Transcript Highlights:

• Windsor is a past president of the Arizona chapter of emergency physicians and the founding chair of
• She has also served as a national wellness spokesperson for the American College of Emergency Physicians
• and continues to support physicians statewide through mentorship and peer coaching.
• Windsor is a past president of the Arizona chapter of emergency physicians and the founding chair of
• and continues to support physicians statewide through mentorship and peer Thank you.

Summary: The House convened with prayer, the Pledge of Allegiance, approval of the prior journal, and recognition of the Doctor of the Day and several guests and community groups, including correctional officer Jacob Polanco, Pima Community Land Trust representatives, student interns, and Arizona PTA members. Members also adopted a proclamation recognizing Kosovo’s Independence Day in Arizona, with remarks highlighting the Kosovo American community’s contributions to the state. The chamber then moved into Committee of the Whole on a calendar of bills and resolutions. HB 2307 and HB 2758 were considered first; HB 2307 received committee amendments and was recommended do pass, while HB 2758 drew extensive debate over groundwater transport in La Paz County. Supporters argued the measure preserved a transportation-basin framework and added protections, while opponents warned it would facilitate water export for private investors and harm rural residents. After a division and recorded vote, HB 2758 failed to receive a due-pass recommendation. The House also considered HCR 2003, a referral related to transgender athletes in sports, where supporters framed it as a fairness and women’s sports issue and opponents argued it targeted a small population and should be left to athletic associations; it received a due-pass recommendation. HCR 2047 and HCR 2002, both relating to Judea and Samaria, also received due-pass recommendations after remarks citing biblical and historical references. After the Committee of the Whole report was adopted, the House referred the approved measures to engrossing and noted HB 2758 failed. The chamber then took up third-reading votes on several bills, passing HB 251, HB 262, HB 272, HB 296, and HB 2459, with brief explanations on some votes, including support for a Buffalo Soldiers monument, AHCCCS-related changes, water infrastructure authority, and mobile home park utility billing protections. The House also heard personal privilege remarks and announcements, including comments on antisemitism after vandalism at a University of Arizona campus center, a request to wear pink or green in support of a murder victim’s mother testifying on a bill, tributes to Jesse Jackson and Bishop Peter Bowie, and committee meeting notices before adjourning until February 18, 2026.

Transcript Highlights:

• The treating physician must refer the inmate to the mental health treatment facility for an involuntary
• physician.
• It requires specific standards for treating children in hospital, emergency departments and treating
• How will physicians know that time?
• So you are not saying are you, senator, that a physician has to know whether or not the physician to

Transcript Highlights:

• Next we have Tony Large, Florida College of Emergency Physicians. Thanks.
• Next, we have Tony Large, Florida College of Emergency Physicians. Would you like to speak?
• Tony Large, representing the Florida College of Emergency Physicians.
• or lack of insurance. and we treat every patient that presents regardless of their insurance or lack
• And a lot of the physicians that you're going to go to do not have software solutions like that.

Summary: The Health Care Facilities and System Subcommittee met with a quorum and considered five bills. HB 1101 on out-of-network providers drew the most discussion; Rep. Albert said it would require written notice when a patient is referred to an out-of-network provider and would count certain insurer payments toward deductibles. Several members and the Florida College of Emergency Physicians raised concerns about placing the burden on doctors’ offices, possible delays in referrals, and unclear enforcement, but the bill was reported favorably 16-2. Public testimony included support from AARP and concerns from emergency physicians about ER workflow and insurance-network transparency. The committee then unanimously approved PCS for HB 475, reducing fines for ambulatory surgery centers that violate good-faith estimate requirements from $1,000 to $250 per day, with a lower maximum penalty. The bill sponsor said the change was intended to right-size penalties for smaller facilities; witnesses from surgery centers and HCA supported it. HB 797, which would allow a nonprofit retirement community serving veterans and spouses to create veteran-and-spouse nursing home beds and transfer a certificate of need within 100 miles, also passed unanimously after members discussed whether it could affect access for veterans; the sponsor said it would create additional private beds rather than displace existing ones. HB 1085 on the Children’s Medical Services Program was amended and reported favorably 14-3. The bill would move managed care plan operations for medically fragile children from the Department of Health to AHCA, keep clinical eligibility at DOH, and shift PPEC services fully into managed care. The adopted amendment changed the waiver provision to require AHCA to develop and present a comprehensive redesign plan for the Medicaid model waiver for children receiving private duty nursing. Several members supported the goal but raised concerns about eliminating family choice and the impact on medically fragile children. Finally, HB 1353 on home health care services passed unanimously. The bill would remove geographic limits on home health administrators, allow more licensed RNs including contract RNs to perform visits, and revise the home health excellence award program. Supporters said it would address workforce shortages and improve access, while one member warned it could increase costs and competition for nurses. The committee adjourned after reporting all five bills favorably.

Transcript Highlights:

• am the Maui physician and representing am the Maui physician and representing Hawaii<00:17:52.799><c>
• I'm a physician on the Big Island.
• I'm a physician on the Big Island.
• </c> shortages of the primary care physician. shortages of the primary care physician.
• </c> treated there? treated there?

Summary: The joint hearing opened with House Bill 1969, which would provide state funding for colorectal cancer screenings for uninsured and underinsured residents. The Department of Human Services said it supports the goal of early screening but would need new administrative capacity, including a program manager and claim pre-screening, to run the program. The Department of Health supported the measure and cited low screening rates in Hawaii, noting an educational campaign to encourage screening. The Insurance Division raised concerns about reliance on federal FAQs, warning that guidance can change and may create state cost exposure. Supporters including the American Cancer Society Cancer Action Network and the Hawaii Medical Association argued the bill would close a preventive-care gap, reduce late-stage diagnoses, and save long-term costs; the committee also discussed implementation costs, estimated by DHS at roughly $1.4 million to $2 million annually plus administrative expenses, and a 6-month to 1-year timeline to establish the program. The committee then took up House Bill 1965, which would require health carriers to spend at least 6% of total medical expenditures on primary care providers. The Insurance Division said several provisions raise technical and legal concerns, including the premium freeze, the medical loss ratio language, the lack of an existing external review process for downcoding claims, and a new mandate for medically necessary inter-island transportation that could trigger an ACA defrayal. The Department of Human Services supported the intent but suggested broader language to include primary care supports and services, and noted that QUEST integration plans already invested at least 9% of total medical expenditures in primary care in 2024, with additional spending on supports and low-value care reductions. State health planning officials strongly supported the bill as an investment in primary care, saying it could improve outcomes and lower long-term costs, though they acknowledged a possible temporary premium increase during the transition. Testimony in support emphasized Hawaii’s physician shortage, especially on Maui, the Big Island, and other neighbor islands, and warned that clinics are under financial strain and may close without higher primary care reimbursement. The Hawaii Healthcare Task Force, AARP Hawaii, and other supporters said the bill would help retain providers, improve access for Medicare and Medicaid patients, and prevent downstream costs from emergency room use and avoidable hospitalizations. No votes or final committee action were taken in the portion of the hearing provided.

Transcript Highlights:

• Although when we're not performing well, it's okay to treat us like a vendor.
• Although when we're not performing well, it's okay to treat us like a vendor.
• Although when we're not performing well, it's okay to treat us like a vendor.
• </c> um 17% of our primary care physicians um 17% of our primary care physicians are<01:05:56.960><c>
• </c> what would success look like if we treat what would success look like if we treat and<01:08:23.759

Summary: The Budget Review Subcommittee on Health and Family Services opened its first meeting of the 2026 interim session, took roll, and moved directly into presentations. The main presentation was from Ryan Bramble of Crisp Shared Services, who described the organization’s health information exchange and health data utility model in Kentucky and other states. He emphasized that Crisp is a nonprofit, that data ownership remains with providers, and that governance is local. He also outlined the technical infrastructure, including a master patient index, cloud-based data lake, support for modern standards like FHIR and USCDI as well as older formats, and data quality tools used to normalize and standardize information. Bramble said the model is intended to reduce duplication, lower costs, and support rural providers and future use cases such as reporting, analytics, and AI-enabled decision support. Members asked how the state can ensure the data is actually used and who should drive priorities for health care improvement. Bramble said Crisp can provide tools, expertise, and examples from other states, but local teams such as KHI and state stakeholders must tailor and lead utilization efforts. In response to questions about ownership and coordination, he stressed that successful HIE governance requires a multistakeholder body that includes hospitals, health plans, government, and other interests, with a unified approach rather than multiple competing directives. He also said the Commonwealth has an opportunity to convene those stakeholders and set clear priorities. A senator raised concerns that responsibility for Medicaid and broader health policy has become fragmented and suggested a stronger central role for the state, possibly through the Department of Public Health, to coordinate health priorities. Bramble agreed that a single convening authority and multistakeholder governance are important, and noted that local governance should determine what data is shared and how it is used. No votes or formal actions were taken during this portion of the meeting. After Bramble’s presentation and questions, the committee was told that Secretary Stack from the cabinet would testify next on the rural health transformation plan.

Transcript Highlights:

• California workers' compensation system, an unauthorized payment reduction for medical providers who treat
• My name is Basil Besham, an orthopedic surgeon who treats injured workers.
• The fee goes back to the official medical fee schedule, the statutory fee schedule for treating injured
• That makes them think twice about treating injured workers. Your time is up.
• Physicians have been asked to do more, including asking their staff to do more with less.

Summary: The Senate Labor, Public Employment and Retirement Committee heard and advanced several bills covering workers’ compensation transparency, public pensions, prevailing wage, workplace harassment training, and employee benefits. AB 1048 would require disclosure of the contract justifying reduced workers’ compensation payments to medical providers; supporters said it would improve transparency without changing reimbursement rates, while opponents argued the problem was overstated and existing dispute remedies were sufficient. AB 1601 would give Sonoma County flexibility to target a cost-of-living adjustment for retirees rather than requiring an all-or-nothing COLA; county and union witnesses said retirees have gone without a COLA since 2008 and have lost purchasing power, and the bill passed unanimously. AB 1439 would commission a UC Berkeley study on labor standards in pension-funded real estate and infrastructure projects; labor groups supported it, while local governments, housing, and industry groups opposed it, and it passed on a 4-1 vote after one senator voted no in committee. The committee also heard AB 1697, which would delay implementation of a prior law restricting certain employment debt and pay-to-quit arrangements until 2027; the author said the delay would give employers, including professional sports leagues, time to adjust, while a financial services group sought a further delay to 2028. AB 1803 would require anti-hate speech content in existing workplace harassment training for employers with five or more employees; supporters cited rising antisemitic and other hate incidents and said the bill would help workers recognize and report hate, while opponents raised First Amendment concerns and argued existing harassment law already covers hostile conduct. AB 2120 would extend Los Angeles Unified’s selective certification hiring authority and allow retention of specialized employees in layoffs, and AB 2292 would bar providers from charging administrative fees for disability insurance and paid family leave certification forms; both drew support and were advanced without opposition testimony. AB 1198, the Fair Pay for Construction Workers Act, would require prevailing wage to be based on the time work is performed rather than the date a project is advertised for bid. Labor and contractor supporters said the current rule can lock in outdated wages and underpay workers on long projects and change orders, while cities, counties, and contractor groups warned it would create uncertainty, raise costs, and jeopardize projects funded by fixed grants or bonds. After testimony and questions, the committee voted to send all of the bills forward, with final recorded votes later showing unanimous or near-unanimous approval and several measures placed on call before the committee adjourned.

Transcript Highlights:

• California workers' compensation system, an authorized payment reductions for medical providers who treat
• My name is Basil Besham, an orthopedic surgeon who treats injured workers.
• The fee goes back to the official medical fee schedule, the statutory fee schedule for treating injured
• That makes them think twice about treating injured workers. Your time is up.
• Physicians have been asked to do more, including asking their staff to do more with less.

Committee: Senate Labor, Public Employment and Retirement

Transcript Highlights:

• of report to be done by the treating physician and be considered by the panel?
• of report to be done by the treating physician and be considered by the panel?
• So the examiner should be one examiner or three examiners, and the treating physician should have input
• </c> rendering a decision versus the treating rendering a decision versus the treating Physicians<00:
• actively treating Physicians actually actively treating the<00:58:55.240><c> patient</c><00:58:55.680

Committee: House Health

Summary: The committee first took up SB 1494 on hearing aids. Testimony was generally supportive of expanding hearing-aid coverage, with the Insurance Division raising concern about possible federal defrayment issues, SHPDA supporting the goal of hearing augmentation, DCAB strongly supporting the bill as an important access issue, and health plans and insurers asking for amendments. Kaiser Permanente and the Hawaii Association of Health Plans requested changes to add a medical-necessity standard and clarify annual notice language, while HMSA suggested the proposal should be studied by the auditor. The chair noted concerns about federal preemption and the lack of an audit, and deferred the bill in favor of a related resolution calling for a study. The committee then heard SB 1448, an emergency appropriation for the Hawaii State Hospital. DAGS and the Department of Health supported the measure, with the hospital administrator saying the funding would improve the environment of care, support cleaning, and allow a third-party review of the building. Committee members questioned the size of the request and the status of litigation against the design-builder. Administration witnesses said they were pursuing a comprehensive study involving destructive testing, had made a demand on the design-builder to fund the study, and were using different processes than before. They also said the roof work would be handled through a separate CIP request. No final action was taken in the portion provided. The committee next heard SB 1432, relating to the future responsibilities of the Department of Health and land issues at Kalaupapa after the last patient dies. DOH supported the bill in part but said its long-term role would be limited mainly to environmental cleanup, with operations expected to continue under the National Park Service and land-use decisions left to DHHL and beneficiary consultation. DHHL asked that the measure reflect that any land-use or zoning changes on homeland lands require commission approval and beneficiary consultation. Testifiers from Kalaupapa and Maui County, including Degra Vanderbilt-Papa and Council Member Keani Rollins-Fernandez, supported deferring the bill, saying there had been no meaningful community discussion about provisions affecting Kalaupapa’s future management and possible transfer of responsibilities to Maui County. The committee also read into the record written testimony from Gloria Marks emphasizing that Kalaupapa stakeholders must be included in future discussions. Finally, the committee heard SB 955 on fitness-to-proceed examinations. The Judiciary and the Public Defender’s Office both supported raising pay and standardizing expectations for private examiners, but opposed reducing felony fitness evaluations from three examiners to one and opposed expanding use of expedited reports. They argued that a single examiner would reduce reliability, create a more adversarial process, and likely increase costs and contested hearings, while expedited reports do not contain enough information for a proper fitness determination. The Department of Health also supported the bill’s intent but asked to preserve a three-examiner framework and said the goal was to reduce the number of people sent to the State Hospital, where admissions have reportedly risen about 20% year over year since Act 26. The bill remained under discussion in the excerpt, with no final vote shown.

Transcript Highlights:

• As a physician, I can tell you, seconds matter.
• We are just wanting to be treated fairly, with dignity and consistency.
• Since 1987, the Maddie Fund has been the only source of reimbursement for emergency physicians when treating
• The Maddie Fund has been the only source of reimbursement for emergency physicians when treating uninsured
• The Maddie Fund has been the only source of reimbursement for emergency physicians when treating uninsured

Committee: House Public Safety

Transcript Highlights:

• Their main focus is really treating the overall population with multiple different tests.
• However, there are multiple physician-owned laboratories that perform their own service within their
• And again, going back to what the providers and the people that are treating folks in the state of New
• Therefore, what we're proposing is to, instead of limiting to seven drug classes, allow the physician
• Therefore, they can actually treat the patient accordingly. Thank you. Thank you.

Summary: The House Health and Human Services Committee first heard House Bill 256, which would require school cardiac emergency response plans to address sudden cardiac arrest at school athletic activities and ensure AEDs are clearly marked and accessible at those events. The sponsor and an American Heart Association representative said the bill builds on last year’s law and is meant to improve implementation, not add new equipment costs. Members asked about funding, were told the AEDs are already in place, and the bill received a due pass with no opposition. The committee then took up House Bill 278 on Medicaid reimbursement for toxicology testing in substance use disorder treatment. The sponsor and Southwest Labs argued that current payer policies limit providers’ clinical judgment, that a new flat-rate code for unlimited analytes would improve care, keep Medicaid dollars in New Mexico, and support local laboratories. Several members raised concerns about whether the bill effectively rewrites bundled G-codes, whether it mainly benefits one company, how it affects MCO contracts, GRT/tax issues, and whether the fiscal estimates were realistic. After extensive questioning and conflicting views, a due-pass motion was made but the vote ended in a tie, so the bill did not advance. Finally, the committee considered House Bill 287 to create a permanent, full-time Health and Human Services Committee with a director and expanded membership, similar to other permanent legislative committees. Supporters from advocacy and policy groups said health care is too large and complex to be handled by a part-time interim committee and that year-round staffing would improve oversight and policymaking. Members discussed committee composition, staffing, subpoena power, and the proposed appropriation, and the sponsor said the bill is a starting point that could be refined later. The committee approved HB 287 on a do-pass motion and then adjourned until Monday morning.

Transcript Highlights:

• Emergency physicians are treating the effects of smoking cigarettes in emergency departments across the
• And every minute counts when treating these time-sensitive emergencies.
• Emergency physicians are treating the effects of smoking cigarettes in emergency departments across the
• And every minute counts when treating these times-sensitive emergencies.
• I'm a Washington resident and physician.

Summary: House Finance held public hearings on three Senate bills. SB 6129 would raise cigarette taxes, replace current nicotine/vapor product taxes with a 95% tax on nicotine products, and adjust revenue distributions to the Andy Hill Cancer Research account, the Foundational Public Health Services account, and a youth prevention account; staff and supporters said it would correct an unintended loss of public health funding and reduce youth nicotine use, while opponents argued it would be highly regressive, harm retailers and wholesalers, and push sales into illicit markets. SB 6231 would repeal the data center sales tax exemption for refurbishment and end replacement server equipment eligibility; the sponsor and staff said it would raise roughly $200 million and remove an obsolete preference, while labor, port, business, and data center representatives opposed it, citing lost jobs, reduced investment, and concerns about upsetting existing contracts and rural economic development. SB 6228 would repeal the preferential B&O rate for warehousing and reselling prescription drugs and create a lower preferential rate for critical access pharmacies; the sponsor said it would restore horizontal equity in the tax code and offset impacts on rural pharmacies, but pharmacy groups, wholesalers, retailers, and business organizations warned it would raise medication costs, worsen pharmacy closures, and be passed through to patients. The committee heard extensive public testimony on all three bills. Supporters of SB 6129 included public health, cancer, pediatric, and emergency medicine advocates who emphasized youth prevention, cessation funding, and long-term health savings; opponents included tobacco, vape, retail, and business groups who said the bill would increase black-market activity and burden small businesses. SB 6231 drew opposition from construction trades, ports, local governments, chambers, and data center interests, who argued the tax preference supports ongoing construction, permanent jobs, and local tax bases, while committee questions focused on whether the bill would affect existing refurbishment contracts. SB 6228 was opposed by pharmacy associations, independent pharmacists, wholesalers, grocery retailers, and AWB, who said the tax increase would be passed through and could accelerate pharmacy desert conditions; the sponsor and supporters framed the bill as a correction to an outdated preference and a way to protect critical access pharmacies. No votes were taken; each hearing was closed, and the chair announced amendment requests were due Thursday at 5 p.m. and amendments posted by Friday at 5 p.m.

Transcript Highlights:

• here in Hawaii year in years physician here in Hawaii year in years past<00:15:57.880><c> uh</c><00:
• back pain neck pain chiropractors treat back pain neck pain headaches<00:20:51.760><c> joint</c><00:
• </c> um such as various techniques to treat um such as various techniques to treat soft<00:21:14.640>
• with a diagnostic procedure and treated with a diagnostic procedure and the<00:25:09.559><c> the</c>
• </c><00:27:03.880><c> breast</c> eventually effectively treating breast eventually effectively treating

Committee: Senate Health and Human Services

Summary: The committee opened its first hearing of the 2025 session with procedural instructions about testimony limits, Zoom participation, written testimony, and a reconvening date if needed. It then heard SB 200 on speedy trials. The Office of the Public Defender opposed the bill, arguing it could create conflicts of interest for prosecutors, potentially make victims or witnesses quasi-parties to criminal cases, force traumatizing testimony on continuance motions, and unfairly delay trials for in-custody defendants. A World Care representative supported the bill and urged broader protections for minors, disabled people, and seniors. The chair also pressed the public defender to suggest improvements, emphasizing that the bill was driven by victims and families. No vote or final action was taken on SB 200. The committee next took up SB 8 on jury duty exemptions for health professionals. Testimony was strongly supportive from nurses, physicians, and disability advocates, who said APRNs and other nurses are in short supply and that jury service can disrupt patient care, especially in rural and neighbor island areas. One witness suggested expanding the exemption to include registered nurses as well as APRNs, while a senator raised concerns about blanket exemptions for non-practicing APRNs and suggested a time limit. The bill remained under discussion with no final action reported. The committee then heard SB 144 on chiropractic, with the state chiropractic board offering comments and the Hawaii State Chiropractic Association supporting the measure as a way to address workforce shortages and provide students more hands-on clinical experience. A World Care witness also supported the bill after clarifying her remarks. The chair then moved to SB 107 on medical informed consent, where the Hawaii Medical Board opposed the bill and the Healthcare Association of Hawaii and Queen’s Health System offered comments, citing concerns about duplicative standards. A support witness proposed expanding the bill to better address combined mental and physical health conditions. Finally, SB 189 on breast cancer screening drew support from the Hawaii Medical Association, Hawaii Radiological Society, Queen’s Health Systems, and others, while the Insurance Division raised concerns about possible insurance mandate defrayment and the need for a sunrise analysis. Senators also asked about local demographic data and coverage impacts; the chair indicated decision-making would be deferred to another day.

Transcript Highlights:

• Senator Warnick asked about the struck language, specifically the licensing exception for physicians
• Representative Burnbaum said the provision was cleaning up the statute because physicians and attorneys
• Senator Warnick asked whether, in the past, physicians or attorneys could become foster care providers
• He said he is well aware of the research and practices for managing and treating individuals committed
• Do we have to check every box or have someone treat it all the same?

Summary: The Senate Human Services Committee held a brief Monday meeting to hear two bills and a gubernatorial appointment. House Bill 2464, sponsored by Rep. Ortiz-Self, would require private detention facilities to report serious incidents such as abuse allegations, deaths, suicides, injuries requiring hospitalization, and service disruptions to the Department of Health and local law enforcement by the next business day, and would require annual law-enforcement reporting to DOH. Rep. Ortiz-Self said the bill is needed because private facilities have been inconsistent and delayed in sharing information, while state facilities already provide data more readily. Testimony from Columbia Legal Services, the League of Women Voters, La Resistencia, and the Northwest Immigrant Rights Project strongly supported the bill, citing barriers to reporting crimes and concerns about abuse in private detention. The committee did not vote on the bill during the hearing, but the chair said it would be considered in executive session. The committee also heard Engrossed Substitute House Bill 2253, a DCYF request bill making several licensing-related changes for foster care, crisis residential centers, and child care. The bill would require immediate termination of certain child-specific foster licenses if high-potency synthetic opioids or illicit substances are found, exempt kinship caregivers from blood-borne pathogen training, allow DCYF to close inactive foster homes, remove sex designation from foster licenses, adjust CRC staffing ratios to one staff for four youth during waking hours and one for six during sleeping hours, and strengthen child care subsidy fraud enforcement through electronic attendance verification and possible license revocation. DCYF and Community Youth Services testified in support, describing the changes as technical fixes that align statute with current practice and reduce burden on providers. Committee members raised concerns that some child care provisions may belong in a different committee and noted the need to ensure the bill does not duplicate or conflict with existing licensing and fraud rules. The committee then held a confirmation hearing for Corey McNally, reappointed to the Indeterminate Sentence Review Board. McNally described the board’s role in release decisions, supervision conditions, violation management, and release plans, and discussed his background in community mental health, the Special Commitment Center, DOC sex offense treatment, and ISRB leadership. Members asked about advances in sex offense assessment and treatment, the distinction between ISRB cases and sexually violent predator civil commitment, board consistency and recidivism work, and victim participation in hearings. McNally said the board uses structured decision-making and actuarial risk assessments, remains neutral on legislation, and provides victim liaisons to offer participation options. The chair closed the hearings, noted the committee would meet the next day on a large packet of bills and one appointment, and adjourned.

Transcript Highlights:

• Additionally, the bill requires at least 24 hours before an abortion occurs, a physician, referring physician
• Madam Whip, members, House Bill 2190 adopts the physician assistant licensure compact to allow physician
• Additionally, the bill requires at least 24 hours before an abortion occurs, a physician, referring physician
• Madam WIPP, members, Houseville 2190 adopts the physician assistant licensure compact to allow physician
• This compact streamlines licensure for podiatric physicians and licensing boards.

Summary: The meeting covered a long series of House bills across health, commerce, education, elections, government, and veterans issues, with many measures described as consent-calendar items. In health and human services, members discussed updates to radiology technology standards, a tribal Medicaid waiver bill, an emergency medicine study committee, fetal death certificate and remains-transfer requirements, a physician assistant licensure compact, dementia care telemonitoring funding, and SNAP error-rate reduction and eligibility oversight. Sponsors generally framed these bills as technical updates, workforce or access improvements, cost savings, or support for families and vulnerable populations, while some bills drew brief questions about implementation or opposition. In commerce and finance, the committee heard bills on mobile food vendor licensing, earned wage access services, CPA certification, cash acceptance by retail businesses, unmanned aircraft regulation, timeshare salesperson licensing, social credit score restrictions for lending, and a ban on state assistance to the International Criminal Court. Sponsors emphasized reduced regulation, consumer protections, transparency, and state sovereignty. The committee also considered tax and retirement-related measures, including conformity with the Internal Revenue Code, ASRS technical changes, and a 529 plan update that also addressed Roth IRA rollovers. Education and school governance bills focused heavily on school district oversight and transparency. Members discussed patriotic youth group presentations in schools, school board term limits and mandatory training, bond-advisor requirements, restrictions on school districts buying operating charter or private schools to affect funding formulas, conflicts of interest on the School Facilities Oversight Board, public meeting and travel disclosure rules, limits on long-term school property leases, job-order contracting caps, and a computer science proficiency seal. Sponsors repeatedly argued these bills would improve accountability, prevent misuse of public funds, and increase public access to school board decisions. The meeting also included elections, veterans, government, and other administrative measures. These included changes to sample-ballot mailing deadlines, a requirement that courts ask about veteran status at first appearance, a veterans awareness study, broader military leave protections, SAVE database verification for voter registration and licensing, U.S.-sourced election equipment requirements, Electoral College affirmation, justice court due-process protections, library trustee reporting deadlines, adult protective services reporting cleanup, and procurement transparency. No final floor votes were taken in the excerpt, and most items were presented for questions or moved through consent with brief sponsor explanations and occasional opposition noted in committee testimony.

Transcript Highlights:

• It's the like treats, not drugs.
• And ultimately, that's why we physician.
• doesn't happen. physician ask to see their records make physician ask to see their records make sure
• </c> physician wasn't even on the island. physician wasn't even on the island. &gt;&gt; Right?
• ><c> in</c><01:21:59.760><c> general</c> physician board certified in general physician board certified

Summary: The committee first heard SB 888, which would bar operators of smart household security devices from sharing user data with law enforcement unless the user consents or police obtain a warrant. DCCA’s Office of Consumer Protection offered comments and Judiciary submitted written support. Several individuals also submitted written support. The committee recommended passage with amendments clarifying that the Office of Consumer Protection may enforce violations and adopting Judiciary’s recommended changes, while also deferring the effective date to July 1, 2050. The motion passed unanimously among members present, with one senator excused. The committee then took up SB 2777 on insurance disclosures. The bill would require authorized insurers to disclose claim-handling data to consumers, including claims open at the start of a period, closed with payment, closed without payment, and open at the end of the period. The committee described amendments to clarify the bill, remove a requirement for the DCCA insurance division to handle publication, and defer the effective date to July 1, 2050. The measure was passed with amendments and the recommendation was adopted, with one member voting no and another excused. In a joint Commerce and Consumer Protection/Judiciary hearing on SP2738 relating to tax haven abuse, the Department of Taxation offered comments and the Tax Foundation testified in opposition, arguing the state should rely on IRS audits and existing worldwide reporting rules rather than create a separate state approach. Other written testimony was noted in both support and opposition. The committees recommended passage with amendments adopting Taxation’s technical changes and deferring the effective date to July 1, 2050; the recommendation was adopted, with one senator noting reservations. The joint hearing then moved to health-related bills, including SB 2690 on primary care spending, SB 3103 on energy assistance, SB 3137 on Department of Health authority over food, drugs, and cosmetics, SB 3164 on child welfare service organizations, and SB 3206 on cannabinoids. SB 2690 drew strong support from physicians and advocates who said it would address primary care shortages, especially on neighbor islands, while HMSA and others warned a fixed spending percentage could raise costs and suggested a working group. SB 3164 drew support from child welfare providers and opposition from the Attorney General over indemnification language, and SB 3206 drew mixed testimony: state agencies raised federal-law and vagueness concerns, while hemp and cannabis advocates and some farmers supported the measure and urged broader legalization or amendments.

Transcript Highlights:

• </c><00:39:55.640><c> prostate</c> originally developed to treat prostate originally developed to treat
• </c><01:20:38.960><c> to</c> medically necessary by physicians to medically necessary by physicians to
• ><c> could</c><01:20:41.760><c> you</c> treat gender dysphoria follow could you treat gender dysphoria
• </c> relationship as a society of Physicians relationship as a society of Physicians New<02:16:02.440
• </c> need to be made between the physician need to be made between the physician and<02:16:16.199><c>

Committee: House Health, Human Services & Elderly Affairs

Transcript Highlights:

• As a physician, I evaluate an applicant's health holistically and risk appropriately.
• We believe that if a physician... ...the risk of a developing disease.
• Not only as a physician, but as a patient. I'm a human being, too.
• The physician sees the applicant. The physician knows the applicant.
• , and the physician says, I'm not worried about it in you, we're both happy.

Committee: House Insurance

Transcript Highlights:

• Are there enough physicians? Are there enough nurses? Antitrust immunity is just the beginning.
• So traditional Medicare publishes their fee schedule for physicians and hospitals... ...So traditional
• Medicare publishes their fee schedule for physicians and hospitals, and you don't negotiate that.
• I'm the chief medical officer for ambulatory care for MU Health Care and a family physician.
• It's natural for physicians and staff to wonder what integration means for local access, for clinical

Committee: House Special Committee on Rural Issues

Summary: The committee first met in executive session on House Bill 1714, adopting an amendment that clarified the bill would not apply to hunting dogs or animals not under direct control of the hunter and would not affect a specified section of law. The committee then rolled the amendment into a House Committee Substitute and voted the substitute do pass, with the roll call showing passage. The committee then heard House Bill 317, which would authorize MU Health Care to collaborate with hospitals and providers in a 25-county area and seek state-action antitrust immunity for those transactions. The sponsor and MU Health Care testified that the bill is intended to help preserve rural hospitals and keep care local, citing multiple hospital closures in Missouri and examples from Alabama and other states. Supporters from MU Health Care, rural hospitals, and local business and health leaders described the bill as a way to stabilize struggling facilities, maintain emergency access, and protect rural economies. Opponents, including the Missouri Insurance Coalition and the Missouri Health Plan Association, warned that the bill could codify monopoly power, raise prices, and reduce competition, and argued that the language was too broad and not limited to distressed hospitals. Some committee members also raised concerns about antitrust immunity, facility fees, market share, and whether the bill should be tightened to ensure voluntary participation and clearer limits. No vote was taken on House Bill 317 before the hearing adjourned.

Transcript Highlights:

• largest physicians union representing 40,000 resident and fellow physicians across the United States
• , I will be a primary care physician at Boston Medical Center.
• Eisenberg and I treat every single day at Cambridge Health Alliance.
• They employ 90,000 physicians, and that's insane.
• They employ 90,000 physicians, and that's insane.

Committee: Joint Joint Committee on Health Care Financing

Summary: The Joint Committee on Health Care Financing held a public hearing on a broad set of health care bills focused on cost, market oversight, pharmaceutical access, transparency, hospital closures, and pharmacy access. Chairs John Lawn and Cindy Friedman opened by emphasizing recent health care reforms and the need for further action on the drug supply chain, PBMs, private equity, and affordability. The committee heard testimony on several measures, including a Betsy Lehman Center bill to make technical changes and create a permanent trust account for federal and private funding, and bills on hospital profits and fairness, hospital closures and health planning, pharmacy deserts, and health care market oversight and pharmaceutical access. No votes were taken during the hearing. On the hospital profits bill, physicians and labor advocates strongly supported capping hospital CEO compensation at 50 times the lowest-paid worker, requiring greater financial transparency, and directing penalties from high-margin public hospitals into a Medicaid reimbursement fund. Testifiers argued that executive pay is excessive while frontline staff and safety-net services are under strain. Committee members raised concerns about unintended consequences, including whether hospitals might shift workers to contract status or lose executive talent, and whether the bill would actually direct money to the safety net. Supporters responded that the measure is one piece of a larger effort and that the bill’s Medicaid reimbursement provisions would help underserved hospitals. Testimony on market oversight and pharmaceutical access centered on rising health care and drug costs, PBM practices, and the proposal to give the Health Policy Commission authority to set upper payment limits for certain drugs. Consumer advocates, disability advocates, an independent pharmacist, the Attorney General’s office, and others supported stronger oversight, citing premium increases, affordability problems, and the impact of high drug prices on patients and community pharmacies. Pharma and some industry witnesses opposed parts of the bill, warning that upper payment limits could disrupt access, create legal issues, and fail to address the broader supply chain. The committee also heard support for stronger hospital closure notice and public hearing requirements, and for a pharmacy deserts bill aimed at identifying and addressing closures like the one in Roxbury that affected thousands of patients.

Transcript Highlights:

• We learn what to look for in disease, how to treat disease, and how that impacts every single one of
• </c><00:15:01.360><c> How</c> impact how I treat my patients. How impact how I treat my patients.
• I believe that it's important for physicians to receive education in health care financing.
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• </c> physicians who will serve our state. physicians who will serve our state.

Committee: Senate Higher Education