Transcript Highlights:

• And so in many cases these are specialists and the copay is twice.
• Um, and so it's just a copay is twice.
• And so in many cases these are specialists and the copay is twice.
• Um, and so it's just a copay is twice.
• Um and so it's just a copay is twice.

Keywords: 1187, senate, all

Transcript Highlights:

• Insured patients can't always meet their deductibles or pay their copays, and so they don't have access
• Patients will pay their regular copay that's established under their employer plan, and the employer
• insurance, if they went to an outside pharmacy, uh, they would be changed, they would be charged the same copay
• Yeah, they'd be charged the same copay you're paying, you're charging just you guys wouldn't get the,

Transcript Highlights:

• But sometimes you have to do a copay. No, there was no copay.

Transcript Highlights:

• you treat them and you're saying that the carrier charges determines what their deductible, their copays
• This is how much we get to collect and it's based on their deductible and copay, coinsurance.

Transcript Highlights:

• Take a slight, which is 45 75 90% think it kind of like a copay and I've got some more slides that we'll
• very first road, that is gross losses is a way to think about that before the company's retention copay

Transcript Highlights:

• The way the subsidy program operates is that your lowest income families have zero or very little copay
• about families who lose a childcare subsidy and they're all of a sudden faced with maybe they had a copay

Keywords: 914, all

Transcript Highlights:

• There's a $30 copay if they don't follow under the regular mammogram...
• There's a $30 copay if they don't follow under the regular mammogram screening, and their maximum, if

Keywords: 908, all

Summary: The Senate opened with prayer, the Pledge of Allegiance, and a quorum call showing 46 members present. It then took up multiple House messages and amendments, appointing conference committees on several measures, including SB 2007, SCR 4007, SB 2374, SB 233, and House bills 1029, 1218, and 1022. The chamber also considered a series of House bills on the sixth and 14th orders, often adopting committee amendments before final passage or, in some cases, rejecting the bill outright. Among the major policy items, the Senate passed HB 1524 on regional planning council grants, HB 1143 increasing a food bank appropriation to $10 million, HB 1126 modernizing cosmetology licensing and inspections, HB 1542 making student applications for admission exempt records, HB 1613 regulating law enforcement use of robots, HB 1582 directing a study on false reports and accusations, HB 1214 revising school transportation funding, HB 1448 creating a study on advanced technologies, HB 1280 on drainage project voting rules, HB 1499 protecting records related to federal judges, and several Senate bills returned from the House, including SB 2221, SB 2117, SB 2198, SB 2120, and SB 2214. The Senate also adopted amendments to HB 1541 on septic systems before rejecting it on final passage. Several high-profile bills failed after debate. HB 1566, dealing with kratom regulation, saw an amendment to convert it to a study fail on a 21-25 vote, after which the chamber laid the bill over for one legislative day rather than take final action. HB 1283, which would have eliminated cost-sharing for diagnostic and supplemental breast exams in the state employee plan, was defeated 22-24 after extensive debate over cost, precedent, and insurance impacts. HB 1527, requiring Holocaust education in statute, also failed 22-24, with supporters emphasizing the importance of the subject and opponents arguing curriculum belongs in standards rather than statute. The Senate adjourned after announcements, scheduling its next meeting for Monday, April 14, 2025.

Transcript Highlights:

• the insurance company covers chiropractic, yes, you can get 12 visits a year, with deductibles and copays
• and you know year and with deductibles and you know you<00:25:32.000> know<00:25:32.720> copays
• and<00:25:33.320> whatever<00:25:34.000> and<00:25:34.120> that's you know copays
• speaks, the $22 was based on the unamended bill when it included the exemption from deductible and copay
• copay copay so<00:38:57.079> with<00:38:57.560> the so with the so with the amendment<

Keywords: 928, house, all

Summary: The subcommittee first reviewed its schedule, noting that 13 bills were being executed the next day and that additional subcommittee work would be scheduled around Town Meeting Day and the following session days. The chair explained that the committee would not meet on Town Meeting Day, would handle the remaining bills on the next available subcommittee day, and would continue any unfinished items later in the month. The committee then took up House Bill 774, which concerned Medicare-related coverage issues. Members discussed the bill’s purpose and the differences between Medicare standard and Medicare Advantage, with one member saying the proposal was informative but did not offer a workable solution. The committee also moved to inexpedient to legislate on House Bill 185, and the motion passed on a 6-0 vote. House Bill 241, relating to alternatives to opioids, was retained for further work. Members said the bill raised concerns about insurers effectively practicing medicine and about the lack of evidence on the efficacy of some alternative treatments, while also noting that chiropractic coverage mandates already exist in statute. The committee voted to retain the bill, with the motion passing 6-0. The most extended discussion was on House Bill 648, which would expand insurance coverage for glucose monitoring. Testimony and committee comments focused on whether coverage should be tied to insulin use or instead to a physician’s medical judgment, the role of continuous glucose monitoring for people with type 2 diabetes who are not on insulin, and the potential cost impact. An insurance department fiscal analyst said the original $22-per-member estimate was based on the unamended bill and that the amended version would require updated analysis; members agreed to retain the bill to narrow the eligible population and revisit the language later.

Transcript Highlights:

• That was the conversation that we've been having: include the copay charging extra copay for the patient
• Yes, I think about the copay under the current way it's structured under 420J.
• <01:56:45.760> charging<01:56:46.320> extra<01:56:46.639> copay include the
• copay charging extra copay include the copay charging extra copay uh<01:56:48.080> for<01:56:48.239
• <01:56:52.080> under<01:56:52.320> the yes I think about the copay under the yes I

Keywords: 928, house, all

Summary: The committee first heard Senate Bill 47, sponsored by Senator Regina Birdsell at the request of the Insurance Department. The bill would clarify that a birth mother’s health insurance is the primary policy for a newborn’s care unless the mother has no coverage or no employer-sponsored coverage. Birdsell and Insurance Commissioner DJ Benton Court said the measure simply codifies the department’s long-standing interpretation of existing law. Representative Miles asked whether the coverage would extend to a grandchild if a young woman on her parents’ plan had a baby, and Birdsell said it would. The hearing on SB 47 was then closed. The committee next heard Senate Bill 121, introduced by Grant Bosi for Senator Kevin Avard. The bill requires insurers to notify the Insurance Department when they stop writing an entire line of business or, in some cases, when they change Medicare Advantage offerings. Benton Court said the bill was prompted by disruption in the Medicare Advantage market, where consumers and the department were confused by carriers exiting, changing plans, or narrowing offerings. He said the department does not regulate Medicare Advantage itself, but does license the carriers, and the notice requirement would help the department advise consumers; he also said noncompliance could affect a carrier’s license and could lead to fines. Members discussed the notice period, and the department and AHIP indicated support for changing it from 120 days to 90 days to align with federal timing. The hearing was closed with plans to work on an amendment in subcommittee. Finally, the committee heard Senate Bill 247, introduced by Representative Brian Cole, which would prohibit network exclusion for pharmacies that refuse to dispense prescriptions when PBM reimbursement is below acquisition cost. Cole said the bill is meant to stop pharmacies from being forced to sell at a loss. Members questioned whether pharmacies voluntarily enter PBM contracts, whether the bill would raise consumer prices, and whether it would mainly affect independent pharmacies. Cole and others said the issue has changed over time because PBMs now control a much larger share of the market, and that the bill would let pharmacies refuse loss-making fills and direct patients to mail order instead. The discussion also noted that the bill excludes Medicare and Medicaid and that the current proposal does not create a middle-ground option for patients to pay a premium at the counter.

Transcript Highlights:

• For a patient with insurance, if they went to an outside pharmacy, they would be charged the same copay
• Yeah, they'd be charged the same copay you're charging.
• The copays, this is how it works.

Bills: HB712, HB722, HB946, HB1687, HB1809, HB1899, HB2528, HB2583, HB2741, HB2750, HB3021, HB3150, HB3265, HB3658, HB3812, HB3960, HB4392, HB4432

Keywords: prostate cancer, health benefit plans, insurance coverage, cost sharing, preventive health care, auto insurance, total loss evaluation, disclosure, insurance materials, vehicle appraisal, HB 946, Texas Insurance Code, automobile insurance claims, oral release, written release, settlement agreement, claim release, property damage, bodily injury, psychological injury

Transcript Highlights:

• pockets of people who are working and might be on Medicaid, who are now going to be required to pay copays
• To pay copays, maybe they're already working and they're not getting their tips charged.

Transcript Highlights:

• go to the doctor for the first time, get a cavity filled, get a prescription filled without a $75 copay
• go to the doctor for the first time, get a cavity filled, get a prescription filled without a $75 copay
• go to the doctor for the first time, get a cavity filled, get a prescription filled without a $75 copay

Bills: HB20, HB276, HB644, HB812, HB816, HB916, HB1131, HB1247, HB1518, HB1525, HB1537, HB1541, HB1546, HB1553, HB1562, HB1565, HB1566, HB1576, HB1577, HB1591, HB1605, HB1612, HB1613, HB1614, HB1618, HB1620, HB1650, HB1656, HB1658, HB1661, HB1664, HB1668, HB1676, HB1707, HB1711, HB1713, HB1715, HB1718, HB1727, HB1749, HB1756, HB1774, HB1776, HB1801, HB1802, HB1805, HB1813, HB1815, HB1831, HB1838, HB1853, HB1854, HB1859, HB1863, HB1871, HB1872, HB1918, HB1920, HB1952, HB1965, HB1966, HB1967, HB1969, HB1972, HB1973, HB1974, HB1975, HB1980, HB1985, HB2005, HB2023, HB2031, HB2033, HB2062, HB2113, HB2114, HB2116, HB2138, HB2139, HB2156, HB2158, HB2159, HB2171, HB2208, HB2268, HB2270, HB2272, HB2273, HB2276, HB2289, HB2310, HB2315, HB2335, HB2338, HB2339, HB2340, HB2343, HB2361, HB2384, HB2387, SB2338, SB2431, SB2438, SB2593, SB2907, SB2671, SB2321, SB3084, SB2401, SB3033, SB2972, SB3032, SB2806, SB3014, SB2108, SB2981, SB2973, SB2423, SB2078, SB2322, SB2397, SB2896, SB2088, SB2347, SB2408, SB2970, SB2851, SB2713, SB2697, SB2312, SB2192, SB2363, SB2530, SB3028, SB2024, SB3007, SB2599, SB2596, SB2662, SB2930, SB3334, SB2378, SB3019, SB3231, SB2240, SB2372, SB2175, SB2046, SB2298, SB2922, SB2835, SB3263, SB2174, SB2128, SB2006, SB2489, SB3134, SB2982, SB2425, SB2849, SB2797, SB2795, SB2575, SB2521, SB2765, SB2386, SB2852, SB2022, SB2117, SB2277, SB2387, SB2688, SB2885, SB3132, SB3219, SB2169, SB2591, SB2090, SB2983, SB888, SB3249, SB2611, SB2429, SB2463, SB3154, SB3131, SB3152, SB3315, SB2448, SB2054, SB2140, SB2520, SB2377, SB2986, SB2010, SB2189, SB2026, SB3010, SB2818, SB2002

Keywords: lava insurance, homeowners, insurance market, subsidy, Hawaii, condominiums, annual report, filing fee, real estate, developer, residency, property regime, PFAS, single-use plastics, environmental health, food ware, pollution reduction, local produce, agriculture, Hawaii Revised Statutes

Transcript Highlights:

• operationally, any willing pharmacy, any willing provider, clinician-administered drugs, prior auth, copay
• accumulators, Any willing provider, clinician-administered drugs, prior auth, copay accumulators.
• So when we were testifying on the copay accumulator bill, which I'm sure Representative Osley doesn't

Keywords: 908, all

Summary: The committee met to review the history and current treatment of North Dakota health insurance mandates, with presentations from Blue Cross Blue Shield of North Dakota, Sanford Health Plan, the Public Employees Retirement System (PERS), and the Insurance Department. The discussion focused on how mandates apply differently to fully insured, self-funded, ACA, Medicaid, and PERS plans; how the state’s benchmark plan and federal essential health benefits affect coverage; and how the existing process requires cost-benefit analysis and, for certain measures, a PERS pilot period before broader application. Presenters also reviewed the long list of existing state mandates, including provider, beneficiary, and coverage requirements, and noted that many were enacted decades ago and have not been revisited despite changes in medical evidence and treatment options. Witnesses from the carriers argued that mandates should be reviewed periodically because some are outdated, can create unintended costs, and may not align with current medical guidance. Examples cited included PSA screening, off-label drug coverage, prior authorization rules, step therapy, and cost-sharing provisions for mental health and substance use treatment. They emphasized that carriers often cover services without a mandate when supported by clinical evidence, and that mandates can shift costs to employers and employees, especially in the fully insured small-group market. They also suggested possible policy improvements such as clearer mandate definitions, better transparency around cost-benefit analyses, a regular 10-year review of mandates, and more timely submission of proposals through the interim process. PERS and the Insurance Department highlighted a recurring tension over what counts as a mandate and when a measure triggers the state’s defrayal obligation under federal law. PERS described its interim committee process, the April 1 deadline for fiscal-impact proposals, and the limited pilot program used for certain measures, noting that only a few bills have gone through the full pilot process. The Insurance Department explained that it views new benefit mandates through the lens of the ACA benchmark plan and essential health benefits, distinguishing true new benefits, such as infertility coverage, from changes to existing benefits, such as telehealth or insulin cost-sharing caps. No votes were taken on policy changes; the meeting was informational, with members asking questions about costs, applicability, transparency, and whether a periodic mandate review should be established.

Transcript Highlights:

• biggest concern being on the health committee because even though it did take away the office visit copay
• If you look at your office visit copay, it's usually going to be the price of your PCP visit, especially
• Knowing that the health insurance plans do have to pick up that zeroed out copay, it is going to be shared

Transcript Highlights:

• As part of efforts, what we're trying to do is make sure that members maximize those copay cards.
• When they do maximize those copay cards, that $250 expense that you mentioned, Representative Bojanowski
• first several months until the member is getting closer to meeting that deductible. maximize those copay
• When they do maximize those copay cards.

Keywords: Meeting Start 00:00:00 State Health Insurance Plans 00:00:03 Executive Branch Salary Schedule Adjustments 00:29:15 Nutrition Program for the Elderly 00:34:52 Update on DORIS 01:05:38, 958, all

Summary: The committee met on November 5, 2025, and first approved the minutes after a moment of silence for the UPS airport tragedy. The main presentation was from the Personnel Cabinet on the state health insurance plans and executive branch salary schedule adjustments. Officials said the health plan covers roughly 265,000 active members and up to about 300,000 across all benefit offerings, including school board employees, retirees, and other eligible groups. They described rising claims and expenditures, especially from high-cost claimants and pharmacy spending, and said recent premium and benefit changes were intended to balance costs while preserving recruitment and retention efforts. They also explained that employee premiums had not increased for several years, while employer contributions rose sharply in recent years, and projected a 10% employer increase and 3% employee increase going forward based on actuarial analysis. Committee members asked about deductibles, GLP-1 drug costs, claims validation, and the causes of cost growth; officials said the plan uses multiple payment-integrity vendors and that the increases reflect utilization, drug trends, and high-cost cases rather than a change in coverage. The committee also discussed executive branch salary schedule adjustments. Personnel and budget officials explained that when the legislature approves annual pay increases, the salary schedule is adjusted by the same percentage through executive order so the minimum and midpoint stay aligned with approved compensation levels. They said the 2025 adjustment was a 3% match effective September 16 and that the change was costless because salaries had already been increased. Members raised concerns about salary compression, noting that new hires can sometimes be paid near the level of long-serving employees. Officials said the adjustment helps prevent compression from worsening but does not solve it, and they acknowledged prior RFP efforts to address the issue were unsuccessful because no qualified bidder met the requirements. After the health plan and salary discussions, the committee began a presentation from the Cabinet for Health and Family Services on Kentucky’s senior meal program. Secretary Stack explained that the program is a federal-state-local partnership under the Older Americans Act, with area development districts helping deliver services. He outlined eligibility rules, noting that congregate meals at senior centers are available to people age 60 and older, with a spouse of any age allowed to join, and that home-delivered meals have additional homebound and assistance requirements. Members asked whether there was any means test for congregate meals, and the secretary said there is not; the only threshold is age for the center-based meals, while the home-delivered program has additional criteria.

Transcript Highlights:

• The facility may not waive copay, deductible, or coinsurance.
• that sometimes we see from out-of-network kind of bad actors out there is the kickback of waiving a copay

Bills: SB227, SB269, SB407, SB463, SB527, SB547, SB1283, SB1380, SB1383, SB1511, SB1640, SB1784, SB2069

Keywords: school funding, education reform, state budget, property taxes, equity in education, healthcare policy, vaccines, exemptions, religious beliefs, public health, workplace violence, healthcare facilities, definition expansion, safety regulations, health and safety code, health insurance, anesthesia, pediatric dental services, coverage, medical necessity

Transcript Highlights:

• And secondly, it raises the cap on the subsidy of copays from 7% to 10%.

Bills: HB1979, HB1225, HB3931, HB4454, HB3849, HB1746, HB3720, HB4275, HB4300, HB3586, HB2268, HB3755, HB4117, HB4294, HB3650, HB4298

Keywords: early childhood education, task force, governance structure, healthcare access, stakeholder engagement, quality services, vital records, birth certificate, birth registration, biological sex, sex designation, male, female, nonbinary, gender identity, X marker, transgender, vital statistics, State Department of Health, State Commissioner of Health

Transcript Highlights:

• front and center in every doctor-patient relationship because we must necessarily now focus on the copays

Bills: HB3794, HB3796, HB3928, HB2955, HB4453, HB4460

Keywords: licensure, criminal history, public safety, occupational certification, rehabilitation, state regulations, insurance, regulations, certification, long-term care, mergers, consumer protection, property safety, vision insurance, optometry, reimbursement, healthcare policy, ophthalmic materials, provider agreements, captive insurance

Transcript Highlights:

• So, insurance-driven clinics, for example, you come in, pay your copay, and they ask you all kinds of

Bills: HB3015, HB3521, HB5632, HJR182, SJR57

Keywords: healthcare, direct primary care, insurance deductibles, Texas Health Benefit Plans, telemedicine, police retirement, disability pension, municipalities, law enforcement, retirement benefits, retirement, beneficiary, Employees Retirement System of Texas, divorce decree, beneficiary designation, Veterans' Land Board, general obligation bonds, constitutional amendment, veterans, housing assistance

Transcript Highlights:

• act ensuring prompt access to health care, which would include several critical conditions without copay
• But under copay accumulator practices, the insurance companies accept...
• But under copay accumulator practices, the insurance companies accept the financial assistance, do not

Keywords: 995, all

Summary: The Joint Committee on Financial Services held a lengthy public hearing with testimony on a wide range of health insurance and access-to-care bills. Early testimony focused on prescription drug pricing and pharmacy reimbursement, with supporters of H. 1326 arguing that pharmacy benefit managers and MassHealth managed care arrangements reimburse independent pharmacies too little, contributing to pharmacy closures and “pharmacy deserts.” The committee also heard repeated support for H. 1151/S. 742 on cognitive rehabilitation for acquired brain injury, H. 1288/S. 716 on telehealth parity for nutrition counseling, H. 1309/S. 761 on full-spectrum pregnancy care without cost-sharing, H. 1312 on insurance coverage for doula services, H. 309 on prompt access to health care by removing deductibles for certain services, H. 809/H. 1227 on biomarker testing, H. 1162/S. 810 on reducing inequities in access to medical procedures by limiting insurer cuts tied to Modifier 25, and S. 726 on insurance coverage for mobile integrated health. Testifiers included legislators, physicians, pharmacists, dietitians, emergency and rehabilitation clinicians, and patients and family members. Supporters of the brain injury bill said cognitive rehabilitation is medically necessary, improves long-term outcomes, and can reduce institutional care and public costs; they noted the bill has been heard repeatedly and has support from the Brain Injury Commission and prior favorable committee action. Supporters of the pregnancy care and doula bills described out-of-pocket costs as a barrier to maternal health and shared personal stories of high bills and unmet support needs. Biomarker testing advocates and cancer patients said coverage gaps deny patients access to precision treatment, can lead to avoidable suffering, and should be standardized across insurers; several speakers said insurers often deny claims despite clinical benefit. Dermatology witnesses said insurers’ use of Modifier 25 cuts reimbursement for same-day evaluation and procedure visits, forcing separate appointments and increasing patient burden. Mobile integrated health supporters described home-based care as a way to reduce emergency department use and hospital readmissions, especially for patients with transportation or mobility barriers. No votes or formal committee actions were taken during the hearing itself.