Transcript Highlights:

• Chair, and thank you, Committee, for considering House Bill 99: Reform of the Medical Malpractice Act
• If they're dealing with a Medicaid patient, they'll take significantly less than they bill.
• And in fact, what we know from other states that have adopted tort reform like this is that they don't
• Chair, that access to care doesn't increase with tort reform.
• I did not think it was an appropriate consideration for reforming medical malpractice.

Committee: Senate Judiciary

Keywords: 996, all

Transcript Highlights:

• These bills aim to strengthen nursing home services, address Medicaid eligibility and asset limits, protect
• Here we sit in 2025 with the Medicaid cut elephant in the room. Do we give up?
• Other states have figured out how to serve ABA to adults through the Medicaid systems.
• Our school-based Medicaid program should be a powerful tool to leverage.
• Our school-based Medicaid program should be a powerful tool to leverage federal dollars, yet its full

Committee: Joint Committee on Health Care Financing

Keywords: 995, all

Summary: The Joint Committee on Health Care Financing held a public hearing focused on two broad sets of issues: home- and community-based care, and school-based Medicaid reimbursement. In the morning session, legislators and advocates testified on bills affecting children and disabled enrollees, including proposals to clarify rate-setting for home health and home care services (H. 767/S. 870), allow family members and spouses to be paid caregivers under MassHealth (H. 1394/S. 886 and related bills), extend MassHealth coverage for applied behavior analysis and other therapies beyond age 21 for adults with autism and developmental disabilities (H. 1351/S. 871), and protect medically fragile children by improving access to continuous skilled nursing. In the later portion of the hearing, testimony shifted to a bill to improve MassHealth reimbursement for schools (S. 862), with speakers describing the school mental health crisis and the need to reinvest Medicaid funds directly into school health services. Witnesses on the home care rate-setting bill said current reimbursement methods are opaque and outdated, contributing to workforce shortages, unfilled shifts, long waitlists, and patients remaining in hospitals longer than necessary. Home care providers and trade groups argued the bill would not set rates directly but would require more transparent methodology and fuller consideration of real costs such as wages, benefits, taxes, training, and technology. On caregiver bills, many family members and provider organizations described the financial and emotional strain of caring for disabled or medically fragile relatives, especially when parents, spouses, or guardians are barred from being paid caregivers. They argued the bills would recognize existing unpaid care, help families remain at home, and reduce reliance on more expensive institutional care. Advocates for adult ABA coverage said services remain medically necessary after age 21 and that ending coverage at that age creates an inequitable “cliff” for MassHealth members compared with those with private insurance. For the PACE/community care bill, elder law attorneys and PACE advocates said current MassHealth income rules force some older adults with modestly higher incomes to spend down to $542 per month, making community living unrealistic and pushing people toward nursing homes. They supported changing the eligibility structure to a premium-based approach that would allow more people to remain in the community. On the school Medicaid bill, advocates said schools are providing effective, preventive mental health care, but reimbursement currently flows to municipalities rather than directly back to school health budgets, limiting districts’ ability to hire and retain staff. No votes were taken during the hearing; the committee heard testimony and several witnesses requested favorable reports on the bills.

Transcript Highlights:

• Basic Medicaid is for pregnant women and children, as well as family Medicaid and Idaho's CHIP program
• the Medicaid.
• for solving the Medicaid growth issue.
• Medicaid expansion repeal may make it possible to avoid this and protect the core Medicaid population
• And recall that before Medicaid expansion, there were no Medicaid supports, no Medicaid eligibility for

Summary: The Joint Finance-Appropriations Committee held a budget hearing on the Division of Medicaid within the Department of Health and Welfare. Legislative Services analyst Alex Williamson reviewed Medicaid’s five budgeted programs, enrollment groups, staffing, historic spending growth, and the distinction between ongoing base adjustments and one-time enhancements. She explained that most Medicaid spending is in trust and benefit payments, discussed the large FY 2026 and FY 2027 budget changes, and walked through the governor’s recommendations, including hospital assessment fund alignment, claims forecast updates, MMIS procurement funding, estate recovery, program integrity support, and population forecast adjustments. Members asked extensive questions about the 4% provider rate reduction, the expansion population, federal match rates, and the effect of House Bill 345 and federal changes on Medicaid costs and eligibility. Williamson and Deputy Director Sasha O’Connell said the expansion population has declined, but costs are driven by utilization, provider rates, pharmacy, hospital, developmental disability, behavioral health, and long-term care services. They said the department is pursuing cost containment through prior authorization, redeterminations, higher cost sharing, and program integrity efforts, while noting that expansion is codified in law and any repeal or major eligibility change would require legislative action and could affect hospital assessment revenue and other offsets. The committee also discussed the MMIS replacement project, with lawmakers emphasizing milestone-based funding and risk control. O’Connell explained the estate recovery request as a replacement case management system plus contractor support to help recover Medicaid costs from estates, and said the program is federally required and revenue-generating. Several members raised concerns about backlogs, contractor costs, and whether AI or other technology could improve efficiency in program integrity and estate recovery. No votes were taken during the hearing; the discussion remained informational and focused on the governor’s budget recommendations and possible future reductions or policy changes.

Transcript Highlights:

• One of the questions that came up early on is: We're paying more for Medicaid expansion.
• Some of it could be reformed, and there's lessons to be learned from that.
• And just listening to your testimony, I'll just pull out the Medicaid.
• But we've had the collaboration with the agencies to say, I don't know what Medicaid...
• But we've had the collaboration with the agencies to say, I don't know what Medicaid.

Keywords: 908, all

Summary: The Leadership Division of the Budget Section approved the prior meeting minutes and then received an update from Senator Jonathan Sickler on the Cash Management Board’s interim work under House Bill 1278. He said the board has reviewed state cash, investments, and liquidity across agencies and concluded the state’s overall mix of long-term and short-term assets is appropriate, with about $35 billion in total liquid assets and investments and roughly 89% in longer-term investments. He highlighted process improvements already underway, including replacing more than 500 six-month CDs with a special-rate savings account to reduce administrative work, and said the board sees opportunities to improve forecasting, automation, and statewide coordination. Members asked about whether the CD change would increase returns, how the Legacy Fund transfer for the homestead tax relief bill affected earnings, and whether more state cash could be consolidated or better managed through BND; Sickler and BND staff said those issues are being studied and may lead to legislation for the 2027 session. Representative Nathan Toman then updated the committee on the Task Force on Government Efficiency. He said the group has focused less on cutting dollars and more on defining metrics and asking how the legislature knows whether programs are working. The task force is pushing a standard set of questions for new or expanding programs—who is affected, expected outcomes, alternatives, how success will be measured, and full funding—and OMB has agreed to require those answers in future budget requests. Members discussed possible use of dashboards, program evaluators, AI tools, and possible rule or statutory changes to require performance measurement. Toman said the task force will continue meeting with agencies such as the courts, university system, auditor, HHS, Commerce, and ITD to identify workflow bottlenecks and potential efficiencies. Phil Davis of Job Service North Dakota gave a workforce update, reporting that North Dakota’s unemployment rate is 2.5% and labor force participation is about 68.7%, both well above national performance. He described Job Service’s 15 workforce programs, including H-2A housing inspections for foreign agricultural workers, the job placement partnership program with DOCR, WOTC, and other federal and state workforce efforts. Davis said the agency served more than 11,000 individuals in 2025, operates nine workforce centers, and tracks outcomes through quarterly and annual reporting. In response to questions, he said job openings data reflect only positions in the system and may understate actual hiring needs, that child care and other assistance programs could be better tied to employment outcomes, and that the DOCR partnership has shown strong results with lower recidivism and higher earnings. He also said the H-2A inspection workload is growing quickly and additional staffing or less frequent federal inspection requirements could help. Allen Knutson then presented S&P Global’s updated revenue forecast. He said oil prices have risen sharply since the prior month’s outlook, improving the state’s near-term revenue picture, though the economy remains volatile and agriculture is facing weaker commodity prices. Based on the updated forecast, total major tax revenues for the current biennium are projected to be about $89 million above the legislative forecast, and the next biennium could be about $500 million higher, though that estimate is preliminary and may change. He also walked through an alternate oil-price scenario showing significantly higher oil and gas collections and a larger Strategic Investment Fund balance if prices remain elevated. Members asked whether another forecast should be requested once oil markets stabilize and about tribal allocation changes in the alternative scenario; Knutson said additional updates are possible through OMB and future forecast cycles.

Transcript Highlights:

• They have to use a participating pharmacist, and the patient has to be enrolled in either Medicaid or
• So, I mean, that's why these issues are in such dire need of reform.
• So, I mean, that's why these issues are in such dire need of reform.
• Members, this is a technical fix to existing law regarding the Medicaid diagnostic lab cap.
• I think that's a risk in all of our health care programs, not just Medicaid.

Committee: JBC-SPECIAL LANGUAGE

Keywords: 1204, all

Transcript Highlights:

• So what is Medicaid?
• I do want to note that dental services are also provided in Medicaid for children in CHIP and in Medicaid
• This was not an extension, for example, of Medicaid postpartum.
• This is you are a full Medicaid beneficiary, right?
• Yeah, zero to two, they were full Medicaid beneficiary.

Committee: Appropriations

Keywords: budget, House Bill 1, public education, healthcare, border security, federal funding, spending limits

Summary: The meeting primarily focused on reviewing the proposed budget for the upcoming biennium, with substantial discussions around House Bill 1 and its implications for public education, healthcare, and border security. The Comptroller presented a revenue overview indicating a total of $194.6 billion available for general purpose spending, which reflects a slight decrease compared to previous years due to fluctuating economic conditions. Members raised questions regarding spending limits and the impact of federal funding on state programs, highlighting concerns about the sustainability of funding in light of potential changes at the federal level.

Transcript Highlights:

• The Medicaid program uses currently an $11.81 amount.
• to write prescriptions for his Medicaid.
• for his Medicaid.
• Those are Medicaid patients.
• were more PBM reforms.

Committee: Health and Welfare

Summary: The committee first adopted the minutes from several prior 2025 meetings, then took up HB 574 by Rep. Spell, which updates the names of two organizations on the Mental Health Advocacy Service Board of Trustees. Rep. Spell explained it as a technical cleanup bill to correct the names of the Louisiana Mental Health Association and the Louisiana State Medical Society so the board’s membership records match current organization names. With no objections, HB 574 was reported favorably. The committee then heard HB 486, also by Rep. Spell, to join the Psychology Interjurisdictional Compact (PsyPact) and allow Louisiana psychologists to provide telepsychology and temporary in-person services across state lines. Rep. Spell and PsyPact representatives said the compact would expand access to mental health care, especially in rural areas, while maintaining standards and disciplinary oversight. The committee adopted amendments on fees and the effective date, and HB 486 was reported favorably with amendments. HB 198 by Rep. Eccles proposed a Medicaid reimbursement methodology for ambulatory surgical centers, using a Medicare-based rate to improve access for Medicaid patients needing specialty procedures. Amendments were adopted to add ophthalmology-related services and to cap reimbursement at the lesser of the outpatient hospital rate or 100% of the Medicaid rate, along with a technical amendment to address the fiscal note. Supporters from GI and ASC groups said the bill would improve access and lower long-term costs, and the bill was reported favorably with amendments. The committee spent the most time on HB 182 by Rep. Travis Johnson, which would require hospitals to ensure access to sexual assault forensic exams and related training. Johnson, law enforcement witnesses, and the Attorney General’s office emphasized the need for timely evidence collection, especially in rural areas, and said the current system leaves victims traveling long distances or losing evidence. Hospital and coroner witnesses supported the goal but opposed the bill as written, arguing it could impose duties on hospitals without enough trained personnel, funding, or a workable statewide training and coordination system; they urged a statewide coordinator, mobile SANE units, and clearer implementation. The bill was not finally disposed of in the portion of the meeting provided, and members discussed continuing to work on amendments and timing before floor consideration.

Transcript Highlights:

• </c> criminal justice reform issues. criminal justice reform issues.
• </c> working on administrative state reform working on administrative state reform and<00:16:35.760><
• </c> worked on this project um reforming worked on this project um reforming judicial<00:28:33.560><c
• </c><00:28:43.680><c> before</c> and we were pushing that reform before and we were pushing that reform
• I'm general counsel to the division of Medicaid at DHHS, but not here to speak a Medicaid matter.

Committee: Executive Departments and Administration

Keywords: 1191, senate, all

Transcript Highlights:

• </c> legislature to oversee the Medicaid legislature to oversee the Medicaid program. program. program
• :13:07.440><c> waiver</c> Another component is reforming waiver Another component is reforming waiver
• </c><00:24:43.440><c> Glenn,</c> are on Medicaid? Do you know? Glenn, are on Medicaid? Do you know?
• </c><00:47:18.359><c> So,</c> around the Medicaid access rule. So, around the Medicaid access rule.
• </c> support shifting some Medicaid support shifting some Medicaid eligibility<00:57:50.400><c> tasks

Committee: Human Services

Keywords: 1187, senate, all

Transcript Highlights:

• If Medicaid would be minimal.
• </c> expense of perhaps losing Medicaid expense of perhaps losing Medicaid shouldn't<00:29:31.039><c>
• </c> their reinstatement into the Medicaid their reinstatement into the Medicaid uh<00:50:54.079><c>
• </c><01:41:01.840><c> courts</c> establishing the reforming courts establishing the reforming courts
• The amendment reforms in the 1970s.

Committee: Judiciary

Keywords: 1189, house, all

Transcript Highlights:

• But why do we keep conducting studies instead of implementing the reforms?
• Fund, so LFC Endorsed legislation to reform the reform fund, to build in some of those performance measures—measurement
• I know what it does, and that's the Public Education Reform Fund.
• What project or what programs are in the Public Education Reform Fund?
• ID, and then enrolling in Medicaid, and then enrolling in SNAP benefits.

Committee: House Appropriations & Finance

Transcript Highlights:

• Engrossed Senate Bill 5142 relates to Medicaid network adequacy requirements for post-acute care services
• providing availability in a regional service area, timeliness of care, and compliance with federal Medicaid
• The goal of this bill is to expand Medicaid and really access to predictable and timely post-acute care
• The goal this bill is to expand Medicaid and Raleigh access to predictable and timely The goal this bill
• is to expand Medicaid and Raleigh access to predictable and timely post-acute care, post-acute rehab

Committee: Health Care & Wellness

Keywords: 904, all

Transcript Highlights:

• In terms of education, we fully adopted the reforms of the state equalization guarantee formula that
• Going out and Medicaid alone. Mr. Chairman, then I would like to turn your attention to page 179.
• So Medicaid alone is larger than your entire general fund budget.
• The biggest portion of it was 12 to 13% reductions in federal aid for Medicaid.
• If we got a hit from Medicaid, we have $3 billion in reserve that would last us 3 months if Medicaid

Committee: Senate Finance

Transcript Highlights:

• </c> Centers for Medicare and Medicaid Centers for Medicare and Medicaid Services<00:04:47.120><c> or
• </c> in Medicaid funding. in Medicaid funding.
• Deputy Commissioner and State Medicaid Deputy Commissioner and State Medicaid Director<00:07:37.280><
• Like, as a The Medicaid benefit.
• We demand reform.

Bills: HF3542

Committee: Fraud Prevention and State Agency Oversight Policy

Keywords: data privacy, investigative data, welfare system, public funds, transparency, 1183, house

Transcript Highlights:

• How we got here, I mean for years, even decades, I think we've talked about reforming Idaho's funding
• And so, you know, we may put band-aids on that, but it does need to be reformed.
• They must demonstrate that Medicaid or any other available payer source has been applied first.
• We've heard that $100 million in a shortfall in this area, but the OPE report also excludes Medicaid
• revenue and expenditures. ...a shortfall in this area, but the OPE report also excludes Medicaid revenue

Keywords: 989, all

Transcript Highlights:

• So if there are any questions, this will not impact Medicaid. We have no problems.
• Bail reform does not work, and it will not work.
• Until bail reform is addressed properly, crime is going to continue. Thank you.
• Bail reform does not work, and it will not work.
• Until bail reform is addressed properly, crime is going to continue. Thank you.

Committee: House Consumer & Public Affairs

Keywords: 996, all

Transcript Highlights:

• I think there's a lot to be said about reforming our tax credit system.
• And year after year, we come and talk about how we need CEQA reform. It is an abused statute.
• And so I do think that we need CEQA reform because I think the balance is not there.
• We need to look and tackle the big issues in California, and I think there needs to be CEQA reform.
• For too long, working people have relied on Medicaid, SB 1284 is needed now.

Summary: The committee heard SB 921, which would create a tax credit to help agricultural employers offset overtime wage costs for farmworkers. Senator Grove and supporters, including farmworkers, the California Farm Bureau, Western Growers, and other agricultural groups, argued that California’s ag overtime law has reduced take-home pay by limiting hours and that the credit would help employers continue offering overtime while putting more money back into workers’ paychecks. Opponents, including the California Federation of Labor Unions and CRLA Foundation, argued the bill would subsidize employers for complying with the law, shift costs to taxpayers, and set a precedent for industry-specific carve-outs. The bill was held in subcommittee and taken up later when more members arrived. The committee then considered SB 1083, a follow-up to last year’s school employee misconduct database law. Senator Perez said the bill would add due process protections for classified school employees by requiring an administrative law judge review before placement in the statewide egregious misconduct database, require notice when an employee leaves during an investigation, and extend vetting to some contractors and non-permanent workers. Supporters, including the California School Employees Association and California Federation of Teachers, said the bill balances student safety with fairness for employees who could be wrongly accused. Opponents, including school business officials, joint powers authorities, administrators, and school employers, warned the bill could delay investigations, create conflicting timelines, and weaken child-safety protections. The committee approved SB 1083 on a 3-0 vote and sent it to Appropriations. SB 1089, authored by Senator Richardson, would require CalPERS health plans to cover GLP-1 medications for chronic weight management and direct CalRx to help make the drugs more affordable. The senator described the bill as a response to personal experience with coverage denials and high out-of-pocket costs, and said broader access could improve health outcomes and reduce long-term costs. The American Diabetes Association and other medical groups supported the measure, citing diabetes prevention and treatment benefits, while a pharmaceutical industry representative said there were still concerns but noted ongoing discussions. The committee passed SB 1089 4-0 to Appropriations. The committee also approved the consent calendar. The committee next heard SB 954, which would revise last year’s CEQA exemption for advanced manufacturing by narrowing the definition and adding environmental, tribal, labor, and community protections, including prevailing wage, skilled-and-trained workforce requirements, and review for projects near disadvantaged communities. Support came from labor unions, environmental groups, and community organizations, which said the bill would restore oversight and prevent harmful projects from bypassing CEQA. Business groups and chambers of commerce opposed, arguing the bill would make the exemption too restrictive, discourage investment, and worsen California’s manufacturing job losses. The bill passed 3-1 to Appropriations. Finally, the committee began hearing SB 1299, which would codify training and certification standards for fire sprinkler fitters after a court decision invalidated prior regulations on procedural grounds; the author and supporters said the bill is needed to protect public safety and ensure qualified installation of fire suppression systems.

Transcript Highlights:

• </c><00:06:55.760><c> eliminate</c> to come to streamline, reform eliminate to come to streamline, reform
• </c> limited, many of which had Medicaid limited, many of which had Medicaid insurance<01:08:10.400><
• </c> providing care and our Medicaid providing care and our Medicaid reimbursement<01:21:11.840><c> rates
• </c> across the majority of our Medicaid across the majority of our Medicaid mental<01:25:29.200><c>
• </c> services will fall under Medicaid services will fall under Medicaid changes<01:37:19.880><c> in<

Committee: Health and Human Services

Keywords: 1187, senate, all

Transcript Highlights:

• That package was tax reform in 12 bills.
• And in 1969, another tax reform package.
• It's a reform measure within the more limited context of legal and administrative reform.
• That was a huge bill that was worked on. ...and administrative reform.
• those Medicaid dollars, including the MCO contracts.

Summary: The committee’s final day focused first on a historical overview of New Mexico tax packages by Pam Stokes of Legislative Council Services. She described how tax packages have alternated over the decades between tax relief, revenue raising, and tax reform, with examples ranging from the creation of the gross receipts tax in 1966 to major packages in 1981, 1986, 1991, 1994, 2005, 2019, 2022, 2024, and the vetoed 2025 package. Members discussed how tax policy often tracks revenue conditions, how packages can combine increases and decreases, and how local government gross receipts taxes and hold-harmless distributions have affected communities differently. Several members reflected on past packages, especially the 2004 food tax repeal and the 2013 film tax and manufacturing changes, and noted that tax policy can have major economic and political effects even when it is not “sexy” legislation. The committee then heard a proposal to expand the health care practitioner gross receipts tax deduction to include co-insurance, and to extend the sunset date. Sponsor Senator Figueroa said the bill was intended to help recruit and retain medical providers and build on prior deductions for co-pays and deductibles. Testimony explained that co-insurance is the patient’s share after the deductible, that providers currently absorb the gross receipts tax on those payments, and that the proposal would cost about $30 million to the state plus about $20 million to municipalities and counties, with the exact fiscal impact likely to be updated. Members raised concerns about the effect on local governments, whether insurers could be required to reimburse providers, whether the bill would actually attract doctors, and whether better evaluation measures and sunsets should be added. The sponsor said the bill was part of a broader set of efforts to address provider shortages and that the discussion would continue. Representative McQueen then presented a bill to update the Land Conservation Incentives Act. He and conservation partners said the program has protected more than 500,000 acres but has not kept pace with rising land values, especially for irrigated agricultural land in the Middle Rio Grande. The proposal would increase the percentage of conservation value eligible for the credit, raise the per-transaction cap from $250,000 to $2 million, and make the credit refundable rather than only transferable. Testimony emphasized that the program is voluntary, keeps land in private ownership and production, and helps land-rich, cash-poor landowners preserve farmland and water rights. Members asked about average credit amounts, how easements work, whether landowners could effectively buy land and then use the credit, and whether there should be inflation indexing or a statewide cap. The discussion also touched on water rights, fencing, and the role of conservation easements in protecting agricultural land and compact water deliveries. Finally, Senator Sharer previewed his 2% tax proposal with a historical presentation on New Mexico tax law, using props to illustrate the evolution from early territorial tax codes to the modern tax system. He argued that the state’s current tax structure is overly complex and that recent federal changes have disrupted the personal income tax base. The committee did not take any votes on the day’s presentations; the meeting was primarily informational, with members offering feedback and raising policy concerns for future sessions.

Transcript Highlights:

• The reform was in entirely bipartisan, just as President Trump and Secretary Kennedy's call to make America
• Senator, as you know, the FDA is not involved in Medicaid or coverage decisions. I understand that.
• We agreed that despite the need for reforms at the FDA, that the FDA is sort of the gold standard.
• and you said no there wasn't even though again you've got reforms you'd like to make here is a an issue
• I would welcome the opportunity to work with you on reforming. Thank you. I yield back.

Committee: Health, Education, Labor, and Pensions Committee

Keywords: nominations, labor, health, veterans, Social Security, Elon Musk, transparency, government accountability

Summary: The meeting primarily focused on various executive nominations and their implications on labor and health affairs. Significant discussions surrounded the nomination of Mr. Sonderling as the Deputy Secretary of Labor, with members expressing concerns about workforce cuts affecting veterans and Social Security employees. There was also a debate led by a member regarding the authority and influence of private individuals, specifically citing Elon Musk's involvement in government decisions. Such discussions raised questions about transparency and accountability within governmental agencies, leading to a proposal for Mr. Musk to provide testimony before the committee.