Transcript Highlights:

• </c> public hearing with stakeholder input public hearing with stakeholder input and<00:50:36.640><c>
• ,</c> with public input, with public input, not<01:28:40.800><c> behind</c><01:28:41.440><c> closed</
• ><c> have</c><02:33:26.240><c> a</c> These new regulations will have a These new regulations will have
• </c> it appears to prioritize a care input it appears to prioritize a care input staff<02:56:25.680><
• </c> a voluntary receiverhip to the regulator a voluntary receiverhip to the regulator so<03:34:41.439

Transcript Highlights:

• It's very complicated data.
• data to the overall rate-making process.
• We collect a lot of data on what they're doing. We mine a lot of data. We do a lot of data.
• We collect a lot of data on what they're doing. We mine a lot of data. We do a lot of things.
• Data ultimately, I'm a big data guy.

Summary: The subcommittee held its first meeting on homeowners property insurance, with members from both parties introducing themselves and repeatedly noting that insurance affordability, roof condition, claims handling, and storm recovery are top concerns for their districts. Chair Yeager said the meeting was intended as an educational discussion rather than a legislative debate, and introduced a panel that included Insurance Commissioner Mike Yaworski, consumer Chad Carr, agent Mary Catherine Lawler, insurer executive Melissa Burt DeVries, and policyholder attorney Chip Merlin. The panel and members discussed major cost drivers in Florida homeowners insurance, including inflation, home age, roof age, mitigation features, claims history, litigation costs, reinsurance, and the Florida Hurricane Catastrophe Fund. Commissioner Yaworski said underwriting has become more sophisticated and that litigation costs, reinsurance, and replacement-cost inflation all affect premiums; he also said litigation is down about 30% and average requested rate increases have fallen from about 22.1% in 2022 to 0.8% today. DeVries said age of home, replacement cost, roof age, and coverage choices can materially change premiums, and explained that reinsurance is a major expense passed through to consumers. Merlin emphasized transparency concerns, argued that insurers are increasingly individualizing risk, and said consumers often struggle with coverage limits, deductibles, and claim denials. Members asked about flood coverage, hurricane deductibles, managed repair programs, mitigation credits, new insurer capitalization, and whether savings from reforms are reaching consumers. Yaworski explained that flood is generally excluded from homeowners policies and covered separately, that hurricane deductibles are mandatory in Florida and usually around 5%, and that the office tracks savings from reforms through rate filings and insurer discussions. He said the state is updating mitigation discounts and monitoring new entrants closely for solvency and market conduct. Several members and panelists said recent reforms have helped reduce some abuses and litigation, but many consumers are still seeing higher premiums because replacement costs and reinsurance remain elevated. No votes or formal actions were taken.

Transcript Highlights:

• From the data available, has early education and care actually shared with us an analysis of whether
• From the data available, has early education and care actually shared with us an analysis of whether
• From the data available, has early education and care actually shared with us an analysis of whether
• And colleagues, the data increasingly show Massachusetts is falling behind.
• And the latest data on this is quite alarming. U.S. Census data from the U.S.

Summary: The Senate opened with the Pledge of Allegiance, adopted two commendatory resolutions honoring the Plimpton Historical Society’s Deborah Sampson Day recognition and Megan’s Light’s Cystic Fibrosis Awareness Month observance, and suspended Joint Rule 12 to refer several House petitions to committee. The chamber also briefly recognized Diane Talk of the South Shore Regional Emergency Communication Center on her retirement after 30 years of dispatch service. Later, the Senate passed two local bills to enactment: House No. 4006, authorizing Dartmouth to grant an additional all-alcoholic beverages license, and House No. 473, relating to the charter of Westwood. The main business was the Senate Ways and Means presentation of the fiscal year 2027 budget, totaling about $63.3 billion. The chair described the budget as balanced, with no new taxes or tax cuts, based on a consensus revenue estimate of $986 million in growth over FY26 (2.4%), and including about $15.8 billion in federal financial participation and roughly $2.7 billion from the Fair Share surtax. The budget emphasized record local aid, including $1.376 billion in unrestricted general government aid, $7.66 billion for Chapter 70 education aid, increased minimum school aid, higher regional school transportation reimbursement, rural aid, and the revival of the Foundation Budget Review Commission. It also highlighted major investments in MassEducate free community college, food security, housing, and support for vulnerable residents. Members then engaged in extended colloquy on the budget’s major cost drivers and policy choices. Questions focused on debt service, pension and OPEB liabilities, MassHealth caseload and rising per-enrollee costs, child care funding, and program integrity in DTA and other benefit programs. The chair said debt service would be about $2.67 billion, pension payments would be $5.1 billion, OPEB would receive a $150 million payment, and MassHealth enrollment was projected at about 2 million with costs driven by acuity and medical inflation. He also said the budget includes no collective bargaining agreements and no state tax changes. Senators supporting the budget praised its investments in education, local aid, homelessness prevention, public health, libraries, and housing, while minority leaders and others stressed the need for fiscal discipline, transparency, and further work on affordability and municipal support. The Senate also received a House message on House No. 5316, which the House had nonconcurred in, and a conference committee was appointed on the disagreement.

Transcript Highlights:

• From the data available, has Early Education and Care actually shared with us an analysis of whether
• From the data available, has Early Education and Care actually shared with us an analysis of whether
• From the data available, has Early Education and Care actually shared with us an analysis of whether
• And colleagues, the data increasingly show Massachusetts is falling behind.
• And the latest data on this is quite alarming. U.S. Census data from the U.S.

Summary: The Senate first adopted two resolutions commending the Plimpton Historical Society for Deborah Sampson Day and Megan’s Light for recognizing May 2026 as Cystic Fibrosis Awareness Month. It also suspended Joint Rule 12 on several House petitions, referred those matters to committees, and later took up final passage of two local bills: one authorizing Dartmouth to grant an additional off-premises liquor license and another relative to the charter of Westwood. Both bills were passed to be enacted and sent to the Governor. The main business of the session was the opening debate on the Senate Ways and Means FY27 budget, which was described as a balanced $63.3 billion proposal. The chair and supporters highlighted major investments in unrestricted local aid, Chapter 70 education funding, regional school transportation, rural aid, community college affordability, food security, housing, and health and human services. They also emphasized that the budget was built on the consensus revenue estimate, included no new taxes or tax cuts, did not use the rainy day fund, and relied in part on federal funds and Fair Share revenue. In extended questioning, the minority leader pressed for details on the budget’s assumptions and cost drivers, including federal participation, Fair Share revenue, debt service, MassHealth caseload and spending, pension and OPEB liabilities, settlement reserves, collective bargaining funding, and controls against waste, fraud, and abuse. The chair responded that federal funds account for about 22% of budgeted revenues, Fair Share revenue is estimated at about $2.7 billion, debt service is about $2.67 billion, MassHealth and related health and human services total about $36.4 billion, pension funding is $5.1 billion, and OPEB receives a $150 million payment. Members also discussed the C-3 child care program, DTA program integrity, and housing permitting reforms, with several senators speaking in support of the budget’s priorities and urging further debate and amendments before final passage.

Transcript Highlights:

• Whether it's evaluating large data sets in air modeling or effluent limit calculations or even taking
• Whether it's eval evaluating large<00:08:25.840><c> data</c><00:08:26.160><c> sets</c><00:08:26.319><
• </c> regulated parties and their consultants. regulated parties and their consultants.
• They are trying to make data more transparently available.
• </c><00:41:52.800><c> that</c><00:41:53.040><c> is</c> way that we get data that is way that we get data

Bills: HF1587 , HF2293 , HF2218 , HF1208 , HF1482

Committee: House Environment and Natural Resources Finance and Policy

Keywords: HF1587, Cass County, Minnesota Department of Natural Resources, DNR, condemnation, eminent domain, state land, surplus land, public waters, tribal land transfer, federally recognized Indian Tribe, tribal ownership, land conveyance, no consideration, land appropriation, natural resources, U.S. Highway 2, Section 27 Township 145 North Range 28 West, land return, Tribal sovereignty

Transcript Highlights:

• That data is too little, too late.
• I've heard the data. Yes, New Mexico is behind.
• This is just not data. We in education are slammed with data: what are your test scores?
• or through statute, regulation being the department.
• To that data, and from our data processing center, I'm not aware of what that quantity is.

Transcript Highlights:

• My statement today is based on several issued reports, as well as on updated appropriations data.
• Is that a law or a regulator problem?
• And my inclination would be that there's so much data out there that if there is some data gaps, or if
• The modeling aspect is again trying to sort of figure out the inputs from from the data that you're collecting
• And there's different time frames for different reports that's written into the regulations.

Committee: Senate Environment and Public Works Committee

Keywords: presidential nominations, EPA, environmental policy, Fish and Wildlife, committee meeting

Summary: The committee meeting focused on the presidential nominations of Brigadier General Brian Nesvick as Director of Fish and Wildlife and Jess Kramer and Sean Donahue as assistant administrators at the EPA. Each nominee presented their qualifications and experiences in their respective fields, with an emphasis on their commitment to uphold the laws passed by Congress. The discussion highlighted the nominees' dedication to addressing environmental issues and their proactive stances on regulatory matters. After deliberation, votes were held to report the nominations favorably, despite some members voicing concerns regarding their qualifications and potential conflicts with environmental interests.

Transcript Highlights:

• </c> why the and such other regulations why the and such other regulations relating<00:48:13.359><c>
• Again, I'm getting input from you.
• </c> I I'm I'm getting input from you. I I'm I'm getting input from you.
• Senator Lang will accept input into this bill from the other senators that wish to provide such input
• Senator Lang will accept input into this bill from the other senators that wish to provide such input

Committee: Senate Election Law and Municipal Affairs

Transcript Highlights:

• It's going to go into a big data pool.
• integrity of that data, and it is essential that we protect that data from abuse.
• integrity of that data, and it is essential that we protect that data from abuse.
• We threaten the integrity of that data, and it is essential that we protect that data from abuse.
• The data itself is not critical; there's nothing special about the data.

Summary: The committee held its first hearing and took up several privacy, AI, and consumer protection bills. SB 1106 (Cabaldon) would shorten the Delete Act data broker deletion response deadline from 45 days to 30 days; it received support from the California Initiative for Technology and Democracy, one senator said they would lay off pending implementation of the original law, and the bill passed on a due-pass motion to Appropriations with a 5-0 vote on call. SB 923 (Becker) would expand the CCPA deletion right to all personal information held by businesses and require online-only businesses to offer a web form or similar method for privacy requests; supporters included the California Privacy Protection Agency and privacy groups, while business groups raised concerns about scope, compliance, and the email/web-form requirement. The committee advanced it 6-0 to Appropriations, on call, with members noting continued work on amendments. SB 1142 (Becker) would regulate digital replicas and deepfakes, including takedown and notice provisions for large online platforms and protections against misuse of a person’s likeness, voice, or identity. Supporters emphasized harms from non-consensual synthetic media and fraud; opponents, including the Motion Picture Association and tech industry groups, raised First Amendment, due process, Section 230, and overbreadth concerns, especially around deceased persons and the 48-hour takedown process. Members said they would support the bill while working on constitutional issues, and it passed 6-0 to Judiciary, on call. The committee also adopted its rules without objection. The committee then heard several member bills. SB 867 (Padilla) would impose a four-year moratorium on AI chatbot-powered toys for children; supporters cited research showing sexual content, dangerous advice, and privacy risks, while opponents asked for narrower definitions and retailer liability protections. It passed 7-0 to Appropriations, on call. SB 1247 (Padilla) would give child influencers a right to request deletion or modification of images and likenesses used in monetized social media content; there was little testimony beyond a civil justice group’s opposition to a new private right of action, and it passed 7-0 to Judiciary, on call. SB 1114 (Cabaldon) would restrict sharing of state-collected LGBTQ-related data absent an enforceable order; Equality California and other advocates supported it as a safeguard against misuse of sensitive data, and it passed 6-0 to Appropriations, on call. SB 1159 (Cabaldon) would limit local governments’ obligation to treat AI bots and agents as persons in public participation and records processes; supporters said AI-generated comment floods and requests can drown out human participation, while opponents argued the bill should focus on fraud and warned about overreach. It passed 9-0 to Appropriations. Finally, SB 1050 (Ashby) would require disclosures when advertisements use AI-generated synthetic performers; supporters framed it as a truth-in-advertising and worker-protection measure, while opponents urged narrower, materiality-based standards and exemptions for broadcasters. Members generally supported the goal but raised concerns about breadth and alignment with existing law, and the bill was moved forward on a due-pass motion to Judiciary.

Transcript Highlights:

• to us to start measuring the performance of that revenue forecast. ...data.
• Here it is, and not much chance to really get input or ask questions, et cetera.
• So if you want to have more input in the green sheet, there's your guy right there, okay?
• I know we put the regulation in there for the one-to-one.
• I know we put the regulation in there for the one-to-one.

Summary: JFAC began with a presentation from Legislative Services on the general fund and the “green sheet,” explaining how the committee tracks starting cash, revenue forecasts, transfers, appropriations, and ending balances. The analyst walked through general fund revenue sources, the difference between transfers and expenditures, structural balance, and how the green sheet is used to compare current-year collections against forecasts. Members asked about continuously appropriated funds, federal dollars, sales tax exemptions, and cash reconciliation issues tied to the state’s new Luma finance system and interest allocations. The discussion also covered the revenue monitor and how the committee can use it to track collections against forecasted amounts. The committee then moved into the Department of Health and Welfare’s overall budget overview. Legislative Services reviewed the department’s size, organizational structure, vacancy rate, five-year spending trends, and the role of continuously appropriated funds such as the Idaho Children’s Trust Fund and Rural Physician Fund. Members asked about personnel vacancy rates, reverted funds, and whether the department could provide a list of subgrants and trustee-and-benefit payments. Department officials explained that some vacancies reflected a department-wide review, hiring freeze, and FTP realignment, including moving positions to State Hospital South and reverting some federal spending authority. They also said the department was actively filling funded positions and would provide additional information on grants and other payments. The committee then heard the first division-level budget presentation for Indirect Support Services. The analyst described the division’s role in centralized administration, IT, legal, communications, and management support, along with its staffing, historical expenditures, and base budget changes. The division’s budget request included a one-time irrigation system project at State Hospital West, a fund adjustment for the background check unit, the transfer of 58 FTP and related costs to the Office of Information Technology as part of modernization, and a request to remove restrictive budget language on personnel and trustee-and-benefit transfers. The governor’s recommendation also included support for some replacement items and a major new item tied to Idaho’s Rural Health Transformation Program, including 12 limited-service FTP in 2026, ongoing FTP in 2027, and $294 million in one-time operating funds. Members questioned the need for the new FTP, the use of AI, the definition of “rural,” and the mechanics of the IT transfer; department and ITS officials explained the transfer was a budget shift of personnel and operating costs, not a net increase in staffing. The committee adjourned after members also raised broader concerns about public input on Health and Welfare budgets and suggested a joint public meeting with the Health and Welfare committees.

Transcript Highlights:

• Data is incomplete.
• include HIV data on a county-by-county basis, among other data.
• We have heard from our area agencies on aging partners that they utilize this data from the data dashboard
• And as I noted, we're adding the data on HIV by county to our data dashboard for aging.
• CHCQ licenses and certifies... ...and regulations.

Transcript Highlights:

• Without your input and without us seeing the needs across the state, we wouldn't be able to put together
• </c><00:36:14.880><c> A</c><00:36:15.119><c> data</c> By the DFL leader of this body.
• </c> data base. data base.
• Overprescriptive regulations about supervision and more accurate ways to keep attendance.
• This bill takes all those regulations and makes them make a whole lot more sense.

Transcript Highlights:

• Well, I think the data will be very illustrative. Oh, do you all own?
• Speaker: ...I think the data will be very illustrative.
• The agency provided the data used in the table on page 4.
• We appreciate your input.
• We appreciate your input. All right. I will ask again.

Bills: SB 1

Committee: Senate Finance

Keywords: campground safety, youth camp regulations, flood safety, emergency evacuation, health and safety standards

Transcript Highlights:

• Um, I would move that the Senate suspend its rules in order to move H211, the data broker bill, to the
• This bill allows the board to go forward based on data that they have and data from other states that
• And they'll be using, as I said before, data from other states, data from this state, and the board certainly
• So looking at quality data analysis that is left in at the board level.
• We have a lot of data that supports the...

Transcript Highlights:

• </c><00:39:08.960><c> by</c> a boat in China that is not regulated by a boat in China that is not regulated
• </c> to be regulated and policed in some way. to be regulated and policed in some way.
• </c> recovery rate data recovery rate data that<04:30:30.479><c> can</c><04:30:31.040><c> show</c><04
• </c><04:42:37.360><c> to</c> just don't think we have the data to just don't think we have the data to
• </c><04:49:52.798><c> or</c> aware of is that if we can regulate or aware of is that if we can regulate

Committee: House Ways and Means

Summary: The committee heard testimony on House Bill 1596, which would raise New Hampshire’s cigarette excise tax from $1.78 per pack to about $2.80, using an inflation-based adjustment since the rate was last set in 2008. Representative Jerry Stringham, the bill’s sponsor, said the measure would keep New Hampshire competitive with neighboring states, generate revenue, and help offset other budget pressures. He also described the bill as repealing an income-based premium charge in Medicaid/CHIP-related programs and restoring cuts to the University System of New Hampshire, arguing that the combined package would still leave the state in a positive fiscal position. He said the tobacco tax increase would likely have some cessation effect but would remain low relative to other New England states, and he cited prior testimony from health groups supporting a larger increase. Members questioned the sponsor about how the new rate was calculated, the prior tobacco tax reduction and restoration, whether tobacco companies would absorb or pass on the tax, and the fiscal note’s estimates for Medicaid premium revenue and UNH funding. Stringham said he used Bureau of Labor Statistics inflation data, that the earlier 10-cent reduction did not produce the expected sales increase, and that the current bill would eliminate the premium charges now in the budget. He later clarified that the Department of Medicaid Services had updated the revenue estimate, but said the bill still showed a surplus overall. He also said the federal government already imposes a $1-per-pack tax and that New Hampshire would remain below neighboring states even after the increase. Two public witnesses testified in opposition to the tax increase. Anna Bettincourt, a tobacco category manager, argued that higher tobacco taxes would unfairly target smokers, reduce New Hampshire’s tax advantage, and likely shift purchases to other states or illicit markets rather than reduce use. She said tobacco companies generally do not lower prices and that Massachusetts’ flavor restrictions had not eliminated sales. In response to questions, she maintained that a smaller increase would still be harmful and that enforcement problems make bans ineffective. The sponsor and some members countered that smokers impose higher health costs and that tobacco taxes are a policy tool for both revenue and public health. No vote or final committee action was taken in the portion of the meeting provided.

Transcript Highlights:

• And it's in law, and it's in regulation.
• Census and other relevant data and community-level input and other relevant factors.
• That data.
• health data as well.
• health data as well.

Committee: House Health

Summary: The Assembly Health Committee heard a special order of bills focused largely on utilization management and prior authorization in health care. Chair Bonta opened by explaining the committee’s rules and noting several consent items, then moved into bills aimed at reducing delays and barriers in coverage decisions for mental health, substance use disorder treatment, chronic care, and rehabilitation services. The committee also noted AB 1429 had been pulled from the agenda. AB 384 by Assembly Member Connolly would prohibit prior authorization for inpatient mental health or substance use emergency admissions and for physician care delivered during those inpatient stays. Supporters, including behavioral health groups, hospitals, emergency physicians, and patient advocates, argued that prior authorization delays crisis care and can worsen outcomes. Opponents, including health plans and insurers, warned about fraud, waste, abuse, and ambiguity around residential treatment facilities and review processes. The bill passed the committee on a do pass as amended vote and was sent to Appropriations, though it was placed on call. AB 510 by Assembly Member Addis would require health plans to provide a peer of the same or similar specialty when a treating provider appeals a prior authorization decision. Supporters said this would make appeals fairer and more clinically informed; opponents said the specialty-matching requirement and timelines were unworkable and could strain the system. AB 539 by Assembly Member Schiavo would extend prior authorization approvals to one year or the duration of the prescribed treatment, with supporters citing chronic illness and cancer care delays and opponents arguing the bill was too broad. AB 669 by Assembly Member Haney would bar certain utilization reviews for the first 28 days of in-network substance use disorder treatment and limit prior authorization for related outpatient medications; it drew strong emotional support from a parent who lost her son after treatment was cut short, while insurers and health plans opposed it as too restrictive. AB 512 by Assembly Member Harabedian would shorten prior authorization turnaround times to 24 hours for urgent requests and 48 hours for non-urgent requests, and AB 574 by Assembly Member Mark González would allow up to 12 physical therapy sessions for a new episode of care without prior authorization. Across these bills, supporters emphasized timely access and patient harm from delays, while opponents repeatedly raised concerns about oversight, medical necessity review, and cost. Several measures were voted out on call or held on call for later action.

Transcript Highlights:

• California's Clean Miles Standard targets were set using 2018 data before a global pandemic reshaped
• If children are to be transported at all, they should be provided with a regulated safe passage that
• We have CHP and DMV managing regulations and adjusting those regulations as time goes on and as technology
• and state regulation.
• And look, And state regulation. They have a culture of give and take.

Summary: The Assembly Communications and Conveyance Committee met with several bills on the agenda, beginning with SB 739 (Arreguín) on the Clean Miles Standard and Incentive Program for transportation network companies. The author and supporters from Lyft, Uber, and TechNet said the bill would update EV miles traveled and greenhouse gas targets to reflect current market conditions, add flexibility for CARB and the CPUC, and protect drivers from losing platform access while also creating a path for future electrification. Opponents including the American Lung Association, Sierra Club California, and NRDC argued the bill would weaken a program meant to accelerate EV adoption and should retain stronger targets. Members discussed affordability, charging infrastructure, and the need to balance climate goals with feasibility. The committee approved SB 739 as amended and re-referred it to Appropriations, later recording a 9-0 vote when the roll was completed. The committee then heard SB 1190 (Grove), the “Safe Passage for Youth Act,” which would regulate private youth transport services used for out-of-state residential placements. The author and sponsor testimony described abusive practices such as nighttime pickups, blindfolds, restraints, and emotional trauma, and said the bill would require CPUC permitting, TrustLine background checks, training, parental consent, and bans on certain practices. Support came from youth and disability advocates, with no opposition testimony. The bill was moved on a due pass as amended recommendation and later passed 9-0. SB 1191 (Ochoa Bogh) would extend the sunset for California High Cost Fund A and B universal service programs that help provide affordable telephone service in rural and high-cost areas. Supporters from rural telecom companies and industry groups said the funds are essential for maintaining service, 911 access, and emergency communications in remote communities. There was no opposition, and the committee advanced the bill on a due pass recommendation; it later passed 9-0. The consent item, SB 985 (Strickland) on the 911 emergency system, was also approved. Finally, the committee heard SB 1246 (Cortese) on autonomous vehicles and emergency response. The author and supporters from SEIU California and the California Professional Firefighters said the bill would require AV companies to provide incident response, notify local jurisdictions during system failures, ensure U.S.-based remote drivers, and prevent public safety workers from having to manage AV breakdowns. Industry opponents argued the bill intrudes on federal vehicle standards, gives local governments enforcement authority they should not have, and could create overly broad notification and response requirements. Members raised questions about local control, response times, and whether the bill was premature given existing DMV regulations. Despite those concerns, the committee passed SB 1246 on a due pass as amended recommendation, later recording a 7-1 vote. The committee then recessed and returned to complete roll calls before adjourning.

Transcript Highlights:

• This is typically a state-regulated activity, and it's a rare directive to FERC.
• So we use that data to advocate on behalf of ratepayers at FERC.
• This is SB 1174 data.
• So we've been able to provide that data, and now we've been able to discuss the data in a variety of
• We do not ask for that data point from developers.

Committee: House Utilities and Energy

Transcript Highlights:

• , I oppose this bill at this time because I think it needs more research and professional educator input
• to know what are schools that data to know what are schools using. using. using.
• Again, I would strike the non-voting member because I find their input valuable.
• I mean, you might want to look at state regulations, for example, that cost districts money.
• Huge changes in the 306 regulations, all of which were unfunded.

Committee: House Education Policy and Administration

Transcript Highlights:

• </c><00:52:10.079><c> tech</c> regulation and and and challenges. tech regulation and and and challenges
• </c> cataloged all that input we've gotten. cataloged all that input we've gotten.
• A lot of it is uh correlational data.
• </c> if you look at those really big data if you look at those really big data sets,<01:42:02.400><c>
• </c> trials or follow that follow the data trials or follow that follow the data longer<01:42:52.480>

Summary: The committee met and approved the minutes from its August 27 meeting. It then received a presentation from Katherine Castanza of the National Conference of State Legislators on the Medicaid provisions in the 2025 budget reconciliation bill, referred to as HR1. She explained that the bill is estimated by CBO to save the federal government $911 billion over 10 years, with more than 20 Medicaid-specific provisions, most of the savings concentrated in five policies and largely backloaded into 2030-2034. She emphasized that the bill’s effects will vary by state, but that expansion states and hospitals are expected to be most affected, in part because of changes to eligibility, provider taxes, and state-directed payments. Castanza highlighted several new funding and flexibility provisions, including a $50 billion Rural Health Transformation Fund for 2026-2030 and a new home- and community-based services waiver option effective July 1, 2028, with $100 million in grants in fiscal year 2027. She also outlined major eligibility changes for Medicaid expansion adults: work or community engagement requirements effective January 1, 2027; twice-yearly redeterminations for the expansion population effective the same date; and new cost sharing for certain expansion adults effective October 1, 2028. She noted that Kentucky, as an expansion state, would be subject to these changes and that state agencies would face significant implementation demands, especially because federal guidance and timelines are tight. A substantial portion of the presentation focused on financing changes. Castanza described new limits on provider taxes, including a 0% safe harbor for new taxes and a phased reduction for existing taxes in expansion states beginning in 2028, while nursing facilities and intermediate care facilities are exempt from the reduction if already taxed. She also explained that state-directed payments will be capped and phased down over time, with existing arrangements grandfathered only briefly; she said Kentucky has 11 approved state-directed payments and could see significant fiscal effects. She added that the bill also bars Medicaid payments to Planned Parenthood or similarly situated providers for one year, changes immigrant eligibility rules effective October 1, 2026, lowers the federal match for certain emergency services, and expands the scope of the federal erroneous payment recoupment provision effective October 1, 2029. Throughout, she stressed that federal savings may translate into state cost shifts and that implementation timing will be critical.