Transcript Highlights:

• Or changes in tariff policy.
• significant change from what we had in September.
• people to fight for change.
• Crops and timing changes because of weather, because of climate change, that has increased our water
• That's a bill that was passed last year that made a number of changes, including the change to the expected

Summary: The Ways and Means Committee held a work session covering the state revenue outlook, caseload forecasts, wildfire costs, budget balance, tort liability, water supply, and pension policy. The Economic and Revenue Forecast Council reported modest near-term U.S. growth, no near-term Washington employment growth in 2026, continued personal income growth, and elevated inflation, with tariffs and federal policy cited as major risks. Revenue forecasts were slightly improved for the current biennium by about $105 million but down about $185 million for the next biennium. Members asked about income inequality and housing permits; staff said personal income is an aggregate measure and housing production remains below long-term needs. The Caseload Forecast Council then reported that most forecasts were unchanged or only slightly changed, but several programs increased, including Washington College Grant, Working Connections, aged/blind/disabled cash grants, nursing homes, home and community services, and developmental disabilities personal care. The largest policy-driven change was in Medicaid low-income adult caseloads, where federal H.R. 1 was projected to reduce coverage substantially through narrower eligibility, community engagement requirements, and shorter eligibility periods. The committee also heard a wildfire funding update and a 2025 fire season review. Staff explained that the state budgets $93 million annually for suppression and uses supplemental appropriations for costs above that level, with an estimated state supplemental need of about $139 million for the current year. Department of Natural Resources officials said 2025 fire activity remained below the 10-year average in acres burned, but fires were more complex and closer to communities, contributing to higher residence loss. They described expanded use of aircraft, firefighters from other states, corrections crews, and the Arcadia 20 hand crew, and said the state did not need National Guard ground support this year. A budget preview then showed that the near general fund outlook had worsened after vetoes, lapses, and forecast changes, and that maintenance-level costs alone would leave a projected negative balance by fiscal year 2027 and about $4.3 billion by fiscal year 2029, before any policy decisions. Jason Seams, the state risk manager, reported a sharp rise in tort claim costs, with indemnity expenses nearly doubling from fiscal year 2023 to 2025 and DCYF accounting for most of the increase. He said the state self-insurance liability account has run deficits for four straight biennia and is now facing nearly $600 million in deficits, driven largely by a surge in DCYF claims, especially juvenile rehabilitation and long-running sex abuse cases. Members asked about the role of old claims, comparisons with other states, excess insurance, and whether more Attorney General staff could reduce special assistant attorney general costs. The committee then shifted to water policy, hearing from tribal leaders, Ecology, and the Washington Water Trust. Tribal witnesses emphasized overappropriation, declining flows, climate impacts, and the need for legislative oversight and tribal participation in water policy. Ecology described major projects in the Odessa sub-area, Yakima Basin, and Dungeness, along with the need for storage, recharge, conservation, and policy changes to support water supply development. The Washington Water Trust argued that climate change is reducing summer flows and that the state needs more funding, enforcement, and long-term commitment to restore instream flows. The final item was a pension update on LEOFF 1 surplus assets; staff reviewed two 2025 bills that would have merged or restructured the plan and used surplus assets, but neither passed, and instead the budget directed the Select Committee on Pension Policy to study the issue and report back.

Transcript Highlights:

• and would you go over what those changes and would you go over what those changes are?
• <01:02:56.079> that it's been motivated by changes that it's been motivated by changes that
• And so I have made substantial changes And so I have made substantial changes to<01:08:57.679>
• and so I think that do when you change and so I think that do when you change or<01:24:07.600>
• can be very intentional about the change can be very intentional about the change and<01:24:35.120

Keywords: 1136, house, all

Transcript Highlights:

• And so, at least on those, whenever you enroll in that, you have to have verification of enrollment.

Bills: HB1590, HB1242, HB3818, HB4305

Keywords: education funding, linked deposits, education infrastructure, charter schools, nonprofit organizations, Oklahoma Education Infrastructure Program, HB1242, cervidae, deer, elk, sales tax exemption, agricultural exemption, livestock, ranching, farm tax, agricultural sales tax, Oklahoma Tax Commission, agriculture, producer sales, private treaty

Summary: The committee first considered and unanimously approved the nomination of Keith Ventress to the Oklahoma Development Finance Authority and then to the Oklahoma Industrial Finance Authority. Members noted his banking background and asked a brief question about the reference to old congressional district boundaries in the nomination materials, but there was no substantive opposition and both nominations advanced to the Senate. House Bill 1590, by Senator Daniels, would create an Oklahoma education infrastructure linked deposit program to provide reduced-interest loans for charter schools and nonprofit private schools for capital and building needs. Supporters said it would use existing state linked-deposit structures already used for agriculture and affordable housing, while opponents raised concerns about using taxpayer-backed funds for private schools, the bill’s broad nonprofit language, and whether it could lead to more state oversight of private education. The bill passed 9-2. House Bill 1242, which would add survey day to the list of agricultural sales tax exemption items, was discussed briefly but received no motion for a do pass recommendation and remained in committee. House Bill 3818, by Senator Coleman, would create tax-advantaged insurance loss savings accounts for homes and vehicles; members expressed concern about missing definitions, contribution limits, and the potential for abuse, but agreed the concept had promise and the bill passed 9-2 after the enacting clause was stricken for further work. House Bill 4305, as amended, clarified how affordable housing properties are assessed for ad valorem tax purposes by excluding certain income-based subsidies from valuation; after questions about prior court cases and assessment practices, it passed 6-5.

Transcript Highlights:

• House Resolution 7 by Assemblymember Tom relative to Enrolled Agents Day.
• House Resolution 7 by Assembly Member Ta, relative to Enrolled Agents Day.

Keywords: 988, house, all

Transcript Highlights:

• Remove all barriers so that we may see clearly, recognize where change is needed, and respond with courage
• Behind those numbers are families, traditions, and entire communities that were forever changed.
• A delay in re-enrollment may mean that the student fails to enroll at all and drops out of school altogether
• A vote change from the member's desk. Change of vote for Davies.
• Vote change, Assembly Member Davies, on the motion to suspend the rules: aye to no. Thank you.

Keywords: 988, house, all

Transcript Highlights:

• <00:09:25.279> All that before I I make the change. All that before I I make the change.
• <01:18:04.000> change<01:18:04.239> our volume we're going to change change our volume
• we're going to change change our attack.<01:18:05.360> Okay.
• Is there anyone who changed opposed. Is there anyone who changed their<01:21:36.960> mind?
• . changed. changed.

Keywords: 1191, senate, all

Transcript Highlights:

• I see a big change. Yeah.
• I see a big change. Thank amendment? I see a big change. Thank you.<00:07:26.479> Yeah.
• It makes no changes to that. standard. It makes no changes to that.
• Changes in my apologies. the language. Changes in my apologies.
• That doesn't change those rules.

Keywords: 1189, house, all

Transcript Highlights:

• The change in assets over the past five years was mainly due to changes in investments due to market
• I mean, it's changing all the time. And let me ask you this... Never changing.
• I mean, it's changing all the time.
• It's changing.
• It never changes.

Keywords: 1204, all

Transcript Highlights:

• So the bill makes a minor change in the process.
• We are changing the language to crime victims' compensation.
• So we need to make some changes. No, no, no, no.
• So we need to make some changes.
• I'd also like to change my vote.

Bills: HR218, HR219, HR220, HR221, HR222, HCR91, HCR92, HCR93, HR210, HR211, HR212, HR213, HR214, HR215, HR216, SCR29, SCR38, SB100, HR171, HCR49, HCR65, SCR23, HB276, HB508, HB512, HB599, HB632, HB656, HB998, HB1052, HB1084, HB1171, HB1193, HB1194, HB1204, HB1209, HB1250, SB2, SB19, SB24, SB50, SB70, SB96, SB101, SB103, SB104, SB114, SB122, SB159, SB160, SB173, SB180, SB182, SB260, SB412, SB418, SB424, SB442, SB460, SB476, HCR41, HCR76, HCR77, HCR63, HCR69, HCR86, SCR19, SCR3, SCR6, SCR18, HB64, HB68, HB92, HB130, HB167, HB227, HB243, HB321, HB335, HB398, HB492, HB624, HB689, HB708, HB804, HB906, HB926, HB955, HB968, HB969, HB978, HB985, HB1005, HB1029, HB1069, HB1077, HB1095, HB1104, HB1107, HB1187, HB1203, HB1217, HB1220, HB730, HB225, HB175, HB198, HB437, HB457, HB488, HB646, HB763, HB909, HB971, HB981, HB1066, HB1089, HB1125, HB1154, HB1231, HB1246, HB1248, HB1249, SB47, SB82, SB106, SB206, SB210, SB248, SB305, SB376, SB397, SB441, HCR32, HB59, HB617, HB897, HB911, HB1223, HB798, HB824, HB989, HB1140, HB1166, HB1244, HB901, HB79, HR20, HR74, HB284, HB306, HB366, HB393, HB458, HB459, HB577, HB582, HB605, HB614, HB682, HB733, HB752, HB773, HB996, HB1035, HB1113, HB1180, HB1234, HB1240, SB89

Keywords: EJ Fields, Shreveport, Louisiana, gospel music, commendation, resolution, honorary resolution, Billboard Gospel Airplay, Mediabase Gospel Airplay, Mercy Endureth, music award, ministry, artist recognition, cultural heritage, spiritual heritage, African American gospel, local hero, state commendation, St. Charles Parish, parish day

Summary: The House met with a quorum and began with prayer, the pledge, and routine journal and leave actions. Members then used personal privilege remarks to recognize several Capitol Day events and visiting groups, including St. Bernard Parish Day, Gulf States Renewable Energy Industries Association Day, local ARPEC members, a retirement tribute to Barney Arsenault, Deaf History Month, Asthma and Allergy Awareness Month, Young Farmers and Ranchers, housing advocates, and Louisiana Hospital Day. The chamber also received Senate messages on concurred resolutions, adopted Senate resolutions, and newly passed Senate bills, along with committee and Legislative Bureau reports on various House and Senate measures. The House then considered and passed a series of bills. Among those approved were measures requiring documentation for inmates upon release (HB 167), allowing court filings on letter-sized paper (HB 227), clarifying recusal procedures for district attorneys (HB 243), strengthening safe harbor protections for trafficking victims (HB 321), adding citizenship verification oversight for public benefits (HB 335), capping state travel meal reimbursements to GSA rates for the judiciary (HB 398), establishing a Governor’s Task Force on Impaired Driving (HB 492), updating school emergency operation plans (HB 624), improving coordination of public assistance benefits when children enter or leave foster care (HB 689, later amended and passed), expanding justice of the peace jurisdiction in East Baton Rouge Parish (HB 708), revising election petition and unaffiliated voter rules (HB 906), regulating electronic monitoring device removal (HB 968), renaming and expanding the crime victims’ compensation fund (HB 969), raising the indigent defender contribution threshold for small municipalities (HB 978), requiring QR codes on sex offender licenses (HB 985), reorganizing the state public defender system (HB 1005), extending an alcohol permit moratorium (HB 1029), allowing microbreweries to sell at special events (HB 1077), adding alternative backup power options for nursing facilities (HB 1095), creating a misdemeanor for relay-attack vehicle theft devices (HB 1104), revising capital case procedures for defendants with intellectual disabilities (HB 1107, amended), allowing Citizens Property Insurance to direct certain emergency assessment funds to the Fortify Homes Program (HB 1187), updating medical board membership and vacancy procedures (HB 1220), and several others. Some bills were returned to the calendar or held over, including HB 804, HB 926, HB 955, HB 1069, HB 1203, and HB 1217. The chamber also revisited a previously failed airport surveillance bill, HB 730, and used a successful motion to suspend the rules to reconsider it, as well as a motion to reconsider HB 225 after it had failed twice. The Speaker explained the two-thirds threshold for suspending the rules, and after debate on procedure, the House adopted the motion to suspend the rules and then the motion to reconsider, setting HB 225 up for further action the following Tuesday. Throughout the session, many bills were adopted with little or no opposition, while a few drew questions about scope, costs, or policy effects before passing by recorded vote.

Transcript Highlights:

• <00:09:26.640> in preschool children uh not enrolled in preschool children uh not enrolled
• <00:12:01.040> to there are some significant changes to there are some significant changes
• I see no change in the future.
• changes were coming forward. changes were coming forward.
• But no attorney, to be changed."

Keywords: 928, house, all

Summary: The committee opened hearings on SB 69, including a germane amendment on school board votes to accept or reject gifts and donations, and a non-germane amendment creating a virtual early childhood readiness family engagement program for preschool children not yet in kindergarten. Prime sponsor Rep. Glenn Cordelli said the literacy program was modeled on earlier HB 671, would be funded through gifts and donations rather than state appropriations, and would include reporting requirements to the governor and legislature. Members questioned changes from the earlier bill, including the move away from center-based language, the lack of a dollar threshold for school board action on donations, anonymous gifts, and whether the amendment preserved enough evaluation data. Testimony on the donation provisions raised concerns about broad language, timing, and public-meeting requirements. Rep. Timothy Han and Becky Wilson of the New Hampshire School Boards Association both noted that school districts already have policies and asked how the bill would work for routine donations, anonymous gifts, and situations that might require non-public discussion under right-to-know law. Wilson cited examples such as field-trip scholarships, backpack drives, and sports uniforms, and said the association was not taking a position but wanted clearer guardrails. Rep. Han said school boards may need to discuss some gifts in non-public session and that the bill should better address those circumstances. On the early literacy amendment, Wilson and others questioned whether the program was sufficiently developed, whether it was appropriate to rely on a primarily online model for very young children, and how it would interact with special education services and IEPs. A representative from Waterford.org, Rob Riley, testified in support, saying the program would be supplementary, adaptive, and family-engagement based, and that Waterford could provide devices and internet access for families who need them. He said the program would work alongside school districts and IEP teams rather than replace existing services. No vote was taken during the hearing; the chair said the committee would later exec the bills and try to get reports in for the calendar.

Transcript Highlights:

• Senator Lang says the bill is the same exact bill as the Senate passed last year, except for one change
• in the bill if you look on page change in the bill if you look on page two<00:02:08.560> line
• So I don't see that the amendment changes that case law, and I don't see that the original bill changes
• So that's not going to change under this.
• the period to a comma, and change it to add the words for CA.

Keywords: 1191, senate, all

Transcript Highlights:

• But the tipping point for me was Budget Director Hicks in his presentation indicates that in 2028 enrollment
• But the tipping point for me was Budget Director Hicks in his presentation indicates that in 2028 enrollment
• Enrollment in the Medicaid program will be reduced by 28,539 participants, reducing the population of
• certainly has given us an opportunity to do an intrinsic review of that program, and we know the changes
• And that certainly is a kind of standard practice we follow now, that any changes that go to that committee

Keywords: 958, all

Summary: The committee first heard Senate Bill 173 from Senator David Givens, which would create a legislative review process for the state health plan and state plan amendments, modeled after the administrative regulations process. Givens argued the legislature should have a stronger policy role in reviewing the plan, saying the bill would allow lawmakers to find components deficient rather than approve them outright. He tied the proposal to Medicaid spending growth and projected enrollment changes, saying the state needs a new oversight tool. Committee members generally supported the concept, though Senator Berg expressed concern that the legislature lacks the executive branch’s healthcare expertise. The bill was reported favorably on a unanimous roll call vote. The committee then took up Senate Bill 137, sponsored by Chairman Meredith, which would create a pathway for certain internationally trained physicians to practice in Kentucky without repeating residency in the United States. Supporters said the bill is aimed at addressing Kentucky’s physician shortage, especially in rural areas, and cited projections of a statewide shortage of about 3,000 physicians by 2030 and a shortage of primary care doctors in particular. Testimony from Cicero Action and Baptist Health emphasized that many foreign-trained physicians are already fully trained, that residency slots are limited, and that the bill could help fill shortages in underserved counties while preserving quality through existing exams, ECFMG certification, English proficiency requirements, primary source verification, and mentoring/oversight. Several members raised questions and concerns. Senator Berg asked about verification, required exams, and oversight, and Senator Tishner raised concerns about fraudulent credentials in some countries and whether the bill could admit underqualified physicians. Witnesses responded that applicants would still have to pass the same exams, obtain ECFMG certification, and undergo primary-source credentialing and employer oversight. Supporters also argued the bill would not displace U.S.-trained physicians because it would use otherwise limited residency capacity more efficiently. After discussion, the committee adopted the bill and reported it favorably by unanimous vote.

Transcript Highlights:

• Is something changed?
• Is something changed?
• Is something changed?
• <00:22:40.600> the state because they changed the state because they changed the age<00:22
• Did the terms ever change?

Keywords: 928, house, all

Summary: The subcommittee met on House Bill 637, which was described as a measure to make whole certain New Hampshire Retirement System retirees who were not included when Senate Bill 57 was incorporated into the 2023 budget. The chair and several members reviewed the bill’s legislative history and fiscal impact, citing estimates that the broader change would cost about $1.4 million to the state and $5.74 million to municipalities, with an actuarial liability increase of about $45 million. The chair argued that the omission of already-retired members was not an oversight but a policy choice made in the Senate, based on the bill’s prospective language and the budget process used in 2023. Testimony and discussion focused on whether the bill should be treated as a fairness correction or as an expensive policy expansion. Supporters, including retirees and representatives of employee groups, said the language was unclear, the fiscal note did not match the bill’s effect, and the change would unfairly leave out actual retirees who had expected the same treatment as active members. They also argued that the retirement system historically linked benefits to Social Security and that the bill would restore equity for those affected. Opponents emphasized the cost, the prospective nature of the original language, and the view that the Senate knowingly chose not to extend the change retroactively. After discussion, the chair moved to recommend the bill inexpedient to legislate, and the motion was seconded. Members then heard brief public comments after the motion was withdrawn and reintroduced because of the weather and the public’s travel. At the final vote, the subcommittee recommended inexpedient to legislate on a 3-2 vote, with the chair noting that the full committee would take up other bills at a later subcommittee hearing.

Transcript Highlights:

• That's not being changed.
• As every member voted, may members change their vote.
• Do any members wish to change their vote?
• So those things can change.
• So those things can change.

Keywords: 908, all

Summary: The House convened with prayer, the Pledge of Allegiance, and a quorum present. Representative Hoverson offered remarks recognizing World Autism Day, and the House then handled conference committee motions on several bills, including House Bills 1460 and 1248 and Senate Bills 2262, 2070, 2294, and 2297, with the Speaker appointing members to each conference committee. The chamber also set aside Senate Bill 2200 for re-referral to Appropriations and moved to amendments on Senate Bill 2128, which was the main subject of the day. Senate Bill 2128, a major criminal justice and corrections bill, drew extensive debate over truth-in-sentencing, mandatory minimums, parole, transitional facilities, work release, electronic monitoring, and the fiscal impact of longer incarceration. Division A of the amendments removed mandatory minimums for resisting arrest and felony simple assault while keeping consecutive-sentence language; supporters said this preserved judicial discretion and reduced costs, while opponents argued it weakened public safety. Division A was adopted 70-23. Division B proposed broader changes to preserve transitional programming, add penalties for tampering with electronic monitoring and escape, limit some work-release restrictions, create a parole board study, and fund electronic monitoring with a $600,000 appropriation. Supporters framed it as a compromise that balanced rehabilitation and public safety; opponents said it undercut the bill’s intent and left dangerous offenders with too much access to transitional release. Division B failed on a 46-46 tie. The House then took up the bill itself, with the Judiciary Committee reporting a do-not-pass recommendation as amended, and debate continued over whether the amended bill should advance, with members split between concerns about victims and public safety versus rehabilitation, prison capacity, and recidivism.

Transcript Highlights:

• I'd like to change my vote to an A. Hicks is now a nay. Our eyes, six nays.
• question so that I could Explain this is a work in progress, and I think the language will need to be changed
• sensitive to maybe people who are moving around and they've got credit hours and they're already enrolled
• I think it changes the nature of things.

Bills: SB514, SB346, SB1593, SB1782, SB1366, SB1497, SB366, SB1895, SB2048, SB2005, SB2006, SB710, SB1480

Keywords: SB514, school choice, charter school, virtual charter school, OSSAA, extracurricular activities, interscholastic activities, athletics, homeschool, other means of education, alternative education, student eligibility, student transfer, district policy, public school district, adjacent district, blended learning, virtual learning, school sports, academic eligibility

Transcript Highlights:

• That's something that was changed not too long ago.
• Those factors change along the way.
• Any sort of policy changes that might affect their budget.
• I don't see that there's any big change.
• What do we expect to change?

Transcript Highlights:

• Coalition that M&P guided, MME changed its name, and Minnesota's education systems have also changed,
• Coalition that M&P guided, MME changed its name, and Minnesota's education systems have also changed,
• Our education systems need to keep changing, and we know they want to change and evolve for the better
• <01:21:08.960> the just do that Amendment and change the just do that Amendment and change
• <01:36:40.320> there talked about making some changes there talked about making some changes

Bills: HF2090, HF982, HF2229

Keywords: higher education, scholarship, financial aid, state grant, tuition assistance, Pell grants, student retention, education equity, disabled veterans, veterans' dependents, dependent children, college affordability, books and fees, University of Minnesota, public colleges, Office of Higher Education, veterans benefits, military families, permanent disability, 100 percent disability

Transcript Highlights:

• Um, we look at not only what's happening today because our enrollment changes, staffing changes, everything
• changes year to year.
• <00:59:10.720> changes,<00:59:11.760> staffing our enrollment changes, staffing our
• enrollment changes, staffing changes,<00:59:13.040> everything<00:59:13.280> changes<00
• changes, everything changes yeartoear. changes, everything changes yeartoear.

Keywords: 919, house, all

Summary: The Legislative Budget Office Oversight Commission met on January 22, 2026, with a quorum present and approved the minutes from the December 17, 2025 meeting. The main presentation was by Erikica McKeler of the National Conference of State Legislatures on dynamic fiscal notes, dynamic scoring, and how they differ from static fiscal notes. She explained that dynamic analysis tries to capture broader economic and behavioral effects of policy changes, but that most states have experimented with it only briefly, often for tax bills, and many have later scaled back or abandoned the practice because it is staff-intensive, expensive, and difficult to validate. McKeler highlighted examples from Texas, Utah, and Arkansas. Texas requires dynamic fiscal impact statements for certain large tax or fee measures and for the biennial appropriations bill; Utah has done such analyses on request during the interim but only when staff time allows; and Arkansas recently began producing dynamic fiscal notes with thresholds and request limits. She noted that these states generally use REMI software, though Utah switched to IMPLAN for cost reasons. She also outlined common challenges, including the need for strong staff expertise, the sensitivity of results to assumptions, the expense of software licenses, and the difficulty of measuring accuracy over time. Members then discussed whether dynamic scoring could be useful for health and human services programs where a policy may shift costs between settings rather than create a simple new expense. Senator Marty raised a Medicaid example involving home-based blue light therapy for newborns, arguing that dynamic analysis might better capture potential savings from avoiding longer hospital stays. Legislative Budget Office and Minnesota Management and Budget staff responded that such effects may be better understood as direct program substitutions rather than true dynamic effects, and emphasized the need for reliable data and caution because savings estimates could reduce appropriations if they do not materialize. The discussion also touched on whether dynamic models would capture local government impacts, but no formal action was taken beyond the approval of minutes and receipt of the presentation.

Transcript Highlights:

• How many people are enrolled in those classes?
• How many people are enrolled in those classes?
• It's not changing any of those Greater Minnesota programs.
• It's not changing any of those Greater Minnesota programs.
• <01:28:56.400> in and they're actually seeing a change in and they're actually seeing a change

Bills: HF47, HF434, HF1503, HF1702

Keywords: telecommunications, installation, certification, safety, underground utilities, HF434, cervidae, deer, elk, moose, chronic wasting disease, CWD, wildlife importation, animal health, biosecurity, zoo, Association of Zoos and Aquariums, AZA, USDA exhibitor, species survival plan

Transcript Highlights:

• life-changing therapy. life-changing therapy.
• with an estimated 1,500 of them enrolled with an estimated 1,500 of them enrolled in<00:21:10.480
• Um a lot of those payment two changes.
• Uh a change in the tax a PR rata basis.
• 2023 changes where the IMHAP payments 2023 changes where the IMHAP payments went<01:07:20.799> up<

Keywords: Medicaid - Room 216, 4 February, 2026; 2:00 PM, 925, all

Summary: The committee heard presentations on several Medicaid-related topics. First, a pharmacy representative discussed nonopioid pain medications as a way to reduce opioid dependence and overdose risk, emphasizing that options such as acetaminophen, NSAIDs, and topical diclofenac can be useful for pain management. She cautioned that nonopioids can still have risks and said any policy should avoid requiring patients to step through opioids before accessing safer alternatives, while still allowing reasonable step therapy among nonopioid options. The presenter said the goal is to keep patients from being pushed toward opioids by cost or insurance design. The committee also heard emotional testimony from parents of a child with Prader-Willi syndrome, who described the condition as a rare genetic disorder that causes severe, lifelong hyperphagia and requires rigid supervision and ongoing treatment. They argued that alternative funding programs can disrupt access to medically necessary drugs such as human growth hormone, forcing families into costly and uncertain coverage gaps. They asked lawmakers to ensure insurance coverage remains stable for rare disease patients and thanked Senator Blackwell for prior support of rare disease legislation. Next, a Livanova representative urged the committee to support higher Medicaid reimbursement for vagus nerve stimulator surgery for drug-resistant epilepsy. He said inadequate hospital reimbursement has reduced access in Mississippi, causing patients to travel long distances or go without treatment, and argued that better reimbursement would improve outcomes and save money over time. He cited studies showing seizure reductions, lower ER use, and a projected $2.8 million in five-year savings for Medicaid based on 40 patients, and asked that hospitals be reimbursed at 100% of Medicare rates for the procedure codes. Finally, a Medicaid official gave a broad overview of hospital payment structure, including fee-for-service, managed care, MHAP, DSH, UPL, provider taxes, and related funding mechanisms. She explained that hospital payments are interrelated and have shifted over time, with major changes tied to managed care, MHAP/UPL increases, and provider taxes. At the end of the discussion, the committee was running short on time and asked her to skip ahead to the provider tax component; no votes or formal actions were taken in the portion provided.