to report the bill, so HB 737 failed. Next, the committee considered HB 628 by Rep. Landry, as substituted, to allow school boards and the Department of Education to work with licensed early learning centers to operate micro centers at schools, including dual licensing at one location. Supporters said it would expand access for three-year-olds, improve school readiness, and help families and the workforce. The substitute was adopted, and the bill was reported by substitute without objection. Finally, the committee heard HB 1008 by Rep. Owen, which would prohibit public post-secondary institutions from retaliating against faculty for disclosing certain violations or exercising academic freedom and free speech. The author and a professor witness said the bill would protect open inquiry and reduce self-censorship in higher education. The committee adopted two amendments to clarify academic freedom and tighten remedies; the transcript cuts off before any final vote on the bill.

Transcript Highlights:

• </c> every motan has access to dental care. every motan has access to dental care.
• </c><00:07:38.560><c> For</c> innovative care delivery models. For innovative care delivery models.
• </c> example, Apple Tree brings mobile care example, Apple Tree brings mobile care to<00:07:40.960><c
• </c> reimbursement rates, inconsistent care reimbursement rates, inconsistent care coordination,<00:10
• ,</c><00:10:29.440><c> and</c> the fee for service, managed care, and the fee for service, managed care

Committee: House Health Finance and Policy

Transcript Highlights:

• And then this Legislature enacted managed care organizations.
• understood that they've paid into a system and they do expect proper care and proper health care, would
• We are a state where access to care is not theoretical.
• We're to take care of each other.
• I understand it and I care about it.

Bills: HB3312 , HB3700 , HB2981 , HB2961 , HB3016 , HB4478 , HB4326 , HB3025 , HB3710 , HB4125 , HB2951 , HB3082 , HB4142 , HB4106 , HB1752 , HB3268 , HB4440 , HJR1067 , SB1144 , SB1145 , SB1146 , SB1147 , SB1148 , SB1156 , SB1157 , SB1158 , SB1159 , SB1161 , SB1162 , SB1163 , SB1164 , SB1165 , SB1166 , SB1149 , SB1167 , HJR1024 , SB1174 , SB1175 , SB1176 , HB3419 , HB3748 , HB4335 , HB3057 , HB3279 , HB4428 , HB3420 , HB3040 , HB4140 , HB1638 , HB3298 , HB4113 , HB1082 , HB4301 , HB3269 , HB3587 , HB4226 , HB4324 , HB4339 , HB4342 , HB3278 , HB3996 , HB4236 , HB4352

Summary: The Senate first took up House Bill 4440, a proposal related to Medicaid expansion. Pro Tem Paxton said the measure would move parts of the expansion from the Constitution into statute, add work requirements for able-bodied adults, and create a trigger if the federal FMAP match falls below 90%. Supporters argued this would give the Legislature more flexibility to manage costs and protect the program long term, while opponents said it would weaken voter-approved constitutional protections and could lead to reduced coverage or benefits. After extended debate, the bill itself passed 30-8, but the separate motion to place it on an August special election ballot failed 30-9. The Senate then advanced and passed H.J.R. 1067, a related November ballot measure that would repeal the constitutional Medicaid expansion obligation entirely; it passed 29-8. The chamber then considered several retirement cost-of-living adjustment bills. SB 1144 would provide a 3% or 6% COLA for retired teachers depending on years retired, while ending a dedicated revenue apportionment once the system reaches 100% funded or in 2036. Senators raised concerns about the long-term funding changes, but the bill passed 43-1. SB 1145 provided similar COLAs for retired state employees and passed 41-4. SB 1146 offered COLAs for police retirees and passed unanimously 48-0. SB 1147, a COLA for firefighters and volunteer firefighters with estimated added unfunded liability, was also adopted by the Senate after committee approval and proceeded to final passage as the transcript ended.

Transcript Highlights:

• facilities are safe and receiving quality care.
• Chair, Secretary, do you know what the average monthly cost is for nursing home care, long-term care?
• But most people can't afford that type of care. Mr.
• With respect to the provision of your New Mexico Care Program, an individual can learn to take care of
• Chair, Emily, for the Health Care Authority, we'll...

Transcript Highlights:

• institutional care.
• long-term care, managed care program.
• , they get, they also get enhanced services through the long-term care managed care waiver.
• That's everything from nursing home care to in-care, in-home care uh types of services.
• Are we seeing better access to care, uh, more timely access to care where we had really um bad access

Transcript Highlights:

• This is about access to care.
• This is a way to provide options, if you will, for health care, health care freedom, if you will.
• This is not about medical care.
• We hear a lot about access to care, but my question is when all of the opposition is from care providers
• And again, I'd love to talk about access to care and ways to expand access to care.

Summary: The House opened with prayer, the Pledge of Allegiance, approval of the prior journal, and several guest introductions and proclamations, including a proclamation designating March 10 as Cade’s Day in honor of Cade Keller and suicide prevention efforts. Members also welcomed guests from schools, cities, and medical and advocacy groups, and the clerk announced committee assignments and bill referrals. The chamber then moved through committee-of-the-whole action on several bills. HB 2946 and HB 4018 were amended and given do pass recommendations. In a later committee-of-the-whole, HB 2083, HB 2308, HB 2388, and HB 2389 were considered; HB 2083, HB 2308, and HB 2388 received do pass recommendations as amended, while HB 2389 drew debate over environmental review for power plants, with supporters arguing it would lower energy costs and opponents saying it weakened oversight. The House also retained HB 4030 and HCR 2052 on the calendar. The House then took up third-reading votes on a long list of measures. Bills that passed included HB 2047 on forcible entry and detainer, HB 2127 on special license plates, HB 2344 on the local government investment pool, HB 2371 on dissolution of marriage, HB 2140 and HB 2620 on financial institutions and veterans services, HB 2429 on short-term rentals, HB 2434 on the prescription monitoring program, HB 2437 on emergency medical services, HB 2444 on pharmacy-based testing and treatment, HB 2573 on DUI-related psychotherapy treatment, HB 2601 on state highways and routes, HB 2781 on solar energy power plants, HB 2914 on cameras in long-term care rooms, HB 2968 on evidence in child custody proceedings, HB 4043 on public schools, HB 4064 on municipal improvement districts, HB 4130 on local government budgets, and HCM 2016 renaming a stretch of U.S. Route 191 as Chief Barbonsito Highway. HB 2726 on sleep apnea treatment failed, and HB 2123 failed on reconsideration after a close vote. Several votes featured debate over housing, energy, veterans’ services, pharmacy scope, family-court evidence rules, and the balance between local control and state oversight. The session ended with committee announcements for the following week, personal privilege remarks, and a motion to adjourn until 1:15 p.m. on Wednesday, March 11, 2026, which was adopted.

Transcript Highlights:

• During those years, for example, there was a focus on health care workers, home care health care workers
• Injured workers deserve high quality medical care in accordance with current health care best practices
• Doctors shouldn't have to fight this hard to get care for their patients.
• That diagnosis should bring compassion and care.
• That diagnosis should bring compassion and care.

Summary: The committee first received an update from the Attorney General’s office on a new workers’ rights unit and two request bills. The office said the unit will focus on wage theft and civil rights enforcement, using existing resources for a small staff. It also described a bill to expand civil investigative demand authority for labor, wage theft, prevailing wage, and discrimination investigations, and an Immigrant Worker Protection Act that would require employer notice when federal immigration authorities request employee records, limit access to nonpublic work areas without a warrant, and restrict disclosure of employee data without proper legal process. Senators asked about costs, funding sources, and the scope of the proposed authority, and the office said it would follow up with more detail. The committee then heard a detailed presentation on Washington’s workers’ compensation system from Labor and Industries, including how claims are filed, how the medical provider network works, and how treatment authorizations and utilization review are handled. L&I said the network was created to improve care quality and return workers to work, and explained that most routine care is automatically authorized while certain procedures require prior approval or review. A question from Senator Conway focused on the role of the medical director and the appeals process; L&I said decisions can be protested and reconsidered, with exceptions reviewed through a complex treatment unit and medical staff. An experience panel followed with testimony from labor representatives, physicians, and an injured-worker attorney, who argued that the medical provider network and treatment guidelines can delay or deny needed care, especially in complex cases such as PTSD, brain injuries, and serious orthopedic injuries. They described long appeals, utilization review barriers, provider shortages, and the impact on injured workers and families, while L&I’s presentation emphasized the system’s structure and review safeguards. The committee then heard a report from the Underground Economy Task Force in the construction industry. L&I summarized the task force’s findings on worker misclassification, unregistered contractors, and unpaid taxes and premiums, and outlined consensus and majority recommendations, including better interagency communication, stronger penalties for repeat offenders, more authority to address successorship, possible contractor notice requirements, and further study of cash payments. The Attorney General’s office, labor, and business representatives generally supported the report’s goals but differed on some recommendations, especially those affecting independent contractors, contractor liability, and administrative burdens. The chair and Senator Conway thanked participants and said the report would inform future legislation.

Transcript Highlights:

• I have cared for fragile infants in the NICU.
• I have taken care of kids that have been harmed by their parents in the pediatric intensive care unit
• I have taken care of kids that have been harmed by their parents in the pediatric intensive care unit
• I have taken care of kids that have been harmed by their parents in the pediatric intensive care unit
• I have taken care of kids that have been harmed by their parents in the pediatric intensive care unit

Committee: House Health and Welfare

Transcript Highlights:

• care for particularly our most vulnerable residents here in the state.
• But also essential, success is bringing Success of our health care authority.
• . ...safely and effectively medication according to the standard of care.
• So this amendment is asking that health care providers and health care entities may only distribute abortion
• To be very careful.

Summary: The Senate opened with roll call, the pledge, prayer, and recognition of guests from the Sikh Coalition and Kalsa Gramath Center. Members then approved the journal and moved through committee reports and resolutions, including Senate Resolution 8678 honoring the Chimicum High School Marching Band for being selected to represent Washington in the 2026 National Independence Day Parade in Washington, D.C. The resolution was adopted unanimously, and the band and its supporters were recognized in the gallery. The chamber then confirmed two gubernatorial appointments to major health agencies. Ryan Moran was confirmed as Director of the Health Care Authority by a 49-0 vote, with supporters citing his Medicaid and health system experience and ability to provide stable leadership. Dennis Worsham was also confirmed as Secretary of Health by a 49-0 vote, with senators highlighting his long public health career, statewide outreach, and work on HIV/AIDS and community health. On legislation, the Senate passed Senate Bill 6011, expanding Court of Appeals bailiff authority to conduct threat assessments, and Senate Bill 5831, creating the Uniform Mortgage Modification Act. Senate Bill 6188, which expands Labor and Industries’ authority to update asbestos training and certification rules, passed 38-19 after an amendment to limit the bill to federal standards was rejected. Substitute Senate Bill 5917, concerning access to abortion medications through the Department of Corrections pharmacy, passed 32-17 after several Republican amendments were defeated. The Senate also passed In Gross Senate Bill 6024 on developmental disability services confidentiality and Substitute Senate Bill 6091 on prohibiting real estate brokers from marketing residential properties in exclusive private listings. Finally, Substitute Senate Bill 5840, adjusting campaign finance expenditure reporting deadlines, passed 46-3. After completing the day’s business, the Senate recessed for caucus and lunch until 1:15 p.m.

Transcript Highlights:

• I know how much she deeply cares for women. I know how much she deeply cares for children.
• access, no maternity health care.
• There's a reason that I care about these kinds of bills.
• That's why I care about these things.
• So if you care about these things, this is a good start.

Summary: The House convened, completed the roll call, prayer, and Pledge of Allegiance, and then took up several measures. The main floor debate centered on House Bill 2787, a one-time $2 million supplemental for the Choosing Childbirth program through the State Department of Health. Supporters said the money would prevent a lapse in services for more than 4,000 mothers and children, especially in rural areas, until the organization can reenter the bidding process in 2028. Opponents questioned the nonprofit’s transparency, donor base, leadership, and prior use of state funds, arguing the Legislature should not provide another supplemental without clearer accountability. The bill passed 70-19, and the emergency clause also passed. The House also considered Senate Bill 546 on data privacy. After floor amendments removed the emergency clause and set a January 1, 2027 effective date, the bill was explained as a comprehensive consumer data privacy measure applying to certain businesses operating in Oklahoma. It would give consumers rights to access, delete, and opt out of the sale of personal data, with enforcement through the Attorney General’s Consumer Protection Division and civil penalties for violations. The bill passed 84-4. In addition, House Bill 2786 received a joint committee report and passed with no debate; it provides supplemental funding to the Department of Mental Health and Substance Abuse Services to complete fiscal year 2025 payments to CCBHCs and other vendors, and its emergency clause also passed. The House adopted House Resolution 1034 recognizing February as Black History Month. The chamber also heard several introductions and announcements before adjourning.

Transcript Highlights:

• FOR THE SYSTEM OF CARE.
• WE HAVE CITRUS FAMILY CARE NETWORK THAT HAS A CHANCE MODEL.
• EVERYBODY IN THAT GROUP HAS HAD EXPERIENCE IN THE FOSTER CARE SYSTEM.
• A VARIETY OF PLACEMENT SETTINGS EXIST FOR CHILDREN IN OUT OF HOME CARE.
• THOSE UP TO AGE 26 THAT SPENT AT LEAST 60 DAYS IN CARE.

Transcript Highlights:

• those discussions with overall cost so that those who need care can afford it.
• My amendment would establish a task force to ensure health care is affordable.
• So I'm offering this amendment to tie it... ...health care more affordable.
• We care about farmers?
• We care about farmers because Trump's bad. Farmers. Look at us.

Summary: The Senate met with 27 members present and a quorum, opened with an invocation and the Pledge of Allegiance, and then moved through a series of motions, recesses, and introductions of bills. Several new bills were read and referred, including measures affecting the Income Tax Act, Natural Resources and Environmental Protection Act, public utilities, nondisclosure agreements, data centers and community benefit agreements, zoning, Medicaid false claims, and the Neighborhood Enterprise Zone Act, with referrals mainly to finance, energy and environment, and housing and human services committees. In the Committee of the Whole, Senate Bills 592, 49, and 50 were reported without amendment and advanced. On third reading, the Senate passed Senate Bills 900, 820, 966, 967, 968, 973, 974, 975, 976, 977, and 978. SB 900 dealt with the Vehicle Code, SB 820 with election law, SB 966 and SBs 974-978 with housing and insurance-related changes, and SB 967 with the Income Tax Act. SB 966, 967, 973, 974, 975, 976, 977, and 978 all passed on 20-16 votes, while SB 900 passed 35-1. Senate Bill 973, creating a state-based health insurance exchange as a nonprofit corporation, drew the most debate. Senators Weber, Lindsay, and Halk offered amendments, all of which were defeated after recorded votes; Weber argued for cost controls and consumer savings, while supporters said the bill would give Michigan more control over health care decisions and could lower premiums. Senator Irwin spoke in support of the housing-related package, saying it would help address the state’s housing shortage. Senate Bill 592, concerning the Corrections Code, was also passed after a 31-5 vote, with Senator Lindsay explaining his no vote as concern about how the bill treats juvenile offenders. The Senate also adopted Senate Resolution 133, urging the U.S. Department of Agriculture to honor commitments to Michigan farmers participating in the Rural Energy for America Program. Senator McCann supported the resolution, citing farm losses from federal rollbacks, while Senator McBroom gave a strong no-vote explanation criticizing state energy policy and the resolution’s framing. The session ended with remarks recognizing Juneteenth and an anecdotal bipartisan exchange between senators before the chamber adjourned until June 23 at 10:00 a.m.

Transcript Highlights:

• Okay, so what you're telling me today is that the claims for intensive outpatient care are being paid
• We have multiple ways to ensure that we have network adequacy throughout the managed care network.
• The difference between that and the managed care organizations is very much a network.
• Managed care organization for clarity or for further review or any potential compliance actions.
• Those managed care organizations have multiple staff.

Committee: Senate Senate Health and Human Services COR

Summary: The Committee on Health and Human Services held another oversight hearing on Access, focusing on fee-for-service behavioral health management, prior authorization and claims processing, the Targeted Investment Program (TIP), and network adequacy. The chair criticized Access for implementing a covered behavioral health services guide without public comment and for failing to produce records such as decision-making documentation, work group minutes, and public/tribal feedback. Members also raised concerns about ARPA compliance, the reduction of intensive outpatient reimbursement to a $157 per diem, and the impact of these actions on providers and Native American communities. Interim Director Roberta Harrison said Access had improved fraud controls and operations after the sober living fraud crisis, including tripling prior authorization speed, reducing denial codes by 64%, cutting claims processing to under 30 days, and adding dashboards and staffing. She said the agency is modernizing outdated systems and invited fraud referrals. On questions about claims and prior authorizations, Access reported average processing times of six days overall and 17 days for behavioral health prior authorizations, and said it had hired Constellation under a direct procurement to help with claims backlog. Harrison acknowledged that a proposal language suggesting higher ROI from denying more claims was not part of the contract scope. The committee also pressed Access on TIP delays. Staff explained that TIP payments depend on provider documentation, programmatic review, and allocation across many sites, and said year one of TIP 2.0 had been paid while years two and three had not yet been distributed. The chair requested a formal plan within 30 days to pay the delayed year two and year three TIP funds, estimated at about $122 million, along with all CMS-related TIP 2.0 documentation. On network adequacy, Access described its standards and annual MCO reporting process, but acknowledged gaps in tracking and said it would follow up on whether a fiscal year 2025 report was submitted to CMS. Members cited a federal ghost network report finding 28% of providers in Santa Cruz County inactive or unavailable, and requested unredacted network adequacy reports and further information on CMS engagement. The hearing ended with the chair noting some improvements but saying more oversight may follow, and the committee adjourned.

Transcript Highlights:

• The bill appropriates the money to the Health Care Authority and what the Health Care Authority will
• The Affordable Care Act was supposed to fix health care affordability.
• to health care.
• This is our chance to lead with care.
• Mexico, we take care of our own.

Transcript Highlights:

• On page 10, at the top, you'll see at the end of the quarter the number of children in foster care at
• At the bottom of page 10, you can see in the third quarter 578 children entered into foster care, 478
• And then, just as a reminder, a child can enter into foster care for more than one identified reason.
• On the top of page 13, you will see the caseworker visits to children in foster care.
• At the bottom of page 15, re-entries into foster care: 4.5 percent.

Transcript Highlights:

• Next, we will take up Tab 2, SB 1240 on substance abuse and mental health care by Senator Claudio.
• The annual needs assessment is an unnecessary barrier to providing care.
• Would they be okay to bill for the care under the Medicaid program?
• So if they were in the long-term care facility, then they would be able to bill Medicaid.
• might go as a provider, a home health care provider, twice a day.

Committee: Senate Children, Families, and Elder Affairs

Summary: The committee met with a quorum present and took up several bills. SB 894, relating to faith-based content in batterers’ intervention programs, was explained as allowing certified programs to offer voluntary faith-based components alongside existing models. Members raised questions about how faith would be defined, whether participation would be optional, and how all faiths would be included. An amendment was adopted clarifying that faith-based activities may be offered but not required and removing language directing DCF to repeal a rule. After supportive testimony from faith-based advocates and some debate, the committee reported the bill favorably, with Senators Harrell and Garcia later recording affirmative votes. The committee then considered SB 1240 on substance abuse and mental health care, which would assign state oversight of the 988 Lifeline, remove the annual needs assessment barrier for medication-assisted treatment licensing, and require annual continuing education for forensic evaluators. An amendment with technical conforming changes and two substantive clarifications was adopted. Members expressed support for expanded access to behavioral health services, and the bill was reported favorably. Later, the chair presented SB 1736, which would allow direct support professionals and relatives to administer insulin in group home settings for individuals with developmental disabilities. After an amendment clarifying sliding scale insulin and related medication administration, the committee heard testimony from family advocates describing how the bill would prevent unnecessary institutionalization and reduce costs. The bill was reported favorably. The committee also passed SB 1286, which clarifies that allowing children to engage in unsupervised activities such as biking or playing outside does not by itself constitute neglect unless reckless or dangerous. After brief support testimony, that bill was also reported favorably, and the meeting adjourned.

Transcript Highlights:

• In Humboldt County, which I represent, 40% of all of the foster care system are youth that come from
• California has been focused on more resources to prevent kids from entering foster care.
• Foster care should provide safety, not cause more harm.
• I worked with a lot of kids who were in foster care. I happen to work with little kids as well.
• Foster care should provide safety, not cause more harm.

Committee: House Human Services

Transcript Highlights:

• > direct</c><00:08:10.240><c> care</c><00:08:10.400><c> and</c> health care system, direct care and health
• care from our state's fantastic health care providers.
• </c> year will lose care access to care that year will lose care access to care that we<00:52:24.599>
• </c> long-term care in Minnesota? long-term care in Minnesota?
• it's the community care hub. This is the it's the community care hub.

Committee: Senate Human Services

Transcript Highlights:

• </c><00:48:46.280><c> and</c> reducing premiums for manage care and reducing premiums for manage care
• compensated care, because she, let's say, is going to still need that emergency care treatment, she
• ><c> she</c><01:26:55.880><c> let's</c> care compensated care because she let's care compensated care
• </c> and the uncomp uncompensated care and the uncomp uncompensated care associated<02:00:34.239><c>
• we make an estimate of what care we make an estimate of what uncompensated<02:05:58.480><c> care</c>

Summary: The House Finance Division Three work session on February 21, 2025 focused on the Division of Medicaid Services budget. The chair opened with procedural guidance, noting the division’s role is to make recommendations to the full Finance Committee, that the budget must be balanced, and that members should track possible amendments ahead of a March 26 target for House Bills 1 and 2. Members also discussed the importance of using official budget documents and online resources, and the chair said no motions would be taken at this session. A major early topic was concern over a five-point Medicaid policy document and the timing of House Bill 2. Representative Tarki objected that the document appeared to be an unofficial draft and argued that significant Medicaid policy changes should have been transmitted by February 15 under state law. He said the lack of an official, posted document raised transparency concerns because the changes could affect tens of thousands of residents. Committee leadership responded that the five-point document was a working document, that it would be posted online within minutes, and that House Bill 2 is often delayed while the Office of Legislative Services finalizes and formats the governor’s proposed trailer bill. DHHS Chief Financial Officer Nathan White and Medicaid Director Henry Litman then began the budget presentation. White said the committee would use the PowerPoint as the document of record, starting with the governor’s operating budget pages 885-893, and noted that Medicaid is the largest accounting area in the state budget. He said the governor’s budget reflects about $60 million in reductions within the Medicaid area, with Granite Advantage handled off-budget and another $10 million in reductions there, for roughly a $70 million difference overall. Members asked whether the comparison was being made against an efficiency budget or a prioritized-needs budget, and White said the department could look at it different ways. The presentation then outlined Medicaid’s role in New Hampshire: it provides health coverage, serves as the state’s direct interface with the federal Centers for Medicare & Medicaid Services, and helps finance related services such as long-term supports, school-based services, adult dental coverage, and re-entry programs for people leaving correctional settings. White also reviewed enrollment and program context, saying New Hampshire has about one in seven residents enrolled in Medicaid, making it the fourth smallest Medicaid program in the country by enrollment, and described recent efforts such as youth re-entry and the Medicaid unwind after the end of the federal continuous coverage period. He said the state had to process more than 238,000 redeterminations after the public health emergency and that the department tried to avoid unnecessary coverage loss during that transition.