Transcript Highlights:

• homes have to large family childcare homes.
• We didn't extend it to large family care homes.
• I hope no other family has to experience.
• These families are also working class, you know, they're doing the right thing taking their family to
• your support of this good bill.

Transcript Highlights:

• She says licensed family child care is critical to the care of children and support of families in Minnesota
• She says family child care is critical to the care of children and support of families in Minnesota,
• Cunningham says licensed family child care is critical to the care of children and support of families
• </c> support specifically to licensed family support specifically to licensed family child<00:48:54.839
• </c><00:49:12.880><c> family</c> the state of Minnesota supports family the state of Minnesota supports

Keywords: 1187, senate, all

Transcript Highlights:

• services.
• So, for instance, if a school purchases IT technical support services, then the school would not owe
• It was families like the Lucas family and so many more.
• Child care providers support children and families across our state. Don't do it. Okay, thank you.
• Child care providers support children and families across our state. Don't do it. Okay, thank you.

Summary: The committee opened with a public hearing on Senate Bill 5808, a proposal to require nonprofit health carriers with “excess surplus” to pay 10% of that surplus into the state health care affordability account for Cascade Care Savings. Committee staff said the bill could generate about $330 million one time in 2027, while the Office of Insurance Commissioner would have implementation costs. Supporters argued the bill would redirect consumer premium dollars to help people afford coverage, while opponents from health plans said reserves are needed for solvency, claims, and capital needs and warned the bill would destabilize nonprofit insurers. The committee also heard testimony on House Bill 2254, which would let the Partnership Access Line assessment cover administrative costs; HCA and Seattle Children’s supported it as a technical fix that saves general fund dollars, and a child psychiatrist asked that savings be reinvested in behavioral health services. House Bill 2385, which extends deadlines for the Medicaid Access Program because of federal restrictions on new provider taxes, also drew support from provider groups seeking future Medicaid rate increases. The committee then heard Substitute Senate Bill 6286, which would increase fines on private detention facilities that deny Department of Health inspections and dedicate the fines to an account for community repair and assistance to harmed individuals and families. Supporters, including Tacoma’s mayor and family members affected by detention, framed the bill as an accountability measure; fiscal staff estimated Department of Health costs of about $395,000 in the 2025-27 biennium. Senate Bill 6006 would exempt food banks from sales tax on certain services enacted last session, with food bank and tribal representatives saying the savings would go directly to food and operations. Senate Bill 6351 would create exemptions from the new sales tax on live presentations for before- and after-school care, arts and cultural nonprofit classes, and K-12 school purchases; school districts, arts groups, and PTA representatives supported it, while asking for clarifying language and broader nonprofit exemptions. Engrossed Substitute House Bill 1717 would let cities and counties create local sales tax remittance programs for affordable housing projects, and housing builders, Habitat affiliates, counties, and city officials supported it as a local tool to lower development costs. In executive session, the committee received briefings on several tax and spending bills and then voted to advance multiple measures. It adopted a substitute and passed Senate Bill 5949, which narrows a B&O tax exemption related to insurance premiums; a proposed retroactivity-removing amendment failed. It adopted a substitute and passed Senate Bill 6129 on cigarette, tobacco, and nicotine taxes after rejecting several amendments, including proposals to study the tax policy or replace the bill with illicit-market enforcement language. The committee also passed Senate Bill 6228 repealing a preferential B&O rate for prescription drug resellers, Senate Bill 6231 repealing data center sales tax exemptions, and Second Substitute Senate Bill 5965, which retained a bag-fee approach rather than a full ban after adopting an amendment. The committee then returned to public hearing and began testimony on Senate Bill 6353, a major Working Connections Child Care bill that would keep income eligibility at 60% of state median income, lower the provider rate target from the 85th to the 75th percentile, and make other program changes; the briefing was underway when the transcript ended.

Transcript Highlights:

• And we're also long-term care services and supports accredited before expound on the history of Humana
• Simultaneous to that we are in the process of building a network that will support these these services
• The state's investment supports a wide range of services.
• As of last month, the family successfully completed services and remain safely together.
• inpatient and residential care and provide meaningful support to families across the state.

Transcript Highlights:

• We have, um, family support specialists, nurses. So the idea is that you...
• into that school and be there to provide support to the families, to the staff.
• We use a family support specialist who is a person who does a lot of outreaching to make sure families
• the, well, uh, she, her team provides counseling services through the Midda Youth and Family Services
• They provide prevention, Intervention, shelter, counseling, and family support.

Summary: The committee held an interim study on how to educate and support students with severe violent or disruptive behavior while protecting classmates, teachers, and school staff. Members framed the issue as one involving students who have often experienced trauma and may be removed from class through suspension, expulsion, or juvenile placement, but who still need a meaningful path back to school. Several legislators shared personal experiences as former educators or administrators and emphasized that schools need clearer criteria for removal and return, along with stronger support for families and staff. Dr. Michelle Butler, an alternative education director, testified that Oklahoma’s current alternative education system is not designed to serve students removed for major discipline issues because placement is generally voluntary and programs are built around students who need a different learning environment, not punitive removal. She argued for early intervention, stronger attendance enforcement, trauma screening, teacher training, and a regional or cooperative model that would combine credentialed educators, social workers, therapists, and family counselors. She also described existing programs such as Trace Academy, Rogers County Youth Services diversion programs, and the limitations of virtual-only models and current funding, saying the system lacks sufficient resources and staffing. Representatives and senators asked about funding, staffing, credentials, and whether statutes should be changed to prevent alternative education dollars from going to programs that do not provide direct services. Other testimony came from Family and Children’s Services and Mid-Del Youth and Family Services, both of which described embedded school-based mental health, crisis response, intensive outpatient services, family engagement, and juvenile diversion programs. Witnesses stressed that wraparound services, school-community partnerships, and a bridge back to the home school are essential, and that many students and families need mandatory or strongly supported participation rather than purely voluntary help. The study concluded with members noting possible next steps, including expanding or supplementing alternative education, improving early intervention, and examining participation requirements and transition supports; no votes were taken, and the committee adjourned after the presentations.

Transcript Highlights:

• I rise today in strong support of my bill to designate the United States Postal Service facility on San
• I encourage my colleagues to join me in supporting the life of Mayor Kennedy and her public service for
• I thank the Kennedy family for working with me on this bill, and I urge my colleagues to support HR 3350
• his family, his friends, and his fellow soldiers, and honor his memory with gratitude for his service
• For our families.

Keywords: U.S. House of Representatives Floor Proceedings on Monday, June 29, 2026, 1012, house, all

Transcript Highlights:

• . for that family and for 11% we referred that family for family based safety services, which we're going
• First, and preferred, is our family-based safety services.
• We use family-based safety. services when there is safety concerns in a family and the family has needs
• Post-adopt services, post-adoption services can be really, really important to those families.
• members in the family and they need the right services and supports.

Keywords: 1184, house, all

Transcript Highlights:

• wraparound support services from the county?
• support to the family so, frankly, kids are safe.
• support to the family so, frankly, kids are safe.
• support to the family so, frankly, kids are safe.
• </c><00:13:31.639><c> service</c> end up having like family service end up having like family service

Keywords: 1183, house

Transcript Highlights:

• Uh, here to testify in support of HB 2160 on behalf of the Texas Family Law Foundation.
• I, because of the family-based service, which can take 3 months if if just the talking to the family
• Administration for Children and Families to administer the review of child and family services programs
• The Department of Family and Protective Services.
• But I know that Family Violence Prevention Services in San Antonio or Denton County Friends of the Family

Bills: HCR 10

Keywords: balanced budget amendment, federal budget, deficit reduction, deficit spending, fiscal restraint, constitutional amendment, U.S. Constitution, Congress, PAYGO, Gramm-Rudman-Hollings, national debt, budget deficit, taxpayer dollars, balanced budget resolution, memorial resolution, Texas Legislature, federal spending, budget reform, fiscal conservatism

Transcript Highlights:

• Annie Thomas, on behalf of the California Alliance of Child and Family Services, we support the one-time
• That means that the state doesn't have to spend as much general fund to support those services.
• Family planning services receive a 90% match in federal Medicaid funding, although...
• And also for the family planning services today, currently we are reimbursing for these services at several
• And also for the family planning services today, currently we are reimbursing for these services at several

Summary: The Assembly Budget Subcommittee on Health held the first of several hearings on the Governor’s May Revision for health care, with opening remarks focused on the state’s projected $12 billion deficit, looming federal Medicaid changes, and the potential impact on Medi-Cal, public health, reproductive health, and safety-net providers. Several members criticized the proposal as balancing the budget on vulnerable Californians, while others defended the need for cost containment and questioned the administration’s assumptions. The chair set ground rules for respectful, focused questioning and outlined three topics: the Medi-Cal proposals, Proposition 35, and Proposition 56. DHCS Director Michelle Baas presented the May Revision’s Medi-Cal package, saying the department’s budget totals $200.6 billion overall, including $45.2 billion General Fund, and that the proposals are intended to address rising caseloads, pharmacy costs, and managed care spending. She described proposed changes for adults with unsatisfactory immigration status, including a freeze on new full-scope enrollment for those 19 and older, $100 monthly premiums beginning in 2027, elimination of adult dental and long-term care coverage, removal of PPS/RAP payments to FQHCs and rural health clinics for that population, and a pharmacy rebate aggregator. Other proposals included eliminating certain OTC drug classes, removing GLP-1 coverage for weight loss, prior authorization and step therapy changes, reinstating the Medi-Cal asset test, eliminating acupuncture as an optional benefit, allowing utilization management for hospice, raising the managed care minimum medical loss ratio to 90%, reducing PACE capitation rates toward the midpoint of the actuarial range, eliminating the skilled nursing facility workforce and quality incentive program, and suspending the SNF backup power requirement. The LAO said the revised Medi-Cal spending estimate is about $2.5 billion higher than the Governor’s Budget in the budget year, and that the increase appears driven more by higher per-enrollee costs than by caseload alone. The LAO said the budget solutions are concentrated in a few areas, are largely ongoing, and should be considered in light of federal uncertainty, but suggested the Legislature could explore alternatives such as more targeted income thresholds for the undocumented expansion and simpler asset-test rules. Department of Finance officials said the proposals are difficult but necessary to address a third consecutive deficit and rising Medi-Cal costs. Members then pressed the administration on the methodology and impacts of the proposals, especially the enrollment freeze, premiums, asset test, hospice controls, PACE reductions, and the elimination of benefits and provider payments. No votes or formal actions were taken at this hearing.

Transcript Highlights:

• These families really do deserve recognition and support.
• These families really do deserve recognition and support for the essential role they already play in
• supports, home- and community-based services, hospice, home health, and nursing facility.
• children, facilitate pathways to natural supports, and address service gaps.
• children, facilitate pathways to natural supports, and address service gaps.

Summary: The House Health Care and Wellness Committee met at policy cutoff and first took up executive session on four bills. It considered a proposed substitute for HB 1589 on health carrier contracting practices, which would require carriers to provide providers advance notice and clean copies of contract changes and payment methodologies, and would also add notice requirements for significant payer contract modifications. The committee also considered HB 2402 on phthalates in IV solution containers and tubing, with a substitute delaying implementation dates and creating shortage and FDA-related exemptions. HB 2555, concerning Medicaid coverage of traditional health care practices, and HB 2685, concerning tribal data and disease reporting to tribal health jurisdictions, were also before the committee. HB 2599 was deferred. The committee reported HB 1589, HB 2402, HB 2555, and HB 2685 out of committee with do pass recommendations, with recorded votes showing some members voting no or no without recommendation on the more contested bills. The committee then held a work session on private duty nursing in the Medically Intensive Children’s Program. Health Care Authority and DSHS staff described how the program serves children with complex medical needs through managed care and fee-for-service pathways, the role of prior authorization and medical necessity review, and the ongoing shortage of nursing staff. They said many approved hours are not filled, especially in rural areas, and that family members often provide unpaid care to fill gaps. Committee members asked about the structure of the children’s and adult PDN programs and about how many authorized hours are actually being served. The committee also heard testimony from a home care agency representative and a parent caregiver, both of whom described severe staffing shortages and the burden on families when nursing shifts go unfilled. They supported models that would allow trusted family caregivers to be paid for some of the skilled care they already provide. The committee then heard examples from Montana and Massachusetts of similar family caregiver or complex care assistant programs. Montana described its pediatric complex care assistant model as a gap-filling service with prior authorization and a set hourly rate, while Massachusetts outlined its complex care assistant program, including training, supervision, wage pass-through requirements, and early growth in participation. The meeting concluded after the work session.

Transcript Highlights:

• That leads to families losing needed supports.
• It supports our families in need but also can support farmers and ranchers, and you heard Maui Food Bank
• Next up we have HB 20009 relating to family caregiver support.
• Next up we have HB 20009 relating to family caregiver support.
• Um relating to family caregiver support.

Bills: HB2488, HB2456

Keywords: disability, communication access, deaf, hard-of-hearing, deaf-blind, healthcare, sign language interpreters, auxiliary aids, weight loss, GLP-1 drugs, obesity, Medicaid, healthcare costs, 910, house, all

Summary: The committee heard testimony on HP 1972, which would create a nonrefundable family caregiver tax credit, and on a related tax measure to increase the existing dependent care tax credit. Supporters of HP 1972, including AARP, the Executive Office on Aging, the Hawaii Public Health Institute, Hawaii Children’s Action Network, and others, said unpaid caregivers are essential to keeping kūpuna and other loved ones at home and described significant out-of-pocket costs. The Department of Taxation and the Tax Foundation raised technical concerns, including the need to avoid overlap with existing credits and to prevent double-dipping. The department said taxpayers can claim credits to the extent allowed, but recommended explicit language barring the same costs from being claimed under more than one credit. No vote was taken in the excerpt, and the chair moved the bill along after questions. The committee then heard HP 1975, which would repeal the sunset on the state rent supplement program for kūpuna. AARP, Catholic Charities Hawaii, the Executive Office on Aging, and others supported making the program permanent, saying it helps low-income older adults avoid eviction and homelessness and allows them to remain in affordable housing. Catholic Charities described clients who were paying unsustainable shares of income for rent before receiving the supplement. Members also shared a constituent example of an elderly retiree who needed the subsidy to stay housed. Written support was noted from additional organizations and individuals. Next, the committee took up HB 1706, which would expand Medicaid prospective payment reimbursement to include mental health services furnished in federally qualified health centers and rural health clinics by mental health professionals under supervision. The Office of Hawaiian Affairs supported the bill, and DHS said it appreciated the intent to address workforce shortages and expand training, but cautioned that unlicensed professionals cannot currently bill Medicaid and that a state plan amendment would be needed, with limited precedent for approval. Members asked about the likelihood and timing of federal approval and whether the bill could help rural areas; DHS said approval is uncertain and the process can take time, though it saw possible alignment with the state’s rural health transformation efforts. The committee also discussed HB 546, a three-year health coverage continuity pilot program for people losing Medicaid coverage. DHS, the Attorney General’s office, DCCA, Catholic Charities, the University of Hawaii, and others testified, with DHS warning that federal changes could increase uninsured rates and that the state may need to act quickly. Catholic Charities and others emphasized the risk to Medicaid recipients, including homeless and near-elderly residents, while DHS explained the state’s existing premium assistance program for certain immigrants and compared it to the proposed pilot. The excerpt ends during discussion of that comparison, with no vote shown.

Transcript Highlights:

• Clients on hospice need timely services; family caregivers who look...
• Medi-Cal provides critical home care services through In-Home Supportive Services and other programs,
• Medi-Cal provides critical home care services through In-Home Supportive Services and other programs,
• Medi-Cal provides critical home care services to in-home support services and other programs which ensure
• I also want to say that when we cut in-home supportive services, it impacts community-based adult services

Keywords: 988, house, all

Transcript Highlights:

• We have work in our Division for Economic Services that really provides the concrete supports that families
• We have work in our Division for Economic Services that really provides the concrete supports that families
• We have work in our Division for Economic Services that really provides the concrete supports that families
• We have work in our Division for Economic Services that really provides the concrete supports that families
• We have family mutual support.

Keywords: 928, house, all

Summary: House Finance Division III held an informational hearing with the Department of Health and Human Services focused on child and family services, children’s behavioral health, DCF, juvenile justice, and adult mental health. Before the presentation, members discussed scheduling a future site visit to Waypoint, including possible dates, mileage reimbursement logistics, and whether to reschedule the department’s developmental disabilities and healthy aging presentation because the associate commissioner was out sick. The department then outlined that it would concentrate on children’s behavioral health, DCF residential care and the Sununu Youth Services Center/YDC new build, and adult mental health, while noting the broader DHHS structure and the value of keeping related services under one leadership. The department emphasized an integrated “system of care” approach and said it was trying to shift resources toward earlier, lower-intensity interventions rather than relying mainly on high-cost residential and acute services. It cited youth risk data showing roughly four in ten New Hampshire high school students feeling sad or hopeless and about one in five considering suicide in the past year, and said these trends worsened during the pandemic, peaking in 2021 and easing somewhat by 2023. Members asked how New Hampshire compared with neighboring states and about pre-COVID trends; the department said it would follow up with more exact data. The presentation also described a long-term policy effort beginning with federal funding in 2012, the state’s 10-year mental health plan, and later legislation aimed at strengthening children’s behavioral health and transforming juvenile justice so that youth with behavioral health needs are not routed into punitive systems first. Members raised questions about out-of-state residential placement oversight and the statutory basis for inspections and follow-up. The department said the General Court had funded more “boots on the ground” oversight, in coordination with the Office of the Child Advocate, and agreed to provide a longer follow-up presentation on that topic after the governor’s budget is released. The department also described evidence-based prevention efforts, including home visiting programs such as Healthy Families America and a DCF-connected home visiting cohort for families already touching the child welfare system, as examples of trying to keep children out of deeper system involvement.

Transcript Highlights:

• And to support a critical human service workforce, the FY27 recommendation is to maintain Chapter 257
• that are going to be needed in what place, and what is it going to take to support those services?
• of homemakers, and an array of other in-home services and supports.
• in need of family preservation services.
• together screening out those in need of family preservation services we've also supported many other

Keywords: 1212, all

Transcript Highlights:

• I'm also the executive director of Crisis Support Services of Alameda County.
• Hi, Annie Thomas, on behalf of the California Alliance of Child and Family Services, in support.
• Implementing multiple service pathways simultaneously will take careful planning and support.
• On behalf of the California Academy of Family Physicians, in support. Thank you.
• While Medi-Cal has covered lactation support services, including IBCLCs, since 1998, families face delays

Keywords: 987, senate, all

Transcript Highlights:

• We need whole communities to wrap around families so the families, you know, have the kind of support
• So the families, you know, have the kind of support they need.
• Stable child care supports consistent employment for parents and reduces family stress.
• of child care programs, preserving existing capacity, and supporting families and employers.
• , recovery coaching, and family support.

Keywords: 989, all

Summary: The committee met to hear presentations on possible uses of temporary Millennium Fund dollars for youth- and family-focused prevention programs. Members first approved the prior meeting minutes, then heard from the Idaho Children’s Trust Fund, which requested $682,000 for mid-sized grants to community organizations for child abuse prevention, parenting support, family resource centers, and school-based programs. The presenter emphasized the link between adverse childhood experiences and later substance use, and described the fund’s statewide grant-making process and current projects. Committee members asked about grant selection, funding sources, and how families are identified for services. The committee also heard from Children’s Bridge, which requested $3.5 million over four years to build a shared-services infrastructure for child care providers. The proposal focused on helping providers stabilize their businesses through software, coaching, shared purchasing, bookkeeping, and access to benefits such as health insurance and retirement plans. The presenter argued that child care is part of Idaho’s prevention infrastructure and said the model would transition toward earned income and employer support over time. Members asked about similar programs, infrastructure, and how the model would be sustained after 2029. Idaho Safety Assessment Centers requested $1 million to support 12 youth assessment centers that divert youth from court, ERs, and school discipline into screening, counseling, and family support. The presenter cited individual success stories and said the centers served more than 12,000 youth in a year, with an estimated return of more than $3 in benefits for every dollar invested. The committee also heard from the Idaho Network of Children’s Advocacy Centers, which requested $3 million in one-time bridge funding for 10 centers that conduct forensic interviews and coordinate child abuse investigations; members asked about coordination with state agencies and sustainability. Ross Edmunds of the Department of Health and Welfare requested $150,000 for a 10th recovery community center in Kamiah, explaining that the department already oversees nine centers through quarterly payments and reporting requirements. Finally, Representative Jordan Redman proposed a $5 million statewide drug-use awareness campaign using research, surveys, and targeted media buys; he said the campaign would be evaluated through impressions, reach, and frequency. No decisions were made, and the chair said the committee would return later to continue reviewing the requests, noting the fund is one-time money and that the governor’s recommendations and a $25 million request reduce the amount available.

Transcript Highlights:

• services: nutrition, information and assistance, and caregiver support.
• Medi-Cal provides critical home care services through In-Home Supportive Services and other programs,
• Monica Kirkland with Senior Services Coalition of Alameda County. We support... Thank you.
• I also want to say that when we cut in-home supportive services, it impacts community-based adult services
• are projected to lose that support service under the current proposals.

Summary: The joint informational hearing focused on the impact of H.R. 1 on older Californians and related county administration issues. Chair Jackson and Chair Addis opened by emphasizing California’s rapidly aging population and the need to protect seniors’ access to food, health care, housing, and in-home support services. Testimony from the Department of Social Services, Department of Health Care Services, and Department of Aging described how H.R. 1 would expand work and reporting requirements in CalFresh and Medi-Cal, increase redeterminations, and create new eligibility barriers. Witnesses and advocates warned that these changes could lead to large coverage losses, especially for adults ages 55 to 64, people experiencing homelessness, caregivers, and some immigrant groups, while also increasing administrative burden on counties. The LAO noted that many provisions do not directly apply to Californians 65 and older, but highlighted indirect effects and some direct impacts, including a new home equity limit for certain long-term care recipients and narrower immigration eligibility rules. Committee members pressed the administration and counties on how exemptions would be identified and implemented, whether data systems could automatically protect eligible people, and how outreach would reach older adults, women, LGBTQ seniors, and people with limited digital access. DHCS and CDSS said they are working to use existing data, cross-program information sharing, and human-centered communications to maximize exemptions and reduce churn, including text outreach, print and radio campaigns, and navigator support. Members also raised concerns about the need for legal aid and county eligibility workers to help people navigate complex rules, and requested updated analyses on the number of people likely to lose both Medi-Cal and CalFresh and the broader human and system impacts. No votes were taken. The second major topic was the administration’s proposal to shift some future IHSS costs to counties by establishing a statewide baseline for average authorized hours per case. CDSS said the proposal is intended to improve consistency in assessments and not reduce services, while counties and labor groups strongly opposed it, arguing that rising hours reflect real increases in need, an aging and higher-acuity caseload, and state-mandated assessment tools rather than county error. County representatives said the proposal would strain already limited local revenues, worsen the effects of H.R. 1, and could force cuts to other safety-net services. Committee members questioned the proposal’s timing and impact, but the hearing ended without action, with the chairs asking for continued updates, additional analysis, and more information before May Revision.

Transcript Highlights:

• We provide no out-of-pocket cost services for youth and their families.
• , exactly what services and supports they need.
• , exactly what services and supports they need.
• Others can go into family settings with additional services and supports to meet their needs.
• They need support services to make that reunification happen.

Keywords: 996, all

Transcript Highlights:

• The family health programs include the California Children's Services Program, or CCS, the Genetically
• For services and supports for primary care, $50 million.
• These payments are necessary to support important therapy and nursing services that are happening in
• These payments are necessary to support important therapy and nursing services that are happening in
• were designed to churn people off coverage and reduce revenues supporting Medi-Cal services.

Summary: The subcommittee heard a lengthy Department of Health Care Services presentation on the governor’s Medi-Cal budget, including a $229.1 billion total-funds proposal, projected Medi-Cal enrollment declines as redeterminations continue, and several major cost drivers such as managed care growth, Medicare-related costs, pharmacy spending, and changes tied to federal policy. Members focused heavily on the elimination of Prop. 56 dental supplemental payments beginning July 1, 2026, questioning the likely impact on provider participation and utilization. DHCS said it is completing the required rate reduction/access analysis for CMS, has been holding stakeholder meetings and issuing provider bulletins, but could not yet quantify the real-world effect. The committee also discussed a $50 million savings proposal tied to new hospice utilization management authority and asked about possible effects on emergency dental care and provider participation. The hearing then moved through the November 2025 family health estimate and several county and program administration issues, including CCS, GHPP, and Every Woman Counts. DHCS said family health costs are rising despite slight caseload declines because of higher utilization and medical costs, and members raised concerns about CCS website accessibility, county administrative funding, and the transition of youth aging out of CCS. The department said most CCS beneficiaries are also on Medi-Cal, that counties have long raised funding concerns, and that it had clarified use of maintenance-and-operations dollars to address some county workload issues. Members also asked about Every Woman Counts potentially seeing higher demand as Medi-Cal changes take effect; DHCS said that is possible and that the program has multiple funding sources including General Fund. A major portion of the hearing focused on provider taxes and federal changes under H.R. 1, especially the Medi-Cal managed care organization tax and the hospital quality assurance fee. DHCS explained that H.R. 1 restricts new or increased health care-related taxes, phases down allowable tax levels over time, and tightens “generally redistributive” rules, which could sharply reduce the state’s ability to use the MCO tax for Medi-Cal financing. Members asked whether the Legislature could amend Prop. 35 or whether voters would need to act; DHCS said a three-fourths legislative amendment may be possible if it aligns with the measure’s purpose, but the department is still evaluating options. The committee also discussed hospital financing, with DHCS describing recent increases in state-directed payments and the effect of H.R. 1 in capping those payments at Medicare levels, and the LAO noting the tradeoff between preserving provider taxes and maintaining Medi-Cal funding. The subcommittee also reviewed a series of DHCS budget change proposals and trailer bill items, including managed care final-rule implementation, managed care operations, a hospital value strategy, a one-year extension of skilled nursing facility financing, long-term care payment transparency, and interoperability/prior authorization requirements. Members repeatedly questioned the use of limited-term versus permanent positions, the overlap among proposals, and the timing of new financing reforms. DHCS said the SNF extension would preserve current workforce standards, sanctions, growth limits, and the SNF quality assurance fee while the department develops a broader 2027-28 redesign. No votes were taken; items were repeatedly held open for later action. Covered California then presented on the expiration of the federal enhanced premium tax credit and the resulting affordability crisis. The agency said Californians will lose about $2.5 billion in premium assistance for 2026, average premiums could nearly double for many enrollees, and as many as 400,000 people could eventually leave marketplace coverage. Open enrollment ended with 1.9 million sign-ups, down 3% from the prior year, with especially steep declines among middle-income consumers and increased movement into bronze plans. Covered California said the state’s $190 million affordability subsidy is helping lower-income enrollees retain coverage, but cannot fully replace the lost federal assistance. Members also asked about the Health Care Affordability Reserve Fund, repayment of loans from that fund, the status of federal review of California’s essential health benefits benchmark, and implementation of the new gender-affirming care benefit under AB 144.