Transcript Highlights:

• Have you had any recent discussions with HHS regarding the cost that Medicaid is taking on these out-of-state
• Have you had any recent discussions with HHS regarding the cost that Medicaid is taking on these out-of-state

Keywords: 928, house, all

Summary: The committee first discussed HB 443, which would change terms and vacancy language for members of a higher education commission. Members raised concerns that the bill was too narrow to address broader issues with commission membership, including expired appointments, attendance expectations, and whether the Department of Education could replace the commission’s role. Several members suggested the bill was not ready for action and favored holding it for further work, possibly through a subcommittee or work session. One member suggested that if attendance standards were added, no more than two unexcused absences should trigger removal, given the commission’s meeting schedule. The chair said he would defer action and form a small subcommittee to report back before the committee deadline. The committee then moved to HB 484, dealing with repurposing Career and Technical Education classroom space after 20 years of exclusive use. The chair explained that the bill was aimed at the Milford CTE project, where shared use of space could allow a school to repurpose part of a CTE facility while still using it for CTE-related instruction. Members discussed other possible situations around the state, including Claremont, North Conway, and Jaffrey/Rindge, and whether the bill should be limited to Milford or broadened to allow local districts more flexibility. Some members favored passing the bill now to help CTE projects move forward, while others argued for an amendment removing the requirement that the space be vacated specifically to expand the CTE program occupying it. Testimony and discussion emphasized that the Milford project had state approval but reduced funding, requiring a smaller scope and repurposing of existing space. Supporters said the bill could help preserve CTE programs while also benefiting general education space needs, and that local districts should have flexibility after 20 years. Opponents or cautious members noted that the language might not fit every district situation and asked for feedback from Director Beard and Steve Rothenberg before final action. The committee did not take a final vote in the portion provided, and instead discussed waiting for an amendment and additional input before acting.

Transcript Highlights:

• So, I like to call HHS to order this morning, and we are going to get right into it.

Keywords: 1187, senate, all

Transcript Highlights:

• It makes it a forecasted program similar to programs in the E12 and HHS budgets.

Keywords: 1187, senate, all

Transcript Highlights:

• I've been asked to ask if you want to refer it to HHS or laying it on the table is your final answer.

Keywords: 1187, senate, all

Transcript Highlights:

• We're usually here for maternal health and HHS, so thanks for your time.

Keywords: 1191, senate, all

Transcript Highlights:

• Senator Kupec, you know, sitting next to you in HHS has been a really helpful primer on learning what

Keywords: 918, senate, all

Summary: The Select Subcommittee first took up adoption of three previously prepared nonpartisan committee summary reports dated October 15, November 13, and November 21. Senator Rasmusson objected to the lack of advance notice about the day’s testifiers and criticized the practice of having nonpartisan staff summarize what he described as a partisan agenda. The chair responded that the committee’s purpose is to gather information, not hear bills, and that the summaries were intended as neutral resources for the Senate. Senator Coopek moved adoption, the motion was opposed by Rasmusson and another member, and the motion passed. The committee then turned to the day’s hearing on federal impacts on Minnesota, with the chair focusing on federal funding threats and the effect of congressional budget actions on health care, especially in greater Minnesota. The first presentation came from the Minnesota Department of Health on the state’s rural health transformation work. Assistant Commissioner Carol Broom introduced the team and described the rural hospital transformation program as a major opportunity to invest in rural health, while acknowledging longstanding challenges such as demographics, transportation barriers, and the financing of care. Nitha Moibi outlined the state’s rural health chart book and data showing an aging population, workforce shortages, and many health professional shortage areas, and described proposed strategies including workforce pipelines, bridge payments for low-volume birth hospitals, telehealth access points, mental health urgent care, and chronic disease prevention. Acting Assistant Commissioner Anna Ashby of the Minnesota Management and Budget office explained the state’s application to CMS for the Rural Health Transformation Program, which was created in federal law and awarded Minnesota just over $193 million for federal fiscal year 2026. She said the application was shaped by public comments, stakeholder meetings, and legislative outreach, and included initiatives on preventive care, workforce, care access, behavioral health, and provider financial stability. She also reviewed implementation constraints, including a January 30 revised budget deadline, limits on administrative spending, restrictions on using funds to offset Medicaid losses, and the need to show measurable progress to remain eligible for future funding. The presentation noted that most year-one funding would go to rural hospitals, with additional support for federally qualified health centers, community mental health centers, tribal partners, and technical assistance.

Transcript Highlights:

• > provisions Bill 2, you'll see there are provisions specific for agencies, not all agencies—HHS

Keywords: 928, house, all

Summary: The Committee of Conference on HB 1 and HB 2 was called to order, and Legislative Budget Assistant Michael Kaine reviewed the working documents before the committee. He explained the compare report, the detailed change sheet, the HB 1 index, the HB 2 side-by-side, the surplus statement, and a revenue handout, noting that the committee would vote up or down on all detail-change items and that unresolved items on hold would be removed from the final bills. He also identified staff available to answer technical questions and noted that the committee would track the dollar impact of decisions as it proceeded. Members then turned to the revenue outlook, with discussion focused on the gap between the House and Senate budget positions. House members said their budget guidance was based on revenue estimates that were significantly below the governor’s proposal, and they discussed whether additional revenue could close part of the gap. Department of Revenue Administration Commissioner Lindsey Stepp presented updated revenue estimates based on May data, explaining the methodology and the ranges for fiscal years 2025, 2026, and 2027. She said business taxes were the largest source of uncertainty, with estimates reflecting current economic conditions, recent revenue performance, and a range of possible growth rates. Committee members questioned the assumptions behind the business-tax ranges, including why the low and high scenarios were set at 2% and 8% growth. Stepp said the range was based on historical performance and current economic factors such as inflation, tariffs, and business behavior, and she noted that June is a major estimate-payment month for business taxes. Members also discussed recent revenue trends, including the effect of tariffs and the possibility of federal tax policy changes affecting repatriated profits. The commissioner and House members also discussed other revenue sources, including rooms and meals and real estate transfer taxes, with the House side arguing that lower mortgage rates and home prices could increase real estate transfer revenue. No votes were taken in the portion provided, but the committee discussed possible upward adjustments to House revenue assumptions, including increases of roughly $70 million in total based on the updated outlook and additional insurance-related revenue.

Transcript Highlights:

• So, um, HHS has about $1.5 billion in state fiscal years 26 and 27 in contracts.

Keywords: 928, house, all

Summary: The committee met with DHS Chief Financial Officer Nathan White to receive an update on the department’s budget lapse and vacancy rates. White explained the difference between the “back-of-the-budget” reduction and lapse assumptions, saying DHS is facing a current biennium reduction of about $23 million and estimating roughly a $60 million general fund lapse in state fiscal year 2025, compared with about $13.5 million the prior year. He said DHS’s lapse is driven largely by program utilization, labor market conditions, contract spending, and statutory carry-forwards in areas such as Medicaid and developmental disabilities, which tend to produce a smaller lapse in the first year of the biennium and a larger one in the second year. He also noted that the House and Senate budgets differ on some operating items, including Medicaid rates, with the Senate having struck a House proposal to reduce rates by 3%. Members questioned White about whether DHS ever spends down lapse money on last-minute purchases. He said the department does not engage in that practice, though it does retain some flexibility in its facilities budget for emergencies. He also described the process for transferring funds within and between class lines, including the need for fiscal committee approval above statutory thresholds, and gave examples such as moving funds to cover overtime in the SYSC budget and to ensure Medicaid payments for nursing facilities. White said such transfers are public and transparent and are reviewed by the governor and Executive Council. The committee then discussed DHS staffing. White said the department has a little over 3,200 authorized positions, with a vacancy rate around 14.5%, and that a hiring freeze had been imposed a few months earlier while exempting direct care positions. He said DHS is planning for about a $30 million general fund reduction to personnel, equivalent to just under 400 positions, and is managing postings centrally to stay within budget by July 1. In response to questions about the loss of about $80 million in federal funds, White and Associate Commissioner Patricia Tilly said DHS avoided layoffs by shifting staff into vacant positions, but that the cuts affected community contracts, public health workers, laboratory work, and some IT/data projects. Tilly said roughly 20 positions were affected, most were reassigned, a few staff left voluntarily, and the department has less flexibility going forward if more federal funding ends.

Transcript Highlights:

• It's going to allow the establishment of a grant program with HHS to help high-risk families.

Bills: HB75, HB188, HB199, HB4029, HB330, HB507, HB524, HB1517, HB 1065, HB1375, HB1630, HB1398, HB 1227, HB689, HB1814, HB2160, HB2140, HB4897, HB5600, HB5489, HB4188, HB2881, HB2048, HB3900, HB4074, HB5568, HB5528, HB3811, HB3726, HB3382, HB4507, HB4775, HB3626, HB3569, HB5212, HB5248, HB5178, HB3453, HB3231, HB3941, HB1571, HB1969, HB1865, HB2879, HB2643, HB4799, HB4891, HB5567, HB5549, HB5187, HB5118, HB3191, HB1730, HB1687, HB2192, HB4511, HB4805, HB1863, HB3195, HB3199, HB5562, HB5551, HB5169, HB3290, HB3712, HB3996, HB5098, HB5097, HB5089, HB3897, HB3868, HB3829, HB4840, HB3753, HB4368, HB4142, HB2841, HB3457, HB3784, HCR46, HCR109, HCR10, SB1844, SB1833, SB2284, SB2052, SB1666, SB1265, SB1146, SB1921, SB480, SB1734, SB296, SB2039, SB462, SB1646, SB2173, SB2925, SB682, SB1173, HB4535, HB4520, HB3824, HB3066, HB2442, HB3863, HB4773, HB4327, HB5115, HB5515, HB3372, HB5659, HB 127, HB386, HB 115, HB2868, HB 1249, HB4766, HB3720, HB4879, HB5383, HB4621, HB5431, HB5678, HB5534, HB4212, HB3954, HB3966, HB3918, HB1422, HB4765, HB4732, HB4742, HB4518, HB5084, HB3986, HB4144, HB3976, HB4473, HB3425, HB3641, HB3642, HB3475, HB3424, HB4744, HB4539, HB3159, HB5228, HB5370, HB4359, HB4443, HB4466, HB3849, HB4240, HB5141, HB5686, HB3629, HB3554, HB3567, HB2015, HB3575, HB5381, HB4398, HB3514, HB4614, HB4546, HB5681, HB5663, HB4271, HB4350, HB4035, HB3812, HB3540, HB3715, HB3664, HB4233, HB3333, HB3510, HB4222, HB2070, HB2854, HB2347, HB 113, HJR218, HB5623, HB4921, HB5673, HB5520, HB 105, HB4685, HB5354, HB4683, HB75, HB983, HB4847, HB1449, HB3833, HB5151, HB265, HB1845, HB782, HB 108, HB1960, HB158, HB1954, HB1955, HB2512, HB605, HB2581, HB2803, HB627, HB2667, HB1738, HB636, HB3679, HB2638, HB2655, HB871, HB2438, HB 1107, HB1765, HB1822, HB2153, HB4099, HB3732, HB3171, HB3178, HB3182, HB3749, HB2814, HB3977, HB4204, HB4207, HB4449, HB1820, HB1876, HB1939, HB1347, HB2593, HB2136, HB2132, HB2658, HB2413, HB2757, HB2080, HB3154, HB3063, HB3009, HB3448, HB3006, HB2844, HB3241, HB3680, HB3169, HB2078, HB2507, HB4559, HB3946, HB3460, HB3405, HB475, HB3463, HB3441, HB3441, HB3520, HB2060, HB4731, HB4991, HB1991, HB5596, HB2014, HB2142, HB2673, HB2731, HB2417, HB2399, HB2301, HB2301, HB3335, HB3234, HB3320, HB5573, HB5573, HB4848, HB4848, HB4748, HB4769, HB4795, HB2086, HB2086, HB2234, HB2234, HB2203, HB4916, HB5624, HB4505, HB139, HB5093, HB5302, HB5402, HB5606, HB2333, HB4630, HB4701, HB2583, HB2983, HB4924, HB3339, HB3339, HB3793, HB3631, HB4882, HB5509, HB5499, HB5430, HB5561, HB5561, HB5611, HB5043, HB5064, HB5064, HB3733, HB3733, HB3781, HB3219, HB32, HB4515, HB5348, HB3902, HB4420, HB3269, HB469, HB336, HB316, HB5396, HB993, HB1342, HB1342, HB5216, HB2046, HB2046, HB2188, HB2188, HB2450, HB2813, HB2857, HB4075, HB4075, HB2911, HB4682, HB4682, HB3117, HB3253, HB3442, HB4820, HB4336, HB5356, HB3669, HB3428, HB5465, HB3662, HB2590, HB2288, HB2288, HB1886, HB3458, HB3458, HB5603, HB5620, HB1489, HB1489, HB4101, HB4990, HB5685, HB5685, HB4950, HB4950, HB4980, HB5684, HB3507, HB3507, HB3566, HB4487, HB4487, HB4462, HB4462, HB4876, HB4915, HB4663, HB5570, HB2929, HB5261, HB2920, HB4642, HB4746, HB1609, HB5403, HB5453, HB3844, HB2336, HB1572, HB 1226, HB 1226, HB2806, HB2806, HB2617, HB2617, HB2827, HB3948, HB3948, HB3945, HB4266, HB4542, HB3319, HB1772, HB2496, HB1970, HB3434, HB5545, HB5545, HB5577, HB5577, HB31, HB31, HB279, HB370, HB370, HB4768, HB513, HB875, HB982, HB 1085, HB 1085, HB2677, HB2874, HB5478, HB4880, HB4798, HB4514, HB4958, HB4958, HB4508, HB4508, HB3758, HB3830, HB3744, HB3622, HB741, HB741, HB2204, HB2204, HB2860, HB4659, HB4578, HB813, HB712, HB712, HB1551, HB2790, HB2698, HB3365, HB3504, HB3118, HB3118, HB2959, HB1862, HB1862, HB 1026, HB4401, HB4401, HB4164, HB4164, HB3920, HB4737, HB4966, HB4966, HB4967, HB1958, HB4979, HB4979, HB5459, HB3862, HB1823, HB1823, HB4415, HB4893, HB2343, HB 1228, HB4337, HB188, HB199, HB4029, HB330, HB507, HB524, HB1517, HB 1065, HB1375, HB1630, HB1398, HB 1227, HB689, HB689, HB1814, HB2160, HB2140, HB4897, HB5600, HB5489, HB4188, HB2881, HB2048, HB3900, HB4074, HB5568, HB5528, HB3811, HB3726, HB3382, HB3382, HB4507, HB4775, HB3626, HB3569, HB5212, HB5248, HB5178, HB3453, HB3231, HB3941, HB1571, HB1969, HB1865, HB2879, HB2879, HB2643, HB4799, HB4891, HB5567, HB5549, HB5187, HB5118, HB3191, HB1730, HB1687, HB1687, HB2192, HB4511, HB4805, HB4805, HB1863, HB3195, HB3199, HB5562, HB5562, HB5551, HB5169, HB3290, HB3712, HB3996, HB5098, HB5098, HB5097, HB5089, HB5089, HB3897, HB3868, HB3829, HB4840, HB3753, HB4368, HB4142, HB2841, HB3457, HB3784, HCR76, HCR76, HCR127, HCR9, HCR40, HCR118, HR559, HCR59, HCR59, HCR135, HCR141, HCR46, HCR46, HCR109, HCR10

Keywords: magistrate, criminal procedure, probable cause, written findings, law enforcement, Texas STRONG defense fund, severance tax revenue, oil and gas revenue, constitutional transfers, rainy day fund, economic stabilization fund, state highway fund, oil and gas production, qualifying county, county grants, water infrastructure, first responders, public safety, DPS staffing, commercial motor vehicle safety

Transcript Highlights:

• I'm here against the HHS. be 17, I stand for myself.

Bills: HB17, HB34, HB41, HB 118, HB 119, HB 127, HB 128, HB 129, HB 130, HB132, HB133, HB17, HB41, HB118, HB119, HB127, HB128, HB129, HB130, HB132, HB133

Keywords: foreign ownership, real estate, national security, designated countries, Texas property law, lobbying, foreign adversaries, compensation prohibition, transparency, civil penalties, higher education, foreign adversary, research security, trade secrets, academic partnerships, HB 128, sister city, sister-city agreement, international exchange, municipal diplomacy

Transcript Highlights:

• total $455 million will be, assuming the base is appropriated, would be appropriated either in the HHS

Keywords: 1187, senate, all

Transcript Highlights:

• We support the amendments that HHS has proposed as well. Mahalo. Mahalo. Thank you.

Keywords: 910, house, all

Summary: The joint hearing covered HB 553 on biomarker testing coverage, HB 556 on colorectal cancer screening access, and later HB 712 on 340B drug pricing. For HB 553, the American Cancer Society Cancer Action Network, patient advocates Natalie Heyman and Susan Hirano, a surgical oncologist, and the American Lung Association strongly supported the bill, arguing that biomarker testing should be covered when ordered by a doctor and guided by current evidence. DHS and several insurers offered comments and requested amendments, with DHS saying it appreciated the intent but wanted changes. The committees then voted to pass HB 553 with amendments, including a House draft and a defective date of July 1, 3000; both the House Health and Human Services and Homelessness committees adopted the recommendation unanimously. For HB 556, testimony focused on closing gaps in colorectal cancer screening, especially for uninsured and underinsured patients who can get stool-based screening but then cannot access follow-up colonoscopies. Community Clinic of Maui, ACS CAN, and the American Cancer Society supported the bill, with ACS CAN urging a program similar to the breast and cervical cancer control program and offering amendments. DHS requested that the program and appropriation not conflict with executive budget priorities, and the committees noted technical amendments, a defective date, a blank appropriation amount, and corrections changing Medicare references to Medicaid. HB 556 was also passed with amendments by both committees. The hearing then moved to HB 712 on 340B drug pricing and contract pharmacies. The Department of Health and the Attorney General’s office expressed concern that the bill would require the state to regulate private commercial activity and said the department lacked the expertise and resources to implement it as written, suggesting it might belong in a different statutory section. In contrast, PhRMA opposed the bill, while Hawaii Pacific Health and Hawaii Island Community Health Center supported it, saying 340B savings are important for hospital services and patient access to low-cost medications, especially where manufacturers have restricted shipments to contract pharmacies. No vote on HB 712 was taken in the portion provided.

Transcript Highlights:

• The legislation would require the Secretary of HHS, in consultation with the Secretaries of Defense and
• The legislation would require the Secretary of HHS, in consultation with the Secretaries of Defense and

Keywords: U.S. House of Representatives Floor Proceedings on Tuesday, April 21, 2026, 1012, house, all

Transcript Highlights:

• Again, you'll have to talk to HHS.
• I believe it was Governor Sununu's HHS association with the Katy group that came, um, that that's why

Keywords: 1189, house, all

Transcript Highlights:

• But to kind of go back with Seth though, if we are talking about like HHS and other agencies that aren't

Keywords: 1189, house, all

Summary: The commission met to review stable tokens, real-world asset tokenization, and blockchain-based trust, approved the agenda and December 12 minutes, and heard a presentation from Anchorage Digital after postponing a planned Bitco presentation because of its IPO quiet period. Anchorage’s Melinda Delos, Joe Mioli, and Kevin Wasaki introduced the firm, describing it as a global digital assets platform and the first crypto-native institution in the U.S. to receive a federal banking charter. They said their approach emphasizes security, regulated custody and trading services, and responsible innovation for institutional clients, banks, states, and sovereigns. The presentation focused on post-Genius Act momentum in the stablecoin market. Anchorage said the law provided regulatory clarity and helped spur activity with major clients, including Athena, Tether, and Western Union. The speakers highlighted Western Union’s planned stablecoin as especially significant because it reflects adoption by a long-established traditional payments company, and they said the project illustrates how stablecoins can support programmable, real-time, interoperable payments. They also noted that Anchorage is providing issuance infrastructure for the Western Union project. The commission and presenters also discussed government uses of tokenized assets, including reserve legislation, digital assets for tax collection and fees, and a Marshall Islands initiative to use a tokenized sovereign bond for direct citizen payments. In response to a question, Anchorage said it would follow up on which states are using digital assets for revenue collection, mentioning Louisiana and Pennsylvania as examples. The banking discussion centered on remittances, instant payments, and interbank settlement, with Anchorage arguing that stablecoins can reduce settlement time, fees, and foreign exchange risk while improving traceability and auditability.

Transcript Highlights:

• We need Senate, HHS, and House public health hearings on the risks and benefits of psychiatric drug and

Bills: HB5

Keywords: hemp, cannabinoids, regulation, occupational licenses, consumable products, marketing, criminal offenses, labeling requirements, health and safety, 997, house, all

Transcript Highlights:

• This amendment assures that moms who are not given this information can still file complaints with HHS

Bills: SB6, SB30, SB13, SB2878, SB2501, SB66, SB268, SB331, SB618, SB414, SB1394, SB2425, SB898, SB993, SB442, SB735, SB784, SB2538, SB1919, SB1013, SB2215, SB2322, SB626, SB570, SB747, SB2183, SB673, SB1015, SB1447, SB1370, SB1784, SB1897, SB2873, SB2891, SB2933, SB2540, SB2681, SB2695, SB1965, SB2203, SB872, SB875, SB1030, SB1277, SB1730, SB1681, SB1152, SB2969, SB2747, SB2705, SB2541, SB1708, SB2080, SB2721, SB1986, SB2392, SB2539, SB2857, SB2799, SB2785, SB2782, SB1531, SB1927, SB1263, SB1098, SB835, SB3070, SB22, SJR27, SB25, SB7, SB552, SB1612, SJR87, SJR1, SB6, SB30, SB13, SB2878, SB57, SB127, SB293, SB441, SB3059, SB512, SB241, SB1718, SB140, SB2055, SB2075, SB2018, SB1534, SB1567, SB785, SB1233, SB1580, SB1663, SB413, SB447, SB519, SB467, SB1579, SB1191, SB1021, SB1838, SB2807, SB2835, SB546, SB2121, SB2167, SB2035, SB2024, SB1032, SB1049, SB1266, SB1400, SB1302, SB401, SB1596, SB1281, SB1242, SB1343, SB310, SB1346, SB2753, SB2703, SB2221, SB1719, SB2177, SB800, SB790, SB748, SB571, SB1957, SB1923, SB1896, SB1760, SB1335, SB2368, SB2477, SB2587, SB2972, SB2986, SB2965, SB1563, SB1467, SB1164, SB1137, SB614, SB705, SB961, SB918, SB955, SB869, SB850, SB863, SB1610, SB1055, SB2206, SB457, SB2337, SB1362, SB926, SB1494, SB251, SB456, SB500, SB1307, SB2615, SB2995, SB2321, SB973, SB974, SB865, SB506, SB781, SB1522, SB1558, SB510, SB667, SB763, SB2073, SB1858, SB1660, SB505, SB2900, SB1433, SB1540, SB1964, SB1300, SB1644, SB2217, SB2373, SB2431, SB1758, SB2480, SB3039, SB3047, SB3073, SB2920, SB2781, SB826, SB766, SB2460, SB527, SB1946, SB2885, SB1243, SB2610, SB2595, SB857, SB2501, SB66, SB268, SB331, SB618, SB414, SB1394, SB2425, SB898, SB993, SB442, SB735, SB784, SB2538, SB1919, SB1013, SB2215, SB2322, SB626, SB570, SB747, SB2183, SB673, SB1015, SB1447, SB1370, SB1784, SB1897, SB2873, SB2891, SB2933, SB2540, SB2681, SB2695, SB1965, SB2203, SB872, SB875, SB1030, SB1277, SB1730, SB1681, SB1152, SB2969, SB2747, SB2705, SB2541, SB1708, SB2080, SB2721, SB1986, SB2392, SB2539, SB2857, SB2799, SB2785, SB2782, SB1531, SB1927, SB1263, SB1098, SCR9, HB5560, HB762, HB 107, HB 114, HB138, HB4386, HB2495, HB581, HB3348, HB5323, HB1584, HB4341, HB6, HB171, HB143, HB449, HB3486, HB4263, HB5246, HB2, HB2011, SB17, SB21

Keywords: electric power, interconnection, utilities, ERCOT, large load customers, water supply, sewer service, demand management, school libraries, library advisory councils, parental rights, library materials, educational content, challenging materials, judicial branch, court security, expunction, pretrial intervention, youth diversion, record retention

Transcript Highlights:

• And needless to say, after that point, this person had to go to, um, HHS or what do you call it, DCYF
• Needless to say, after that point, this person had to go to, um, HHS or what do you call it, DCYF at

Keywords: 1189, house, all

Transcript Highlights:

• But we had the last meeting where we had Henry Lipman come in from HHS dealing with Medicaid, and he

Keywords: 928, house, all

Summary: The subcommittee opened its second meeting on House Bill 742, which would require catastrophic special education aid to be drawn from the education trust fund, and discussed whether to also examine differentiated aid within the adequacy formula. The chair said the committee had previously heard from HHS/Medicaid officials and now wanted to hear from local special education directors about how the aid system works in practice, including billing, training, data collection, and whether districts handle claims consistently. Members also referenced Arkansas as a possible comparison state and said they hoped to develop ideas by November to address the current funding process. Committee members focused on the current special education aid thresholds and the impact of proration. The chair described the existing formula as requiring districts to absorb costs up to 3.5 times the state average per student, with the state paying 80% from 3.5 times through 10 times and paying above that, and said FY25 appropriated about $34 million while actual claims were about $50.1 million, leaving roughly a $16 million shortfall that caused proration. Members also raised the possibility of lowering the threshold to 2.5 times and asked how that would affect the number of eligible students and costs. Another member asked about how districts decide whether services are education-related or medical-related and how Medicaid or private insurance reimbursement affects later state aid claims. District representatives from Boothby Therapy Services, Bedford, and Guilford introduced themselves and described their roles. Guilford’s director said the district tracks students with paraprofessional support, nurses, transportation, or specialized programming, uses a data system to log every service touchpoint, and tries to maximize both Medicaid and special education aid; she said a lower threshold would likely capture all students with paras or nurses and that rising staffing and service costs would increase the number of students over the cap. Bedford’s assistant director said the district uses a different system, tracks roughly 60 to 80 students a year, and pursues Medicaid and special education aid simultaneously but does not pursue private insurance if it would affect FAPE; she said reducing the threshold to 2.5 times would likely double the number of qualifying students. Members asked follow-up questions about software, data entry, and how districts decide whether to bill Medicaid or seek state catastrophic aid, and the directors explained that their systems log services by staff type and student, with some districts using the same data for both Medicaid and state reimbursement claims.

Transcript Highlights:

• For sure, this is something that we've skimmed over in previous budgets, and I even, when I was on HHS

Keywords: 928, house, all

Summary: The House Finance Division III held an informational hearing on Medicaid, Medicare, Choices for Independence, and related financing, while postponing nursing facility financing and the county cap discussion to a later date. DHHS officials Ann Landry, Jonathan Ballard, and Medicaid Director Henry Litman provided an overview of Medicaid’s role, noting it is a federal-state partnership with state-specific eligibility and benefits, and emphasizing that Medicaid is a major funding and programmatic support for other DHHS initiatives. They also distinguished Medicaid from Medicare and explained that Medicaid funding is not the same as grant funding, though some providers may also receive federal grants through other channels. The presentation focused on New Hampshire’s relatively small Medicaid program and why it differs from national averages. Officials said about 184,000 residents are covered, roughly one in seven Granite Staters compared with one in five nationally, and attributed the difference largely to the state’s higher per-capita income and older population. They highlighted that about 65% of Medicaid-enrolled adults in New Hampshire are working, that only 22% of births are covered by Medicaid versus 42% nationally, and that the state’s uninsured rate is lower than the national rate. Members asked about covered services, income limits, federal matching rates, and the names of optional eligibility groups; staff explained that New Hampshire offers the optional groups discussed, with matching rates varying by category, including 90% for Granite Advantage and certain other groups, and 65% for children above the required level. A substantial portion of the hearing covered eligibility rules and recent policy changes. Officials reviewed the history of Medicaid, including HCBS waivers, the CFI program, Katie Beckett, the Olmstead decision, the ACA, and the end of continuous enrollment after the public health emergency. They also discussed the 2023 legislative expansion of postpartum coverage from 60 days to 12 months and child eligibility changes. In response to questions, DHHS said it is tracking utilization and costs for the postpartum expansion and reported that many maternal deaths occur after the prior 60-day coverage period, often involving substance use disorder or suicide; they said the longer coverage is intended to improve access to treatment and prevention. The committee also walked through household-income examples, clarified that Medicaid eligibility is based on household income and categorical rules, and confirmed that Granite Advantage ends at 138% of the federal poverty level unless another categorical basis applies. No votes were taken, and the hearing remained informational.