Transcript Highlights:

• The only add-on program without a teacher bonus is the early graduation program.
• CAPE programs require more equipment than most other instructional programs.
• FEFP programs.
• the program.
• the programs.

Summary: The Pre-K through 12 Budget Subcommittee met for its first meeting of the 2025 session and received an overview of add-on weights in the Florida Education Finance Program (FEFP), followed by a Department of Education presentation on a legislatively required study of add-on weight funding and expenditures. The chair explained that add-on weights apply to acceleration and career programs such as AP, IB, ACE, CAPE, dual enrollment, early graduation, and certain small-district needs, and noted that add-on funding has grown substantially as the base student allocation increased. The chair also raised concerns that the department’s report did not clearly show whether districts’ reported costs included the full costs required by the proviso, and asked for more specificity on any recommended adjustment to the weights. Deputy Commissioner Suzanne Pridgen said the department surveyed districts on how they spent add-on revenue for fiscal years 2021-22 through 2023-24, with categories including teacher compensation, materials, equipment, professional development, exam fees, counseling, apprenticeship costs, and other expenditures. She said most add-on funds were spent on teacher bonuses and compensation, with AP, ACE, CAPE, and dual enrollment showing the largest increases in spending in 2023-24 due to higher FEFP funding; IB and early graduation were relatively flat. The department reported that add-on revenue covered between 41.8% and 79.2% of total program expenditures in 2023-24 and recommended adjusting add-on weights to better align with pre-2023-24 funding relationships, though no specific percentage was given during the meeting. Members asked about how “other” expenditures were categorized, whether teacher compensation included only statutory bonuses, how dual enrollment tuition and fees were counted, the small district factor, and whether the weights incentivize districts to offer advanced programs. The department clarified that teacher compensation in the study referred only to bonuses, that some “other” costs included charter school payments and dual enrollment tuition/fees, and that the small district factor is 1.0277, increasing base funding by 2.77% for fiscally constrained counties. No votes were taken, and the meeting adjourned after the presentation and questions.

Transcript Highlights:

• Senior escort programs will shut down. Youth prevention and know-your-rights programs will be cut.
• . lose more than programs.
• But these programs were able to leverage and continue and extend some of those programs as well.
• But these programs were able to leverage and continue and extend some of those programs as well.
• These programs were able to leverage and continue and extend some of those programs as well.

Committee: House Human Services

Keywords: 988, house, all

Transcript Highlights:

• Take advantage of this program.
• hiring in other programs.
• For many years, It has been called the Pilot Agricultural Microloan Program, but we've had this program
• Time to develop a good program that works for farmers. So, we developed a pilot program.
• to get the program kickstarted.

Committee: House Agriculture, Veterans, Broadband, and Rural Development

Transcript Highlights:

• program.
• poverty programs.
• One of our largest programs is the Women, Infants, and Children Program.
• Another program that we offer is the fruit and vegetable incentive program.
• branch of the SNAP program.

Summary: The House Agriculture and Natural Resources Committee held a work session on food systems and food security, with no public testimony. The first panel focused on household food security and data. Marie Spiker of the University of Washington explained what food insecurity means, its health impacts, and the importance of reliable measurement, warning that the federal Census food security data is being terminated and that there is no true replacement. She described Washington’s WaFOOD surveys as a useful complement, not a substitute, and noted that they show food insecurity affects households at a range of income levels. Katie Raines of WSDA described the state’s food systems work, the need for shared data and dashboards, and the role of agriculture in both food production and the hunger safety net. Committee members asked about the $2.2 million state food assistance allocation, the scale of the SNAP gap, and how household size, housing costs, and other factors intersect with food insecurity. The committee then heard from Tracy Roof of the University of Richmond on the history of SNAP and its relationship to agriculture. She traced the program from Depression-era commodity distribution through the modern farm bill, emphasizing that food assistance has long functioned both as anti-hunger policy and as an agricultural and economic stabilizer. She highlighted how SNAP expands during recessions, supports retailers and farmers, and has become more important since the Great Recession because participation stayed high even as the economy recovered. Roof also noted that Washington has relatively high SNAP participation and low payment error rates, but that recent federal changes could reduce eligibility and shift more costs to states. Members asked how Washington compares to other states and why the program is structured as it is. A later panel featured the Washington State Food Policy Forum and a joint systems presentation from the Washington Farm Bureau, Washington Retail Association, and Washington Food Industry Association. The Food Policy Forum described its consensus-based recommendations on food insecurity, climate and water, regional food infrastructure, farmland protection, and farm viability, including more support for producer purchasing, water planning, and farmland conservation. The industry groups presented a systems map showing how agriculture, processing, retail, and transportation are interconnected, and argued that rising costs, regulations, labor and fuel expenses, retail theft, and thin margins make it harder to keep farms and stores viable. They said food security depends on store viability and local agricultural profitability, and promised to provide a more detailed list of policy recommendations. The final panel included state agency staff from DSHS, DOH, and WSDA. Bryce Montgomery said the Basic Food program serves about 920,000 Washingtonians monthly and warned that H.R. 1 could require Washington to pay up to 15% of SNAP benefits, broaden work requirements, and restrict immigrant eligibility. Karen Mullen described DOH nutrition programs, including WIC, farmers market nutrition benefits, fruit and vegetable incentives, and a fruit-and-vegetable prescription program, while noting funding instability and the end of SNAP-Ed. WSDA’s Katie Raines began describing ongoing food assistance and farmer support challenges, including farmer mental health and the need to address food insecurity across both producers and consumers.

Transcript Highlights:

• In the Medicaid program, we're referring to this as a family home health aide program.
• health aide program.
• to as the SMMC program.
• program to an opt-out.
• have in our Medicaid program.

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

Transcript Highlights:

• WICHE offers three major student access programs. WICHE offers three major student access programs.
• Our graduate program is the Western Regional Graduate Program, or WRGP.
• Excuse me, student access programs—they were called student exchange programs, but we are...
• access programs they were called student exchange program but we are excuse me, student access programs
• , especially a program as important as the school safety program.

Committee: Senate Senate Education Committee of Reference

Summary: The Senate Education Committee of Reference first heard a sunset review of the Credit Enhancement Eligibility Board. Governor’s Office staff explained that the board was created in 2016 to lower borrowing costs for qualifying schools by providing a state guarantee that improves credit ratings, but the board has no dedicated staff or budget and is now largely in a monitoring role because it has reached its statutory leverage cap. Members discussed the long maturities of the approved financings, whether rural districts might benefit from additional capacity, and why a 10-year continuation was being requested. The committee voted to recommend continuing the board for 10 years until July 1, 2036. The committee then heard a sunset review of the Western Interstate Commission for Higher Education (WICHE). WICHE’s president described the interstate compact, its regional student access programs—WUE, WRGP, and PSEP—along with behavioral health fidelity reviews and cooperative purchasing savings. Testimony emphasized tuition savings for Arizona students, the return of health care graduates to Arizona, and the value of regional collaboration. The committee voted to recommend continuing WICHE for 10 years until July 1, 2036. Finally, the committee reviewed the Arizona Department of Education School Safety Program performance audit. The Auditor General reported that the program has grown substantially, but many sampled schools were not fully complying with requirements such as operational plans, safety teams, training, activity logs, and reimbursement documentation. The department agreed with the finding and said it would implement the recommendations. The school safety director responded that the department has already begun tightening monitoring, training, and documentation procedures, and he answered questions about emergency plans and campus safety. No further action was taken on the audit, and the meeting adjourned.

Transcript Highlights:

• AS FAR AS THE CAPITAL PROJECTS FUND PROGRAM WE HAVE THREE PROGRAMS WITHIN ITS.
• THE MULTIPURPOSE COMMUNITY FACILITY PROGRAM IS A PROGRAM THAT HAS FUNDED OVER $86 MILLION TO 29 GRAMS
• HERE SOON IN THE DIGITAL CAPACITY GRANT PROGRAM AS WELL AS THE B PROGRAM.
• TWENTY NINE COMMITTEE FACILITIES TO THE MULTI PURPOSE PROGRAM AND 15 DIGITAL DEVICE PROGRAMS.
• DIGITAL CAPACITY GRANT PROGRAM.

Keywords: 999, senate, all

Transcript Highlights:

• The health insurance counseling and advocacy program, or HICAP, is a program designed to educate and
• The health insurance counseling and advocacy program or high cap is a program designed to educate and
• Home Program.
• They're not new programs per se.
• But not any programs. No programs are going to be additional.

Keywords: 987, senate, all

Transcript Highlights:

• We have five main program areas.
• Care Affordability, the CalRx program, and the Hospital Fair Billing Program.
• We are actively coordinating the program design now to build out those programs.
• prepare for this program.
• screening program and the voluntary prenatal screening program.

Summary: The hearing began with a stakeholder presentation from Let California Kids Hear urging coverage of pediatric hearing aids for children in the large group market. Advocates described the issue as a long-running developmental emergency, argued that existing state efforts have been inefficient, and said the new proposal would cover about 70% to 80% of affected children without new spending by redirecting existing dollars. Public commenters, including parents, audiologists, and children’s advocates, strongly supported the proposal and emphasized the need for timely access to sound. The chair thanked the group and noted hope for a future fix, including continued work on the exchange market. The Department of Finance then gave a broad budget warning about the state’s more than $20 billion structural deficit and said new investments must be weighed against out-year shortfalls. HCAI followed with an overview of its programs, including CalRx insulin and naloxone, reproductive health grants, the Office of Health Care Affordability, seismic hospital compliance, workforce programs, and the Data Exchange Framework. Members asked about geographic targeting of workforce funds, behavioral health pipeline programs, the status of the 21st Century Nursing Initiative, and future CalRx products such as EpiPens and GLP-1s. HCAI also described its enforcement approach for health care spending targets, saying the board would not change the targets in response to H.R. 1, and outlined the diaper access initiative, which will distribute diapers through hospitals in higher-need areas. Several HCAI budget items were discussed and held open, including additional expenditure authority, the transfer of the Data Exchange Framework and Office of the Patient Advocate, long-term care payment transparency staffing, and reporting on health care worker waiting periods. The department also presented its Behavioral Health Services Act workforce initiative and a proposed $100 million General Fund offset, which both the LAO and the chair questioned as unclear and potentially one-time in nature. HCAI said the final workforce plan would be adjusted after stakeholder consultation if the offset proceeds. The department also described the Rural Health Transformation Program, saying California received $233.6 million in federal funds, had to revise its proposal to satisfy CMS, and must obligate the money by October 30; the program will fund rural care models, workforce development, and technology, with grants rolled out on a phased basis. The Department of Managed Health Care then presented its budget and three legislative implementation requests: SB 41 on PBM reform, SB 306 on prior authorization transparency, and AB 1041 on provider credentialing timelines. Finally, the administration outlined a menopause care proposal requiring coverage and education for menopause-related services, provider training, and an outreach campaign, with DMHC requesting staffing and funding to implement and enforce the new requirements. Throughout the hearing, most items were held open for later action, and no final votes were taken in the portion provided.

Transcript Highlights:

• To start us off today, we will be receiving program updates and conducting oversight regarding the programs
• , Pathways program.
• , Pathways program.
• rollout, program coordination.
• 6 of the program.

Summary: The subcommittee heard an overview from Go-Biz Director D.D. Myers on the administration’s economic development strategy, centered on the California Jobs First framework. Myers described regional planning across 13 regions, the Jobs First Council, and pilot sectors including ag-tech, space and defense, life sciences, and semiconductors. She also outlined budget requests for CalCompetes, CalExport, the California Film Commission, innovation/emerging technologies, and the California Civic Media Fund, along with the new California brand campaign. Committee members raised questions about misinformation about California, regulatory burdens, tourism versus broader economic messaging, and how the brand campaign would highlight underrepresented communities. No vote was taken; the item was informational. The committee then reviewed CalOSBA’s work on small business support, including California RISE, the Performing Arts Equitable Payroll Fund, and TAP/SIP technical assistance and capital infusion programs. CalOSBA reported that California RISE’s first cohort awarded $16.9 million to 61 employment social enterprises, with growth in revenue, contracts, and jobs; the performing arts payroll fund paid all 100 recipients but was heavily oversubscribed; and TAP supported more than 112,000 businesses in the past year, helping leverage federal and local funds. Testimony from program partners emphasized the importance of small business counseling, community-based outreach, and support for arts organizations facing post-pandemic and AB 5-related cost pressures. Senators pressed for more data on long-term job retention, better outreach to smaller and ethnic media, and possible program changes to speed grants and stretch funding further. Finally, the committee heard Go-Biz’s request for additional staff and funding for the California Film and Television Tax Credit Program. Staff said the request would support application review, DEIA implementation, and data tracking. The Film Commission reported that about 147 productions had been approved and roughly 90% were opting into the new diversity provisions, with career pathways reporting to include demographic and participation data and a future report expected in 2027. Senators asked about accountability, apprenticeship and internship hours, and whether the program was producing real career pathways and inclusive hiring outcomes. The item remained informational, with no vote or action taken during the hearing.

Transcript Highlights:

• capacity in one of our programs.
• schools to use program monies to ...program provisions, including authorizing schools to use program
• So going back to 2018, the school safety program was a $12 million program. It's funny...
• Going back to 2018, the school safety program was a $12 million program.
• We appropriated money for the grant program, but no money to administer the program, apparently.

Committee: House Education

Keywords: 1182, all

Transcript Highlights:

• program.
• program.
• program.
• . program. program.
• </c><03:24:35.520><c> in</c> program a neutral benefit program in program a neutral benefit program in

Committee: Senate Education

Keywords: 1191, senate, all

Transcript Highlights:

• It's a balancing act in the program, and they set a very ambitious and unique program for us.
• examples of how implementation looks in the program, as well as how change happens in the program.
• DNR also employs a program administrator who oversees the program.
• And lastly, it's a developing and responsive program. There will be changes in this program.
• Our F2P program, the Family Forest Fish Passage Program, invested nearly $50 million since its inception

Committee: House Agriculture & Natural Resources

Keywords: 904, all

Transcript Highlights:

• California's core programs.
• But comparing this program to the existing Distressed Hospital Loan Program, the intention is for this
• These are very different programs.
• Issue 12 relates to CDSS adult programs. Issue 12 relates to CDSS's adult programs.
• efficient programs that exist.

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

Transcript Highlights:

• to new grant programs created, focusing on those newer programs and really asking whether continuing
• , the SHEEP program.
• , the sheep program.
• It's not a standalone program.
• program.

Summary: The Senate Ways and Means Committee heard an overview from OFM Director Katie Chapman See on Governor Ferguson’s 2026 supplemental budget proposal. She said the budget was built in response to higher caseloads and inflation, a roughly $390 million revenue forecast drop, new federal costs tied to H.R. 1, and a relatively small ending fund balance. The proposal would increase near general fund spending by about $1.1 billion and solve an estimated $2.3 billion two-year gap through about $800 million in reductions, revenue shifts and tax preference changes, use of other funds, and about $1 billion from the budget stabilization account. She also noted the budget is balanced over two years but not fully over four years under the state’s outlook rules. Chapman See highlighted reductions in Working Connections Child Care, including a soft cap on enrollment and holding subsidy rates at the 75th percentile, delays to long-term care and developmental disability-related changes, and across-the-board reductions to higher education and administrative spending. She also described investments in wildfire suppression and preparedness, affordability programs like utility rebates and home energy assistance, housing-related planning and permitting support, One Washington IT replacement, behavioral health workforce programs, and continued support for some K-12 initiatives such as ninth grade success and homeless student stability. In response to questions, she said some proposed cuts were based on the governor’s subjective judgment about what was critically necessary, that current child care enrollees would not be cut off immediately, and that the budget would maintain services for about 500 highest-acuity Medicaid clients who lost eligibility under federal changes. Public testimony was largely critical of the proposed cuts in K-12, early learning, and higher education. School officials, educators, nurses, and advocacy groups opposed reductions to Transition to Kindergarten, Local Effort Assistance, Running Start, MSOC, school leadership and support grants, and higher education funding, arguing the cuts would worsen existing funding gaps and harm student outcomes. Several witnesses supported restoring or maintaining funding for ninth grade success, Treehouse’s foster youth graduation program, homeless student stability, and Science on Wheels. In early learning, child care providers and advocates opposed the Working Connections cap and subsidy-rate reduction, warning it would reduce access and destabilize providers. In higher education, campus leaders and labor representatives opposed across-the-board cuts and fund shifts, while some institutions and advocates supported targeted investments such as behavioral health workforce programs and DigiPen aid restoration. In human services, Planned Parenthood advocates praised restored abortion access funding and Medicaid reimbursements. The committee took no votes or final action in the transcript provided.

Transcript Highlights:

• Now I'm going to break out rp and programs for says are are are in program.
• When we look at our current programs, I'm going to present the are in programs divided by program type
• , the ad and programs and the DS and programs statewide.
• the approved programs.
• The program is allowed us to offer nursing program for Citrus County residents.

Keywords: 999, senate, all

Transcript Highlights:

• But comparing this program to the existing Distressed Hospital Loan Program, the intention is for this
• These are very different programs.
• This is the Education and Outreach Grant Program for outreach and education grant program activities.
• Issue 12 relates to CDSS's adult programs. Issue. Issue 12 relates to CDSS as adult programs.
• efficient programs that exists.

Keywords: 987, senate, all

Transcript Highlights:

• And again, those are programs out of districts, not charter schools with virtual programs.
• And my kids are thriving in this program. It's a fantastic program.
• And my kids are thriving in this program. It's a fantastic program.
• For existing programs, it does not. These requirements do not apply to existing programs. Mr.
• online program.

Bills: HB2 , SB204 , SB241 , HB34

Committee: House House Education

Keywords: general appropriation, budget, Medicaid, education funding, public safety, higher education, research funding, federal funding, New Mexico, appropriation, University of New Mexico, New Mexico State University, New Mexico Institute of Mining and Technology, child care, child care assistance, child care subsidy, early childhood education, early childhood care, daycare, preschool

Transcript Highlights:

• AB617 Community Air Protection Program, also the farmer program.
• In the TIRCP— In the TIRCP program, it is a competitive capital program, right?
• In the TIRCP program, it is a competitive capital program, right?
• So this program, unlike the other, is not a program that is a competitive grant program.
• program.

Summary: The Budget Subcommittee No. 4 hearing focused on the Greenhouse Gas Reduction Fund (GGRF) and cap-and-trade reauthorization, with members and panelists discussing how to balance climate goals, affordability, and legislative oversight. The chair emphasized the hearing as a broad review of past GGRF spending and future options, while the LAO outlined how GGRF revenues are generated, how variable they have been, and the tradeoffs between continuous appropriations and annual budget control. Two academic panelists, Dr. Kyle Meng and Danny Cullen Ward, argued that cap-and-trade remains an effective climate policy, but stressed that future revenue will depend heavily on market design, allowance allocation, and price levels. They also raised the idea that GGRF could be used more directly for affordability, especially by lowering electricity costs, and for targeted investments in technologies that the market would not otherwise support. Committee members pressed the panelists on where revenues come from, how much has actually been spent, and whether continuous appropriations reduce oversight. CARB staff said more than $33 billion has been generated to date and a little over $11–12 billion has been spent, with the rest committed or in process, and noted that project timelines can be lengthy. Members also asked about ways to lower electricity rates, reduce wildfire-related utility liabilities, and support electrification. The panelists said transportation fuels are the largest source of GGRF revenue, that industrial emitters receive a smaller share of free allowances, and that reducing wildfire liability and investing in grid-scale batteries could help lower costs and speed decarbonization. Public commenters largely urged the Legislature to preserve or expand continuous appropriations for specific climate programs. Speakers supported funding for nature-based solutions, natural and working lands, urban greening, agricultural climate solutions, waste and composting programs, clean transportation, AB 617 community air protection, clean cars, transit, affordable housing near transit, and dairy digesters. Several groups argued these programs are cost-effective, provide public health and affordability benefits, and should receive dedicated shares of GGRF. Others urged reducing free allowances and using more GGRF revenue to directly lower energy costs for households. No votes were taken during the hearing.

Transcript Highlights:

• to implement a physician health program.
• Savings from the 340B program are how we are in the 340B program.
• a result of the 340B program.
• through the Medicaid drug rebate program were $6.5 billion less as a result of the 340B program.
• and think it is a great program.

Summary: The committee heard public testimony on several health-related bills. SB 5904 would restrict nursing titles such as RN, NP/ARNP, and LPN to licensed human people and prohibit non-human entities, including AI chatbots, from using those titles. The sponsor and nursing advocates said the bill is meant to prevent confusion and protect public trust, while preserving the use of AI as a support tool. SB 5877 would add a $70 surcharge for certified anesthesiologist assistants so they can participate in the Washington Physicians Health Program and access HealWA resources; supporters said it closes a technical gap and aligns CAAs with other medical professions. SB 5185 would create a pilot pathway for certain international medical graduates with clinical experience licenses to obtain full primary care licensure; supporters from the medical commission, physicians, and IMG advocates said the program has worked well, has shown no patient safety issues, and could help address workforce shortages. The committee also heard extensive testimony on ESSB 6210, which would let the Health Benefit Exchange adopt additional market-factor certification criteria for exchange plans, including standards aimed at preserving access and affordability in underserved counties. Supporters, including the exchange, OIC, consumer advocates, tribal representatives, and patient groups, said the bill is needed to respond to federal policy changes, rising premiums, and disappearing coverage in places like San Juan County. Opponents from carriers and employer groups argued the timeline is too fast, the criteria are too discretionary, and the bill could reduce competition and raise costs. The committee then heard SB 5981, which would strengthen protections and reporting requirements for the federal 340B drug pricing program and limit manufacturer restrictions on contract pharmacies and data requests. Hospitals, clinics, and patient advocates said the bill protects safety-net care and rural access, while manufacturers, employers, and business groups argued it would expand a program that already raises costs and lacks transparency. In executive session, the committee took action on SB 5917, related to Department of Corrections distribution of abortion medications, rejecting five proposed amendments and then advancing the bill on a 10-6 vote with three excused. The committee also advanced SB 5988, which concerns Department of Health opioid treatment program accrediting activities, on a do-pass recommendation after brief discussion.