Transcript Highlights:

• or respite care services under the Medicaid program.
• We've also directed our statewide Medicaid managed care plans to share these outreach materials with
• care program, the majority of which are enrolled in the Children's Medical Services Program.
• By excluding family caregivers from accessing home health aid services under Florida Kid Care or who
• Allowing families with children on Florida Kid Care to qualify for family home health services will help

Summary: The subcommittee held its first meeting of the 2025-2026 term, took attendance, confirmed a quorum, and heard introductory remarks from members and staff. Chair Anderson outlined the subcommittee’s jurisdiction over access and affordability issues, including health facility regulation, insurance, Medicaid, CHIP, and state employee health coverage. The main agenda item was an update on implementation of HB 391, which created a family home health aide program for medically fragile children. Representative Tramont, the bill sponsor, explained that the law was intended to let trained family caregivers be paid through Medicaid to care for their children, reduce reliance on private duty nursing, and relieve families. He and several members expressed frustration that implementation had taken nearly two years and that families still faced barriers. Deputy Secretary Brian Meyer of AHCA and Bridget Royce of DCF said the program was implemented October 1, 2024, with billing available, but no home health agencies had yet launched the required 80-hour training program and no claims had been paid. They described the program’s requirements, including agency employment, background screening, training, a $25-per-hour Medicaid rate paid to the agency, and an annual assessment report. A major issue discussed was that income earned by family caregivers counts toward Medicaid eligibility and could cause families to lose coverage. AHCA and DCF outlined two possible fixes that would require CMS approval: disregarding the income for eligibility purposes or treating the child as a family of one. Members and public witnesses strongly urged changes to avoid forcing families to choose between income and coverage. Several providers said they had begun preparing training programs, but asked for clearer approval processes and more patient-specific training requirements. The committee then heard extensive public testimony from parents and caregivers of medically fragile children, who described the financial, emotional, and logistical strain of caring for children with severe disabilities and argued that the bill should be expanded to include Florida KidCare families and others in the coverage gap. They also raised concerns about the eight-hour-per-day limit, low pay, and the need for simpler rules and direct support. Home health providers and associations supported the concept but asked for modifications, including more targeted training and clearer implementation guidance. The meeting then shifted to a second agenda item on the Andrew John Anderson Rapid Whole Genome Sequencing Program, which was funded in the 2023 budget. Deputy Secretary Meyer said the program has been implemented since January 1, 2024, but utilization has been lower than expected, with only about 60 claims paid and many denials occurring through managed care. Public testimony from a lab, a hospital, and a pediatric rare disease expert said the program is clinically valuable and cost-saving, but managed care billing barriers, prior authorization issues, and DRG-related denials are limiting access; they urged direct billing to Medicaid and possible expansion to all newborns.

Transcript Highlights:

• We do not provide within the agency any direct care services to clients.
• where we're recruiting a few consumer-directed care plus consultants in maybe one or two pockets of
• Personal care assistant service, or sorry, personal supports, is one of our most commonly used services
• Are they fast-tracked if they were receiving certain services so they can have a continuation of care
• The managed care plans also have the ability to provide in-lieu-of services, which are substitute services

Summary: The Health Care Budget Subcommittee took up two bills and then continued oversight discussions with APD and AHCA. CS/HB 27, the Social Work Licensure Interstate Compact, was presented as a way to let Florida social workers practice in other compact states and vice versa; AARP, the Florida Chamber, and NASW Florida supported it, and the bill passed favorably. HB 1127, a child welfare bill, would create a treatment foster care pilot for children with high behavioral needs, improve DCF data collection on commercially sexually exploited children, and expand recruitment for protective investigators and case managers; the bill also passed favorably after brief supportive testimony. The committee then questioned APD at length about the iBudget waiver waitlist, enrollment pace, spending projections, and provider capacity. APD said it had sent more than 1,100 interest letters in categories 3, 4, and 5, enrolled 1,124 people so far this year, and expects to spend about 96.4% of its waiver appropriation, leaving roughly $82 million unspent. Members pressed APD on why prior discussions suggested more reserve was needed, how long the SANS process takes, whether category 6 could be expanded, and whether the agency has enough waiver support coordinators and direct support providers. APD said it has about 1,061 waiver support coordinators statewide, adequate capacity for current enrollees, but would need further analysis if the legislature directed a much larger enrollment increase. Members also asked about outreach, annual maintenance of the waitlist, portability for military families, and whether communication efforts should be privatized. Finally, AHCA walked the committee through the 2023 Achieved Savings Rebate (ASR) report for Aetna and explained how the report is used for financial monitoring, rebate calculations, and transparency. AHCA said the ASR is separate from the medical loss ratio (MLR) calculation, though both are reviewed, and that Florida uses the ASR mechanism rather than an MLR remittance requirement to recover funds from plans. Members asked about related-party disclosures, CVS/Caremark relationships, expanded benefits, encounter data, network adequacy penalties, denials and appeals reporting, interest earned on capitation payments, and whether rate increases were reaching providers. AHCA and the outside auditors said they review the plans’ reported data, reconcile it to underlying records, and can assess liquidated damages for network adequacy violations; several members requested follow-up data on rebates, interest, provider capacity, and related-party reporting.

Transcript Highlights:

• and services as well. for individuals and families to be able to receive care and services as well.
• Restricts permitted use of value-based purchasing models in our managed care service delivery system,
• For Suquamish, as a sovereign nation, health care is not simply a service line, it's nation building.
• Health care is not simply a service line. It's nation building.
• This Health care is not simply a service line. It's nation building.

Summary: The Senate Health and Long-Term Care Committee met on July 30, 2026, to hear two main briefings. The first, from the Health Care Authority, focused on implementation of federal H.R. 1 Medicaid changes and Washington’s rural health transformation funding. HCA said the state is preparing for major eligibility changes, including the October 1 loss of Medicaid coverage for about 14,000 lawfully present non-citizens and January 1, 2027 work requirements, six-month renewals, and reduced retroactive coverage for roughly 600,000 Medicaid expansion adults. Officials described outreach efforts, new automated verification systems, a verification hub, and plans to use available data sources to reduce manual paperwork, while noting that about one-third of the affected population may still need manual processing. They also said H.R. 1 will limit state-directed payments over time, with an estimated long-term impact of up to $1.5 billion in hospital reimbursements. On rural health transformation, HCA said it is moving quickly to obligate its $181 million federal award through contracts and competitive grants for rural hospitals, workforce, behavioral health, technology, and tribal and community partners. Committee members asked about the impact on rural providers, community service as a work-requirement pathway, emergency Medicaid, tribal and federal reimbursement issues, and whether the state would submit comments on the federal work-requirement rule. HCA said it would file comments, that emergency Medicaid coverage for certain services remains available, and that it is working with tribes and other agencies to avoid erroneous terminations and to move eligible people into other coverage where possible. Members also raised concerns about the administrative burden on families and providers and the need for congressional attention on issues such as TRICARE reimbursement. The second briefing addressed maternal health and the Department of Health’s Maternal Mortality Review Panel report. DOH said maternal mortality in Washington increased for the first time in the report series, but most pregnancy-related deaths remain preventable. Nearly half were linked to behavioral health conditions, especially overdose deaths, with suicide, cardiovascular disease, and COVID-19 also significant causes; most deaths occurred postpartum rather than during delivery. The report found higher mortality rates among American Indian and Alaska Native, Black, Native Hawaiian, Pacific Islander, multiracial, rural, and Medicaid-covered populations, and identified lack of access to care, financial hardship, housing instability, discrimination, bias, and systemic inequities as major contributors. DOH highlighted existing state actions such as one-year postpartum coverage, doula reimbursement, inpatient substance use treatment coverage for birthing people, and vaccine coverage requirements, and offered 12 legislative recommendations focused on affordable and high-quality care, basic needs and community supports, and equitable, culturally responsive services. Presenters from the Suquamish Tribe and Kitsap OBGYN described how the tribe acquired and stabilized a threatened OB-GYN practice to preserve regional access amid provider shortages and hospital service losses. They said rural obstetric care is difficult to sustain because of thin margins, workforce shortages, long travel distances, and higher-risk patients, and emphasized that tribal health systems can offer stronger reimbursement and integrated family-centered care. The Foundation for Healthcare Quality and the Bree Collaborative then outlined statewide maternity-care quality efforts, including work on perinatal behavioral health, care coordination, postpartum screening, doula support, and better-aligned payment models. They said Washington has strengths in innovation but still needs more OB-GYN capacity, better transitions of care, and more culturally responsive, trauma-informed maternal and Native health services.

Transcript Highlights:

• the opportunity for medical service programs from the Department of Health to the Agency for Health Care
• It is a collection of programs that are oriented toward access to health care services for children in
• CMS managed care plan provides health care services for children under 21 years of age with special health
• And special health care needs, it is the determination to be eligible medical service is based on an
• For institutional care services, approximately 71,000 individuals were there for hospice services and

Summary: The Health Facilities Subcommittee met to receive implementation updates from the Agency for Health Care Administration on three bills passed in prior sessions. First, Deputy Secretary Brian Meyer reported on the transfer of the Children’s Medical Services managed care plan from the Department of Health to AHCA under HB 1085. He said the move was administrative only, with no change to enrollment, providers, services, or clinical eligibility functions, and that it was intended to create efficiencies by aligning procurement and shifting staff resources between agencies. Members then questioned AHCA about reports of reductions in private duty nursing and therapy services for medically fragile children, including concerns about appeals, provider credentialing, and whether families were losing services or being transitioned appropriately. AHCA said it was reviewing denials, monitoring the plan, and using contractual remedies while focusing on maintaining access for members. The committee also reviewed implementation of a bill creating permanent Medicaid eligibility for individuals with permanent disabilities. AHCA staff explained that the agency had submitted a federal 1115 waiver request after public comment and stakeholder meetings, but CMS had indicated it did not anticipate approving the requested authority. Members pressed AHCA on why the waiver was submitted later than the bill’s directive date and on whether the delay was avoidable. AHCA said the waiver was complex and required review, drafting, and public input, and noted that DCF already has a specialized unit to help with redeterminations while the agencies work on operational changes. The committee discussed the practical impact on families who struggle with annual eligibility renewals and the need for clearer communication and faster follow-up from the agency. Finally, AHCA presented on the home health aide program for medically fragile children and related Medicaid eligibility changes. The agency described the 2023 law that created a family caregiver provider type and the 2025 changes that increased the hourly rate, expanded hours, reduced training requirements, and removed caregiver earnings from Medicaid eligibility calculations, subject to federal approval. AHCA said it had completed state public comment, submitted the waiver amendment to CMS, and was awaiting federal action. Members raised concerns that some families may have enrolled or begun work before the eligibility fix was in place and may have lost benefits, especially in Broward County. AHCA said it would work with affected families and plans, review outreach through DCF and the health plans, and continue rulemaking, system updates, and provider training. The meeting ended with the chair noting that the committee had received the updates and adjourned without objection.

Transcript Highlights:

• We're also going to look at reproductive health care, long-term care services and supports,...
• At reproductive health care, long-term care services and supports, as well as Medi-Cal Dental that we've
• services, including abortion care.
• , and long-term care services at a PACE center.
• , maternal care, and non-specialty mental health services.

Summary: The Assembly Budget Subcommittee on Health began with a hearing on the impacts of H.R. 1 on California health programs, focusing first on reproductive health state investments. HCAI outlined five state-funded reproductive health programs created after Dobbs, including uncompensated care, practical support, capital and clinical infrastructure, and workforce programs. Essential Access Health and Planned Parenthood testified that these funds have served hundreds of thousands of patients, but warned that the uncompensated care program is fully awarded and needs renewal, and that Title X and Medicaid-related federal uncertainty continues to threaten access. Members questioned who the uncompensated care program serves, why Medi-Cal covers a large share of abortions, and whether Planned Parenthood could expand prenatal services; public commenters urged continued support for reproductive health access. The committee then took up long-term care services and supports, starting with the HCBA and Assisted Living Waiver programs. DHCS reported large wait lists for both programs and said enrollment is limited by workforce and provider capacity, while LAO noted that increasing slots alone may not increase access without additional programmatic changes. Members pressed the department on whether more slots should be added given the lower cost of home- and community-based care compared with skilled nursing facilities, and public testimony argued that the wait lists should be reduced and that staffing concerns do not fully explain unused capacity. The committee also heard testimony on congregate living health facilities, where providers and a patient family described the homes as critical, lower-cost alternatives to nursing facilities for younger, medically complex people. Witnesses requested short-term bridge funding, while DHCS said it is proposing to transition CLFs into a managed care benefit by January 1, 2028, which would remove caps and expand access statewide. The final long-term care topic was PACE. DHCS explained that it has paused new PACE applications and service expansions for at least two years to reassess oversight capacity and develop a statewide strategic growth framework, while existing programs continue operating. CalPACE supported the pause as a planning measure but asked for four additional state nurse positions to reduce delays in level-of-care determinations and speed enrollment for frail older adults. Members shared personal stories about how PACE has helped family members and asked how the state will meet growing demand; DHCS said stakeholder engagement will begin later in the year and that some existing applications already in process will continue. Public commenters broadly supported PACE, HCBA, and CLF funding requests. The hearing then moved to the Department of Health Care Services’ 2026-27 Medi-Cal budget and related trailer bills. DHCS said Medi-Cal spending has grown due to coverage expansions, higher acuity, rising utilization, and especially pharmacy costs, and it described proposals to extend the current skilled nursing facility financing framework for one year while the state develops a new value-based payment strategy. LAO said most recent Medi-Cal spending growth has been driven more by higher per-enrollee costs than by caseload growth, with pharmacy spending growing especially quickly, and recommended better and more timely data to analyze the drivers. Members expressed concern about the rapid rise in Medi-Cal spending and asked for more detail on the largest cost increases.

Transcript Highlights:

• health care social work any other type of services to those populations the local health departments
• </c><00:04:41.440><c> any</c> services health care social work any services health care social work any
• and all services and supports will be individualized service plans, um, and include care coordination
• that</c><00:40:13.359><c> only</c> direction of services stating that only direction of services stating
• care, behavioral health services foster care, behavioral health services for<00:46:10.240><c> children

Keywords: 958, all

Summary: The committee met with a quorum and first heard brief presentations on Kentucky’s 2025 Preventive Health and Health Services Block Grant and Title V Maternal and Child Health Block Grant. Department for Public Health staff explained that the preventive health block grant provides about $2.3 million annually and supports programs such as accreditation and performance improvement, local health department grants, community health workers, prescription assistance, asthma and COPD programs, workforce development, and a sexual assault programs set-aside. They said the Title V block grant provides about $11.7 million, with 35% directed to children and youth with special health care needs and 65% to maternal and child health populations, largely through local health departments and a five-year needs assessment process. After no questions, a motion was made and seconded to approve both block grants. The roll call vote passed 19-0, and the two block grants were approved. The committee then approved the minutes from the prior meeting. The next item was a discussion of the child waiver created in House Bill 6. Committee members raised concerns that the proposed 1915(c) waiver did not match the legislature’s intent, which they said was to move children from the Michelle P. waiver to free slots for adults. Cabinet officials from DCBS, behavioral health, and Medicaid described the proposed “Community Health for Improved Lives and Development” waiver as a targeted home- and community-based program for children under 21 with severe behavioral health or developmental needs, including those stepping down from inpatient or residential care or at risk of out-of-home placement. They said the waiver is designed for about 100 slots, uses a standardized needs-based assessment, and includes case management, community living supports, home modifications, respite, supervised residential care, and clinical therapeutic services. Officials said the public comment period ended July 15, responses are being compiled for August submission to CMS, and the waiver is part of the broader Families First initiative.

Transcript Highlights:

• Primary care services, behavioral health services are excluded.
• Primary care services, behavioral health services are excluded. So we'll...
• Primary care services and behavioral health services are excluded.
• Yes, you could—that would be an example where we direct the managed care plans to pay a higher rate,
• We were funded and directed to implement birth doula services and Apple Health Medicaid reimbursement

Summary: The committee first received an update on the effects of HR1 and related federal Medicaid and marketplace changes from Governor’s Office and Health Care Authority staff. Presenters said the most immediate coverage losses are expected in the individual market beginning in January, with premium increases and an estimated 80,000 people potentially unable to afford coverage. They warned that larger Medicaid impacts will follow over the next year and beyond, including tighter eligibility checks, work requirements, reduced retroactive coverage, limits on state-directed payments and provider taxes, new cost-sharing, and changes affecting certain non-citizen adults. They also said the state plans to seek a waiver or extension for work requirements and will continue to analyze impacts, including on rural providers and Planned Parenthood-related services. Members asked about the effect on nursing homes, rural hospitals, and how the state can help providers and enrollees navigate the new requirements; staff said timelines and a state-specific implementation chart are being developed. The committee then heard a report on the International Medical Graduate Work Group and Washington’s efforts to create pathways for internationally trained physicians. Testimony described the clinical experience license, the clinical evaluation assessment tool, grant funding for IMG support organizations, and a new hardship waiver process enacted this year. National presenters said many states have adopted similar pathways because of physician shortages, but Washington and Tennessee are among the few states that have actually issued licenses so far. They recommended clear guardrails, an employment offer before application, ECFMG certification, supervised practice, and data collection to avoid exploitation and protect patients. Members asked about state-to-state variation, retention of IMGs, and whether Washington should pursue dedicated residency or preceptorship options; presenters said the key next step is moving successful participants from supervised experience to a durable long-term license. The final topic was implementation of Washington’s Apple Health doula benefit and the statewide doula hub and referral system. Senator T’wina Nobles highlighted the state’s $3,500 per-birth Medicaid reimbursement rate for doulas and the importance of the hub for referrals, training, and billing. Health Care Authority staff said the benefit launched January 1, 2025, and covers prenatal intake, labor and delivery, postpartum visits, and telehealth-supported services. They reported 336 state-certified doulas, 134 enrolled in Apple Health, 287 unique clients served, and 641 claims paid so far. Testimony emphasized doulas’ role in improving birth outcomes, reducing unnecessary interventions, and addressing racial disparities in maternal health, while noting that implementation is still early and ongoing.

Transcript Highlights:

• In the biennial operating budget last year, the legislature directed the Health Care Authority to apply
• House Bill 2555 directs the Health Care Authority to apply for that waiver from CMS to allow for the
• received through Indian health care services or tribal organization.
• Since supporting direction of this work last session, the Health Care Authority has been engaged with
• To this point, the governor included a proposal for a revised direction... ...services is structured.

Summary: The House Health Care and Wellness Committee held public hearings on four bills and then took executive action on three measures. HB 2555 would require the Health Care Authority to apply for a Medicaid waiver to cover traditional health care practices provided through Indian Health Service, tribal, and urban Indian facilities. Supporters, including the prime sponsor, tribal health leaders, and the Health Care Authority, said the bill would recognize traditional medicine, expand access, and leverage federal funding, though HCA noted the July 1, 2026 waiver deadline and urban Indian reimbursement questions may be difficult to resolve. HB 2685 would codify tribal data sovereignty principles for state agencies, require reporting of notifiable conditions to tribal health jurisdictions, and exempt certain tribal data from public disclosure. Tribal representatives supported the bill as necessary for access, governance, and better public health planning, while the Washington Coalition for Open Government and HCA raised concerns about the breadth of the PRA exemption, undefined ownership interests, and implementation details. HB 2658 would require health carriers to submit standardized public data on behavioral health and other coverage and access metrics, with the Insurance Commissioner posting the information on a public dashboard. Supporters said the bill would improve transparency about mental health parity and help families, employers, and policymakers compare plans; opponents argued it duplicates or complicates recent parity reforms and could be misinterpreted. HB 2683 would shorten carrier credentialing timelines from 90 days to 30 days and require carriers to post billing and coverage information online. Supporters said it would reduce delays for providers and patients, while opponents warned the shorter timeline could be hard to meet and that posting information without login protections could raise privacy concerns. In executive session, the committee adopted two amendments to HB 2168, which concerns overdose mapping data, then reported the substitute bill out with a due pass recommendation by a vote of 16-1. It rejected an amendment to HB 2196 that would have extended PANDAS/PANS coverage to public and school employee plans, then advanced the substitute bill with a due pass recommendation by a vote of 15-2. Finally, the committee passed HB 2545, which would allow ambulatory surgical facilities to perform elective percutaneous coronary interventions, by a vote of 13-4, after members discussed safety, access, and cost savings.

Transcript Highlights:

• And beyond direct services, we collaborate across agencies to strengthen systems of care, such as our
• These rates now support minimum salaries of $20 per hour for direct care professionals.
• I do think that self-direct community who can provide those services.
• about services, immensely cares about the lives of people with disabilities.
• And they provide a lot of direct services to them.

Committee: Joint Joint Committee on Children, Families and Persons with Disabilities

Keywords: 995, all

Summary: The hearing was an informational and oversight session of the Joint Committee on Children, Families, and Persons with Disabilities, with chairs and members hearing agency updates from several commissioners. The Department of Public Health’s Bureau of Family Health and Nutrition described its maternal and child health work, including home visiting, early intervention, WIC, newborn hearing screening, and cross-agency efforts on prenatal substance exposure, respite care, children’s vision, and maternal health initiatives. DPH emphasized that federal grant cuts, layoffs, and the loss of data systems such as PRAMS would weaken services and planning, and members asked about Title V funding and the impact of federal uncertainty. The Massachusetts Commission on the Deaf and Hard of Hearing highlighted communication access services, interpreter and CART referrals, emergency after-hours support, family navigation, and independent living services. Commissioners and members discussed the shortage of ASL interpreters and the need to expand training pipelines, including partnerships with colleges and possible ASL programming for younger students. The Department of Developmental Services reported serving nearly 50,000 people and focused on youth and adult services, transition-age supports, autism services, self-direction, respite, and new high-acuity residential models. Members asked about respite availability, self-direction outcomes, and workforce shortages; DDS said it was expanding clinical capacity and provider rates while monitoring possible federal Medicaid, SNAP, and immigration-related impacts. The Commission for the Blind described services for about 28,000 legally blind residents, most of whom are older adults, including social rehabilitation, orientation and mobility training, children’s services, assistive technology, vocational rehabilitation, and Turning 22 supports. The commissioner discussed a UMass-based effort to build the workforce pipeline for blindness services and said the agency was watching federal restructuring but had not yet seen direct cuts. MassAbility’s leadership then warned about major federal changes affecting Social Security disability determinations, including staff restructuring, office closures, and a new overpayment repayment policy, and said the agency was preparing for possible increases in claims and uncertainty around reallotment dollars that help fund services. The Disabled Persons Protection Commission closed the hearing with an update on its abuse investigations and protective services for adults with disabilities. DPPC reported rising hotline calls and investigations, a growing caseload, its sexual assault response team, the abuser registry, and a new interagency protective services integration system funded by ARPA dollars through 2027. The agency also flagged new federal rules that could affect funding eligibility and said it may need statutory changes to comply. Members asked about funding, reporting pathways, and how complaints reach DPPC, and the commissioner said the agency uses both mandated reporting and proactive outreach to identify and respond to abuse.

Transcript Highlights:

• </c><01:02:32.160><c> care</c><01:02:32.400><c> services</c> receive their direct care services receive
• Care staff service an official Direct Care staff service can<01:02:51.480><c> assist</c><01:02:51.760
• regulations regarding temporary travel that other direct care services like PCA and CDCS also use.
• that Direct Care file 1810 understands that Direct Care is<01:03:59.920><c> direct</c><01:04:00.279>
• of Direct Care staff have a list of Direct Care staff services<01:04:03.920><c> then</c><01:04:04.000

Committees: Senate Health and Human Services , Senate Human Services

Keywords: 1187, senate, all

Transcript Highlights:

• Our home care members provide shared services to self-directed clients in both the PCA choice program
• We also provide home care services in the consumer direct community support program.
• Our home care self-directed home care.
• /c><00:05:12.960><c> consumer</c><00:05:13.520><c> direct</c> care services in the consumer direct care
• </c> personal care assistant PCA services. personal care assistant PCA services.

Keywords: 1183, house

Transcript Highlights:

• personal care services, the consumer-directed piece of it, is recommended at $17.20 per hour based on
• And the personal care services, the consumer directed piece of it, is recommended at 1720 per hour based
• So there's New Mexico Care, and then what we see here on personal care services.
• personal care services.
• It says here that there's a fiscal intermediary... ...or directed personal care services.

Committee: House House Appropriations & Finance

Keywords: 996, all

Transcript Highlights:

• But with care as we can. All right, we have mostly Department of Health Care Services.
• For services and supports for primary care, $50 million.
• services that moved into managed care under CalAIM.
• And for private hospitals, we are proposing to increase managed care directed payments and fee-for-service
• We are proposing to increase managed care directed payments and fee-for-service supplemental payments

Summary: The subcommittee heard an overview of the Department of Health Care Services’ proposed budget, including a $229.1 billion total-funds budget and projected Medi-Cal enrollment decline as redeterminations continue. Members focused heavily on the fiscal and programmatic effects of prior budget solutions and federal changes, especially the elimination of General Fund-supported Prop. 56 dental supplemental payments beginning July 1, 2026, the hospice utilization-management change, and the impact of reduced caseloads alongside rising health care costs. DHCS said it is still completing required access and rate-reduction analyses for the dental cuts and has been engaging stakeholders, but could not yet quantify the real-world effect on utilization or provider participation. The committee also reviewed the November 2025 Medi-Cal local assistance estimate, which shows higher General Fund spending despite lower enrollment, driven by managed care rate growth, Medicare cost growth, state-only claiming, and federal policy changes. The hearing then turned to provider taxes and federal H.R. 1 constraints, with extensive discussion of the MCO tax, the hospital quality assurance fee, and other health care-related taxes. DHCS explained that H.R. 1 phases down allowable tax levels and tightens “generally redistributive” rules, making the current MCO tax structure and the proposed higher hospital fee levels difficult or impossible to renew as originally designed. Staff and the LAO described the tradeoff between preserving Medi-Cal funding and avoiding higher costs on private providers and consumers. Members asked about options for preserving revenue, including possible amendments to Prop. 35 or returning to voters, and were told the department is still evaluating approaches while federal guidance remains in flux. The committee also reviewed hospital payment increases already implemented through state-directed payments, with DHCS noting that H.R. 1 will force those payments down to Medicare levels over time. Several budget change proposals were discussed and left open, including requests tied to the managed care final rule, managed care operations, hospital value strategy, long-term care payment transparency, and interoperability requirements. The committee also heard about a one-year trailer bill extension for skilled nursing facility financing, including continuation of the SNF workforce standards program, the SNF quality assurance fee, and annual rate growth, while the department develops a longer-term financing redesign for 2027-28. Members expressed skepticism about repeated rate reform efforts and questioned whether a one-year extension of the eliminated workforce quality incentive program should be restored during the transition. Finally, Covered California presented its budget and enrollment update, reporting that the expiration of the federal enhanced premium tax credit is expected to reduce affordability significantly, with average premiums roughly doubling for many enrollees and as many as 400,000 Californians potentially losing marketplace coverage over time. The exchange said California’s $190 million subsidy program is helping lower-income enrollees, but not enough to offset the federal loss, and it is also implementing a new gender-affirming care benefit and awaiting federal action on benchmark plan changes.

Transcript Highlights:

• HB 1567 addresses a critical gap in care by allowing direct support professionals and relatives to administer
• can access the services that they need. ...disabilities transitioning out of foster care can access
• Does the pilot program include any type of consumer-directed care, like take that into consideration,
• that is able to scale up their services to be able to take care of this population. care program.
• up their services to be able to take care of this population.

Summary: The committee met with a quorum present and heard six bills, all of which were reported favorably. HB 1567, relating to insulin administration by direct support professionals, was amended to clarify the type of insulin that may be administered and to allow supervision of self-administration of an insulin pen. Supporters described the bill as a way to keep people with developmental disabilities in group homes rather than forcing institutional placement; the amendment and bill both passed unanimously, 17-0. PCS for HB 1103, on services for persons with disabilities, would expand the APD managed care pilot statewide in phases, require more transparency on waitlist data, create a statewide family care council, and address transition services for young adults leaving foster care. Testimony was mixed: supporters emphasized the long APD waitlist and the need for a voluntary option, while some witnesses and members raised concerns about the accelerated rollout, limited data, and preserving consumer-directed care. The committee adopted the bill 17-0. CS for HB 127, on exceptional student education, would create micro-credentials and coordinate with the Florida Center for Students with Unique Abilities and OSHA to support students with disabilities transitioning to work; it passed 17-0 after testimony from a parent and advocates. HB 989, concerning licensure of family foster homes, was amended to streamline license transfers for foster parents moving within Florida while maintaining oversight and directing DCF rulemaking. A teacher and other supporters said the bill would reduce bureaucracy and help children remain in stable homes; it passed 17-0. PCS for HB 1091, on substance abuse and mental health care, updates processes related to the 988 crisis line, methadone treatment needs assessments, and forensic evaluators, and adds data/reporting requirements for DCF managing entities. After one amendment and testimony from supporters and one opponent, it passed 16-0. Finally, HB 633, on behavioral health managing entities, was amended and then approved 17-0; it requires more structured data and reporting from managing entities to increase accountability and transparency in the behavioral health system.

Transcript Highlights:

• services within the 3% state-directed cap.
• services within the 3% state-directed cap.
• We placed, you know, sending these funds to core direct services.
• And direct services alone does not fill this gap because many people can't benefit from services that
• services, foster care, and adoptions.

Summary: The committee heard opening budget remarks from the Department of Finance and the Legislative Analyst’s Office on the May Revision for Health and Human Services. Finance said the proposal significantly reduces projected out-year operating deficits through a mix of revenue increases and program cost reductions, while the LAO warned that even with booming revenues the state still faces a structural deficit and should prioritize reserves and avoid new ongoing commitments. The chair and members echoed concern about cuts to vulnerable populations, but also noted the need to maintain the overall level of budget solutions and add to reserves. The hearing then moved through a series of CalHHS and HCAI proposals, mostly held open after presentation. CalHHS requested additional legal support to respond to federal H.R. 1-related issues and a net-zero transfer of positions for a shared eligibility/data-sharing platform. Other items included ongoing funding for the 988 Behavioral Health Crisis Service Fund and a request for EMSA to fund maintenance of its enterprise data management system. HCAI presented proposals for hospital fair pricing implementation, the data exchange framework, the all-payer claims database, CalRx insulin development, the diaper access initiative, distressed hospital grants, opioid settlement fund reversion, and the Rural Health Transformation Program. Members questioned funding sources, special fund use, contracting exemptions, timelines, and whether some proposals should be more targeted or supported by alternative funding. A major discussion centered on HCAI’s diaper access initiative and the use of a Public Contract Code exemption to continue contracting for free diapers distributed through hospitals. The chair and some members criticized the optics of the selected vendor and questioned the lack of an income threshold, while HCAI said the program was designed to be universal and administratively simple, with future phase-two direct-to-consumer purchasing to be handled by a different vendor. Another extended exchange focused on distressed hospital funding, where HCAI said the May Revision would provide up to $50 million for hospitals at immediate risk of closure, but members argued the repeated annual need shows a structural problem and asked for broader reforms to hospital payment and care transitions. The final major topic was the Behavioral Health Services Oversight and Accountability Commission’s budget. The Commission opposed the May Revision’s reduction of the Innovation Partnership Fund from $20 million to $10 million and a $6.7 million cut to community advocacy contracts, arguing both are core Proposition 1 tools for statewide innovation and community engagement. Finance responded that the proposal is within Proposition 1’s allowable maximums and that prior unspent appropriations could be redirected if the Legislature wanted to restore the full amount. No votes were taken; items were generally held open for later action.

Transcript Highlights:

• The Medicaid program supports services that help people stay at home with personal care services, developmental
• The Medicaid program supports services that help people stay at home with personal care services, developmental
• And so when you move claims, when you move services from fee-for-service into managed care, there's no
• Primary care case management is a common service in other states.
• State-directed payments once we stand up comprehensive managed care.

Keywords: 989, all

Summary: The committee heard a budget presentation on the Division of Medicaid within the Department of Health and Welfare, including an overview of the division’s five programs, staffing, spending trends, and the large share of the budget that goes to trust and benefit payments. Ms. Williamson explained the difference between ongoing and one-time enhancements, the role of population forecast adjustments, and why the fiscal year 2026 and 2027 numbers change significantly. Members asked about the growth in the budget, the FMAP match rate, the impact of provider rate changes, and the shift of some positions into Medicaid from other divisions after last year’s reorganization. A major topic was House Bill 345 and related budget changes, including the hospital assessment fund alignment, the 4% provider rate reduction, and the effect on Medicaid expansion and other populations. The committee discussed the decline in expansion enrollment, rising costs in traditional Medicaid populations, and the governor’s recommendation to offset part of the 2027 increase with additional reductions. Members raised concerns about access to care, especially for dental, behavioral health, developmental disability, and home- and community-based services, while the deputy director said the department is trying to contain costs through prior authorization, fraud and abuse work, and policy changes. The committee also focused on the MMIS replacement project, which is in year four of a five-year procurement and is funded through dedicated and federal dollars tied to milestones. Another significant item was estate recovery, where the department requested funding to replace an outdated case management system and add contractor support to address a backlog of roughly 20,000 cases; members questioned the return on investment and asked for more detail on the software and staffing split. The deputy director also explained the federally qualified health center reconciliation issue, saying the state had not been properly paying change-in-scope amounts and is now using a new process with interim payments and later reconciliation. In addition, lawmakers asked about program integrity staffing, the use of AI, and whether the department could better target fraud, waste, and abuse investigations. The deputy director said the department is reviewing AI use cautiously and sees opportunities for it in claims review and anomaly detection, but emphasized that the current request is for dedicated receipt authority rather than general funds. No formal votes were taken in the excerpt, but the committee received the presentation, asked extensive questions, and was told that some follow-up information would be provided later.

Transcript Highlights:

• health care gaps at home, I can confidently say that this bill will save services.
• protections to ensure that no individual is excluded from health care coverage or services based on
• Across the country, we are seeing rollbacks in gender-affirming care services and Uncertain.
• Across the country, we are seeing rollbacks in gender-affirming care services and clinics.
• or other gender-affirming care that the health care service plan would otherwise cover if the denial

Summary: The Assembly Health Committee met on March 17 and first approved a consent calendar of several bills, then heard AB 1540 by Assemblymember Mark Gonzalez, which would restore the 988 “Press 3” LGBTQ youth crisis line. Supporters, including suicide prevention advocates, behavioral health groups, and local governments, argued the service is a vital, identity-affirming suicide prevention tool for LGBTQ youth. Opponents, including detransitioners and conservative advocacy groups, argued it would steer vulnerable youth toward organizations they viewed as harmful. The committee approved the bill on a due-pass-as-amended motion to the Communications and Conveyance Committee, with several no votes; the bill was later held on call and then advanced. The committee next heard AB 1671 by Assemblymember Tangipa, creating a Rural Medical Provider Grant Program to help providers serving rural communities with operational costs, equipment, workforce needs, and related expenses. Supporters said the bill would help retain providers and improve access in areas where patients travel long distances for care; committee members also discussed telehealth as an important rural access tool. The bill passed on a due-pass-as-amended motion to Appropriations. The committee then took up AB 1876 by Assemblymember Addis, the Fair Care for All Act, which would codify federal health care nondiscrimination protections into California law, including protections related to race, color, national origin, age, disability, sex, and gender identity. Supporters said the bill is needed because federal protections are vulnerable to rollback and because patients, especially transgender and intersex Californians, face coverage denials and care disruptions. Opponents argued the bill would force coverage of gender-affirming care and raised concerns about detransitioning. The committee approved the bill on a due-pass motion to Judiciary, with some no votes, and later held it on call before it advanced. Finally, the committee heard AB 1629 by Assemblymember Haney, which would require dental plans to honor assignment-of-benefits requests and improve reporting on network adequacy. Supporters said the bill would reduce upfront costs for patients and improve transparency, while opponents, including Delta Dental and dental plan groups, warned it could weaken networks and increase out-of-pocket costs. After discussion about network participation and patient access, the committee passed the bill on a due-pass motion to Appropriations. The committee then completed the remaining votes, including the consent items, and adjourned.

Transcript Highlights:

• All right, we have mostly Department of Health Care Services.
• But with care as we can. All right, we have mostly Department of Health Care Services.
• For services and supports for primary care, $50 million.
• services that moved into managed care under CalAIM.
• And for private hospitals, we are proposing to increase managed care directed payments and fee-for-service

Keywords: 987, senate, all

Transcript Highlights:

• that overlap with HCB services. and adult day care waiver services.
• And and adult day care waiver services.
• And with the direct payment from Medicaid, that's based on cost of care.
• Our state-directed payments right now are a pass-through with the managed care organizations.
• ><c> managed</c> We have fee-for-service versus managed We have fee-for-service versus managed care<00

Keywords: 958, all

Summary: The Medicaid Oversight and Advisory Board met on January 12, 2026, to approve the December 10, 2025 minutes and continue finalizing its findings and recommendations. Members reviewed findings on administrative inefficiencies, Medicaid and workforce participation under HR 1, Medicaid budget growth, rural health transformation fund development, and provider tax/state-directed payment changes. The board approved a motion to change “pilot” to “partnership” in the workforce-related recommendation, and also adopted a technical amendment clarifying overlapping HCBS services by removing reference to adult daycare waiver services and revising the language to focus on reducing duplication, simplifying provider contracting, and standardizing processes across programs. A separate technical correction was noted to change “DMS” to “DPH” in the rural health transformation finding, to be handled in the final edits. Several findings drew discussion but no final substantive vote during the meeting. On the rural health transformation fund, Dr. Berg said Kentucky had done well in federal funding and noted limits on what could be shared publicly, while Commissioner Lee said a public website had been created and recommended the department reference be changed to the Department for Public Health. Finding five prompted extended discussion about provider taxes, state-directed payment reductions under HR 1, and whether the board should address the relationship between actuarial studies, MCO payments, and actual provider reimbursement more directly. Senator Meredith and others argued for a broader, more transparent baseline review of rates across provider groups, while Commissioner Lee said CMS will require certain fee schedule comparisons to Medicare beginning July 1, 2026, and that quarterly expenditure reports already go to LRC. The board did not finish resolving finding five during the meeting and agreed to return to it after staff prepared more explicit language. Members also discussed the possibility of an all-payers claims database as a better way to understand what is being paid across payers and services. No final vote on the full findings package was taken in the portion of the meeting provided, but the board did adopt the noted amendments and continued working through the remaining language.

Transcript Highlights:

• Today, we will have a conversation with the Department of Health Care Services.
• Michelle Boss, Director of the Department of Health Care Services.
• Health services, emergency departments and urgent care centers, urgent care clinics experience sharp
• care clinics, who are largely funded through their service levels and service provision to people who
• care and some services for undocumented immigrants.

Summary: The joint informational hearing focused on the impacts of H.R. 1 on California’s Medi-Cal program and on community health effects from recent immigration enforcement actions. Committee leaders said H.R. 1 would sharply reduce federal funding, increase administrative burdens, and worsen access to care, especially for Medi-Cal enrollees, immigrant families, rural communities, and reproductive health patients. The second half of the hearing examined how ICE raids and related federal actions are creating fear, reducing clinic and emergency department use, and disrupting children’s access to schools and early childhood education. Department of Health Care Services Director Michelle Bass outlined the main H.R. 1 provisions affecting Medi-Cal: work requirements, semiannual eligibility redeterminations, shorter retroactive coverage, new cost-sharing, limits on provider taxes and state-directed payments, reduced federal support for emergency and lawful immigrant coverage, and a one-year ban on Medicaid funding for prohibited abortion providers. She estimated millions could lose coverage, with tens of billions of dollars in federal funding at risk. Planned Parenthood Affiliates of California warned the defunding provision could force clinic closures, service reductions, and loss of access to family planning, STI testing, and cancer screenings. The California Hospital Association said the financing changes could cut hospital revenue by tens of billions over 10 years and threaten access, especially for rural and safety-net hospitals. The Western Center on Law and Poverty argued the law would increase churn, paperwork, and uninsured rates, disproportionately harming working adults and people experiencing homelessness. Committee members asked about implementation timelines, notification systems, administrative costs, the effect on immigrant eligibility, and whether California could delay or mitigate some provisions. Bass said the state was still assessing federal guidance, planning county and provider outreach, and exploring a possible delay for work requirements and a transition period for provider-tax changes. Members also discussed how state budget actions may need to be revisited in light of H.R. 1, and how California might preserve access through state-only funding or other policy changes. In the second panel, CHIRLA, Los Angeles County Department of Health Services, and the Children’s Partnership described the health consequences of immigration enforcement. Speakers said raids and data-sharing fears are causing anxiety, trauma, and avoidance of care, with Los Angeles County reporting declines in emergency, urgent care, and clinic visits after enforcement actions. The Children’s Partnership said school and early childhood absences are rising in some communities and that enforcement is undermining children’s emotional well-being and access to education. Members asked for more data and discussed possible state protections, telehealth, mobile care, and legal and policy responses to reduce fear and preserve access to health and education services.