Transcript Highlights:

• Minnesota's unemployment rate has continued to increase over the past year, both absolutely and relative
• to the national rate.
• Although the unemployment rate has risen, Minnesota's rate remains below the national rate, and the state's
• The increased forecast forecast.
• . rate. rate.

Bills: HF3425

Keywords: supportive housing, grants, housing assistance, funding, Minnesota Statutes, 1183, house

Transcript Highlights:

• does not exceed the Tier 1 rate.
• change the threshold between the fixed Tier 1 rate of $2,750 and the lower Tier 2 rate that fluctuates
• However, we recommend going further and fully fixing the Tier 2 rate at $1,579, the rate it has been
• They asked why one rate versus the other, noting that a Tier 1 rate of about $2,900—close to $3,000,
• the rate the year of.

Summary: The committee heard testimony on three education budget items: the Expanded Learning Opportunities Program (ELOP), differentiated assistance/statewide system of support, and universal school meals plus kitchen infrastructure grants. For ELOP, the Department of Finance described the Governor’s proposal to provide $4.7 billion ongoing Proposition 98 funding and $62.4 million to set a minimum Tier 2 rate of $1,800 per pupil. The LAO recommended instead fixing the Tier 2 rate at $1,579, and committee members questioned how the rate was determined, how much funding is actually spent, and whether overlapping funding from ELOP, ACEs, and 21st Century programs is being tracked. CDE said ELOP is showing positive attendance and math outcomes, but some requested data will not be available until mid-2027; members also raised concerns about double-funding, transparency, and whether middle and high school students are being equitably served. On differentiated assistance, CCEE outlined the statewide system of support and the various tiers of universal, targeted, supplemental, and intensive assistance. Finance explained the Governor’s proposal to replace the current DA structure with a more stable universal and targeted assistance model, funded at $131.9 million ongoing, with a three-year support cycle aligned to LCAP and ESSA timelines and broader State Board authority to revise eligibility criteria. The LAO objected to considering the proposal before the State Board finalizes the new performance criteria, and committee members expressed concern that moving to a three-year cycle could delay support for LEAs that newly fall into need mid-cycle. There was also discussion about whether the proposal would weaken subgroup-based equity guardrails or give the State Board too much discretion over who qualifies for support. For school meals and kitchen infrastructure, Finance proposed $1.8 billion ongoing for universal meals and an additional $100 million ongoing plus $100 million one-time for a fourth round of kitchen infrastructure and training grants. The LAO recommended rejecting the new kitchen grant round because prior rounds are still being spent and the unmet need is not yet clear. CDE said prior investments have improved meal participation, efficiency, and menu variety, but many schools still lack the facilities for scratch cooking and face construction, electrical, and procurement barriers. Members asked for more data on how prior grants were used, which schools are benefiting, and whether funds could also support lower-cost food access strategies such as pantries, while noting federal restrictions on some meal-service innovations.

Transcript Highlights:

• Work requirements are an issue, and it increases the age rate from 54 to 64.
• We've increased behavioral health, primary care, and obstetric reimbursement rates for providers up to
• For years, our hospitals were having to increase the reimbursement rates on the commercial.
• We want to express appreciation for the legislators' support through increased Medicaid rates and the
• Within Presbyterian, Medicaid rate increases have been invested in ways such as investing in technology

Transcript Highlights:

• reimbursement rates and conditioning increases to improve direct care compensation in particular.
• Home care rates, Just one example here, home care rates in particular are, you know, run and developed
• through the Consumer Direct rate-setting board.
• The Consumer Direct rate is a straight labor and administrative rate.
• best rating because then the consumer will choose the one that's got the best rating because, again,

Summary: The committee began with an extended work session on the long-term care workforce. DSHS Assistant Secretary B. Rector described the new Home and Community Living Administration and outlined major workforce pressures: Washington had about 126,000 long-term care workers in 2022, with demand expected to outpace supply as the 85-plus population and dementia prevalence rise sharply. She emphasized that direct care workers are largely women, people of color, and immigrants, and that family caregivers are also a major part of the system. She highlighted recruitment and retention efforts funded through federal Money Follows the Person dollars, including high school training partnerships, a retention toolkit, transportation support, caregiver newsletters, tribal workforce navigators, and a remote caregiving pilot. Committee members asked about career pathways, technology use, and turnover drivers; Rector said wages, benefits, unstable hours, and workplace support are key issues and promised follow-up data. Aidan Swain of the Washington Health Care Association said skilled nursing and assisted living facilities face acute RN vacancies, wage pressures, and Medicaid reimbursement that does not cover costs, and urged modernization of training, better reimbursement, and continued support for facility-based care. Maddie Fouch of SEIU 775, representing about 55,000 caregivers, said low wages, weak benefits, lack of voice, and certification delays are driving turnover and shortages, and argued for higher compensation, better worker protections, and more transparent reimbursement. Catherine Smith of Behavioral Health Solutions described growing behavioral health needs in nursing homes, the role of expanded behavioral supports programs, and credentialing delays that slow hiring. No votes were taken; the panel was informational only. The second agenda item was an overview of the palliative care benefit work group report required by 2024 legislation. Nico Jansen of the Office of the Insurance Commissioner explained that the work group, convened with the Health Care Authority, studied a potential palliative care benefit for fully insured commercial plans and also Medicaid, PEBB, and SEBB. He said palliative care is a philosophy of care focused on symptom management, coordination, and support for serious illness, and is distinct from hospice because it can be provided alongside curative treatment. The actuarial analysis concluded that creating a new benefit would likely increase costs, estimating about a 28-cent per member per month increase overall and roughly $2.6 million to $4.5 million in annual state Medicaid costs if implemented in 2027. Jansen said the consultants did not find sufficient evidence to assume savings from avoided hospitalizations or long-term care, though several work group members disagreed and submitted response letters. Senators asked about other states, Medicare, health homes, and whether more research could clarify cost savings; OIC said some states, including Hawaii, are moving ahead with Medicaid palliative care benefits, Medicare covers some related services but not in the same way, and further evidence may emerge over time. OIC did not take a position on whether the Legislature should create the benefit. The final presentation covered health care price transparency tools in Washington and federally. Evan Klein and HCA Chief Data Officer Vishal Chaudry reviewed federal hospital and health plan transparency rules, the state all-payer claims database, prescription drug price transparency, the Health Care Cost Transparency Board, the Prescription Drug Affordability Board, and other reporting systems. They explained that the APCD contains claims from fully insured commercial plans, Medicaid, and public employee programs, but not self-insured employer data except for limited voluntary submissions. They also described how machine-readable files, consumer price tools, and aggregated dashboards are used, and noted that data limitations, delays, and complexity remain significant. Senators asked about voluntary self-insured participation, the role of AI in making data more usable, and whether transparency can really help consumers given access barriers and medical debt. HCA said AI is increasingly used by private entities to mine large transparency datasets, but state agencies still face limits in data access and analytic capacity. The committee did not take action; the session was informational and ended with a discussion of how transparency data might better inform policy and purchasing decisions in the future.

Transcript Highlights:

• And one is we can try to increase labor force participation rates of people that are already here.
• > in that increase in mandate, increase in that increase in mandate, increase in costs<00:37:39.119
• rate of 0.2% 2% increased at an average rate of 0.2% 2% annually<01:07:41.920> over<01:07:42.160
• I do believe that we can aim to increase the growth rate of per capita GDP by raising the level of TFP
• and increase and things so we increase and increase and increase<01:47:11.679> education<01:47

Keywords: 1183, house

Transcript Highlights:

• by 200 the negative means is a increase by 200 the negative means is a increase increase<00:22:40.039
• increase<00:33:31.279> in have a increase in have a increase in 2024<00:33:33.320> but<
• 30-year mortgage rates, and the spread between the mortgage rate and the bond rate has been abnormally
• :21.720> has<00:57:21.839> been mortgage rate and the bond rate has been mortgage rate
• for the first 11 months increase for the first 11 months increase<01:28:31.560> about increase

Keywords: 910, house, all

Summary: The Committee on Finance held its first informational briefing for 2025, beginning with member introductions and then hearing an economic outlook presentation from Dr. Eugene Tian of the Department of Business, Economic Development and Tourism. Dr. Tian said Hawaii’s economy was in relatively good shape in several areas, especially construction, which he described as at a historical high, with construction employment above 40,000 monthly and building permit values and contracting tax base both up sharply. He also noted real estate sales had rebounded in 2024, the labor market had stabilized with unemployment around 2.9%, and initial unemployment claims were below 2019 levels. At the same time, he highlighted challenges including inflation running above the national rate, a shrinking labor force, lower employment compared with 2023, and continued weakness in visitor spending and arrivals. He said future growth would likely come from health care, professional services, construction, tourism recovery, and diversified sectors such as renewable energy, aquaculture, creative industries, and technology. Dr. Tian also discussed Hawaii’s economic structure and recovery, saying the state remains more concentrated in a few industries than the U.S. overall, with government and hospitality making up larger shares of the economy. He said non-tourism sectors had recovered, but tourism-related jobs and output were still below pre-pandemic levels, with Maui and the visitor industry still affected by the wildfire and COVID-19 impacts. He projected tourism and non-agricultural wage and salary jobs would not fully recover until 2027, and said population trends remain a concern because of aging, the likelihood of deaths outpacing births in coming years, and reliance on in-migration. After his presentation, the chair said questions would be taken later and the committee took a short break. After the break, Dr. Carano of the Hawaii Executive Director’s office presented a second outlook, saying Hawaii’s economy in 2025 looked better than 2024 overall, though he emphasized substantial uncertainty tied to the incoming federal administration. He said possible changes to tariffs, tax policy, immigration, and federal spending could raise inflation and keep interest rates higher than previously expected, which would affect housing, consumer debt, the dollar, and Hawaii’s visitor industry. He noted that U.S. visitors account for roughly three-quarters of visitor spending in the state, making federal policy especially important. He also said deregulation could be a long-term positive but would not likely have much effect in 2025 or 2026. As an additional risk, he pointed to bird flu and its effect on livestock, poultry, and egg prices. No votes or formal actions were taken during the briefing.

Transcript Highlights:

• That led to an increase of funding to amount for the transition of the additional rate one local education
• The rate 2 is...
• There were increases in rates, there were also increases associated with requiring higher percentages
• The 22-23 tip is just the starting point of when those rate increases were first implemented that I think
• after those. those rate increases were set.

Keywords: 988, house, all

Transcript Highlights:

• So, we ask for the appropriation for every single rate increase that we do.
• And this bill in front of you is one of those rate increase bills.
• And uh this bill in front of you is one of those rate increase bills.
• <00:18:31.840> Uh there has been no rate increases. Uh there has been no rate increases.
• <00:35:00.880> increase where this this Medicaid rate increase where this this Medicaid rate

Bills: HB0004

Keywords: medical assistance, birthing centers, healthcare, Medicaid, Wyoming, 916, all

Transcript Highlights:

• This is the value that is multiplied by the tax rate, or the millage rate, in order to calculate the
• By 2020, they had increased to $37.7 billion, less than a $10 billion increase.
• their millage rate.
• The millage rate is something... Chair, which is that the increase is a choice, right?
• increases.

Summary: The Select Committee on Property Taxes held its first meeting with opening remarks from the co-chairs and ranking member framing the committee’s task as developing property tax legislation for next session. Staff then gave a high-level overview of Florida property taxes, explaining how ad valorem taxes work, the roles of property appraisers, tax collectors, taxing authorities, value adjustment boards, and the Department of Revenue, and reviewing key concepts such as just value, assessed value, exemptions, taxable value, millage rates, homestead exemptions, Save Our Homes, and portability. The presentation also emphasized that property tax law is largely rooted in the Florida Constitution and that local governments choose millage rates, which affects collections. No public comment was taken. The committee then discussed five Speaker-proposed concepts. Proposal 1 would require cities, counties, and special districts to hold a referendum on eliminating property taxes on homestead properties; members raised concerns about local funding, public safety, special districts, renters, and the need for extensive voter education, with some suggesting countywide elections or town halls instead. Proposal 2 would create a new $500,000 homestead exemption for non-school taxes and a $1 million exemption for seniors 65+ or long-term homesteaders; members split between seeing it as meaningful relief for seniors and warning it could devastate local tax bases, especially in lower-value or rural counties, while also potentially trapping older homeowners in place. Proposal 3 would authorize the Legislature to raise homestead exemptions by general law; some liked the flexibility, but others worried about statewide one-size-fits-all impacts, political difficulty in reversing changes, and the need for local revenue replacement. Proposal 4 would change assessment caps for homestead and non-homestead property; several members said it would not provide enough relief and could shift burdens to rental properties and non-homestead owners. Proposal 5, eliminating foreclosure on homestead property for tax liens, drew the strongest opposition, with members saying it would undermine lien priority, mortgage and title systems, and incentives to pay taxes. Throughout the meeting, members repeatedly stressed the need to understand local fiscal impacts, including police, fire, infrastructure, and other services funded by property taxes, and to consider alternative revenue sources or offsets if taxes are reduced. The co-chairs said the committee is still in the information-gathering stage, that all ideas remain on the table, and that members should do “homework” by meeting with local taxing authorities and learning how property taxes are set and spent in their districts. The meeting ended with no votes on the proposals and adjournment after a motion to rise.

Transcript Highlights:

• Dickey County was an increase of 14.2%. Divide County was an increase of 18.5%.
• Slope County was an increase of 10.5%.
• And if you look at the standard rate, or not standard rate, but if we used a 2% rate for North Dakota
• I'm here today to talk about the IT rates.
• rate, if you're in the Capitol building itself or the judicial wing, the lease rate this biennium is

Keywords: 908, all

Transcript Highlights:

• This rate can't be tolerated. It keeps increasing as well.
• everybody's rates.
• increases, and that will essentially pay for the rate decreases that people with poor insurance-based
• rates for everybody else.
• We could increase the insurance rates, the premiums for everybody, and we could make uninsured motorist

Transcript Highlights:

• Since then, the rates of immune-related diseases have also increased exponentially.
• They have seen subsequent improvements in immunization rates, increasing the herd immunity protection
• This bill assumes that removing the religious exemption will increase vaccination rates.
• This bill assumes that removing the religious exemption will increase vaccination rates.
• exemption would only marginally, at best, increase vaccination rates.

Keywords: 995, all

Summary: The Joint Committee on Public Health held a hearing on several vaccination-related bills, including proposals to eliminate non-medical or religious exemptions for school immunizations (notably H. 2554 and S. 1557), a bill to require or improve reporting and administration of immunization data and exemptions (described as the Community Immunity Act, S. 1618), and H. 2431, which would prohibit COVID-19, mRNA, or gene-altering vaccine requirements. The committee also heard testimony on H. 2463, which would classify funeral directors as public health workers for vaccine-priority purposes during emergencies. The chair reviewed testimony rules and repeatedly asked speakers to keep comments orderly and brief so the committee could hear as many people as possible. No votes were taken during the hearing. Testimony on H. 2554 and S. 1557 was sharply divided. Pediatricians, infectious disease specialists, public health advocates, and groups such as the Massachusetts Chapter of the American Academy of Pediatrics, Massachusetts Medical Society, March of Dimes, Massachusetts Families for Vaccines, and several parents supported eliminating religious exemptions, arguing that vaccination protects medically vulnerable children and adults, improves herd immunity, and helps prevent outbreaks of measles, pertussis, and other diseases. They cited local school data showing pockets of lower coverage and incomplete reporting, and several speakers referenced outbreaks in other states and the need for stronger, more consistent reporting and exemption management. Opponents argued the bills would infringe on religious freedom and parental rights, force families to choose between faith and education, and unfairly target a small number of families; some also said Massachusetts already has high vaccination rates and that the real issue is incomplete data or the gap population rather than religious exemptions. H. 2431 drew testimony from supporters who said COVID-era mandates caused job losses, privacy concerns, and harm, and that the bill would prevent future requirements for COVID, mRNA, or gene-altering vaccines in schools, workplaces, and public settings. Supporters described personal experiences with alleged vaccine injury or mandate-related hardship. H. 2463 was supported by the Massachusetts Funeral Directors Association, which argued funeral directors work in infection-facing settings and should be eligible for vaccine priority during public health emergencies. The hearing featured extensive public testimony but no committee action beyond hearing the bills and taking questions from members.

Transcript Highlights:

• What we put in this budget was about a 4.5% increase for MCO rates.
• So anything that you're passing today that expands services, increases rates, it's going to have to have
• So anything that you're passing today that expands services, increases rates, it's going to have to have
• So as inflation increases, so does the rates for those.
• So as inflation increases, so does the rates for those.

Keywords: Meeting Start 00:00:00 Attendance Roll Call 00:00:36 Department for Medicaid Services 00:01:44, 958, all

Summary: The House Budget Review Subcommittee on Health and Family Services met for an overview of the Department for Medicaid Services budget. Commissioner Lisa Lee and CFO Steve Beal described Kentucky Medicaid enrollment at about 1.4 million members, including more than 600,000 children, and said the agency’s 2025 total budget was $20.6 billion. They reviewed enrollment trends before, during, and after the COVID-19 public health emergency, noting that redeterminations begun in 2023 reduced enrollment from its peak but that total membership remains above pre-COVID levels. They also explained the difference between the fee-for-service population, which includes long-term care and waiver members, and managed care members, and gave examples of the kinds of services and diagnoses seen in each group. A major focus was the governor’s recommended Medicaid budget and the department’s forecast process. Lee said the budget is split into benefits and administration, with benefits covering fee-for-service services, managed care capitation, transportation, and Medicare premiums, while administration covers contracts, personnel, operating costs, and IT-related advanced planning documents. She said the department uses a consensus forecasting group and actuary input, and that its forecasts have been within 1% of actual spending in recent years. The department also said the governor’s budget includes new waiver slots to address waiting lists, a 2% staff COLA, and a 10% phase-down on state-directed payments beginning in January 2028. Much of the discussion centered on House Resolution 1 and the funding needed to implement its Medicaid-related provisions, including community engagement requirements, six-month redeterminations, and future cost sharing. Lee said the department requested about $35 million in total funds for fiscal 2027, including about $8.2 million in general funds for system changes to the integrated eligibility system, claims processing, notices, and monitoring; and about $11 million in fiscal 2028 for ongoing maintenance, with about $1.6 million in general funds. She said the department expects to seek federal APD matching funds for the IT work. In response to questions, she explained that community engagement would apply to Medicaid expansion members, with qualifying activities including work, school, volunteering, or equivalent income, and that certain groups such as pregnant women, children, caretaker relatives, and some people with chronic disease or substance use disorder would be excluded. She said the department identified roughly 70,000 expansion members who could be subject to the requirement. No votes or formal actions were taken.

Transcript Highlights:

• The reimbursement rate must be applied as an increase to the provider reimbursement rate and in addition
• The bill appropriates the $60 million, as you said, which equates to a 10% rate increase to both our
• We believe that 1451 helps address that documented funding gap, ensuring the rate increases are passed
• a commensurate increase in reimbursement rates.
• Madam Chair, Senator Sears, with these types of rate increases, generally what you'll see is increased

Bills: SB1086, SB1193, SB1318, SB1345, SB1346, SB1451, SB1496, SB1611, SB1630, SB1631, SB1632, SB1672

Keywords: reimbursement, healthcare, laboratory services, noncontracting providers, Arizona health care cost containment, personal identifying information, PII, privacy, confidential records, public records exemption, commercial disclosure, data privacy, licensure, certification, health professions, health care licensing, Arizona Department of Health Services, ADHS, emergency medical care technician, EMCT

Summary: The committee first approved the February 4 minutes and then heard Senate Bill 1086, which would require AHCCCS contractors to reimburse non-contracting providers for certain laboratory services when a member was referred by a contracting provider, and would bar prior authorization for diagnostic services and retaliation tied to such referrals. AHCCCS testified neutral but warned the prior-authorization ban could increase utilization and create fiscal and federal compliance concerns. The committee adopted the Warner amendment limiting non-contracting reimbursement to no more than contracting-provider rates, then passed SB 1086 as amended on a 4-2 vote. The committee next took up Senate Bill 1611, an emergency measure to require AHCCCS to contract with an administrative services organization for program integrity and case management functions for the American Indian Health Plan, while keeping AHCCCS ultimately responsible. The chair’s amendment expanded the ASO’s duties to include provider support, quality improvement, and data analytics, removed AHCCCS claims payment authority, added more tribal observers, and exempted IHS and tribal facilities. Testimony strongly supported reforming the system after fraud and overcorrection harmed Native members and providers, but AHCCCS raised concerns about the fast timeline, possible duplication of fraud-fighting functions, and the need for 45 days of tribal consultation. The committee adopted the amendment and passed SB 1611 as amended on a 5-2 vote. Senate Bill 1630 would create a Medicaid-funded home and community-based services program for adults with serious mental illness, capped initially at 250 members under the Angius amendment, with semiannual reporting and a process for future expansion only if costs are reduced or neutral. Supporters said the bill would help the sickest SMI patients avoid repeated hospitalizations, jail, and homelessness, and could save the state general fund by shifting costs to federal Medicaid funding; AHCCCS was neutral and said it was finalizing the fiscal estimate. The committee adopted the amendment and passed SB 1630 unanimously. The committee also passed SB 1193, protecting emergency medical care technician personal information from disclosure; SB 1318, repealing an outdated state dense-breast notification requirement to align with FDA language; and SB 1345, restricting anonymous complaints against health care institutions, though AHCCCS warned that federal law may still require investigation of complaints from any source and that the bill could reduce reporting and invite litigation.

Transcript Highlights:

• rate.
• all be taxed at a residential rate.
• the residential rate.
• and how they play out and ultimately will wind up increasing the tax rate for the rest of property types
• ...safeguard by capping the non-residential rate at no more than 1.85 times the residential rate.

Bills: HB371

Keywords: HB371, Delaware Agricultural Lands Preservation Act, farmland preservation, agricultural lands, agricultural preservation district, Farmland Preservation Advisory Board, county advisory board, Delaware Foundation, Department of Agriculture, DNREC, planning and zoning, growth zone, open space, land use, farmland protection, rural land preservation, agribusiness, active farmers

Summary: The Senate Executive Committee met in hybrid format, approved the minutes from its June 17 and June 18 meetings, and considered several nominations and bills. The committee heard testimony from Michael T. Skeuse for the Delaware Thoroughbred Racing Commission and Jay Eric Fearwald for the University of Delaware Board of Trustees; both nominees described their backgrounds and qualifications, and no objections were raised. The committee then moved to legislation focused largely on property tax reassessment and related school-tax issues, along with a technical constitutional corrections bill, an agricultural lands preservation cleanup bill, and a child-safety/service-letter bill. A major portion of the meeting centered on Senate Bill 350, which would create a third multifamily residential tax classification at 1.2 times the residential rate. Supporters argued apartments are housing and should not be taxed as commercial property, emphasizing relief for renters and fairness after reassessment. Opponents, including county and school officials, warned the bill would reduce local revenues, complicate tax administration, and create unintended consequences for counties, municipalities, school districts, and agriculture. Similar themes carried into House Bill 462, which would make the split-rate school tax structure permanent and lower the nonresidential cap to 1.85, and House Bill 463, which would align New Castle County senior school-tax exemptions with county exemption rules; both bills drew discussion about shifting burdens, fiscal impacts, and timing. The committee also heard House Substitute 1 for House Bill 320, a technical corrections bill to the Delaware Constitution, with one public commenter objecting to charter-related changes being included in a correction bill. House Bill 371, which removes the requirement for county farmland preservation advisory boards under the Delaware Agricultural Lands Preservation Act, was presented as a streamlining measure and had support from the Department of Agriculture and public comment in favor. House Bill 438, expanding service-letter requirements to a broader set of child-serving facilities and requiring reporting when employers fail to respond, was described as a cleanup bill closing a safety loophole. After public comment and committee discussion, the meeting ended with a motion and unanimous adjournment; no recorded votes on the bills were taken in the transcript.

Transcript Highlights:

• Recommendation number two, increase Kentucky Medicaid behavioral health rates to 100% of Medicare rates
• Recommendation number two, increase Kentucky Medicaid behavioral health rates to 100% of Medicare rates
• Recommendation number two, increase Kentucky Medicaid behavioral health rates to 100% of Medicare rates
• Recommendation number two, increase Kentucky Medicaid behavioral health rates to 100% of Medicare rates
• Recommendation number two, increase Kentucky Medicaid behavioral health rates to 100% of Medicare rates

Keywords: 00:00:22 - Call to Order and Roll Call 00:03:00 – Approval of June 25, 2025 Minutes 00:03:22 - Update on Federal Changes to the Medicaid Program 01:03:44 - State Directed Payments, Provider Taxes, and the Rural Health Transformation Fund: How Medicaid Changes Could Impact Kentucky Hospitals 01:29:42 – Public Comments 01:45:25 – Announcements 01:46:19 - Adjournment, 958, all

Summary: The Medicaid Oversight and Advisory Board met on July 30, 2025, approved the June 25 minutes, and received a presentation from Katherine Castanza of the National Conference of State Legislatures on Medicaid provisions in H.R. 1. The presentation outlined more than 20 Medicaid-related provisions, emphasizing that the largest federal savings come from work/community engagement requirements, changes to provider taxes, limits on state-directed payments, more frequent eligibility redeterminations for expansion populations, and related eligibility/enrollment changes. She said the fiscal effects are backloaded, with most reductions occurring in the later years of the 10-year window, and noted potential significant impacts on hospital payments and state financing. She also described new funding opportunities, including a $50 billion rural health transformation fund and a new home and community-based services waiver with associated grants. A substantial portion of the discussion focused on Kentucky’s pending community engagement 1115 waiver and how it would interact with the new federal requirements. Board members asked whether the waiver had been approved, what the cabinet’s contingency plan would be if CMS does not approve it, and what the timeline is for compliance. Cabinet representatives said the waiver has not yet been approved by CMS, remains under public comment, and that the state will wait for CMS guidance before moving forward; if needed, the state would amend the waiver or submit a new one. They said the work requirement must be in place by January 1, 2027, with a possible extension to 2028. Castanza also explained that expansion adults with incomes between 100% and 138% of the federal poverty level would face new cost-sharing requirements beginning October 1, 2028, and that eligibility redeterminations would move from annual to every six months starting January 1, 2027. She then walked through provider tax changes, including a moratorium on new provider taxes beginning October 1, 2026, and a phased reduction in the hold-harmless threshold for existing taxes beginning January 1, 2028, with exemptions for nursing facilities and ICF/IID providers. Board members questioned the timing and likely impact on Kentucky, and Castanza responded that the effect would depend on each tax’s current rate and would phase in over time.

Transcript Highlights:

• This is a change from the average commercial rate which was a previous cap.
• But the big increase for 25 26 is essentially almost all driven by the increase in the debt directed
• increase of it to the ACR.
• Are we looking at actually funding that billion dollars on a annual rate?
• But yeah, we're going to have to pay billions and rate because of the rate.

Transcript Highlights:

• Both recommendations include increases for health insurance and other rate increases, but the LFC recommendation
• And so, our first increase, which was not recommended by either the executive or the LFC, is the rate
• increases: So the last time we had a rate study, we broke up the rate increase into two fiscal years
• We do think it becomes a problem for kicking this rate increase can down the road because you know we
• So that's my rate increase A discussion on support decision making.

Keywords: 996, all

Transcript Highlights:

• That is a 5.9% increase year over year. And an 80% increase since 2012.
• Between 2016 and 2025, our average credit card processing rate increased from 1.93% to 2.25%.
• That is a 17% increase.
• we're paying in increased rates.
• we're paying in increased rates.

Keywords: 995, all

Summary: The commission met for its second hearing to study the future of credit card payments and sales transactions and their impacts on small businesses. Members heard extensive testimony from credit unions, retailers, restaurants, and payment-industry representatives on interchange fees, processing fees, fraud, chargebacks, rewards programs, and the ability of businesses to pass fees on to customers. Several witnesses argued that swipe fees have risen sharply, are especially burdensome for restaurants and other small businesses, and are charged on taxes and tips that are merely pass-through amounts. They urged state action to prohibit fees on tax and tip portions, improve transparency, and allow surcharging or convenience fees, while opponents warned that state regulation could reduce fraud protections, increase compliance costs, and threaten consumer rewards programs. Business owners and trade groups described thin margins, rising costs, and the difficulty of understanding merchant statements or negotiating with processors. Restaurant witnesses said card-not-present and online transactions create the greatest fraud and chargeback risk, with money often removed immediately from merchants’ accounts and disputes rarely resolved in their favor. Retail witnesses gave examples of rising effective rates, higher fees on rewards cards, and the burden of processing fees on low-value transactions. A representative from the Massachusetts Restaurant Association and others said restaurants are effectively paying fees on meals tax and gratuities, which they argued should not be subject to interchange charges. On the other side, the Cooperative Credit Union Association said interchange revenue helps credit unions fund fraud prevention, rapid card replacement, and member protections, and warned that state limits on interchange could weaken those safeguards and lead to higher consumer costs or reduced services. Airlines for America testified that airline credit card rewards are popular, support travel and jobs in Massachusetts, and could be harmed by interchange reform. The National Restaurant Association and a payments-policy attorney countered that interchange fees are set by card networks rather than competitive markets, that banks remain highly profitable even with rewards, and that states can act after recent court decisions. No votes were taken; the hearing consisted of testimony and questions from commissioners.

Transcript Highlights:

• Payment error rate.
• Again, unfortunately, from 2014 onwards, we saw a steady increase in the error rate.
• been increasing since 2014.
• So adding additional documents may have the opposite effect and increase error rates or shorten the ability
• rate.