Transcript Highlights:

• We have to set up a friend's.
• The average commercial rate is higher than it is. That is the Medicare rates.
• But in my mind, 1.9 4 of the Medicare rates to get reimbursement rate for Medicaid.
• But we hear all the time at the reimbursement rates for Medicaid are very low and the hospital setting
• You know, there's at the base rates, the purity rates that we pay on the inpatient eap tier.

Transcript Highlights:

• And then, uh, we set up an entirely new plan.
• And then, uh, we set up an entirely new plan.
• And then the second set is for the tails, the 28 and 29 biennium.
• The first is for the sets of columns.
• is affected by that, credit rating is affected by that, interest<00:19:03.040> rates<00:19:03.280

Transcript Highlights:

• consider in setting rates and we would consider in setting rates and we would make<02:47:12.399>
• make any better decision within the rate make any better decision within the rate setting<02:48:
• it<02:56:23.680> contains rate setting process because it contains rate setting process
• rates um any ability to state set rates um any information<03:00:27.200> that<03:00:27.439>
• Um, it came to light during the tax rate setting season in time to have the rate adjusted.

Keywords: 928, house, all

Summary: The House Education Policy and Administration Committee met to hear a non-germane amendment to House Bill 131, which concerns bullying and cyberbullying prevention. Representative Glenn Cordelli, the prime sponsor, said the amendment was intended to revise and improve language from last year’s SB 210 and to incorporate measures from a cyberbullying bill previously passed by the House. He described changes to school communication requirements, mandatory reporting of bullying and retaliation, stronger investigation and collaboration requirements for cross-district cases, added safety and remediation language, a required conference with the alleged perpetrator and parents if available, updated reporting deadlines, and disciplinary consequences for harassment, intimidation, retaliation, and false reports. He also noted a later amendment would be needed to insert the words “the perpetrator” in one section, and he explained that some changes were meant to align with prior legislation and legislative drafting suggestions. Committee members raised several concerns. Representative Murray questioned the treatment of private and parochial schools, the change from gross negligence to negligence, and the removal of a definition of bullying based on imbalance of power and perceived characteristics. Representative Damon also objected to deleting that definition, arguing it would narrow the scope of bullying too much. Representative Han spoke in opposition, saying the amendment was too broad, unnecessary in parts, and not ready for final action; he criticized the removal of the imbalance-of-power language, the conference requirement when parents may not participate, and the reporting obligations for bus drivers and others. Cordelli responded that some issues were already addressed in prior law or SB 210 and that private schools have their own policies. Michelle Wongran of New Hampshire Legal Assistance testified in opposition, saying the bill was being heard without enough notice and that it does far more than the committee analysis suggests. She said the amendment adds undefined retaliation language, imposes reporting duties on school vendors and contractors, may conflict with FERPA and other federal privacy rules, and includes provisions that could have serious implications for schools and students. She said she supports parental involvement and some conference provisions in concept, but urged the committee to reject the amendment or at least send it through the normal legislative process for fuller review. No vote was taken during the hearing portion described in the transcript.

Transcript Highlights:

• That would mean setting aside funding to reduce pension liabilities and district contribution rates over
• The trailer bill language sets forth these processes.
• That doesn't look at what we, the actual graduation rates.
• Increasing, including the Tier 2 rate, which is now increasing.
• So sick leave is going to be their normal salary rate, right?

Summary: The committee heard an overview of the May Revision’s Proposition 98 changes for K-12 and community colleges. The Department of Finance said the minimum guarantee rises by $6.4 billion over the Governor’s Budget across the three-year window, with higher guarantees in each year, full payment of the prior settle-up, and larger deposits into the school rainy-day fund. The LAO said the revenue and LCFF updates were reasonable, but urged caution about the settle-up approach and recommended using more of the available funding to protect ongoing programs and build budget resilience. Members focused heavily on the size of the proposed $3.9 billion settle-up, the $10.3 billion reserve deposit, declining K-12 enrollment, and how much of the new funding should be ongoing versus one-time. The committee then reviewed the community colleges portion of the budget. Finance described the May Revision’s higher SCFF COLA, additional funding for enrollment growth, a student support block grant, apprenticeship adjustments, and continued funding for deferred maintenance, Calbright, Common Cloud, and credit for prior learning. The Chancellor’s Office supported the core investments but asked for more funding for enrollment growth, changes to the growth formula, and a COLA for Student Equity and Achievement. The LAO recommended prioritizing the statutory COLA increase, noted that more than half of districts are already above current-year growth targets, and said the new adult learner demonstration project should be rejected because districts already have tools to support similar services. Members also discussed a $52 million current-year apportionment shortfall, which Finance said was discovered too late for the May Revision and would need to be addressed later. Finally, the committee took up the proposed implementation of the federal Workforce Pell program. Finance proposed one-time funding for the California Student Aid Commission and Cradle to Career to build eligibility and data systems, along with trailer bill changes to set up state approval processes. CSAC said the program is promising but highly complex, that California lacks the needed infrastructure, and that the state will need emergency regulations, data linkages, and ongoing funding beyond the one-time proposal. The LAO agreed that some initial funding is needed but warned that the amounts and ongoing costs remain uncertain and that the Legislature should carefully draft the trailer bill language. Members asked about timing, other states’ actions, and how the state would ensure the program is ready for students and institutions.

Transcript Highlights:

• That sets your upper payment limit.
• So from commercial care, now to Medicaid, what's the rate? Why is the rate so low?
• The rate is what it is. The last time we had a rate change.
• the rates.
• So where does the rate that we get for our per diem rate come from?”

Summary: The subcommittee met to review Department of Human Services hospital payments in Arkansas Medicaid, with DHS Secretary Janet Mann and Deputy Secretary Misty Eubanks presenting first, followed by Arkansas Hospital Association Executive Vice President Jody Ann Tritt and a brief comment from Arkansas Children’s. DHS outlined the main hospital payment streams: fee-for-service per diem payments, upper payment limit (UPL) supplemental payments, cost settlements, and smaller payments such as graduate medical education and disproportionate share hospital funds. Members asked for plain-language explanations of cost settlements, why per diem rates vary by hospital type, and why UPL applies to private hospitals. DHS said cost settlements and UPL are mechanisms to help offset Medicaid underpayment, with SFY 2025 hospital payments totaling hundreds of millions of dollars and no general revenue used for supplemental payments beyond the state share funded through hospital assessments and related financing structures. Committee members focused heavily on whether Arkansas hospitals are adequately reimbursed and why rural hospitals struggle. Tritt explained that critical access hospitals, rural emergency hospitals, PPS hospitals, and specialty hospitals operate under different federal and state rules, and said lower per diem rates for some facilities help with cash flow and later cost settlement adjustments. She said Arkansas hospitals are under financial strain, citing a negative patient services margin statewide and noting that Medicaid, Medicare, and commercial payers all contribute to the problem. She also said the association had just authorized a statewide survey of hospital finances and costs, which she expected would take about a year to complete. A major theme was commercial insurance reimbursement. Tritt argued Arkansas hospitals are paid far less than hospitals in neighboring states even though premiums are similar, and said administrative burdens, prior authorizations, and denials add to the problem. She said hospitals receive about 52 to 53 cents on the dollar for Medicaid costs without UPL and about 78 cents with UPL, still below cost. Members also discussed Medicare wage index issues, Medicare Advantage, and whether hospitals could use technology or alternative arrangements to improve finances. No votes were taken on the hospital presentation. At the end of the meeting, DHS provided a brief update on Living Choices and assisted living reimbursement. Officials said one assisted living facility, Pillars of the Community in Crossett, had announced closure, with nine waiver clients being transitioned to other settings. DHS said the current cost reporting period was underway and that a new rate study could be ready for review before the end of the fiscal year if reports were submitted on time. Members also asked about the broader waiver plan, and DHS said the next waiver iteration would likely be brought back to the committee in the summer.

Transcript Highlights:

• and asked for a significant rate and asked for a significant rate increase<00:32:40.279> in
• Even with these rate increases, HPIA has been unable to break even.
• <00:39:50.000> need<00:39:50.319> going look at rate need going look at rate need going
• um it's on them to to agree to the rates um it's on them to to agree to the rates that<00:57:46.480
• ground what they can offer at what rates ground what they can offer at what rates why<01:25:47.639

Keywords: 910, house, all

Transcript Highlights:

• The breastfeeding rates, I'm sorry.
• The bill will set a floor of 95% of the state-determined Medicaid rate for eye care reimbursements. where
• The core structure of Medicaid managed care restricts states from being able to set Medicaid rates, except
• So far, the state of Texas has not set a floor or any rate for any type of provider when it comes to
• do it through the budget process, not by setting rates in statute.

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

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

Transcript Highlights:

• Now, California's rate of food insecurity, that 13%, is pretty close to the national rate of about 14%
• The rate declined between 2011 and about 2017.
• at a rate of four a day.
• The participation rate is high.
• The participation rate is high.

Summary: The joint oversight hearing focused on food insecurity in California and how state and federal nutrition programs, agricultural production, and food distribution systems intersect. Assemblymembers emphasized that many Californians, including farmworkers, seniors, children, and communities of color, remain food insecure despite California’s agricultural abundance. Panelists and members discussed CalFresh, WIC, school meals, Sun Bucks, food banks, and the impact of federal policy changes, including possible nutrition cuts, tariffs, and immigration enforcement, on access to food and the agricultural workforce. Secretary Karen Ross described CDFA programs aimed at improving access to fresh food and supporting local agriculture, including the senior farmers’ market program, California Nutrition Incentive Program, Healthy Refrigeration Grant Program, Community Food Hubs, Farm to School, urban agriculture, and a proposed tribal food sovereignty program. She said these efforts help connect local producers to consumers, expand healthy food access, and build infrastructure such as refrigeration, mobile markets, and aggregation hubs. Department of Social Services Deputy Director Alexis Fernandez Garcia outlined CalFresh, CFAP, Sun Bucks, CACFP, emergency food programs, and tribal nutrition assistance, noting that CalFresh and related programs significantly reduce poverty and food insecurity, but participation gaps remain for non-English speakers, some Asian American communities, and undocumented households. PPIC researcher Tess Thorman presented data showing that 13% of California households experienced food insecurity in 2023, with higher rates among households with children and Latino, Black, and other households. She said nutrition programs reduce poverty and food hardship, but federal rules, income thresholds, immigration restrictions, and high living costs limit their reach. Members asked about simplifying applications, improving call center access, increasing outreach in multiple languages, and adjusting benefits for inflation. Officials said the state has used available federal options to streamline enrollment, improve customer service, and target outreach, but many core rules and benefit levels are set federally. The second panel shifted to food production and market access. A farmer, a UC food systems leader, and a produce distributor described efforts to connect small and medium farms with food banks, schools, universities, and Medi-Cal food-as-medicine programs. They highlighted programs such as Farms Together, the USDA Southwest Regional Food Business Center, Farm to School, food hubs, and climate-smart infrastructure grants as ways to create stable markets for local growers while improving food access. Speakers also raised concerns about land tenure, consolidation, regulatory burdens, labor constraints, and the loss of federal funding, and members discussed whether state investments and Prop. 4 funds could help sustain and expand these efforts.

Transcript Highlights:

• And that's why we have the system set up as it currently is, just for fun.
• Chair, yes, it is triple-A for all three of our rating agencies, and we enjoyed that AAA rating at the
• Johnson do you know what our bond rating Johnson do you know what our bond rating is<00:32:19.200
• and we enjoyed our ra agency ratings and we enjoyed that<00:32:52.440> AAA<00:32:52.880> rating
• ; it has helped our credit rating.

Bills: HF4, HF173

Keywords: tax relief fund, budget surplus, surplus revenue, tax rebate, tax refund, one-time refund, income tax, property tax, constitutional amendment, Minnesota Constitution, general fund, budget reserve, taxpayer relief, state surplus, fiscal forecast, wealthy taxpayers, high-income exclusion, 2026 ballot, referendum, surplus distribution

Transcript Highlights:

• So we have to set a cut point in most cases.
• is just based on the passage rate?
• We'll be back over that rate of growth.
• and employment rates after school.
• I'd like to see it as a About their individual graduation rates and employment rates after school.

Summary: The Higher Education Budget Subcommittee met to review funding models for the Florida College System and district workforce education programs, with an emphasis on how new dollars are allocated in the program fund and how performance and targeted funding are incorporated. Chancellor Hebda explained the Florida College System model, including base program funding, student success and pipeline funds, performance incentives for industry certifications, and the 2022 president-developed formula that weights enrollment, workforce enrollment, completions, small-college factors, and regional cost differences, plus a targeted funding floor for colleges below a minimum per-FTE level. Vice Chancellor Goodman then outlined the district workforce model, which uses lagged enrollment, program cost weights, local revenue offsets, small-district adjustments, and unmet-need calculations to distribute lump-sum appropriations to school districts offering workforce education. The department also provided updates on several grant programs and funding delays. Goodman said the Workforce Development Incentive Grant, Pathways to Career Opportunities Grant, Graduation Alternative to Traditional Education Startup Grant, and teacher apprenticeship/mentor bonus programs all involve multi-year awards and often require reversions and reappropriations because projects are delayed, extended, or not fully obligated by year-end. She said the department is moving toward an electronic grants system and had already adjusted internal deadlines to speed awards, while acknowledging some reimbursement delays and explaining that mentor bonuses for teacher apprentices will not be paid until the first cohort reaches the statutory timing requirement. Members asked about tracking whether CTE students work in their trained fields, how Xello is used to inform students about career pathways, how FTE is calculated, whether the funding formulas could encourage growth over quality, and how students with disabilities are counted in workforce funding. Questions also focused on tuition, enrollment trends, and the gap between college and university funding. The committee heard that tuition has remained flat for more than a decade, enrollment has rebounded from COVID and is projected to exceed pre-pandemic levels, and the college system’s funding per FTE varies widely. Valencia College President Kathleen Plinsky testified in support of the proposed formula and an additional $200 million for the Florida College System, saying Valencia is the second-largest college in the state but ranks last in per-FTE funding, which has made it difficult to recruit and retain faculty and admit qualified students in high-demand programs like nursing. The committee took no vote and adjourned after the presentations and questions.

Transcript Highlights:

• So, we expanded that year, and we continue to set our rates so that our community-based teachers make
• <00:07:29.400> We use a cost model to set our rates.
• We use a cost model to set our rates.
• <00:08:01.040> our continue to set our rates so that our continue to set our rates so that
• And we're setting our<00:10:43.240> rates<00:10:43.920> very<00:10:44.200> close

Keywords: 958, all

Summary: The committee first approved the minutes from its September 24 meeting after a motion and second. It then heard a presentation from New Mexico Early Childhood Education and Care Secretary Elizabeth Gragensky on that state’s early childhood system and planned universal child care rollout. She described how New Mexico consolidated multiple prenatal-to-age-five programs into a cabinet-level department, expanded pre-K to a longer day, and uses a cost model to set reimbursement rates intended to cover true provider costs, including wages, benefits, occupancy, food, and reserves. She also said the state created an Early Childhood Trust Fund and secured a constitutional amendment to dedicate 0.60% of the land grant permanent fund to early care and education, with the department’s budget growing from about $400 million in 2021 to just under $1 billion this year. Gragensky said families can begin applying for universal child care on November 1, with participation voluntary for both families and providers. She reported that New Mexico is aiming to expand capacity by adding 1,000 registered home providers, 120 group homes, and about 55 more centers, supported in part by a $13 million low-interest loan fund and a request for an additional $20 million. She said the state has seen growth in early childhood professionals, including a 64% increase over the last three to four years, and pointed to reported outcomes such as a 21% increase in literacy and a 75% kindergarten readiness rate, while noting that some measures are new and baseline comparisons are still being developed. Members asked about the funding sources, provider profitability, workforce development, and measurable outcomes. Gragensky said the program is designed to support provider sustainability through rates tied to true cost and includes allowances for sick leave, vacation, benefits, and reserves. She also said maternal labor force participation is 10% higher than the national rate and attributed that in part to child care access. The committee then moved to a separate presentation by Department for Community Based Services Commissioner Lisa Dennis and Division of Family Support Director Roger McCann on anticipated cuts to TANF and SNAP, beginning with an overview of TANF as a federal block grant with a fixed annual Kentucky allocation of about $180.7 million.

Transcript Highlights:

• Could be a different rate.
• Or it could be that the rates being charged are not competitive rates.
• Well, actually, TDI, we did approve rate setting authority. Now, so TDI actually reviews our rates.
• I can't tell you a number, but I'll generally say is we set our benefit amounts at the market rate, which
• I can't tell you a number, but I'll generally say is we set our benefit amounts at the market rate, which

Keywords: 1185, senate, all

Transcript Highlights:

• What is the current what is our current bond rating? current bond rating? current bond rating?
• up that was set up the program is set up that was set up the program is set up that was set up years
• I remember when we set that group up remember when we set that group up remember when we set that group
• set up to be able those schools haven't set up to be able those schools haven't set up to be able to
• set up the options.

Bills: HJR 4, HJR 6, HB 195, HB 13, HB 143, HB 135

Keywords: occupation tax, securities, financial regulation, tax exemption, legislative amendment, capital gains tax, realized gains, unrealized gains, investment income, asset sale, capital assets, wealth tax, estate tax, trust tax, tax limitation, constitutional amendment, Texas Constitution, Article VIII, property tax, sales tax

Transcript Highlights:

• It is not the case that global organizations set tax law, it is the United States Congress that sets
• that we're paying on government debt those are the rates that are the base rate when you set mortgage
• rates and when you set other consumer credit rates.
• , a car note rate?
• rates continue to rise.

Keywords: nomination, Deputy Secretary of Treasury, economic policy, inflation, tariffs, tribal nations, government relations

Summary: The meeting convened to consider the nomination of Mike Falkender for the position of Deputy Secretary of the Treasury. During the session, multiple members voiced concerns regarding current economic policies under the Trump administration, particularly around inflation, tariffs, and the impact on small businesses. Discussions frequently centered on the administration's approach to tariffs and taxation, and how these factors contribute to the rising cost of living and potential job losses. Additionally, the importance of bolstering government-to-government relationships with tribal nations was emphasized, highlighting the need for specialized offices focused on tribal affairs within the Treasury Department.

Transcript Highlights:

• And we are right now the highest in the state for syphilis rates.
• The contact rates went down significantly.
• We are higher than what the national average is on success rate.
• exclusion any SED services provided in these smaller settings.
• We administer those in conjunction with the state sales tax rate of 5%.

Keywords: 908, all

Transcript Highlights:

• Though we don’t have five-year rates yet, our teacher residents have a two-year retention rate of 91%
• and three- and four-year rates of 86%.
• If a campus receives a not rated rating for any reason, the commissioner will continue the intervention
• doesn't want to be rated, maybe.
• , and there are other ratings.

Summary: The committee continued hearing testimony on Senate Bill 2252, which would expand early literacy and numeracy screening, parent notification, intervention supports, and teacher training, including math academies and early childhood supports. Supporters from Texas 2036, Good Reason Houston, Texas Business Leadership Council, and several parents argued that early identification of skill gaps, clearer data for families, and stronger teacher preparation would improve student outcomes, workforce readiness, and long-term earnings. They cited low math proficiency statewide, the importance of early intervention, and examples of districts using screeners and data dashboards to guide instruction and resource allocation. One witness also highlighted home visiting as a family-support model, while another urged more funding for pre-K partnerships and stronger support for parents with reading materials and guidance. A district special education administrator testified neutrally, saying the bill reflects practices already used in her district but expressing concern that it could reduce local control and teacher discretion by standardizing screening and tying it to funding. A Texas Classroom Teachers Association representative supported the intent but warned that mandatory math academies and intervention academies could burden teachers if implemented like prior reading academies, and a substitute teacher/teacher-of-the-year witness asked for clearer protections around special education information and pay for alternative certification candidates. After public testimony closed, SB 2252 was left pending. The committee then took up Senate Bill 2253, as substituted, which would phase out routine hiring of uncertified teachers over time, require parent notification when a teacher is uncertified, and expand high-quality preparation pathways such as university programs, residencies, improved alternative certification, and grow-your-own programs. Senator Creighton said the bill responds to the rise in uncertified teachers and aims to strengthen the teacher pipeline with more structured preparation, mentorship, and oversight by SBEC. Invited testimony strongly supported the measure: a Texas Tech researcher said uncertified teachers and fast-track programs are associated with significant learning losses, while year-long residencies and mentored pathways produce stronger outcomes and higher earnings for students. Leaders from Dallas College and Sam Houston State University described successful residency and grow-your-own models, high completion and retention rates, and the need for paid residencies and stipends so candidates can afford to enter the profession. Committee members asked about the difference between mentorship and residency, the cost-effectiveness of paid residencies, retention incentives, and how to scale the model statewide. The committee also adopted the substitute for SB 2253 and later paused to vote out several other bills, including SB 1191, SB 1786, SB 226, SB 326, SB 570, SB 870, SB 991, SB 60, SB 365, SB 1401, and SB 1067, all of which were reported favorably, many with unanimous votes and some placed on the local and uncontested calendar.

Transcript Highlights:

• Well, the rate that you the rate >> we do.
• a weekly rate of 555. a weekly rate of 555.
• the statewide rate, the uh county rates the statewide rate, the uh county rates and<01:45:30.480
• > not >> data set it's the same data set I'm not >> data set it's the same data set
• Um rate.

Keywords: 1189, house, all

Transcript Highlights:

• No, the committee hasn't even set up. Hey, give me some names, man.
• There's a part here around rate setting.
• Ultimately, we agree that these things, we don't want these things in rates.
• So the idea is actually establish this fund, now get the structure set up.
• It's just going to give us, again, resources to take it out of rates.

Summary: The Assembly Committee on Natural Resources heard Senator Becker present a broad energy and affordability bill focused on shifting certain utility-related costs out of rates and into a new public power fund structure. The bill’s major elements included using cap-and-trade climate credit revenues to provide larger and better-timed customer credits, especially for low-income customers; creating a fund to help cover wildfire mitigation, care and fairness, and other public-purpose costs; adjusting rate-setting and wildfire spending oversight; and streamlining permitting and CEQA review through programmatic environmental documents for similar projects. Becker said the goal was to reduce regressive costs in rates while still supporting climate and infrastructure goals. Support came from municipal utilities, community choice advocates, environmental justice and clean energy groups, and the Climate Center, many of whom said they supported the bill and wanted to continue working on amendments. Opposition came from the California Chamber of Commerce, utility companies, business groups, and labor representatives, who argued the bill would shift rather than solve cost pressures, create rate instability, and introduce reliability and investor risks. Several opponents also criticized the proposed funding structure and the inflation-capped rate-setting approach. Committee members asked Becker about the rationale for the power fund, the change from 85% to 100% of cap-and-trade revenues going to customer credits, the reduced frequency of wildfire mitigation reporting, and the adequacy of streamlined environmental review. Becker said the bill was intended to move wildfire and other public-purpose costs out of rates over time and to speed up review without eliminating project-specific environmental analysis. The committee ultimately voted to pass the bill on a due-pass recommendation, with members noting ongoing discussions on permitting and other amendments.

Transcript Highlights:

• at zero, not maybe set at zero, but shall be set at zero.
• In 2022, the legislature capped interest rates on small loans at 36%.
• They don't run interest rates.
• It has to be set at zero; someone would have to put that in.
• It's not an interest rate; it's a fee, and there is a difference there.

Transcript Highlights:

• with us for next year, we had them file two sets of rates: one set that assumed there were no enhanced
• their rate because of concerns about market instability.
• And so, in all honesty, I'm almost more nervous about '27 rates than about '26 rates.
• And so in all honesty, I'm almost more nervous about 27 rates than about 26 rates. and 27 rates, than
• about 26 rates.

Summary: The committee first welcomed new DSHS Secretary Angela Ramirez, who introduced herself and described her background in public service, federal and state legislative work, and health and human services leadership. Members emphasized the importance of building strong relationships with her and noted her focus on protecting services, using strategic approaches in a tight budget environment, and improving partnerships with the Legislature. Ramirez said she wanted to keep communication open and that her priorities would be shaped by what she learns from lawmakers and agency partners. The next work session focused on the West Coast Health Alliance and the broader Governor’s Public Health Alliance. Department of Health and governor’s office staff said the West Coast alliance, involving Washington, Oregon, California, and Hawaii, was formed to coordinate science-based public health guidance, especially around vaccines, return-to-work guidance, and responses to federal changes. They said the alliance is intended to reduce confusion, counter misinformation, and preserve access to evidence-based recommendations, with early actions including vaccine guidance for COVID-19, flu, and RSV, a statement rejecting any vaccine-autism link, and preparation for possible ACIP changes. Members asked about workload and coordination with other regional alliances, and staff said there is informal coordination but no formal regular meetings. The committee then heard from the Washington State Health Benefit Exchange about open enrollment and the effects of federal policy changes. Exchange leaders said the expiration of enhanced premium tax credits, HR1 provisions, and immigration-related eligibility changes are affecting affordability and enrollment, with some customers facing large premium increases and some counties becoming harder to serve. They reported early open-enrollment traffic increases, nearly 10,000 new sign-ups, and nearly 12,000 active coverage drops so far, while noting that many more people may disenroll later if subsidies are not extended. They also described mitigation efforts such as silver loading, Cascade Care Savings, outreach through navigators and community partners, and planning for future HR1 requirements like ending auto-renewal and adding verification steps. In the final work session, staff from the Health Care Authority and Insurance Commissioner’s office reviewed Washington’s health reform history and the state’s current affordability and access efforts. They highlighted past ACA-related coverage gains, continued work on prescription drug affordability, PBM oversight, primary care and behavioral health access, and a pending legislative proposal to preserve access to preventive services. They also discussed federal changes affecting Medicaid and the exchange, including work requirements, six-month redeterminations, and the need to coordinate across agencies to implement new rules. Members raised concerns about network adequacy, provider access, and the complexity of the health care system, while staff said they are trying to mitigate harm, simplify administration, and keep coverage and access as stable as possible.