Video & Transcript : 'Operation Enduring Brain Health' :
Page 419 of 500
AR
Transcript Highlights:
- It's operational dysfunction up here. All right, there you go.
- It's amended for mental health referral services.
- It's an mental health referral services.
- mental health would be an Arkansas provider.
- Item number 13 is DHS, United Methodist Behavioral Health.
Committee:
All JBC-PEER REVIEW
Summary:
The PEER Review Subcommittee met to consider a large agenda of appropriation, transfer, contract, and other review items. Members approved temporary appropriation requests in Sections B through F, including funding for prosecuting attorneys, education-related adjustments, school operating needs, labor licensing divisions, ARPA fund returns from Workforce Services, IIJA grants for state police CDL implementation and a forestry-related county grant, reserve fund transfers for teacher scholarships, school facilities, and economic development, and a Commerce reallocation tied to organizational realignment. Cash fund requests in Section G and budget classification transfers in Section H were also reviewed, along with pay plan requests in Section I, overtime requests in Section J, and multiple methods of finance in Section K. The committee also reviewed discretionary grants in Section L, including agriculture promotion board grants and DHS aging/adult behavioral health grants, plus RFQs, construction contracts, intergovernmental contracts, and out-of-state contracts in Sections M1 through M5.
Several items drew questions from members. Workforce Services explained that $225,000 in TANF-related funds would be returned to the federal government because the two-year hold period for uncashed or moved checks had expired. Commerce officials described the $25 million site infrastructure grant program, saying it supports site development, due diligence, and infrastructure build-out at eligible sites of 30 acres or more, including rural communities, with grant agreements and matching requirements providing accountability. DHS and Education officials answered questions about the Care Solace mental health referral contract, saying it is a statewide concierge/referral service that helps schools connect students to Arkansas providers and follow up so students do not fall through the cracks; members asked for more information on provider selection, school-day scheduling, and Arkansas vendor participation.
The committee held one item over: the DHS discretionary grant item for the RSVP retired senior volunteer program in L2, after concerns were raised about whether state general revenue was being used effectively and how much administrative overhead the providers retain. Members also questioned several contracts, including a DHS sole-source contract with EMSLink for document management software and a DHS bridge contract with Arkansas Foundation for Medical Care for Medicaid inspections of care reviews; in both cases, agency staff explained the need to avoid service disruption and said follow-up information would be provided. A Department of Corrections reentry center contract was discussed for its recidivism results, and ARDOT retirement-system investment contracts were briefly explained. The meeting ended after a lengthy discussion of the Medicaid Trust Fund balance, with DFA and DHS officials saying the state is expected to finish the fiscal year without exhausting the fund, that a restricted reserve of $100 million is available as a backstop, and that the larger question is what minimum balance should be maintained going forward.
WA
Transcript Highlights:
- burden from airport operations.
- Our operations are roughly net profit of 0.3% in 2025.
- And in Washington we operate five distribution centers.
- Our operations are roughly net profit of 0.3% in 2025.
- Wholesalers also operate on very thin margins. Wholesalers also operate on very thin margins.
Committee:
Senate Ways & Means
Keywords:
aircraft fuel tax, tax revenue distribution, aviation funding, transportation, state revenue, aeronautics, taxation, aircraft fuel, state funding, aviation fuel, hazardous substance tax, air quality, noise mitigation, environmental impact, tax exemption, agriculture, hazardous substances, crop protection, warehousing, data center
MO
Transcript Highlights:
- We have more people just getting health care and access to health care, and some parents actually taking
- So I want to make sure that I'm operating from the same set of facts that you guys are operating from
- The response was that even courts without a mental health court are discussing mental health, and the
- , behavioral health, etc.
- , behavioral health, etc.
Committee:
House Budget
CA
California 2025-2026 Regular Session
Senate Budget and Fiscal Review Subcommittee No. 3 on Health and Human Services Feb 26th, 2026
MN
Minnesota 2025-2026 Regular Session
Committee on Agriculture, Veterans, Broadband and Rural Development - 03/05/25
Agriculture, Veterans, Broadband, and Rural Development
Transcript Highlights:
- </c> gotten investments in our soil health gotten investments in our soil health equipment<00:18:32.960
- </c> to appropriate funds for the soil Health to appropriate funds for the soil Health financial<00:56
- </c> practices what makes the soil Health practices what makes the soil Health financial<00:56:51.680
- </c> barriers to implementing new soil Health barriers to implementing new soil Health practices<00:59
- soil Health effectively implement the soil Health practices<01:09:55.000><c> we</c><01:09:55.640><c>
CA
California 2025-2026 Regular Session
Senate Budget and Fiscal Review Subcommittee No. 5 on Corrections, Public Safety, Judiciary, Labor and Transportation May 20th, 2026
Transcript Highlights:
- Dwayne Reader, California Correctional Health Care Services: We do concentrate, like our mental health
- So health care is one issue, age is another issue, mental health is another issue.
- I see with mental health, you talked about programs, you know, to increase mental health professionals
- I'm a current medical student and master's public health student in health equity and criminal justice
- Of course, we support operational costs. We know you need to operate.
NH
Transcript Highlights:
- </c> health benefit to your employees before. health benefit to your employees before.
- </c> through the extra mile to get health through the extra mile to get health insurance<00:19:23.120
- care credit, which up to $10,000 per year at 20% of the health care benefit assumes that health insurance
- care credit, which up to $10,000 per year at 20% of the health care benefit assumes that health insurance
- Operating or contracting. >> On-site tied to operating or contracting. >> On-site or nearby childcare
Committee:
Senate Ways and Means
HI
Hawaii 2026 Regular Session
JDC, EDU-JDC Public Hearings 04-07-2026
Transcript Highlights:
- </c> This requires the Department of Health This requires the Department of Health to<00:05:42.560><c
- </c> provided, or facilitated the health provided, or facilitated the health care. care. care.
- care actions or activities of a health care actions or activities of a health<00:11:10.320><c> care<
- </c> integrity of the operation. integrity of the operation.
- </c> Machine Operators Advisory Board. Machine Operators Advisory Board.
Summary:
The Judiciary Committee took up a large decision-making agenda and adopted most measures, often with technical or clarifying amendments. Bills addressed wildlife habitat conservation plans, civil identification cards for 16- and 17-year-olds, electronic and mail voting for associations, remedies for unauthorized disclosure of intimate images, traffic safety around stationary vehicles and pickup truck passengers, expedited permitting for housing for people with disabilities, rainwater catchment systems, EMS advisory committee membership, social media account deletion, limits on immigration-enforcement cooperation, prompt payment rules for professional solicitors, fetal death vital statistics, protections for gender-affirming care, passenger ropeways, law-enforcement facial coverings and immigration-related detention, domestic violence, health care facility access, guardianship record sealing, child protective proceedings, remote driver’s license hearings, disposable vaping products, dog attacks, insurance premium increase explanations, the DOE harm-to-student registry, Hawaiian Homes lease succession, EMS law modernization, hoisting machine regulation, release on recognizance, language interpretation rules, civil asset forfeiture for fireworks offenses, and assisted community treatment. Several bills were deferred, including HB 1897, HB 1957, HB 2121, and HB 2324, while HB 1957 was deferred indefinitely. Most measures were adopted without recorded opposition, though HB 1875 and HB 1961 drew no votes from Vice Chair Gabbard, and HB 2413 was adopted with reservations.
A number of bills received substantive amendment instructions. HB 1682 was amended with committee report language noting concerns about departing from the model act. HB 1768 and HB 1886 were revised to narrow or clarify immigration-enforcement restrictions and law-enforcement identification and facial-covering provisions, including plainclothes and undercover exceptions, a narrower civil immigration arrest/detention offense, and savings clauses. HB 2540 received extensive amendments to convert policy language into mandatory terms, refine facial-covering and identification rules, align criminal and policy exemptions, narrow immigration-related offenses, and clarify the definition of law enforcement agency. HB 2413 was amended to define violent offenses, change written findings to oral findings on the record, limit reconsideration of bail, and restrict who may request sanctions or financial conditions. Other amendments included technical fixes, bad-date corrections, severability clauses, and chapter-consistency changes.
The committee also heard a joint Education/Judiciary item, SCR 105 and SR 99, urging the Department of Education to provide students information on pre-registering to vote before reaching voting age. Testimony was reported in support from the Department of Education, Office of Elections, Hawaii State Commission on the Status of Women, and the League of Women Voters. With no opposition or further discussion, the committee voted to pass both resolutions with technical, non-substantive amendments (SD1).
CA
California 2025-2026 Regular Session
Senate Budget and Fiscal Review Subcommittee No. 3 on Health and Human Services May 21st, 2026
MN
Minnesota 2025-2026 Regular Session
Committee on Commerce and Consumer Protection - 03/18/25
Commerce and Consumer Protection
Transcript Highlights:
- </c><00:03:26.200><c> insurance</c> people will lose health insurance people will lose health insurance
- Whenever a state mandates a health benefit not covered by the essential health benefit plan, then the
- :07:48.680><c> health</c> the essential health the essential health benefit<00:07:50.599><c> plan</c>
- </c> bottom we also have an operating bottom we also have an operating adjustment<00:09:39.079><c> that
- </c> different committee it'll go to Health different committee it'll go to Health and<00:17:07.000><
Committee:
Senate Commerce and Consumer Protection
CA
California 2025-2026 Regular Session
Assembly Arts, Entertainment, Sports, and Tourism Committee Apr 7th, 2026
Transcript Highlights:
- California is facing a youth mental health crisis.
- They are the frontline support of mental health.
- If we are serious about addressing the mental health crisis, the youth mental health crisis to be more
- However, most, you know... ...mental health distress.
- Essentially, in order to operate one of these online platforms, you would need to In order to operate
Summary:
The committee heard several bills focused on youth health, sports, and entertainment access. AB 1626 would require mental health training for youth sports coaches and create a model training for recreational and club coaches; supporters said coaches are often the first adults to notice mental health struggles, and the bill passed 6-0 to the Assembly Education Committee. AB 1884, as amended, would allow school districts that already use athletic drug-testing programs to add nicotine testing, with safeguards limiting disclosure and removing earlier punitive provisions; supporters framed it as a response to youth vaping, while opponents warned it could stigmatize students, discourage participation in extracurriculars, and burden schools. The bill passed 3-2 to the Assembly Education Committee, with some members still expressing reservations but supporting it after amendments.
AB 2503 addressed heat guidelines for desert school athletics, seeking flexibility in wet-bulb temperature rules so practices and games would not be pushed so heavily into evening hours. The author and a desert athletic trainer argued current standards do not reflect local acclimatization and create scheduling burdens; the bill passed 5-0 to the Assembly Education Committee. AB 1954, the PAR Act, would require third-party golf reservation platforms to have written authorization from municipal golf course operators before listing or reselling tee times, aimed at stopping inflated resale of public golf reservations. Supporters from city and golf organizations said the bill would protect affordable access to public courses; it passed 5-0 to the Assembly Privacy and Consumer Protection Committee.
The committee also heard AB 2319, which would create a standalone California post-production tax credit to keep editorial, sound, visual effects, and finishing work in-state even when principal photography occurs elsewhere. Labor and industry witnesses said California is losing post-production jobs to other jurisdictions and urged the bill be amended to include stronger labor standards; the bill passed to the Assembly Revenue and Taxation Committee. Finally, AB 1720, the California Fans First Act, would cap resale prices for concert and live entertainment tickets at no more than 10% above face value, excluding sporting events and certain season-ticket arrangements. The author argued the bill would curb scalping and make live events more affordable for fans.
MN
Minnesota 2025-2026 Regular Session
Committee on Health and Human Services - 03/12/25
Health and Human Services
Transcript Highlights:
- and those grants and office operations and those grants and operations<00:02:19.239><c> um</c><00:02
- </c> and the behavioral health and the behavioral health fund<00:05:26.000><c> so</c><00:05:26.199><c
- </c> the behavioral health the behavioral health fund<00:13:11.320><c> in</c><00:13:11.639><c> uh</c>
- They're appointing someone as an agent to operate in certain duties and powers over their health care
- the health care agent is aware that they have a responsibility to operate in the best interest of the
Committee:
Senate Health and Human Services
CA
California 2025-2026 Regular Session
Senate Local Government Committee Apr 15th, 2026
Transcript Highlights:
- Matt Kremens, on behalf of the California-Nevada Conference of Operating Engineers and Operating Engineers
- public administrator function that we operate as well.
- These decisions should be operational and local in nature.
- These decisions should be operational and local in nature.
- Our health care system, 30 years later, is not working as it should.
Summary:
The committee heard a long agenda of housing, local government, and governance bills, beginning without a quorum and proceeding as a subcommittee until quorum was established. SB 1003, by Senator Grayson, would create an Infrastructure Partnership Financing Program to help local governments and developers fund infill housing infrastructure; supporters said infrastructure costs often prevent projects from penciling out, while a senator questioned whether the state would actually fund the new program. The bill passed the committee 3-1 on call. The committee also adopted a consent calendar covering SB 1169, SB 1086, SB 1126, and SB 1439-1442, also 3-1 on call.
SB 1014 would require local jurisdictions to provide early good-faith estimates of on-site and off-site improvements and bar undisclosed later requirements; Habitat for Humanity, SPUR, and housing advocates supported the bill, while the City of San Mateo opposed the preliminary-application timing. Members raised questions about the 30-business-day deadline and coordination with other agencies. The bill passed 4-2 on call. SB 1036, which would require fee credits for prior site uses when redeveloping a site with similar prior uses, drew broad support and no opposition and passed 5-0 on call. SB 1145, a district bill for the Concord Naval Weapons Station reuse project, would streamline CEQA and federal base-closure review for qualifying projects; labor, the city, and county supported it, while housing legal advocates opposed unless amended over Surplus Land Act concerns. The bill passed 6-0 on call after discussion of affordability and enforceability amendments.
The committee then heard SB 908, which would streamline permits for energy-code-compliant residential window replacements and limit city/HOA design restrictions; supporters said it would let homeowners and affordable housing providers lower energy costs, while local government groups opposed, citing local control and design standards. It passed 3-1 on call. SB 1172, the Local Tax Savings Act, would add guardrails and transparency to local tax-sharing consultant agreements; the City of Shafter and League of California Cities supported it, and it passed 4-0 on call. SB 1379 would separate the Riverside County Sheriff-Coroner offices and create an independent medical examiner; supporters cited in-custody death rates and public trust concerns, while the sheriff’s association and county representatives opposed on cost and local control grounds. The bill passed 4-1 on call.
Finally, SB 1283 would expand streamlined permitting for EV charging stations to include canopies and on-site energy storage systems; EV industry supporters said the bill updates outdated rules, while cities and counties warned about safety review, liability, and litigation risk. Members discussed battery storage safety and local permitting authority, and the bill passed 4-0 on call. The committee also heard SB 1414, which would create an independent redistricting commission for San Bernardino County; supporters argued it would improve transparency and reduce political self-interest, while the county opposed due to its existing advisory commission and estimated implementation costs. The transcript cuts off during questioning on SB 1414, with no final vote shown.
FL
Florida 2025 Regular Session
December 2, 2025 - 03:30 PM
Transcript Highlights:
- The Health Care Budget Subcommittee will come to order.
- My next one has to do of mental health services.
- No, I want to make sure we protect mental health services.
- This slide gives some operational context of those activities that are categorized into 5 phases of operations
- This example gives visibility on a lean program operating cost in addition to the operating cost.
MO
Missouri 2026 Regular Session
Health and Mental Health Apr 9th, 2026 at 08:00 am
Health and Mental Health
Transcript Highlights:
- The Committee on Health and Mental Health will now come to order.
- care operations.
- Payment is about the same, but health care operations is a nearly 300-word definition. ...about the same
- , but health care operations is a nearly 300-word definition that includes a plethora of activities that
- within your current health system, so the dollars stay within your health system.
Committee:
House Health and Mental Health
AZ
Transcript Highlights:
- He was the lead boom operator for RE4 PAC, the largest.
- , by requiring for health care, more for health care than it already would, by requiring a nurse to be
- CRNAs are critical to our health care system.
- They fill a role in our health care settings.
- So we like proper health care. And I want everybody to know. ...proper health care.
Summary:
The House opened with prayer, the Pledge of Allegiance, approval of the prior journal, and several points of personal privilege introducing guests and honoring military personnel and other visitors. Members also recognized a resident doctor in the gallery and guests from Sahuarita and Buckeye. Later in the day, the chamber paused to honor the University of Arizona men’s basketball team for its Final Four run with a legislative proclamation, and members met the team during a recess. The session also noted Motorcycle Awareness Day at the Capitol before adjournment.
The House then moved through Committee of the Whole on a large consent calendar of Senate bills, adopting committee amendments and reporting numerous measures do pass as amended, including SB 1067, 1100, 1137, 1174, 1189, 1206, 1215, 1235, 1254, 1413, 1503, 1620, 1668, 1671, and 1754. SB 1428 was retained on the calendar. The chamber also sent SB 1160 and SB 1193 to an additional Committee of the Whole under House Rule 12P for further amendment, and both later returned with amendments and were reported do pass as amended.
On third reading, the House passed SB 1058, which concerned firearm transactions and merchant coding, after debate over whether it would burden businesses and financial institutions or protect privacy and Second Amendment rights. The House also passed SB 1237 on election conduct and SB 1294 unanimously. SB 1372, dealing with reimbursement for nurse anesthetists and anesthesiologists, drew extensive debate over rural health care access, insurance company practices, and the proper role of government; it ultimately passed 33-20. HB 2050, relating to radiologic technology, also passed and was transmitted to the governor.
The House concurred in Senate amendments to several House bills and then adjourned until Monday, April 13, 2026.
AZ
Transcript Highlights:
- I'm sorry, Major Sean Kelly, Director of Operations.
- by requiring. for health care, more for health care than it already would by requiring a nurse to be
- CRNAs are critical to our health care system.
- They fill a role in our health care settings.
- So we like proper health care. And I want everybody to know. proper health care.
TX
Transcript Highlights:
- We're working with Operation Lone Star, our biosecurity team. We have an operation down there.
- We're working with Operation Lone Star, our biosecurity team. We have an operation down there.
- We have an operation down there.
- This fight is not about more than animal health.
- Sorry, this fight is about more than animal health.
Summary:
The joint hearing focused on preparedness for the New World screwworm threat and brought together the House Committees on Culture, Recreation, and Tourism and Agriculture and Livestock. USDA officials, Texas Department of Agriculture Commissioner Sid Miller, and Texas Animal Health Commission leadership described the pest as a serious risk to livestock, wildlife, rural economies, and beef prices, and emphasized coordination among federal, state, industry, and Mexican partners. Witnesses repeatedly stressed that Texas is currently seeing no confirmed U.S. detections, but that recent confirmed cases in northern Mexico, including Nuevo León, remain a concern because of their proximity to the border.
USDA testimony outlined current surveillance and response efforts, including more than 120 screw worm-specific traps along the Texas border and neighboring states, thousands of additional dual-purpose traps, wildlife inspections, weekly coordination with Mexico’s Senasica, and a new USDA New World Screwworm Directorate. Officials said the existing Panama sterile fly facility is maxed out at about 100 million flies per week, while a dispersal facility in Tampico is helping move flies farther north in Mexico. They also described plans for a retrofitted sterile fly facility in Metapa, Mexico, expected to come online in 2026, and a new domestic production facility at Moore Air Base, with phase one targeted for late 2026 or early 2027 and phase two adding substantially more capacity later.
Members pressed USDA on timelines, production capacity, the reliability of Mexican reporting, the risk from wildlife, and whether modular or mobile facilities could be deployed faster. USDA said it is also exploring innovative technologies, including a genetically engineered sterile male fly, but that such tools still require EPA review and field validation. Commissioner Miller highlighted Texas biosecurity efforts, five permanent inspection stations, cooperation with FDA and EPA on treatments such as Exzolt, and other pest issues affecting Texas agriculture. He also noted research into fly bait and private-sector efforts to speed sterile fly production.
Texas Animal Health Commission officials described extensive state preparedness work, including weekly coordination calls, field response trainings, outreach to producers and veterinarians, and a Texas Screwworm Response Team. They said Texas has trained more than 100 inspectors and other personnel, with additional trainings planned, and that the state is expanding its cattle fever tick rider program. No votes or formal committee actions were taken during the hearing; the main action was the exchange of testimony and questions about readiness, surveillance, and facility timelines.
FL
Florida 2026 5th Special Session
Banking and Insurance Jan 13th, 2026
Transcript Highlights:
- Legitimate health care sharing ministries operate today in Florida, serving tens of thousands of members
- I want a little bit more assurance in my health care.
- So it's a health savings account, basically, that you're giving guidance on how to save for a health
- It's not structured like a health savings account.
- They handle insurance operations among insurance carriers.
Summary:
The Committee on Banking and Insurance met with a quorum present and took up several bills, beginning with SB 834 on health care sharing ministries and insurance agents. Senator Yarbrough presented the bill to repeal a recent restriction on licensed insurance agents marketing or selling faith-based health care sharing programs. Supporters argued the change restores free speech and consumer education while preserving existing consumer protections; opponents said the bill was unnecessary and could increase confusion or misuse of agents and brokers. The committee adopted a title amendment and then reported the bill favorably after debate, with Senator Pizzo raising concerns about consumer reliance and lack of guaranteed coverage.
The committee then approved SB 642 on foreign and alien bail bond insurers, SB 394 on reinsurance intermediary managers, and SB 266 on public adjuster contracts. SB 266 would let vulnerable adults rescind public adjuster contracts at any time without penalty; it drew support from consumer and industry groups, with some discussion about estimates and claim work product. The committee also passed SB 832 on residential property insurance transparency, which requires rate transparency reports and a consumer resource center at OIR, and adds a provision excluding land value from homeowners coverage calculations in most cases. Testimony on SB 832 was generally supportive of the transparency goal, though insurers said some of the required cost breakdowns may be difficult to produce as written.
The committee next considered SB 1028 on Citizens Property Insurance Corporation, which would create a commercial lines clearinghouse to move eligible policyholders into the private market and reduce Citizens’ commercial exposure. Supporters said it would lower taxpayer risk and improve competition; a speaker suggested additional changes to deductibles, water-damage caps, and repair practices. The bill was reported favorably after a delete-all amendment and supportive debate from Senator Boyd. Finally, the committee passed SB 540 on the Office of Financial Regulation, which adds cybersecurity requirements for certain licensees, updates oversight of investment advisers and money service businesses, adjusts some charter and meeting rules for financial institutions and credit unions, and includes amendments clarifying repossession/deficiency claims, family office exemptions, and virtual credit union meetings. The meeting ended with all of the considered bills reported favorably and the committee adjourned.
NH
New Hampshire 2025 Regular Session
House Commerce and Consumer Affairs (04/23/2025)
Transcript Highlights:
- Chair will call on health health health trust.<05:12:51.080><c> Uh,</c><05:12:52.080><c> it's</c><05:
- currently operate in the reserve range required by SP 297. 16% would have left Health Trust with 16%
- As you've heard, the Secretary of State has raised serious concerns about Health Trust's operational
- Health Trust problems stem from years of questionable operational decisions.
- insurance, health related with health insurance, health related things.<05:50:16.718><c> You're</c><
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.