Transcript Highlights:

• CMS authorized ILOS in lieu of services in 2016 as a service or setting that works as a substitute for

Bills: HB136, HB451, SB425, SB466, SB905, SB1986, SB2311, SB2450, SB2805, SB2826, SB2919, SB3001

Keywords: Medicaid, lactation, healthcare, consultation, reimbursement, maternal health, infant care, commercial sexual exploitation, child sex trafficking, human trafficking, child welfare, foster care, DFPS, Department of Family and Protective Services, juvenile probation, risk assessment, needs assessment, trauma screening, child abuse prevention, exploitation screening

Summary: The committee met with a quorum and announced it would vote on pending bills at 10:30, with public testimony limited to two minutes. It first took up Senate Bill 905, a TDLR cleanup bill on licensing regulation of speech-language pathologists and audiologists. Senator Zafferini said the committee substitute would streamline advisory board consultation, remove obsolete provisional licenses, and allow any licensed physician to authorize hearing instruments for minors; the substitute was adopted and the bill left pending. The committee then heard House Bill 451, which would require universal screening for commercial sexual exploitation risk for children in DFPS conservatorship and youth under TJJD jurisdiction. The author and witnesses from Children at Risk, the Fort Bend Anti-Trafficking Collective, and Texas CASA supported the bill as a prevention tool with existing infrastructure and training; the committee adopted the substitute and left the bill pending. The committee next considered Senate Bill 466, which would clarify that families may request a fetal death certificate at any gestational age, while keeping existing filing requirements for physicians. A constituent father testified about losing his 11-week-old daughter and being told he could not obtain a certificate, which he said prevented funeral arrangements; the substitute was adopted and the bill left pending. Senate Bill 2311 followed, requiring residential treatment centers to have a written agreement with the school that will educate resident children before becoming operational. The author cited a local dispute where an RTC and school district lacked communication, and witnesses from Texas CASA and Disability Rights Texas supported clearer educational planning while suggesting the Education Code may need conforming changes; the bill was left pending. The committee then heard Senate Bill 2826, known as Alyssa’s Law, which would create a statewide education program on medical child abuse for medical students, health care professionals, and CPS caseworkers. The author and Sheriff Bill Weyburn described Alyssa’s case as involving repeated unnecessary surgeries and argued the bill would improve awareness and early identification, while several witnesses and members raised concerns about false accusations, impacts on medically fragile children, and the need for scientific, peer-reviewed training and safeguards. After extensive discussion, the chair left the bill pending. The committee also heard House Bill 136, which would add certified lactation consultants as Medicaid providers to expand breastfeeding support; witnesses from lactation and nutrition fields said the bill would improve access, maternal and infant health, and long-term savings, and the bill was left pending. Finally, the committee took up Senate Bill 2805, a surprise-billing/arbitration measure that would clarify provider identifiers and shift arbitration costs to the losing party. The author said the substitute was a legislative counsel draft with no substantive difference, and witnesses from the Texas Medical Association, Texas Society of Anesthesiologists, and U.S. Anesthesia Partners supported the bill as a modest improvement that would reduce administrative confusion and make arbitration fairer without weakening patient protections. Members discussed how arbitration costs affect settlement behavior and how to define the “winner” in close cases. The bill was heard but not voted out during this segment.

Transcript Highlights:

• kicked off the fight to make health care more transparent for Americans by implementing the infamous CMS

Bills: SB331, SB883, SB926, SB1137, SB1138, SB1144, SB1151, SB1236, SB1270, SB1522, SB1869, SB2207, SB2422

Keywords: healthcare, cost disclosure, transparency, administrative penalties, health facility compliance, COVID-19, off-label use, prescription drugs, patient access, medical standards, insurance, physician ranking, incentives, fiduciary duty, health plan issuers, SB 1137, group home, assisted living, residential care, board and care

Summary: The committee heard testimony on Senate Bill 883, which would protect physicians’ ability to prescribe off-label medications and treatments, framed by the author as a “Right to Treat” measure tied to COVID-19 care. Supporters, including physicians and patient-choice advocates, said the bill would safeguard the doctor-patient relationship and prevent interference by boards, pharmacies, or hospitals. Several witnesses described using hydroxychloroquine, ivermectin, budesonide, antibiotics, steroids, and monoclonal antibodies during the pandemic, and said they faced complaints, board scrutiny, or pharmacy refusals for those prescriptions. The bill was left pending after public testimony closed. The committee then took up Senate Bill 331, which would extend hospital price-transparency requirements to additional health care facilities such as freestanding ERs, urgent care and retail clinics, ambulatory surgical centers, outpatient clinics, and birthing centers. Proponents argued that broader disclosure of prices for shoppable services would help consumers compare costs and reduce surprise billing, while opponents from ambulatory surgery centers said the bill would impose costly compliance burdens on small providers and that insurers or the state already have much of the needed data. The bill was also left pending. Senate Bill 2422 would expunge Texas Medical Board records and impose reparations for disciplinary actions tied to COVID-era treatment decisions, including references to ivermectin, hydroxychloroquine, budesonide, and masks. The author and supporters argued that doctors were unfairly targeted for trying to save patients and should be made whole; the Texas Medical Board representative said most pandemic complaints were dismissed, that actions generally involved broader issues such as privileges, documentation, or informed consent, and that no physician was disciplined solely for prescribing off-label COVID medications. The bill was left pending. Finally, the committee heard Senate Bill 2207, which would loosen Texas Medical Board rules on physicians advertising themselves as board certified, especially by reducing barriers tied to maintenance of certification requirements. Supporters said the current rule is overly restrictive, inconsistent, and costly, and that it drives physicians out of practice; they also said Texas is one of only a few states with such a rule. Witnesses described hospitals using the rule against physicians and said the change would improve transparency and competition. The bill remained pending after testimony.

Transcript Highlights:

• We’ll be looking at CMS and health care, social determinants of health screening, to make sure that we

Keywords: 1187, senate, all

Transcript Highlights:

• and I just want to remind, uh, you, if you don't mind, uh, we use a lot of acronyms, you know, DMS, CMS

Keywords: 958, all

Summary: The Budget Review Subcommittee on Health and Family Services held its first meeting and received an overview from the Department for Medicaid Services on Medicaid’s behavioral health and substance use disorder services. Commissioner Lisa Lee and CFO Steve Beal said Kentucky Medicaid serves about 1.4 million members, including over half of Kentucky children, with 485,000 expansion members, more than 69,000 enrolled providers, and total fiscal year 2024 expenditures of $18.5 billion. They said Kentucky covers a broad range of behavioral health services, and behavioral health provider enrollment has grown from a little over 4,500 in 2019 to nearly 8,000 in 2024. They also described how Medicaid spending and utilization are tracked through claims and encounter data, with most members served through managed care organizations. Members focused on sharp increases in certain behavioral health billing codes, especially peer-to-peer services, and asked about reimbursement, utilization review, and whether the growth reflected increased need or expanded coverage. DMS said the rise was partly tied to combining facility and nonfacility behavioral health fee schedules in 2023, choosing the higher reimbursement rate to avoid cuts, and that the department has seen an uptick in peer-to-peer services. In response to concerns about overutilization, DMS said it mailed a letter to behavioral health providers, is considering limits and prior authorizations for some services, and plans to create a standardized monthly behavioral health report to monitor trends consistently and identify when controls may be needed. Lawmakers also asked whether the provider network is sufficient and whether access is adequate, especially for children. DMS said provider enrollment has expanded because behavioral health services were added to Medicaid in 2014 and because demand increased after COVID, but acknowledged studies showing children have less access than adults and said that would be an area of focus. The department said managed care organizations are required to ensure access to needed services and that current trends indicate access is available, though one member disagreed and said workforce shortages remain a major concern. Another member asked about non-emergency medical transportation spending, and DMS explained that it is handled through a capitated arrangement administered by the Transportation Cabinet rather than directly by the managed care organizations.

Transcript Highlights:

• villaflor Sergeant clerk bian venito C villaflor Sergeant at<01:12:52.800> Arms<01:12:53.600> CM

Keywords: Order of the Day: PENDING, 912, senate, all

Transcript Highlights:

• Why what's substantial at a 2 cm laceration compared to a three, and then you can do something?
• what's<03:33:46.479> substantial<03:33:47.359> at<03:33:47.920> 2<03:33:48.239> cm
• <03:33:48.720> laceration what's substantial at 2 cm laceration what's substantial at 2 cm

Keywords: 928, house, all

Summary: The committee heard House Bill 1331, which would allow the town of Derry to incorporate the Derry Cooperative School District as a department of the town through a charter amendment. The prime sponsor and several supporters argued the change would increase local control, streamline overlapping town and school functions, and potentially help align school spending with Derry’s tax cap. Supporters also said Derry is large enough to warrant a structure more like Manchester or Nashua, and one witness cited a 2018 nonbinding Derry ballot question that passed 597 to 547 in favor of seeking authorization for this change. Opposition came from NEA New Hampshire President Megan Tuttle, who said the association and the Derry Education Association opposed the bill because schools are not simply another municipal department and because Derry voters had already rejected merging the district into town government. She argued the state should respect local control and the community’s prior decision. Committee members asked about the scope of the proposed charter change, the role of the school board, and the reported prior vote, and the sponsor clarified that the amendment would be limited to this specific purpose rather than opening the entire charter. The hearing then moved to House Bill 1374, which would change the procedures for withdrawing from a cooperative school district. Representative Mary Murphy said current law gives other cooperative towns too much control over a withdrawing town’s decision, and her bill would remove the requirement for approval by the other towns while raising the withdrawing town’s approval threshold to a supermajority. She pointed to Francis Town’s 2024 withdrawal vote and said the bill was intended to protect students and local decision-making. The sponsor asked for an ought to pass recommendation, and committee members asked follow-up questions about the prior withdrawal vote and the number of voters involved.

Transcript Highlights:

• Specifically, to CMS, I wrote, and I quote: "The committee is also concerned about the potential for
• Specifically<05:25:20.798> to<05:25:20.958> CMS,<05:25:21.440> I<05:25:21.600>
• > wrote<05:25:22.000> and<05:25:22.240> I Specifically to CMS, I wrote and I Specifically
• to CMS, I wrote and I quote,<05:25:22.560> "The<05:25:22.798> committee<05:25:23.040><

Keywords: U.S. House of Representatives Floor Proceedings on Wednesday, June 4, 2025, 1012, house, all

Transcript Highlights:

• I think there's a misunderstanding on how the CM lobbyist or how these groups work.
• > on<04:41:49.958> how<04:41:50.440> the<04:41:51.120> um<04:41:52.120> CM
• there's a missoma on how the um CM there's a missoma on how the um CM lobbyist<04:41:52.878>

Keywords: 928, house, all

Summary: The committee first dealt with scheduling and housekeeping, including a plan to take a hard break at 2:00 p.m. for an early bill, hold a brief executive session, and then continue with the remaining afternoon bills. The chair also noted the next likely meeting date would be March 12, when the committee expected to take up the remaining bills before crossover deadlines. The main substantive item was House Bill 142, which would recognize the Honor and Remember flag for Gold Star families and related remembrance purposes. Prime sponsor Rep. Michael Moffett described the bill as a bipartisan measure revised to address earlier concerns, arguing that the flag honors fallen service members, can be personalized with names, and complements rather than detracts from the American flag. He said many other states have already adopted it and suggested the committee could amend details such as the number of days and locations for display. He also raised practical issues about flag dimensions and whether the bill should use "shall" or "may" for display requirements. Testimony was divided. Janine Nutter opposed the bill, saying she supports Gold Star families but objected because the flag resembles the Viet Cong flag and because she believes the American flag should remain the sole symbol representing servicemembers. Kevin Grady, representing the State Veterans Advisory Committee under RSA 115:8, also opposed the bill, saying the committee believes the American flag is the only symbol needed, while still praising the work of Honor and Remember in creating personalized flags for families. Committee members asked questions about where the flag would be flown, whether the State Veterans Cemetery in Boscawen is already displaying it, and how the bill’s language would interact with cemetery policies and committee discretion. No vote or final action was taken in the portion of the meeting provided.

Transcript Highlights:

• This bill ensures that the CMS provides a smooth transition as it improves these reporting requirements

Keywords: U.S. House of Representatives Floor Proceedings on Monday, June 29, 2026, 1012, house, all

Transcript Highlights:

• A number of years ago, CMS said that states could amend their Medicaid plan to pay for peer support services

Summary: The meeting focused on Missouri’s substance use prevention and treatment system, with repeated emphasis on recovery support services, peer support, recovery housing, transportation, and harm reduction. Dan Haniken of Into Action described his own recovery from addiction and incarceration and argued that treatment alone is not enough; he urged greater investment in recovery housing, peer support, employment, and community-based supports that help people stay sober and avoid relapse. Members asked about funding sources, program capacity, referrals, treatment court, transportation, and how Into Action supports people on medication-assisted treatment (MAT). Haniken said the organization is funded through a mix of federal, state, county, city, foundation, and private donations, and that housing and transportation remain major barriers, especially because support is often funded for too short a period compared with the longer time people need to stabilize. Matt Cushman of the Raytown Fire Protection District gave a strong endorsement of harm reduction, including naloxone distribution, syringe service programs, and broader decriminalization of harm reduction tools. He argued that stigma is a major barrier to care and that Missouri should expand access to clean needles, test strips, and other services, while also improving access to MAT in jails and communities. Committee members questioned the evidence base, the role of faith-based providers, and whether safe consumption sites should be pursued; Cushman said syringe exchange decriminalization should be the immediate priority, while safe consumption sites are a longer-term issue. He also described community paramedicine and mobile integrated health as valuable but funding-dependent, and said naloxone distribution is improving but still uneven, especially in rural and minority communities. Representatives from Central Ozarks Medical Center and Four Rivers Community Health Center highlighted the importance of peer support specialists, community health workers, care coordinators, and wraparound services in rural health centers. COMC’s Morgan McClure and Monet Lehman described a jail reentry program in Pulaski County, with Lehman sharing her trauma and recovery story and explaining how she helps incarcerated people prepare for release with housing, employment, benefits, transportation, and treatment connections. Four Rivers’ Devon Polarys and Cassandra Trout said their CEO would change Missouri policy to allow FQHCs to receive reimbursement for peer support and community health worker services similar to CCBHCs, arguing that these roles are essential for addressing barriers like transportation, housing, food insecurity, and insurance. Members discussed confusion over reimbursement rules, the differences between FQHCs and CCBHCs, and the need for better funding and clearer policy for peer and community health worker services. No votes were taken; the discussion ended with a suggestion to bring in a subject matter expert on community health workers for a future session.

Transcript Highlights:

• You may not know, but street medicine actually now has a CMS code so that you can bill for seeing patients

Keywords: 959, house, all

Transcript Highlights:

• Version 1 is intended to provide the functionality required to decommission CWS CMS, support new policies

Summary: The Assembly Budget Subcommittee on Human Services held a hearing on the Governor’s May Revision, with no votes taken. The first major topic was child care and early education, where the Department of Social Services and Department of Finance outlined proposed changes to absorb federal Child Care and Development Fund and Proposition 64 revenue reductions, shift some funding between child care programs, end funding for prospective pay implementation now that the federal requirement has been rescinded, adjust the alternative payment administration structure, and fund child care infrastructure grants and a Low-Income Investment Fund contract closeout. The Legislative Analyst’s Office said the budget makes progress on the structural deficit but recommended maintaining the administration’s solution level, making reserve deposits, and avoiding new ongoing commitments; it also raised concerns about shifting reductions to the California Alternative Payment Program and about the proposed administrative-rate change. Committee members strongly criticized the proposed loss of child care slots and said they would oppose eliminating those slots, while also expressing support for child care as essential infrastructure. The committee then reviewed California State Preschool Program proposals. Finance and CDE described reductions to the preschool COLA from 2.41% to 2.01%, removal of prospective pay funding, and increases for the QRIS block grant, audit support, and rate reform implementation. Trailer bill language would codify age-based rate categories, inclusion-rate documentation, family fee collection rules, portability, and excused absences. CDE supported the QRIS increase and some attendance and family-fee changes, but warned that aligning three- and four-year-old rates could reduce support for three-year-olds and that the budget does not fully cover enrollment growth. Members also questioned whether the preschool and child care slot reductions should be reallocated rather than terminated, and the administration said the reductions were intended to reflect current utilization and avoid harm to currently enrolled families. The hearing then moved to CalFresh and nutrition programs. CDSS said the May Revision includes a one-time CalFood augmentation, funding to cover federal SNAP administrative cost-share pressures, and additional staffing and technical assistance to implement HR 1 changes, including the able-bodied adults without dependents time limit and new non-citizen eligibility rules. The department estimated HR 1 could cut CalFresh funding by $2.3 billion to $3.7 billion annually and affect about 500,000 people, with roughly 806,000 adults potentially subject to the time limit and about 34,000 non-citizens expected to lose eligibility once fully implemented. Members pressed for stronger harm mitigation, including a $98 million backfill to protect families from losing food benefits, and raised concerns about county workload and the “chilling effect” on immigrant participation. The final portion of the transcript began the IHSS presentation, noting a revised budget of $33.7 billion total funds and $12.8 billion General Fund, with proposed reductions tied to Medi-Cal asset-limit changes and other federal conformity items.

Transcript Highlights:

• We will seek CMS approval to include employment supports as a county option, but to be covered as a Medi-Cal

Keywords: 987, senate, all

Summary: The subcommittee heard updates from the Department of State Hospitals on its proposed 2026-27 budget, including a $3.2 billion total budget, patient-driven operating cost increases, savings in the IST solutions program, and progress in meeting the Stiavedi court-ordered 28-day treatment standard. DSH reported it has met court benchmarks, reduced the IST pending placement list from a pandemic high of 1,953 to about 250, and is now averaging about five days to initiate treatment. Members asked about the effects of Proposition 36 and SB 1323 on referrals, outside hospitalization costs, Medicare coverage, and whether IST solution funds were being overbudgeted; DSH said referrals are slightly down overall, outside medical costs are rising due to inflation and an aging population, and the IST savings reflect slower-than-expected activation of community programs rather than a service gap. The department also outlined proposed funding for electrical infrastructure upgrades at Napa and Patton, a feasibility study under SB 380 for transitional housing for the CONREP SVP program, and a dental services expansion at Metropolitan and Patton. The committee held those DSH items open after discussion. The Commission for Behavioral Health presented its role in overseeing the transition from MHSA to BHSA, including data, evaluation, transparency, grantmaking, and technical assistance. It described the new Innovation Partnership Fund, a statewide innovation grant program funded at up to $20 million annually for five years, with small and large grants, and said it had received strong interest ahead of the May 8 application deadline. Members asked about what qualifies as innovation, whether grants could be renewed, and how the state would ensure the program supports service delivery rather than general outreach or training. The commission also sought a liquidation deadline extension for up to $4.062 million in remaining Alcove Youth Drop-in Center funds so sites can finish implementation and Stanford can complete the final evaluation; that item was also held open. DHCS provided an overview of behavioral health policy changes under CalAIM and BH Connect, including peer support, mobile crisis, contingency management, traditional health care practices for tribal members, the access reform and outcomes incentive program, workforce investments, evidence-based practice expansion, IMD participation, transitional rent, and upcoming youth-focused guidance such as high-fidelity wraparound and activity funds. On BHSA implementation, DHCS said it is not tracking specific local program cuts, but is monitoring county plans and outcomes while noting that counties must still preserve Medi-Cal specialty mental health and DMC-ODS services. The department also discussed its H.R. 1 implementation strategy, including outreach, streamlined renewals, ex parte exemptions, and proposed clinic navigator and outreach funding to reduce Medi-Cal coverage loss, especially for people with behavioral health needs. In response to questions, DHCS said it has not produced a specific H.R. 1 impact estimate for county behavioral health populations, and later explained that counties can still use BHSA and other funding streams for prevention and early intervention while the state tracks impacts through integrated plans and new performance measures. The department also reported on BH-CHIP bond spending, saying it has awarded $5.8 billion for 437 infrastructure projects creating 546 new or expanded facilities and more than 9,553 residential beds, with tribal set-asides exceeding the original allotment.

Transcript Highlights:

• We will seek CMS approval to include employment supports as a county option, but to be covered as a Medi-Cal

Summary: The subcommittee heard presentations from the Department of State Hospitals (DSH), the Commission for Behavioral Health, and the Department of Health Care Services (DHCS) on budget proposals and implementation updates. DSH outlined its proposed 2026-27 budget, including funding for patient operating expenses, IST solutions savings, conditional release program costs, LPS bed allocation changes, electrical infrastructure projects at Napa and Patton, SB 380 transitional housing feasibility work, and expanded dental services at Metropolitan and Patton. DSH also reported that it has met court-ordered IST treatment benchmarks in the Stiavedi v. Clinton case, with average time to initiate treatment down to about five days and pending placements reduced to roughly 250, while noting that Proposition 36 could increase referrals and SB 1323 may divert some individuals earlier into community-based treatment. Members asked about rising outside hospitalization costs, Medicare enrollment, the timing and structure of capital projects, and whether IST solution funds are being fully used; DSH said the savings reflect slower-than-expected ramp-up of community programs and that the Central California FACT replacement program is still on track for January 2027 activation. The Commission for Behavioral Health described its role under the Behavioral Health Services Act (BHSA), including data, evaluation, grantmaking, technical assistance, and transparency work. It highlighted the new statewide Innovation Partnership Fund, a five-year, $20 million-per-year program with small and large grant categories; the first RFA drew strong interest, with more than 400 questions and over 1,000 bidders’ conference participants. The Commission also discussed a proposed extension to spend down about $4.1 million remaining for the Alcove Youth Drop-in Center grants so sites can finish implementation and Stanford can complete the final evaluation. Members asked about grant duration, whether projects can be renewed, what qualifies as innovation, and whether the fund could support service delivery rather than awareness campaigns or training; the Commission said awards are expected to be three-year contracts and that proposals must be new or meaningfully expanded approaches that support BHSA priority populations. DHCS reviewed major behavioral health changes under CalAIM and BH Connect, including peer support, mobile crisis, contingency management, traditional health care practices for tribal members, updated specialty mental health access criteria, and new substance use treatment standards based on ASAM’s fourth edition. DHCS reported strong contingency management results, with more than 13,000 members served and 95% testing negative for stimulant use during treatment, and said 21 Indian health care providers have been approved to offer traditional health care practices. It also described BH Connect initiatives such as the $1.9 billion access reform and outcomes incentive program, workforce investments, evidence-based practice expansion, IMD participation by four counties, and transitional rent services. On BHSA implementation, DHCS said it is not tracking individual county contract cuts but is monitoring county plans and statewide outcomes, while stakeholders raised concerns about local prevention and service gaps. DHCS also outlined its H.R. 1 implementation strategy, including outreach, streamlined renewals, exemptions for disabled, substance use, and medically frail individuals, and proposed clinic navigator and outreach funding; it said it has not yet produced a focused estimate of H.R. 1 impacts on behavioral health populations. The discussion ended with DHCS noting that B-CHIP bond funding has supported 437 infrastructure projects, creating 546 new or expanded facilities and more than 9,500 residential beds across the state.

Transcript Highlights:

• We have not gotten clearance from CMS to do that.

Keywords: 1204, all

Transcript Highlights:

• The recommendation is to do a House Draft 2 and take the friendly amendment from CMS.

Bills: HB1952, HB1951, HB1929, HB2497, HB2208, HB2572, HB1737, HB1953, HB2551, HB2549

Keywords: HB1952, Hawaii agriculture, University of Hawaii, CTAHR, College of Tropical Agriculture and Human Resilience, Kauai, agricultural research station, extension station, capital improvements, general obligation bonds, GO bonds, appropriation, ADA compliance, Americans with Disabilities Act, certified kitchen, greenhouse, laboratory, field research, cesspool decommissioning, invasive species

Transcript Highlights:

• So, say, for example, if a mandate came before the state of North Dakota, it's declared a mandate by CMS

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:

• Ultimately, the objection that the Hospital Association has is that, as everyone knows, CMS specifically

Keywords: 996, all

Transcript Highlights:

• This is a term used by the federal CMS to describe individuals who are not eligible for federally funded

Summary: The Assembly Budget Subcommittee on Health held the first of several hearings on the Governor’s May Revision for health care, with opening remarks focused on the state’s projected $12 billion deficit, looming federal Medicaid changes, and the potential impact on Medi-Cal, public health, reproductive health, and safety-net providers. Several members criticized the proposal as balancing the budget on vulnerable Californians, while others defended the need for cost containment and questioned the administration’s assumptions. The chair set ground rules for respectful, focused questioning and outlined three topics: the Medi-Cal proposals, Proposition 35, and Proposition 56. DHCS Director Michelle Baas presented the May Revision’s Medi-Cal package, saying the department’s budget totals $200.6 billion overall, including $45.2 billion General Fund, and that the proposals are intended to address rising caseloads, pharmacy costs, and managed care spending. She described proposed changes for adults with unsatisfactory immigration status, including a freeze on new full-scope enrollment for those 19 and older, $100 monthly premiums beginning in 2027, elimination of adult dental and long-term care coverage, removal of PPS/RAP payments to FQHCs and rural health clinics for that population, and a pharmacy rebate aggregator. Other proposals included eliminating certain OTC drug classes, removing GLP-1 coverage for weight loss, prior authorization and step therapy changes, reinstating the Medi-Cal asset test, eliminating acupuncture as an optional benefit, allowing utilization management for hospice, raising the managed care minimum medical loss ratio to 90%, reducing PACE capitation rates toward the midpoint of the actuarial range, eliminating the skilled nursing facility workforce and quality incentive program, and suspending the SNF backup power requirement. The LAO said the revised Medi-Cal spending estimate is about $2.5 billion higher than the Governor’s Budget in the budget year, and that the increase appears driven more by higher per-enrollee costs than by caseload alone. The LAO said the budget solutions are concentrated in a few areas, are largely ongoing, and should be considered in light of federal uncertainty, but suggested the Legislature could explore alternatives such as more targeted income thresholds for the undocumented expansion and simpler asset-test rules. Department of Finance officials said the proposals are difficult but necessary to address a third consecutive deficit and rising Medi-Cal costs. Members then pressed the administration on the methodology and impacts of the proposals, especially the enrollment freeze, premiums, asset test, hospice controls, PACE reductions, and the elimination of benefits and provider payments. No votes or formal actions were taken at this hearing.

Transcript Highlights:

• We are a faith-based, mission-driven senior community with a CMS five-star-rated nursing home.

Bills: SB467, SB325, SB867, SB994, SB1052, SB1237, SB1449, SB1531, SB2063, SB2172, SB2173, SB2520, SB2529, SB2538, SB2541, SJR46, SJR84

Keywords: SB 467, Texas property tax, ad valorem tax, homestead exemption, residence homestead, fire damage, house fire, destroyed home, temporary tax relief, appraisal district, chief appraiser, local taxing unit, tax rollback, tax refund, Tax Code Chapter 11, prorated exemption, homestead improvement, disaster relief, property tax exemption, residential property

Summary: The committee heard several local government and property tax bills, with most testimony focused on appraisal disputes, tax administration, and development rules. Senate Bill 1052 by Senator Hinojosa would address coastal county appraisal litigation by requiring property owners in certain large-value disputes to report an uncontested taxable value while appeals are pending, so taxing units can base truth-in-taxation calculations on more realistic revenue. Nueces County, Del Mar College, and Corpus Christi ISD testified in support, describing major budget shortfalls caused by refinery valuation disputes; the committee substitute narrowed and clarified the bill’s scope. No opposition was heard, public testimony closed, and SB 1052 was left pending. The committee also heard Senate Bill 1531, which would require local tax collectors to accept common electronic property tax payments such as credit cards, debit cards, and e-checks. Witnesses supported modernizing payment options and the committee substitute removed ACH/electronic funds transfer language to avoid bank-account disclosure concerns. Public testimony closed and the bill was left pending. Senate Bill 325, by Senator Perry, would restore platting and groundwater-certification requirements that were unintentionally weakened by prior legislation; supporters from county government, water groups, and builders’ representatives debated whether the real issue was groundwater protection or road standards for private roads. The bill was left pending after extensive testimony and no vote. The committee then took up Senate Bill 994 and SJR 46, which would exempt certain livestock feed inventory from property tax and provide the constitutional amendment needed for that change. Feed store and Farm Bureau witnesses supported the measure as relief for seasonal inventory taxes, and the bills were left pending. Senator Paxton presented SB 467 and SJR 84 to create a temporary property tax exemption for homes completely destroyed by fire, with refunds or corrected bills based on the date of loss; both were left pending. SB 1237 would clarify charitable property tax exemptions for senior housing and retirement communities, with testimony from Catholic and Baptist retirement organizations and a resident describing rising costs and exemption revocations; it was also left pending. The committee later voted 6-0 to report SB 2073, a pending bill on appraisal district authority to purchase or finance real property, and recommended it for the local and uncontested calendar. Finally, the committee heard SB 2172, SB 2173, and SB 2063, all related to property tax administration. SB 2172 would limit when appraisal districts can require homeowners to reapply for homestead exemptions, requiring a specific reason and written notice; SB 2173 would protect new homeowners from surprise tax liabilities caused by prior owners’ erroneous homestead exemptions, with testimony describing large back-assessment bills; both were left pending. SB 2063 would bar appraisal districts from using market-value evidence in unequal appraisal protests, and testimony sharply divided between taxpayer advocates, who said market data improperly overwhelms equity claims, and appraisal district representatives, who argued market value is inherently tied to equal-and-uniform taxation and cited a recent Texas Supreme Court decision; the bill was left pending after testimony.