Transcript Highlights:

• I mean, one of the reasons, Chairman Dever, is because we budgeted FMAP at 52.5 percent last biennium
• didn't change at all, but you have to increase your general fund and decrease your federal because FMAP
• Your federal because FMAP went down from what we budgeted last time, so that didn't add any expenditures
• Yeah, and likely the cuts would come probably in FMAP and Medicaid expansion.

Bills: SB2015

Keywords: corrections, rehabilitation, prison budget, department of corrections, adult services, youth services, correctional facilities, Heart River correctional center, Missouri River correctional center, James River correctional center, minimum security facility, county jails, regional jails, deferred maintenance, capital construction, strategic investment and improvements fund, Bank of North Dakota, line of credit, tasers, body cameras

Summary: The Senate Appropriations Human Resources Division met with all members present and took up several bills, focusing most of the discussion on SB 1577 and SB 1619, along with a detailed review of the HHS budget bill draft. On SB 1577, Senator Magrum explained that the bill was being revised to focus on wastewater rather than raw water, possibly shifting the Washburn project to the Department of Water Resources so it could access matching funds, and potentially converting the bill into a line of credit if federal money is restored later. Members discussed whether to keep an emergency clause or instead use a date-based approach, and agreed the bill would likely be handled through the full committee and possibly reconsidered later. On SB 1619, Senator Davison said amendments were still being worked on, including changes requested by the Bank of North Dakota, and the committee planned to hold it for possible amendment before full committee consideration. The bulk of the meeting was a section-by-section review of the HHS appropriations bill draft. Members discussed one-time funding items such as technology projects, child care programs, housing programs, behavioral health facility grants, infant and toddler care provider support, juvenile justice diversion, medical housing, and other public health and human services projects. Several adjustments were noted, including reductions or changes to IMD-related funding, incarcerated-person treatment funding, the child welfare technology project, and the provider rate increase. The committee also discussed the FTE block grant structure at length, with staff explaining that the apparent increase in positions reflected budgeting mechanics, zero-dollar “phantom” positions, and positions approved previously but not counted in the FTE total. Members raised concerns about transparency and whether the bill should list FTE numbers, but staff said the block grant was intended to give the department flexibility while quarterly reporting would provide oversight. Other topics included Medicaid expansion funding and provider reimbursement rules, the move toward certifying human service centers as certified community behavioral health clinics, a moratorium on new ICF beds, and studies or reports on Medicaid, obesity, disability services, truancy, and behavioral health facility grants. The committee also discussed removing or revising broad intent language in Section 31 so the department would report findings rather than implement changes without further legislative action. No final votes were taken in the transcript; instead, members agreed to make a few technical adjustments, continue reviewing the bill, and likely revisit it the next day before moving it to conference committee.

Transcript Highlights:

• The $72 million impact in fiscal years 2026 and 2027, and the FMAP change mentioned on the previous slide
• How will that impact the budget projections that you talked about, including the FMAP?
• How will that impact the budget projections that you talked about, including the FMAP?
• [member_9948]: So, the only federal interaction that's booked in the forecast is the reduction in FMAP
• Joe Schomacker: So, the only federal interaction that's booked in the forecast is the reduction in FMAP

Keywords: 1183, house

Transcript Highlights:

• What's our current FMAP?
• Current FMAP, I believe, is 69.23, and on October 1, it will be going to 70.52. Okay, thanks.
• What's our current FMAP? Current FMAP I believe is 69.23 and in October 1,000.
• The current FMAP rate is at 69.23. We usually have a blend.” “FMAP rate is at 69.23.
• We usually have a blended FMAP rate of close to 70% because admin is at a different FMAP, and so it’s

Summary: The committee heard a series of Arkansas Department of Human Services budget presentations and questions, beginning with the Secretary’s Office and then the Division of Aging, Adult and Behavioral Health Services. Staff described the divisions’ appropriations, funding sources, and major programs, including senior centers, Meals on Wheels, mental health grants, substance abuse treatment, community alcohol safety, the Medicaid tobacco settlement program, and crisis stabilization units. Members raised concerns about flat or limited funding for senior services, the use and tracing of federal block grants, the lack of a funding source for the veterans’ mental health grant, and the mechanics of the community alcohol safety and treatment programs. The committee also discussed patient benefits funds at state facilities, transportation for senior center clients, and whether some special-language appropriations or fund balances should be revisited. Executive recommendations were adopted for the divisions considered. The committee then reviewed the Division of Children and Family Services and the Division of County Operations. Questions focused on foster care growth, adoption subsidies, professional fees tied to staff training and onboarding, vacancies, the Children’s Trust Fund, and TANF subgrants. Members asked about the reduction or elimination of TANF funding to child advocacy centers and other subgrantees, and DHS explained that prior reserves had been spent down and that the department was now trying to live within the annual TANF block grant and rebuild reserves. County operations questions also covered summer EBT, SNAP employment and training, the farmers’ market program, and the expected impact of a federal SNAP administrative match change, which DHS estimated would increase state costs by about $24 million annually, with roughly $18 million affecting the current year because the change begins October 1. Executive recommendations were again adopted. Finally, the committee heard from the Division of Developmental Disability Services and the Division of Medical Services. DDS testimony covered vacancies, staffing shortages, human development center construction and repairs, the reopening of the Boonville work training program, and funding for infant infirmary and child/family life programs. Medical Services testimony covered the Medicaid program, the current FMAP rate, the Our Kids B CHIP program, Medicaid payments to schools, nursing home distress funding, and large appropriation lines used to provide flexibility for claims and potential facility closures. Members asked for more detail on school Medicaid payments, reserve balances, and why some appropriations were much larger than actual spending. In each division, the committee moved and adopted Executive REC after questions concluded.

Transcript Highlights:

• , the state is responsible for matching those expenditures according to a computed rate called the FMAP
• Yes, the federal government actually then gets the FMAP part of it, which would be about 70% right now
• Do we know what our new FMAP number is going to be? Is it going to be worse? Better? Okay.

Summary: The Medicaid Subcommittee of the Legislative Joint Auditing Committee met to receive a primer on the subcommittee’s history and on how Medicaid oversight works in Arkansas. Legislative audit staff reviewed the subcommittee’s origins in response to earlier Medicaid audit concerns and explained that Medicaid is audited every year in the statewide single audit because it is a high-risk, large federal program. Staff summarized recent audit findings, including issues with eligibility controls, data matching, contractor charging, incarcerated juveniles’ coverage handling, provider eligibility support, and the state’s Medicaid recovery audit contractor exception request. They also noted a DHS departmental audit finding involving employees who improperly received benefits, which was referred for possible prosecution. The Department of Human Services gave an overview of the Medicaid program, describing eligibility groups, delivery systems (fee-for-service, managed care/PASSE, and premium assistance for expansion adults), the size of the program, and the agency’s budget and provider base. DHS also outlined the difference between state plan amendments and waivers and said other committee materials would be sent to members. The Office of Medicaid Inspector General described its role in detecting and preventing fraud, waste, and abuse, explaining that it investigates suspected intentional fraud, suspends providers when there is a credible allegation of fraud, recovers improper payments in mistake cases, and recommends policy changes when trends are identified. The Attorney General’s Medicaid Fraud Control Unit explained that it prosecutes provider fraud criminally and civilly, handles neglect, abuse, and exploitation cases in long-term care settings, and works with DHS, OMIG, and federal partners. Members asked about where cases are filed, how provider suspensions work, whether beneficiary fraud is investigated, and how education is provided to providers. DHS confirmed that beneficiary fraud cases are referred to local prosecutors and said the expansion population will move toward community engagement/work requirements under federal changes, with a soft launch planned before full implementation. The meeting ended with no formal votes beyond adoption of the prior minutes and no other committee actions.

Transcript Highlights:

• , the state is responsible for matching those expenditures according to a computed rate called the FMAP
• The federal government actually then gets the FMAP part of it, which would be about 70% right now.
• Do we know what our new FMAP number is going to be? Is it going to be worse? Better? Okay.

Summary: The Medicaid Subcommittee of the Legislative Joint Auditing Committee met to adopt the November 2018 minutes and receive a primer on the subcommittee’s role and Medicaid oversight in Arkansas. Legislative audit staff reviewed the subcommittee’s history and explained that Medicaid is audited annually through the statewide single audit because it is a high-risk federal program. Staff summarized recent audit findings, including weaknesses in eligibility and data-matching controls, improper use of Medicaid funds for partially non-Medicaid work, issues with incarcerated juveniles’ coverage, the absence of a Medicaid recovery audit contractor program exception request, reporting problems involving MFCU recoveries, and provider eligibility documentation concerns. Staff also noted a DHS departmental audit finding involving employees who improperly received benefits, which was referred for further action. The Department of Human Services gave an overview of Medicaid’s structure, eligibility, delivery systems, and budget. DHS described Arkansas Medicaid as covering about 850,000 people through fee-for-service, managed care, and premium assistance for the expansion population, and outlined major spending categories such as institutional care, long-term services, pharmacy, capitated payments, and supplemental payments. DHS also explained the difference between state plan amendments and waivers, and said it has a beneficiary-fraud unit that refers cases to local prosecutors. The Office of Medicaid Inspector General described its role in detecting and preventing fraud, waste, and abuse, distinguishing between suspensions for credible allegations of fraud and recovery actions for mistakes or overpayments. OMIG said it works with DHS and law enforcement, issues quarterly and annual reports, and has increased recoveries in recent years. The Attorney General’s Medicaid Fraud Control Unit explained that it prosecutes provider fraud criminally and civilly, can also handle long-term care neglect, abuse, and exploitation cases, and works with local prosecutors as special deputies. Committee members asked about court venue, provider suspensions, beneficiary fraud, education of providers, and the status of Medicaid expansion work requirements; DHS said it is preparing to implement community engagement requirements under HR 1 and will begin with a soft launch before full enforcement. No formal votes were taken beyond adoption of the minutes, and the meeting adjourned after questions were answered.

Transcript Highlights:

• The FMAP changes and the per capita cost didn't appear in the, the chairman's mark.
• So the FMAP. You can see on this next stage, this next page 24.
• So, just an example, uh, for FY 25, our FMAP decreased by less than 1% and we had to come up with $69
• a good portion of the budget reconciliation savings may come if they don't do like a change in the FMAP
• A change in the FMAP is where you have to make a decision, do I replace that dollar that they're cutting

Transcript Highlights:

• Sometime in January of '22, the federal government wanted to increase the FMAP in light of the COVID
• Litman and Medicaid to cover the enhanced FMAP. Mr.
• in light of the covid uh crisis so fmap in light of the covid uh crisis so that<00:16:12.079> uh<
• of the enhanced fmap to the counties<00:17:12.600> and<00:17:12.799> from<00:17:13.120
• The FMAP percentage went from 50% up to 56.2%.

Keywords: 928, house, all

Summary: Division 3 Finance held a work session to move through five bills before noon, noting one member’s early departure and adjusting the order of bills accordingly. The first item, HB 54, would allow some alternative treatment centers in the medical cannabis system to operate for profit. Members discussed a fiscal note showing a one-time $133,000 cost, which was described as a Division 1 budget item to be handled through HB 2 rather than directly in Division 3. After discussion about keeping Division 1 informed and the distinction between retaining a bill versus funding it, the committee voted unanimously to retain HB 54 for further finance work and conversion into HB 2. The committee then took up HB 547, concerning reimbursement to counties for enhanced FMAP funds during the COVID period. The chair summarized the issue as federal enhanced Medicaid matching funds that were received by the state before authority existed to pass them through to counties, creating a disputed amount owed to counties. County representatives said the money should have gone to counties and clarified the relevant time period, while the department did not take a position. The chair proposed retaining the bill and moving it into HB 2, with discussion of a possible four-year repayment structure in equal annual installments. The committee agreed to retain the bill for continued work in the budget process. During the HB 547 discussion, members also clarified the fiscal and accounting details, including that the fiscal note had not been widely available and that some figures in the note should be treated as county revenue rather than county expenditure. Testimony explained that the enhanced FMAP increased from 50 percent to 56.2 percent, and that the state’s and counties’ shares of claims were affected by the timing of the federal change and the later state authorization. The committee emphasized that the issue was complex and budget-dependent, and that retaining the bill would allow further negotiation and incorporation into HB 2 rather than immediate final action.

Transcript Highlights:

• Because the FMAP number changed, I know. So just hit on that real quick, if you would.”
• Are you asking about an FMAP?” “TANF.” “I'm sorry, TANF.
• And what's our current FMAP?
• The current FMAP rate is at 69.23.
• We usually have a blended FMAP rate of close to 70% because admin is at a different FMAP, and so it's

Keywords: 1204, all

Transcript Highlights:

• The witness replied that if she was referring to the FMAP, which changes every October 1, they do have
• The witness said that if she was referring to FMAP, they do have a tentative number and build it in,
• tool for that revenue as it relates to either the beginning of the fiscal year, the change in the FMAP

Summary: The committee considered several appropriation and transfer requests, beginning with a $273,000 temporary appropriation for the Department of Labor and Licensing to cover administrative costs for its enterprise licensing platform, funded by license and application fees. It then reviewed two large Infrastructure Investment and Jobs Act requests: $280 million for the Department of Transportation for the final quarter of the fiscal year, and $195 million for the State Broadband Office to support the Arkansas BEAD broadband grant program, including an extra help position and grants to internet service providers. The broadband item drew extensive questions about awardees, contract amendments, accountability, build-out timelines, backup plans if providers default, the definition of broadband serviceable locations, and the cost per location. The State Broadband Director said no providers had requested amendments, the program would use milestone-based disbursements and a four-year build-out period, and the first tranche would serve 51,566 homes and businesses with $126.1 million in grants. Both Section B and Section C items were approved. In Section D, the committee approved a $458,000 transfer within the Department of Correction from the female work release program to the Tucker Unit water treatment plant, a $25 million transfer within the Department of Education to cover declining enrollment, teacher incentive, school recognition, and Easter Seals funding, and a $229,000 transfer for the Department of Shared Administrative Services to support two project management office positions. The education transfer prompted questions about how declining enrollment funding is calculated, how many districts receive it, and how long districts can continue to receive it; agency staff said 152 districts were on the preliminary list and the formula is based on the prior two-year average ADM compared with the previous year. The committee also gave favorable advice on a proposed $4.7 million loan for the Office of State Technology to implement ServiceNow and related IT modernization tools; agency officials said the loan would be repaid through cost recovery rates over five years and would replace an existing loan that is ending, with expected savings from consolidating applications but no precise savings estimate yet. The committee then reviewed cash fund and federal grant requests, including $200,000 for wage and hour claimant payments, $15 million for unclaimed property claims, $8,000 for a heritage program grant, and $1.1 million for a College and Career Coaches grant to expand services in rural districts. It also reviewed pay plan and budget manual items without objection. The most extensive report discussion focused on the Medicaid trust fund, where DHS and DFA officials said the balance has been declining and that the state may need to add capital back into the fund. Senators and representatives asked about the current balance, the projected year-end level, the role of the $100 million set-aside, the impact of outstanding Medicaid rules from the prior session, and whether future federal funding could help reduce long-term Medicaid costs. Officials said they are still working through more than 10 outstanding rules with CMS and do not yet have a final price tag for those changes. The meeting ended after the reports were reviewed and the committee adjourned.

Transcript Highlights:

• So the reason it's not 104 million, you see there, it's 94, is because there is a FMAP component.
• So as the FMAP, or the federal percentages, goes up, the amount that has to be paid by the hospitals
• So as the there is a FMAP component.
• > percentages<00:41:31.680> goes<00:41:32.000> up FMAP or the federal percentages
• goes up FMAP or the federal percentages goes up the<00:41:32.880> amount<00:41:33.119> that

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

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

Transcript Highlights:

• FMAP. What is our FMAP decreased to at this point? And I do believe I have a slide on it.
• So the FMAP decreased by 0.35%, or I'm sorry.
• while they asked for $15 million, we're probably only going to need about half of that for the updated FMAP

Transcript Highlights:

• and inflation, um, members' use of services, and the Federal Medical assistance percentage or the FMAP
• Why is FMAP so important?
• Because a tiny change to that FMAP can have huge uh budget um uh impacts for the state.

Transcript Highlights:

• program costs, specifically changes to the federal match or Federal Medicaid Assistance Percentage (FMAP
• The Senate bill, however, does not address FMAP. There was an FMAP provision, but it failed.
• The FMAP aspect is something we hope to address.

Transcript Highlights:

• Madam Secretary, the specific federal share, the FMAP, changes every year, so I don't have the exact
• The FMAP changes every year, so I don't have the exact number in front of me, but I'm happy to get it
• So the monies that we received from Centene, I believe the FMAP is closer for that time period to 67%

Summary: The committee met to consider a large slate of appointments, with the main discussion centered on the confirmation of Chavon Harris as Secretary of the Agency for Health Care Administration (AHCA). Harris testified about her background in state service and outlined agency priorities including Medicaid financial accountability, transparency, managed care oversight, behavioral health redesign, rural health access, workforce recruitment, and use of technology and AI. Senators questioned her extensively about the Hope Florida/Medicaid settlement controversy, opioid settlement-funded advertising campaigns tied to marijuana prevention and the 2024 Amendment 3 election, public records compliance, abortion reporting and enforcement under the Heartbeat Protection Act, managed care denials, value-based purchasing, and Medicaid funding pressures. After debate, the committee voted to recommend her confirmation, with Senator Polsky voting no. The committee then considered Anna Ortega and Robert Payne for the Florida Public Service Commission. Ortega, a current PSC commissioner and former staff advisor, discussed utility regulation, data center load issues, ratepayer protections, transparency in PSC decisions, and lessons from other states. Payne, a former legislator and longtime utility co-op employee, emphasized his technical background and the need to balance utility returns with consumer affordability. Both nominees were confirmed by unanimous or near-unanimous votes and recommended favorably to the full Senate. Next, the committee heard from Jeffrey Aaron for reappointment to the Public Employees Relations Commission. Aaron described PERC’s role in public-sector labor disputes and said his work had been upheld in appellate courts without reversal. Senators questioned him about his law firm’s state contracts, his role as chairman of Attorney General James Uthmeier’s PAC, and his connection to the Hope Florida Foundation matter; he declined to discuss the pending investigation. Public testimony included opposition from Florida Voice for the Unborn. The committee nevertheless recommended his confirmation, with several no votes. Finally, the committee approved the remaining appointees on tabs 5 through 46 in a single vote, postponing Dr. John Littell and DCF Secretary Hatch, and then adjourned.

Transcript Highlights:

• There was also the Federal Medical Assistance Percentage, or FMAP, decrease.
• You can see as you go down some of the things that Eric mentioned, the difference in FMAP decrease, that
• There's also an FMAP reduction that The Executive included LFC on line 48, which included a savings.
• Sometimes the federal government will threaten an FMAP penalty, which means that they will decrease the
• FMAP penalties can be very expensive, but that payment error rate not coming down is a $152 million impact

Keywords: 996, all

Transcript Highlights:

• heavily on what, if any, measures are taken, how those cuts are enacted, whether they're through an FMAP
• heavily on what, if any, measures are taken, how those cuts are enacted, whether they're through an FMAP
• heavily on what, if any, measures are taken, how those cuts are enacted, whether they're through an FMAP
• an fmap reduction whether through<00:27:06.720> Pro<00:27:07.159> Caps<00:27:07.480>
• It's certainly possible that the enhanced FMAP that we currently receive for that ACA expansion group

Keywords: 1183, house

Transcript Highlights:

• 48:00.720> the other reductions or adjustments to the other reductions or adjustments to the fmap
• > looking<00:48:02.240> at<00:48:02.400> administrative<00:48:03.000> map fmap
• rate looking at administrative map fmap rate looking at administrative map or<00:48:04.119> uh
• going to happen going forward at the federal level, but as you said, just the loss of the enhanced FMAP
• um that 2.5 billion of by any we're fmap um that 2.5 billion of by any we're looking<00:51:26.720>

Keywords: 1187, senate, all

Transcript Highlights:

• Otherwise, relative to the last plan, caseloads are a little bit lower, FMAP is more favorable to us.
• Relative to the last plan, caseloads are a little bit lower, FMAP is more favorable to us.

Summary: The Legislative Budget Commission met with a quorum present to hear the constitutionally required Long-Range Financial Outlook and consider a series of budget amendments. Amy Baker of the Office of Economic and Demographic Research presented the outlook, describing Florida’s continued population growth, strong wage growth, an aging population, housing-market softening, and low consumer sentiment. She said the general revenue forecast was largely unchanged from March, but the state’s funds available had improved because of legislative actions in 2025 that increased the balance forward. She also noted strong reserves, a projected current-year Medicaid deficit of about $125 million, and a three-year outlook that remains positive in the first year but turns negative in years two and three. She highlighted the risk of co-occurring catastrophic events, using a normalized Great Miami Hurricane scenario to illustrate potential state losses. The outlook was adopted after brief comments from House and Senate members emphasizing fiscal restraint and efficiency. The commission then approved multiple budget amendments, mostly without objection. The Agency for Health Care Administration received amendments to realign funding for Florida KidCare based on estimating conference results, to provide $85 million in budget authority for disproportionate share hospital payments, and to adjust Medicaid and long-term care appropriations, including placing surplus funds into reserve. The Department of Health received $6.3 million in additional authority for newborn screening. The Department of Corrections and the Department of Management Services each received $2.2 million in Private Inmate Welfare Trust Fund authority for repair invoices and pending projects. The Department of State was authorized to release $2.5 million in nonrecurring general revenue for cultural and museum grants and America 250 commemorative grants. The Department of Transportation received approval for a project roll-forward and for work program changes, including advancing I-95 widening in Duval County and the I-4 corridor in Polk and Osceola counties. The meeting ended with a motion to adjourn.

Transcript Highlights:

• Changing the FMAP. You heard Eric talk about less than a 1% change cost us like $70 million.
• The FMAP changes or per capita cost weren't in the package, so we dodged a bullet there.

Transcript Highlights:

• A reduction in FMAP for emergency Medi-Cal.
• Instead, states will receive their regular FMAP, which is 50-50, for all emergency Medicaid services.
• Planned Parenthood is not receiving reimbursement at all without those FMAP dollars.
• members are doing right now, given the potential impacts of H.R. 1, the reduction of the MCO tax, the FMAP

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.