Transcript Highlights:

• But to your point, laboratory studies, imaging studies, her past history, obstetrical. ultrasound.
• doctor or and and legal provider who have not been looking at these cases over the years and have not studied
• The problem in my situation was I was pregnant with twins and there there are minimal studies but there
• are very good studies about how how, if there's a fatal anomaly of one of the twins, the high risk it
• The most frequently cited studies covered by Linton in his legal review, which I handed out copies of

Bills: HB44, HB2200, HB1612, HB2747, HB2038, HB3717, HB1431, HB3800, HB3801, HB3560, HB3246, HB44

Keywords: HB 44, Life of the Mother Act, abortion exceptions, medical emergency, reasonable medical judgment, pregnancy complications, maternal health, life-threatening condition, ectopic pregnancy, miscarriage, spontaneous abortion, fetal survival, Texas abortion law, abortion ban, physician liability, health care provider, disciplinary action, aiding and abetting, emergency abortion, obstetric care

Bills: SB397, SB481, SB596, SB760, SB855, SB1195, SB1196, SB1233, SB1257, SB1318, SB1368, SB1388, SB1398, SB1524, SB1558, SB1589, SB1677, SB1792, SB2034

Keywords: SB 397, telemedicine, telehealth, teledentistry, remote care, virtual care, consent documentation, patient consent, data collection, data sharing, audio-only telehealth, in-person examination, irreversible medical procedure, health professional regulation, Occupations Code, Texas Health and Human Services, medical records, provider compliance, data privacy, consumer rights

Transcript Highlights:

• The fact is that if you do an actuarial study on any topic, you're looking at probabilities.
• line up right and every grain of sand in the universe are counted, the fact is that if you do an actuarial
• study on any topic, you're looking at probabilities.
• Really, you got to look at the actual numbers and studies.
• And I think this is what and studies.

Keywords: 928, house, all

Summary: The Finance Committee first took up Senate Bill 63, which Representative Maguire described as a straightforward bill setting funding for the Division of Travel and Tourism. He said it was not controversial. The committee voted to retain the bill by roll call, with one no vote and one member absent, and the motion passed 23-1-1. The committee then considered Senate Bill 74, dealing with annual reporting requirements for state departments that issue permits. Representative Maguire explained Amendment 2282 would shorten the reporting burden by requiring summary data on delayed permits rather than listing every permit, and would delay the first report until 2027 so agencies would not have to reconstruct old data. The amendment was adopted by voice vote, and the bill was then approved as amended by a 24-1 roll call vote. Next, the committee heard Senate Bill 241 on construction of a public pier at Hampton Beach. Representative Sweeney moved inexpedient to legislate, saying the project was ambitious and lacked public support. The motion passed unanimously 25-0, sending the bill to consent. Division Two then took up Senate Bill 145, a replace-all amendment to the education freedom account bill. Supporters said the amendment clarified the bill, kept the policy intact, removed a reimbursement program and an open-ended appropriation, and established a cap of 10,000 students with priority for current students and certain other groups. Opponents argued the measure was still a major expansion, would increase spending after crossover, and that the cap was not meaningful. After discussion, Amendment 2301H was adopted and the bill was approved as amended by a 25-0 vote, with members noting it could go on consent because no money remained in it.

Transcript Highlights:

• It was sometime in the fall as we continued to get our capitation rate adjustments, as the actuaries
• It was sometime in the fall as we continue to get our capitation rate adjustments as the actuaries do

Keywords: 1182, all

Summary: The committee met to review the governor’s fiscal 2027 budget presentation, with the chair repeatedly asking members to keep questions brief and avoid speeches. The discussion focused first on the overall revenue and spending outlook, including concerns from members that the executive forecast was more optimistic than the JLBC baseline and that the budget appeared to front-load revenue and expenditure growth. The governor’s budget team said the forecast was close to JLBC’s, that the budget was structurally balanced, and that differences were roughly $100 million per year on ongoing revenue. Members asked for follow-up calculations in writing, including the total multi-year gap and the amount of revenue enhancements above base revenues. A major portion of the meeting centered on tax and fee proposals tied to data centers, water use, and sports betting. The governor’s team defended eliminating the existing data center tax incentive as the removal of a loophole rather than a new tax, arguing the incentive had already succeeded in attracting major investment. They also described a proposed Department of Water Resources fee-setting authority for data centers to support a new Colorado River Protection Fund, and said the proposal would apply to existing and future facilities without a grandfather clause. Members raised concerns about fairness, competitiveness, and whether the changes would require a supermajority vote. The team also discussed increased sports betting fees, saying the revenue forecast did not include dynamic behavioral effects. The committee then moved through major spending areas, including corrections, public safety, border security, cybersecurity, K-12 education, Medicaid, and developmental disabilities. The governor’s budget includes ongoing funding to prevent correctional officer pay cuts, money to comply with prison health care court orders, probation funding, body-worn cameras, law enforcement staffing, fentanyl task forces, and cyber readiness grants. Members questioned the lack of funding for a prison oversight committee and asked for corrections spending totals over the administration. On border security, the executive said it was seeking about $759.7 million in federal reimbursement for border-related costs and that the governor had met with federal officials, including Secretary Noem and Tom Homan, about the request. In education, the budget proposes renewing Prop. 123, adding K-12 base funding, and issuing $1.5 billion in school facilities bonds over three years; members debated whether the proposal was appropriate and whether Prop. 123 revenues could support the debt service. The meeting also covered AHCCCS cost growth and federal HR1 impacts, with the executive warning of major coverage losses and hospital funding reductions, and DDD funding, where the governor’s team said the budget fully funds services and includes about $120 million in supplemental needs. No votes were taken; the meeting was a presentation and question-and-answer session only.

Transcript Highlights:

• Are there not projections of these kinds of things that they can access actuarial data as populations
• I understand, backtracks on these findings and says that simply Kaiser will conduct a feasibility study
• . ...these findings and says that simply Kaiser will conduct a feasibility study to determine whether
• So allowing them to investigate a feasibility study is allowing them to continue violating the law.
• So allowing them to investigate a feasibility study is allowing them to continue violating the law.

Summary: The Assembly Health Committee held an informational hearing on Kaiser Permanente’s behavioral health care system, focusing on Department of Managed Health Care enforcement actions, Kaiser’s corrective action work plan, and testimony from patients, advocates, and union representatives. DMHC officials reviewed a long history of complaints, surveys, fines, and settlements involving Kaiser’s access to behavioral health services, including deficiencies found in 2012 and 2016, a 2022 non-routine survey, and a 2023 settlement that imposed a $50 million penalty and required $150 million in community investments over five years. DMHC said it continues to monitor Kaiser through quarterly meetings, complaint review, follow-up surveys, and a reimbursement process for members who could not obtain timely in-network care. Committee members pressed DMHC on what “timely access” and continuity of care mean in practice, how virtual care and group therapy fit into the standards, and what triggers a non-routine survey. DMHC said initial behavioral health appointments generally should not take more than two weeks, urgent care should be within days, and follow-up care within 10 days, with out-of-network care required when plans cannot meet standards. Officials also said Kaiser’s initial corrective action work plan lacked detail, but the revised plan was accepted and will be tracked through quarterly reporting and possible additional enforcement if Kaiser fails to comply. The second panel featured testimony from a Kaiser enrollee, a behavioral health policy expert, a Kaiser therapist, and the NUHW president. The enrollee described serious delays and inadequate treatment for his daughter after a suicide attempt, while the therapist and union leader said Kaiser’s behavioral health system is understaffed, relies too heavily on short appointments, group therapy, and webinars, and treats behavioral health as less important than medical-surgical care. They argued Kaiser’s one-appointment-at-a-time scheduling rule and limited treatment time violate parity requirements and harm continuity of care. Several members criticized Kaiser for not appearing at the hearing and said the testimony underscored the need for stronger oversight, clearer metrics, and faster remedies for patients.

Transcript Highlights:

• But the fact that 25% of American CEOs are dyslexic is a fascinating study in what it takes to overcome
• Senate Bill 2843 by Perry, relating to a study of the effectiveness of rules implemented by the Texas
• Senate Bill 3005 by Blanco, relating to a study on the use of psychedelic therapies in the treatment
• Senate Bill 2005 by Blanco relating to a study on the use of psychedelic therapies in the treatment of
• Senate Bill 2018 by Menendez, relating to social studies curriculum choice for public school students

Bills: SJR12, SJR81, SCR39, SB22, SB32, SB241, SB393, SB414, SB458, SB464, SB568, SB583, SB609, SB660, SB693, SB731, SB732, SB746, SB783, SB785, SB897, SB993, SB996, SB1008, SB1029, SB1035, SB1036, SB1120, SB1122, SB1147, SB1163, SB1188, SB1197, SB1209, SB1227, SB1245, SB1267, SB1307, SB1321, SB1332, SB1386, SB1394, SB1396, SB1470, SB1494, SB1537, SB1596, SB1598, SB1610, SB1664, SB1814, SB1822, SB1841, SB1948, SB2065, SB2155, SB2406, SB2407

Keywords: parental rights, education, constitutional amendment, school choice, child education, tax exemption, ad valorem, tangible personal property, income production, border security, southern border, federal immigration policy, illegal immigration, cartels, transnational cartels, fentanyl, drug trafficking, human trafficking, Operation Lone Star, Texas border

Summary: The Senate opened with a quorum call, invocation, approval of routine motions, and the reading of gubernatorial nominations and several honorary resolutions. The chamber adopted resolutions recognizing Jack and Jill of America Day and DJ Daniel Day at the Capitol, with multiple senators offering remarks praising youth leadership, perseverance, and public service. The Senate also introduced the Doctor of the Day and then proceeded to a long series of floor actions on bills. A major focus was Committee Substitute for Senate Bill 568, which overhauls special education funding and services in public schools by moving from a placement-based model to an intensity-based system tied to student needs and IEPs. Senators Bettencourt, Creighton, and Menendez emphasized transparency, parent input, evaluation funding, dyslexia services, and better alignment of funding with actual services; Senator Hinojosa shared a personal story about dyslexia and the importance of early intervention. The bill was advanced on second and third reading and finally passed 30-0. The Senate also passed SB 1396 to prohibit national sex education standards in public schools, SB 2065 on the Texas Emergency Services Retirement System, SB 1664 requiring clearer public disclosure of transmission and distribution utility rate changes, SB 1029 on advertising certain used motor vehicles, SB 1120 expanding rights for family violence victims, SB 1036 regulating residential solar retail transactions, SB 464 creating school-proximity restrictions and penalties for tobacco and vaping sales, SB 1035 giving farmers and ranchers equitable relief from certain local agricultural regulations, SB 1610 addressing civil commitment facility safety and prosecution issues, SB 1197 extending drone restrictions to spaceports, and SB 1386 changing legislative witness immunity from transactional to testimonial immunity. Another major bill was Committee Substitute for Senate Bill 1188, which updates electronic health record requirements. Senator Kolkhorst said the bill builds on Texas medical privacy law by requiring U.S.-based storage of EMR data, prohibiting recording of voter registration status and credit score information, requiring provider verification and disclosure for AI-assisted diagnosis or treatment recommendations, preserving parental access to minors’ records until age 18, and ensuring EMRs can capture metabolic health and biological sex information. A floor amendment clarified the bill’s scope and enforcement, and the bill passed 23-7. Several measures drew debate, especially SB 414 on bond ballot transparency, where Senators Eckhardt and Menendez questioned whether requiring estimated interest and total debt cost on ballots could be misleading or difficult to implement because interest rates and financing terms can change before issuance or over time. The transcript ends during that discussion, with no final action shown on SB 414.

Transcript Highlights:

• Well, a lot of that has to do with studying and schedules and when you can get to the cafeteria, and
• I haven't seen a study that focused on caloric intake.
• From an actuarial standpoint, after the millions of dollars you put into it, it's better than it was.

Keywords: 996, all

Transcript Highlights:

• I would argue that there’s also a very, um—I’m not an accountant, I’m an attorney—but there’s an actuarial
• <01:18:03.040> definition<01:18:03.520> of there's an Actuarial definition of there's
• Most recently, Senate Bill 411 created a study committee to identify gaps in coverage for children's
• <01:50:55.360> 411<01:50:56.159> created<01:50:56.560> a<01:50:56.719> study
• Senate Bill 411 created a study Senate Bill 411 created a study committee<01:50:57.520> to

Keywords: 1191, senate, all

Transcript Highlights:

• We went through the actuarial reviews and said, 'Okay, what can we lower the state's contribution percentage

Bills: SB1177, HB3705, SB1942, SB2026, SB1533, SB1327, SB2065, SB2155, SB2159

Keywords: education funding, mental health services, public safety, housing, state budget, tax credit, parental choice, private school, income tax, dental insurance, health care, medical necessity, insurance claims, dentist rights, military discharge, veterans, DD Form 214, confidentiality, grandchildren access, veteran burial

Transcript Highlights:

• this is now the the we did a rate study this is now the the rate<01:13:48.600> adjustment<01:
• Okay, so our request for behavioral health: we are doing an ongoing rate study, and we expect in the
• Okay, so our request for behavioral health: we are doing an ongoing rate study, and we expect in the
• planning for Actuarial expenses for data<02:31:21.600> acquisition<02:31:22.160> for<02
• Okay, so we did a quick study. It's a little scientific, but not hugely scientific.

Keywords: 912, senate, all

Summary: The joint Ways and Means and Health and Human Services committees heard Hawaii Health Systems Corporation’s biennium budget request, with testimony from HHSC leadership on the Hilo/Big Island region (HTH 212) and the Oahu region (HTH 215), plus discussion of capital improvement projects and systemwide partnerships. HHSC described its role as the rural healthcare safety net, serving a high share of Medicare, Medicaid/Quest, and uninsured patients, and said its costs are elevated by state employee fringe benefits, which it said are about 64% compared with roughly 30% in the private sector. HHSC also said pandemic-era federal aid, including relief funds and PPP loans totaling about $100 million, reduced the need for general fund support in prior years. For HTH 212, HHSC said its general fund request for fiscal years 2026 and 2027 was higher than the governor’s recommendation because of rising insurance, pharmaceutical, and contractor labor costs, and because it includes $13.2 million in FY 2026 and $2.3 million in FY 2027 for Epic electronic medical record implementation in East Hawaii. For HTH 215, HHSC said the requested general funds were aligned with the governor’s recommendation, in part because of increased Medicaid reimbursement rates for long-term care facilities under prior legislation. HHSC also said it was restoring a special fund ceiling so the region could spend its cash collections on operations. Members asked about the 64% fringe rate, and HHSC explained the difference was mainly due to defined-benefit pension and retiree health insurance costs, which private hospitals generally do not bear at the same level. Members also asked about the Daniel K. Akaka State Veterans Home, and HHSC said operations would be funded through the general fund corporation for the home when it opens, with management by Ohana Pacific, but no additional legislative operating funds were being requested at that time. Other questions focused on staffing and vacancies, including an abolished procurement position and an ongoing IT help desk recruitment need. HHSC highlighted several capital and partnership projects, including a $25 million state CIP request matched by $25 million from the Benioff family for the Benioff Health Center, an ER expansion and reconfiguration at Corner Community Hospital, and $7.5 million in each fiscal year for Kauai EMR capital funds to join the Epic platform. Testimony also described collaborations with Queen’s, the University of California San Francisco, Hawaii Pacific Health, the Hawaii Cancer Consortium, the Department of Health, and the state hospital to improve specialty access, clinical trials, behavioral health, and patient placement across the system.

Transcript Highlights:

• In fact, an independent organization called the Physician Advocacy Institute (PAI) did a study based
• I've talked to CEOs, I've talked to doctors, so it's not—we have actuarial tables, you know, that tell
• Have you done a study on what it would cost to self-insure?
• In my facility, a study done back in 2021 found that Medicaid only paid 44% of the cost.
• I've seen studies where the vast majority of individuals who are on Medicaid work.

Transcript Highlights:

• Um, so the intent of this study committee is to look at data from all branches of government, right?
• that study committee could come<01:11:01.199> back<01:11:01.679> and<01:11:02.199>
• uh ideally the output of the study uh ideally the output of the study committee<01:11:20.440>
• know when we reach if the study know when we reach if the study committee<01:13:07.480> were<
• I think that, you know, one could probably study this for years and keep finding more stuff.

Keywords: 1189, house, all

Summary: The committee first heard House Bill 180, which concerns critical incident stress management teams. Representative Mark PR, the bill sponsor, proposed an amendment to add a definition of “team leader” and to clarify that teams may or may not be affiliated with a municipality. He argued that a certification test offered by the International Critical Incident Stress Foundation is unnecessary and too expensive at $400, since team members are volunteers who already receive training and continuing education. Committee members asked about the training structure and certification language, and the sponsor explained that the teams are self-certified and that the amendment was intended to clean up the bill’s language. The committee then voted on HB 180 in executive session. Amendment 0261H was adopted 11-0, and the bill was then moved as amended and passed 11-0. The committee placed the bill on consent. Later, the committee heard House Bill 438, sponsored by Representative Timothy Horan, dealing with immigration detention and related state policy. Horan described the bill as an update to earlier legislation and said it would codify best practices, prohibit state cooperation with mass deportation efforts, bar for-profit operation of immigration detention facilities, and require Executive Council approval before the governor could deploy the National Guard for immigration deportation activities. Committee members questioned whether the bill could be read as authorizing detention facilities and discussed the relationship between the state and Strafford County Jail. An amendment presented on behalf of Representative Patrick Long was described as a technical rewrite that removed several sections and changed language, but the hearing ended before any vote was taken on HB 438.

Bills: HB4322, HB4202, HB4203, HB4457, HB3983, HB3660, HB3802, HB2933, HB2955, HB2956, HB3781, HB3521, HB3794, HB3796, HB3800

Keywords: funeral services licensing, funeral director, embalmer, funeral director in charge, dual licensure, mortuary science, Oklahoma Funeral Board, funeral establishment, commercial embalming establishment, crematory, cremation, alkaline hydrolysis, apprenticeship, licensing requirements, professional regulation, undertaker, mortician, burial services, death care industry, workers' compensation

Bills: HB4421, HB4426, HB4432, HB4329, HB3551, HB3763, HB1411, HB2730, HB3465, HB3649, HB3650, HB3674, HB3941, HB3970, HB3979, HB3980, HB3981, SB1074

Keywords: child welfare, fentanyl exposure, drug endangerment, environmental testing, safety analysis, remediation, child protection, Department of Human Services, violence prevention, HB4426, SIDE tax credit, strategic industrial development enhancement, income tax credit, economic development, tax incentive, qualified economic development expenditures, qualified initial infrastructure expenditures, industrial park, economic development zone, port authority

Bills: HB4421, HB4426, HB4432, HB4329, HB3551, HB3763, HB1411, HB2730, HB3465, HB3649, HB3650, HB3674, HB3941, HB3970, HB3979, HB3980, HB3981, SB1074

Keywords: child welfare, fentanyl exposure, drug endangerment, environmental testing, safety analysis, remediation, child protection, Department of Human Services, violence prevention, HB4426, SIDE tax credit, strategic industrial development enhancement, income tax credit, economic development, tax incentive, qualified economic development expenditures, qualified initial infrastructure expenditures, industrial park, economic development zone, port authority

Transcript Highlights:

• that was most recently done also study that was most recently done also in<01:02:30.440> 2021.
• also findings there, uh, a few studies also findings there, uh, a few studies that<02:19:12.639>
• And we can do that with an actuarial analysis.
• And we can do that with an actuarial And we can do that with an actuarial analysis.<03:22:36.080
• <03:38:53.320> widely an issue that has been studied widely an issue that has been studied

Keywords: 916, all

Transcript Highlights:

• Our FY26 budget did include rate increases and reflects a new actuarially sound methodology for calculating
• We did do a rate study for our direct caregiver workforce.
• mental health rooms into schools, and then to make sure that they are staffed with people who are studying
• That's why that study you mentioned is so important to me: to comprehend where you're at internally before
• We are getting much closer to that right ballpark, but we'll have that study released probably late January

Transcript Highlights:

• There was a national study, a national project done that involved behavioral health providers and primary
• That's been well studied. Treatment plans.
• Representative Chávez and I put our GROW money into this study.
• She said they were actually studying it and looking at the cost.
• And then I want to out myself: I helped fund this study as well several years ago, and I stopped funding

Transcript Highlights:

• summarized in quarterly and annual reports posted publicly on the association's website by an independent actuarial
• by publicly on the association's website by an<00:57:11.280> independent<00:57:11.760> actuarial
• an independent actuarial firm. an independent actuarial firm.

Bills: HF3388, HF400

Keywords: HF3388, Minnesota premium security plan, reinsurance, health insurance, group health carriers, MCHA, MNsure, individual market, premium stabilization, carrier assessment, health insurance assessment, premium security plan account, state innovation waiver, high-risk pool, reinsurance payments, healthcare premiums, insurance carriers, deferral of assessment, financially impaired condition, HF400

Summary: The committee approved the minutes from the prior day and then heard House File 400, a bill described as a defrayal measure for health insurance mandates. Representative Perryman said the bill would not block future mandates, but would require the state to pay the added costs of any new mandated benefits so those costs would not be shifted to premium payers. She and supporters framed the bill as a way to protect affordability for Minnesota employers, workers, and families, especially in the fully insured market. Testimony in support came from the Minnesota Chamber of Commerce and the Minnesota Council of Health Plans. They argued that Minnesota has a high number of mandated benefits, that each new mandate adds cost to premiums, and that businesses—especially small and midsize employers—are already struggling with rising health insurance costs. The health plans representative said the bill would use the existing Commerce defrayal process to reimburse plans for eligible mandate-related claims, allowing those costs to be removed from premium rates. Several members echoed support, saying the bill would improve transparency by showing the fiscal impact of proposed mandates and help prevent people from being priced out of coverage. Members also explored how mandates apply in the market and how premiums are set. Deputy Commissioner Julia Dryer explained that, unless otherwise specified, mandates generally apply to the individual, small group, and fully insured large group markets, while self-insured ERISA plans and other markets are generally outside that scope. Representative Elkins noted that the affected market is relatively small and said small businesses are increasingly moving to self-insured plans because of cost. He and others raised concerns about affordability, while Representative Smith argued that mandates often ensure needed care and that the bill shifts costs to taxpayers rather than insurers. Representative Bacham added a personal example from tribal self-insurance, saying preventive physicals had saved lives and asking whether other factors besides mandates are driving insurer costs. No amendments were offered, and the bill was laid over for possible future consideration.

Transcript Highlights:

• And that comes, like I said, it comes from an actuarial basis and so forth.
• c><00:50:10.680> comes<00:50:10.840> from<00:50:10.960> an<00:50:11.000> actuarial
• like I said, it comes from an actuarial like I said, it comes from an actuarial basis<00:50:11.840

Keywords: 958, all

Summary: The Medicaid Oversight Advisory Board first approved the September 24 minutes and then heard a presentation from four certified community behavioral health clinic providers: Pathways, NorthKey, Seven Counties Services, and NewVista. The presenters explained the difference between traditional community mental health centers and CCBHCs, describing CCBHCs as an enhanced model that integrates behavioral health, primary care, wraparound services, and crisis response. They reviewed the federal history of the model, Kentucky’s entry into the Medicaid demonstration in 2022, and the scheduled end of the enhanced federal match on December 31, 2027. They also emphasized required services such as 24-hour mobile crisis, care coordination, and services for veterans, and described care coordination as a key feature that helps patients follow up after hospital or emergency discharge, manage medications, and connect to transportation and other supports. The presenters gave examples of improved outcomes, including a patient who was able to remain living independently because of coordinated home-based and telehealth support, and they argued that CCBHCs are helping Kentucky build a more responsive crisis system through 988, mobile crisis teams, and crisis stabilization units. They said the model is data-driven, uses performance metrics, and has led to stronger collaboration among community partners. One speaker said more than 100 agencies participated in a Jefferson County community health needs assessment and continued meeting afterward to reduce redundancies and barriers to care. They also said crisis call hub compliance and mobile crisis outreach compliance improved significantly over the past year. Members asked about how navigators and connectors fit into the model, how CCBHCs work with managed care organizations, and how the program could expand statewide. The presenters said navigators are not built into the CCBHC model but may be used through referrals, while the CCBHCs continue to bill MCOs the same way and receive a Medicaid wrap payment for the enhanced rate. They said the goal would be for all community mental health centers to become CCBHCs, but that a state plan amendment would be needed and could not be limited only to CMHCs if submitted to CMS. They estimated about $28 million would be needed statewide to continue the program in the next biennium, combining the loss of enhanced federal match and the state share of enhanced service costs. The board also discussed transportation, with one presenter explaining that their program arranges Medicaid transportation for eligible appointments, and members raised concerns about mental inquest warrant transport and whether sheriffs should remain involved. No votes were taken on the CCBHC or transportation items during the discussion.