Transcript Highlights:

• We do estimate that this could impact up to... Levels.
• The Rural Collaborative also will be sending money to the rural 30-member hospitals.
• in some rural supports for youth.
• It was good to be with you on that rural tour.
• health transformation project in rural areas.

Summary: The Senate Health and Long-Term Care Committee met on July 30, 2026, to hear two main briefings. The first, from the Health Care Authority, focused on implementation of federal H.R. 1 Medicaid changes and Washington’s rural health transformation funding. HCA said the state is preparing for major eligibility changes, including the October 1 loss of Medicaid coverage for about 14,000 lawfully present non-citizens and January 1, 2027 work requirements, six-month renewals, and reduced retroactive coverage for roughly 600,000 Medicaid expansion adults. Officials described outreach efforts, new automated verification systems, a verification hub, and plans to use available data sources to reduce manual paperwork, while noting that about one-third of the affected population may still need manual processing. They also said H.R. 1 will limit state-directed payments over time, with an estimated long-term impact of up to $1.5 billion in hospital reimbursements. On rural health transformation, HCA said it is moving quickly to obligate its $181 million federal award through contracts and competitive grants for rural hospitals, workforce, behavioral health, technology, and tribal and community partners. Committee members asked about the impact on rural providers, community service as a work-requirement pathway, emergency Medicaid, tribal and federal reimbursement issues, and whether the state would submit comments on the federal work-requirement rule. HCA said it would file comments, that emergency Medicaid coverage for certain services remains available, and that it is working with tribes and other agencies to avoid erroneous terminations and to move eligible people into other coverage where possible. Members also raised concerns about the administrative burden on families and providers and the need for congressional attention on issues such as TRICARE reimbursement. The second briefing addressed maternal health and the Department of Health’s Maternal Mortality Review Panel report. DOH said maternal mortality in Washington increased for the first time in the report series, but most pregnancy-related deaths remain preventable. Nearly half were linked to behavioral health conditions, especially overdose deaths, with suicide, cardiovascular disease, and COVID-19 also significant causes; most deaths occurred postpartum rather than during delivery. The report found higher mortality rates among American Indian and Alaska Native, Black, Native Hawaiian, Pacific Islander, multiracial, rural, and Medicaid-covered populations, and identified lack of access to care, financial hardship, housing instability, discrimination, bias, and systemic inequities as major contributors. DOH highlighted existing state actions such as one-year postpartum coverage, doula reimbursement, inpatient substance use treatment coverage for birthing people, and vaccine coverage requirements, and offered 12 legislative recommendations focused on affordable and high-quality care, basic needs and community supports, and equitable, culturally responsive services. Presenters from the Suquamish Tribe and Kitsap OBGYN described how the tribe acquired and stabilized a threatened OB-GYN practice to preserve regional access amid provider shortages and hospital service losses. They said rural obstetric care is difficult to sustain because of thin margins, workforce shortages, long travel distances, and higher-risk patients, and emphasized that tribal health systems can offer stronger reimbursement and integrated family-centered care. The Foundation for Healthcare Quality and the Bree Collaborative then outlined statewide maternity-care quality efforts, including work on perinatal behavioral health, care coordination, postpartum screening, doula support, and better-aligned payment models. They said Washington has strengths in innovation but still needs more OB-GYN capacity, better transitions of care, and more culturally responsive, trauma-informed maternal and Native health services.

Transcript Highlights:

• Impact, just general fund versus new fund. Okay. All right. So no negative impact on locals.
• How will this impact them? Mr.
• Yet, New Mexico is 65% rural.
• Twenty-three percent are practicing in rural New Mexico, yet New Mexico is 65% rural.
• Representative Paterjon, there actually have been no definitive studies about the impact of rural tax

Transcript Highlights:

• </c><00:21:28.640><c> So</c> cost and coverage impact. So cost and coverage impact.
• If you're impacted, the impact will come later.
• ><c> be</c><00:26:52.720><c> the</c><00:26:52.960><c> impact</c> you're impacted, it will be the impact
• Who are the scope of impact?
• </c> that will address the scope of impact? that will address the scope of impact?

Keywords: 958, all

Summary: The committee met and approved the minutes from its August 27 meeting. It then received a presentation from Katherine Castanza of the National Conference of State Legislators on the Medicaid provisions in the 2025 budget reconciliation bill, referred to as HR1. She explained that the bill is estimated by CBO to save the federal government $911 billion over 10 years, with more than 20 Medicaid-specific provisions, most of the savings concentrated in five policies and largely backloaded into 2030-2034. She emphasized that the bill’s effects will vary by state, but that expansion states and hospitals are expected to be most affected, in part because of changes to eligibility, provider taxes, and state-directed payments. Castanza highlighted several new funding and flexibility provisions, including a $50 billion Rural Health Transformation Fund for 2026-2030 and a new home- and community-based services waiver option effective July 1, 2028, with $100 million in grants in fiscal year 2027. She also outlined major eligibility changes for Medicaid expansion adults: work or community engagement requirements effective January 1, 2027; twice-yearly redeterminations for the expansion population effective the same date; and new cost sharing for certain expansion adults effective October 1, 2028. She noted that Kentucky, as an expansion state, would be subject to these changes and that state agencies would face significant implementation demands, especially because federal guidance and timelines are tight. A substantial portion of the presentation focused on financing changes. Castanza described new limits on provider taxes, including a 0% safe harbor for new taxes and a phased reduction for existing taxes in expansion states beginning in 2028, while nursing facilities and intermediate care facilities are exempt from the reduction if already taxed. She also explained that state-directed payments will be capped and phased down over time, with existing arrangements grandfathered only briefly; she said Kentucky has 11 approved state-directed payments and could see significant fiscal effects. She added that the bill also bars Medicaid payments to Planned Parenthood or similarly situated providers for one year, changes immigrant eligibility rules effective October 1, 2026, lowers the federal match for certain emergency services, and expands the scope of the federal erroneous payment recoupment provision effective October 1, 2029. Throughout, she stressed that federal savings may translate into state cost shifts and that implementation timing will be critical.

Transcript Highlights:

• </c> ranchers, and rural communities. ranchers, and rural communities.
• You know, growing up in a rural community, I grew up in a rural community.
• I still live in a rural community and went to a rural church.
• I know rural access to child care, rural communities is already an issue.
• I know rural access to child care, rural communities is already an issue.

Keywords: 918, senate, all

Summary: State legislators and farm leaders held an impromptu discussion focused on the impact of federal immigration enforcement activity, especially ICE presence in Minnesota, on agriculture and rural communities. Speakers argued that agriculture is central to the state’s economy and said fear of raids is causing legal immigrant and guest workers, including H-2A workers, to stay home, disrupting farms, food processors, restaurants, grocery stores, and other parts of the food supply chain. They also linked the issue to broader federal uncertainty, including USDA funding freezes and cuts, and said the lack of transparency from federal agencies is making it difficult for state officials and producers to plan. Senator Rob Kupec and Minnesota Farmers Union president Gary Wertish said ICE activity in both the Twin Cities and greater Minnesota is creating fear, trauma, and labor shortages, with reports of workers avoiding work, lunch trips, medical appointments, and school. Wertish said the organization supports comprehensive immigration reform and called for an end to the ICE surge, while also emphasizing the need to respect local law enforcement and the rule of law. Deputy Agriculture Commissioner Andrea Vaubel said immigrants are a critical part of Minnesota’s food and agriculture workforce, warned that labor shortages could raise production costs and food prices, and said the state would not have its current food supply without immigrant workers. In response to questions, speakers said they had anecdotal reports from rural areas such as Pelican Rapids, Willmar, and Detroit Lakes, but that the situation is changing quickly and many incidents may not yet be public. They said the lack of coordination with local law enforcement and the use of masks contribute to fear and confusion. Legislators said they have no direct jurisdiction over ICE operations but see their role as documenting what is happening, communicating with constituents, and avoiding state actions that would worsen the problem. They also said the issue is not purely partisan and may be mobilizing concern across political lines, especially among farmers worried about labor availability for planting and other seasonal work.

Transcript Highlights:

• And that's true for our rural communities too.
• In Pinal County, rural Arizona really is going to be the next frontier for rural economic development
• Arizona—” “...across rural Arizona.
• They get their impact fees because we're not trying to say that there is not an additional impact.
• Some of the practical impacts of limitations on the applicability of impact fees and the timing, allowing

Summary: The committee first took up HB 2950, which would allow a governing body to approve a tourism improvement area to promote tourism and lodging. Supporters from the Arizona Lodging and Tourism Association, Visit Yuma, and Visit Phoenix said the bill would give communities a voluntary, locally controlled tool to market destinations, attract events, and strengthen rural and urban tourism economies without raising taxes on residents. Members discussed tourism’s economic importance in places like Yuma and other rural communities, and the bill was moved forward with a due pass recommendation on a 7-0 vote. The committee then held a presentation on rural economic development in Pinal County, focusing on the Lucid Motors project and its workforce partnership with Central Arizona College. Speakers from the Arizona Commerce Authority, Central Arizona College, and Lucid described the Drive48 training program, the creation of a skilled workforce pipeline, and broader economic impacts such as higher wages, job creation, and related growth in housing and infrastructure. The committee also read proclamations recognizing Lucid Motors and Central Arizona College for their contributions to economic development in rural Arizona. Finally, the committee heard HB 2946, which revises development fee requirements and prohibits development fees on accessory dwelling units. The sponsor argued the bill was intended to address housing affordability and reduce burdens on families and builders, while cities, towns, the League of Arizona Cities and Towns, and municipal attorneys opposed it, saying it would shift costs from growth to existing taxpayers and weaken the principle that growth should pay for growth. An amendment in the chair’s name was adopted to remove county-related provisions and make clarifying changes. The amended bill was then passed with a 4-1 vote and two members voting present.

Transcript Highlights:

• or are impacting the ability to build not just farmworker housing but rural housing in our community
• The scoring— we're not urban enough to be urban, we're not rural enough to be rural.
• spaces and rural census tracts.
• It has a defined rural project type and a set-aside of 10% of funds in any given NOFA cycle for rural
• To date, the AHSC rural set-asides have funded 31 projects, delivering more than 2,200 units in rural

Summary: The committee held an outcomes review hearing on AB 457 and related farmworker and rural housing policy, with members and witnesses discussing whether recent streamlining laws are actually increasing production. Chair Haney, Assembly Members Soria and Pellerin, and others described the purpose of AB 457 and its predecessor bills AB 1783 and AB 3035: to make farmworker housing easier to build through ministerial approval and other reforms. Witnesses emphasized that farmworkers face severe overcrowding, high rents, long commutes, and limited access to housing in both rural and coastal agricultural regions. The first panel focused on practical barriers and local models. Napa County described its county-owned farmworker centers, which provide nightly lodging, meals, and services, funded by lodger fees, a grower assessment, and state support. Testimony stressed that these centers function as navigation hubs rather than permanent housing, and that stable, inflation-adjusted operating funding, language access, transportation, and local set-asides are critical. United Farm Workers urged that local farmworkers be prioritized over H-2A workers and warned against displacing long-term resident workers. Several witnesses said the biggest barriers remain infrastructure, land costs, local opposition, and insufficient subsidy rather than approval streamlining alone. The second and third panels addressed AB 457’s implementation and broader state funding issues. Santa Clara County said the bill could help on a county-owned Gilroy site, but financing remains the main obstacle. Self-Help Enterprises said AB 457’s expanded geography and project-size rules may help future sites, but rural projects still struggle with water, sewer, and environmental review costs, and with the state’s Super NOFA process, which tends to favor deeper-income projects that do not match farmworker household incomes. HCD reported that CERNA and other programs have increased farmworker housing production in recent years, but witnesses argued that rural regions still receive too little funding, that infrastructure dollars are too fragmented, and that more rural-specific set-asides, local funding incentives, and predictable allocations are needed. No votes or formal actions were taken during the hearing.

Transcript Highlights:

• And then a few observations updating from last year regarding HR1 impacts.
• How does that impact that?
• “More stable leadership, which has been really impactful.
• “Number two, I mentioned the concept around this rural technical assistance center.
• So HR1, the impacts start hitting in 2027–28 and down the road.

Keywords: 988, house, all

Transcript Highlights:

• We hear concern about the impact on the economies in rural parts of New Mexico with this legislation.
• The impact of inaction in rural New Mexico has been...
• We hear concern about the impact of the economies and rural parts of New Mexico with this legislation
• The impact of an action in rural New Mexico has been. Legislation.
• The impact of inaction in rural New Mexico has been devastating.

Summary: The committee first took up the proposed 2026 tax package, Senate Bill 151, and adopted a committee substitute after discussion of the package’s funding capacity and included measures. The substitute bundled five bills: a physician tax credit, a quantum facility infrastructure tax credit, a construction materials gross receipts deduction for affordable multifamily housing, a local journalist employment tax credit, and a health equipment gross receipts deduction. Members discussed amendments that raised the physician credit from $4,000 to $10,000, narrowed the housing deduction to project-based certification, and reduced the journalist credit threshold from four stories to three. Concerns were raised about the fiscal impact on municipalities, especially Albuquerque, and about the funding mechanism, but the committee voted 6-4 to give the substitute a do pass recommendation. Senator Sanchez explained his vote, saying he wished more could have been included in the package. The committee then heard Senate Bill 18, the Clear Horizons Act, which would codify statewide greenhouse gas reduction targets and direct the Environment Department and Environmental Improvement Board to develop plans and rules for emissions reductions. The sponsors said the bill builds on the governor’s 2019 executive order, includes a 10,000-metric-ton threshold for covered emitters, allows certified offsets, and is intended to protect public health, reduce climate-related costs, and provide regulatory certainty. Supporters argued the bill would help communities facing wildfire, drought, health harms, and rising insurance and utility costs, and that it would encourage clean-energy investment and long-term economic stability. Opposition testimony came from mining, oil and gas, rural electric cooperatives, construction, agriculture, auto dealers, chambers of commerce, banks, water recycling companies, and realtors. They argued the bill functions like a carbon tax or broad regulatory mandate, would raise energy and compliance costs, could reduce investment and jobs, and would disproportionately affect rural, tribal, agricultural, and low-income communities. Several witnesses warned of higher electricity and fuel bills, revenue losses for local governments, and uncertainty from delegating major policy decisions to rulemaking. Supporters included public health advocates, educators, local officials, clean-energy businesses, tribal and environmental advocates, and residents affected by wildfire and drought, who said the bill is necessary to address climate harms and protect public health and the economy. No final committee vote on SB 18 was reached in the portion provided.

Transcript Highlights:

• As you consider policies that impact telehealth and the sustainability of the Rural Health Transformation
• communities, rural providers, rural hospitals, and rural health clinics.
• practice rurally.
• that impact.
• Second, maximize the impact of the Rural Health Transformation Fund through targeted loan repayment and

Keywords: 1184, house, all

Transcript Highlights:

• Primary care, rural health care transformation—tremendous amount.
• delivery system in our rural communities.
• programs, thinking about nurse training in rural communities.
• programs, thinking about nurse training in rural communities.
• communities, supporting rural youth in model in rural communities, supporting rural youth in school-based

Summary: The committee met to hear introductory briefings from the Department of Health and the Health Care Authority on agency priorities, federal changes, and implementation challenges. Secretary of Health Dennis Worsham said his department’s listening tour is focused on strengthening governmental public health, improving health care quality and access, and responding to federal funding disruptions and the shutdown’s effects on programs such as WIC. HCA Director Ryan Moran said the agency is prioritizing coverage preservation, oversight of major contracts, affordability, behavioral health integration, rural health transformation, and internal agency operations. Members asked about licensure delays; Worsham said the backlog had been reduced from about four months to six weeks and should be caught up by January 1, with possible further process changes if needed. A major portion of the meeting focused on H.R. 1 and its Medicaid-related implementation. Governor’s health policy advisor Caitlin Stafford, HCA staff, and interim Medicaid Director Trinity Wilson said the state is working with DSHS, the Health Benefit Exchange, tribes, and other partners to prepare for eligibility changes, work requirements, and six-month redeterminations. They said the state expects up to 30,000 Apple Health enrollees could lose coverage under the law’s non-citizen eligibility changes, and that the work requirement/redetermination provisions could affect about 620,000 adults, with roughly 80,000 also enrolled in SNAP. HCA said it hopes to automate most verification, but about 15% to 20% of cases may require manual review, with technology costs estimated at up to $30 million. Staff also said they are trying to keep H.R. 1 implementation mostly in budget language rather than statute, and that communication and navigator support will be important to minimize confusion and coverage loss. The committee also received an update on the Rural Health Transformation Program created in H.R. 1. HCA said Washington submitted its application to CMS on November 5 after extensive stakeholder engagement, including more than 310 written comments, webinars, and tribal consultation. The application centers on six initiatives: rural hospital innovation, community care and prevention, tribal investments, technology and data, workforce development, and rural behavioral health. HCA said the state is likely to receive less than the full $200 million annual amount assumed in the federal program, and that an advisory committee may be created to help guide spending over the five-year program. Members asked about palliative care, small business impacts, and communication with enrollees; HCA said it expects to share outreach toolkits and that no 2026 statutory changes are currently anticipated, though that could change. The final panels covered organ donation and transplant services. Department of Health staff explained the 2023 “Lights and Sirens” law for organ transport vehicles, including licensing, driver qualifications, insurance requirements, and use of emergency lanes and traffic preemption; the department said one company is currently licensed and there have been no complaints. LifeCenter Northwest described the organ procurement process, the legal framework under the Uniform Anatomical Gift Act, and the rarity and complexity of deceased donation, noting Washington has seen strong growth in donation and transplants over the past decade. University of Washington Medical Center staff then outlined its transplant programs for kidney, liver, heart, lung, pancreas, and multi-organ transplants, describing the multidisciplinary evaluation and waitlist process and the coordination required with donor organizations and hospitals.

Transcript Highlights:

• I'm here to explain the impact of this legislation, just so you know how your constituents will be impacted
• is restricted, impacting rural communities most heavily.
• schools and rural school students.
• schools and rural school students.
• I respectfully ask you to consider the impact this bill will have on rural middle school students like

Keywords: 989, all

Summary: The House Education Committee heard House Bill 918, which would realign the Idaho Digital Learning Alliance (IDLA) by narrowing its mission, reorganizing its board, capping administrative costs at 30%, requiring outside and LSO audits, setting course fees, and limiting state funding per course. The bill would eliminate or restrict funding for private school, virtual school, K-5 Launch Pad, driver's education, custom sections, and most middle school enrollment except remediation, while preserving some access through Advanced Opportunities money and an emergency exception for hard-to-fill teaching vacancies. Representative Pickett said the bill was intended to address concerns about double-dipping, private use, and program growth beyond IDLA’s original purpose, and to reduce state spending by about $13.5 million. IDLA Superintendent Jeff Simmons testified in opposition, saying the bill would restrict school choice, shift costs to families and districts, and reduce access for rural students, especially for electives, dual credit, and middle school enrichment. Several superintendents and school officials from Potlatch, Grace, Butte County, Wendell, Cottonwood, and Kimberly also opposed the bill, arguing that IDLA is essential for rural and small schools to provide electives, dual credit, credit recovery, and career exploration, and warning that the bill would force districts to absorb costs or pass them on to families. Supporters of the bill emphasized oversight, fiscal restraint, and limiting use to core supplemental purposes, while some members expressed concern about cutting effective programs and about the impact on rural districts. After testimony and discussion, the committee first failed a motion to hold House Bill 918 in committee. A substitute motion to hold the bill in committee until a time certain on Monday, March 23, then passed on a roll call vote, so the bill was held over for further consideration. The chair said the committee would return to the issue on Monday.

Transcript Highlights:

• I'm here to explain the impact of this legislation, just so you know how your constituents will be impacted
• is restricted, impacting rural communities most heavily.
• schools and rural school students.
• schools and rural school students.
• I respectfully ask you to consider the impact this bill will have on rural middle school students like

Summary: The House Education Committee heard House Bill 918, which would realign the Idaho Digital Learning Alliance (IDLA) by narrowing its mission, reorganizing its board, capping administrative costs at 30%, requiring outside and periodic LSO audits, setting course fees and a per-course state funding cap, and eliminating funding for private school, virtual school, K-5, and driver’s education participation, as well as custom sections except in limited emergency cases. The sponsor, Rep. Doug Pickett, said the bill was intended to address concerns about double-dipping, private use of a taxpayer-funded program, and IDLA expanding beyond its original supplemental purpose while preserving access for rural students and emergency staffing needs. Committee members questioned the rationale for the cuts, the board restructuring, the treatment of dual credit and advanced opportunities funding, and whether the bill would affect students taking IDLA courses during the school day. Pickett said the bill was designed to redirect dual credit through Advanced Opportunities, maintain flexibility without setting a hard enrollment cap, and keep the program focused on filling instructional gaps. IDLA Superintendent Dr. Jeff Simmons and several school leaders testified in opposition, arguing the bill would reduce school choice, shift costs to families and districts, limit middle school electives and dual credit, and disproportionately harm rural schools that rely on IDLA for courses they cannot staff locally. Supporters of the bill emphasized oversight, fiscal restraint, and limiting what they described as overuse of the program. After testimony, Rep. Galavis moved to send HB 918 to the floor with no recommendation. A motion to hold the bill in committee failed 10-4, and a substitute motion to hold the bill in committee to a time certain on Monday, March 23, passed on a roll call vote. The committee adjourned with the bill set to return on Monday.

Transcript Highlights:

• He is a family physician with over 20 years of practice in rural Texas. Dr.
• Three years of rural family medicine... School in Dallas with his medical degree.
• Three years of rural family medicine and his residency in Fort Smith, Arkansas, before he came back to
• because they probably know as good as, if not better than, anybody, what the severities of those impacts
• of the proposed bond, and this is a half of true... ...financial impact of the proposed bond.

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

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

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

Transcript Highlights:

• One, this is our impact.
• This is our impacts, and this is our 2023 impacts. 2024, we're still working on those.
• So we want to talk about a little about rural impact, right?
• So it's a really good way to hit the rural communities and make some impacts.
• I don't see the slide is numbered here, but the slide on rural impact. Yes, sir.

Summary: The Committee on Commerce and Tourism convened with several members present and Senators DiCeglie and McClain excused. The committee first heard a presentation from Greg Britton, State Director of the Florida Small Business Development Center Network, who described the network’s statewide small-business assistance, including startup support, export and contracting help, disaster recovery, and rural outreach. He highlighted reported 2023 impacts such as $3.9 billion in sales generated, $575.9 million in government contracts, $346.2 million in capital, and support for 2,009 new businesses, including 130 manufacturing firms over the past two years. Members asked about comparisons with SCORE and about measuring rural success, with the chair suggesting jobs and wages in rural areas would be useful metrics; Britton said he could provide job data but was unsure about wage information. The committee then took up SB 320 by Senator Gates, which creates a five-year demonstration project for an alternative licensure pathway for surveyors and mappers. The bill would allow a “first-step” probationary license based on industry certification, apprenticeship, recommendation from a licensed Florida surveyor, and passage of the Department of Agriculture exam within the five-year period, without requiring a four-year degree. Senators asked about the labor shortage, education requirements, foreign workers, and moral character standards. Gates said the shortage is chronic and worsening, the bill has no degree requirement, and anyone meeting the qualifications could proceed regardless of visa status. The committee voted to report SB 320 favorably. Next, the committee considered SB 316 by Senator Berman, which authorizes series limited liability companies in Florida and sets rules for how Florida and foreign series LLCs may operate and transact business in the state. Berman explained that the bill is intended to let businesses isolate liabilities across separate series while providing clearer rules for Florida citizens and businesses dealing with such entities. There were no substantive questions, one appearance form in support, and the committee voted to report SB 316 favorably before adjourning.

Transcript Highlights:

• You said that this will harm rural care. I'm in District 24, and that's all I am is rural areas.
• to states to work on their rural health programs.
• Required that 50% of the voting members be from rural districts.
• that requirement from a rural to for these members to be from rural areas, and I'm wondering since this
• This will go on merit because, for example, I am rural. My whole district is rural.

Summary: The Senate Health and Welfare Committee first approved the minutes from February 25 and February 26, 2026, then took up House Bill 928, the Merit-Based Health Care Act. The bill’s sponsor said it would prohibit DEI-related considerations in Medicaid-funded health care hiring, promotion, contracting, and training, while preserving compliance with federal law and allowing certain clinical and quality-improvement activities. Committee members questioned how the bill would apply in practice, especially to hiring and patient preferences, and the sponsor said an amendment would remove certain terms to align with federal code. The committee heard extensive testimony on HB 928. Physicians and the Idaho Academy of Family Physicians opposed the bill, arguing it would restrict evidence-based training, create legal uncertainty, worsen recruitment and retention in a state already facing provider shortages, and interfere with use of social determinants of health and implicit bias training to improve patient care. Supporters, including a plastic surgeon, Idaho Family Policy Center, and the bill sponsors, argued DEI undermines merit and that taxpayer-funded health care should be based on qualifications and excellence. After debate, the committee voted to send HB 928 to the 14th order for possible amendment, with Senators Harris and Wintrow recorded as opposed. The committee then heard House Bill 916, which would create a legislative rural health transformation oversight committee to monitor federal rural health funds flowing to Idaho. The sponsor said the committee would provide legislative stewardship over the money without appropriating funds, while some senators raised concerns that the bill did not require rural representation on the committee and that appointments should reflect rural advocacy. After testimony from a supporter emphasizing oversight and taxpayer stewardship, the committee voted to hold HB 916 in committee. The meeting ended with notice of a two-hour committee meeting scheduled for the next day.

Transcript Highlights:

• These rural counties would face proportionately higher impacts than urban areas, mainly because the market
• Uh, these royal rural counties would face proportionately higher impacts than urban areas, mainly because
• The fiscal impact to the state would be an additional $7 to $9 million without any impact on employers
• Um, so I'm interested in your comments on the impact, Specifically to rural areas and how there might
• be a disparate impact to them, and maybe even a flight from the rural areas for some businesses.

Summary: The committee held a study on the potential effects of living wage or minimum wage laws in Oklahoma, with the chair emphasizing that the discussion was not intended to advocate for or against State Question 832. The first panel focused on economic and workforce impacts. An Oklahoma Department of Commerce representative argued that living wage calculations vary by region and household type, that Oklahoma’s average wages are already near or above many living-wage estimates, and that higher mandated wages could lead employers to cut hours, reduce hiring, automate, or avoid expansion, especially in rural areas where childcare, healthcare, broadband, and infrastructure constraints also affect labor participation. Committee members asked about wage distributions, rural cost differences, training pathways, and whether higher wages might draw workers or businesses out of state; the witness said many low-wage workers move up over time and that Oklahoma has seen net in-migration. A State Chamber Research Foundation witness then testified that a $15 statewide wage floor would raise payroll costs substantially, especially for small rural employers, and cited examples from California and Seattle to argue that higher wages can reduce hours, jobs, and benefits while increasing consumer prices. She suggested alternatives such as expanding the state earned income tax credit and promoting upskilling through existing education and training programs. A Missouri Chamber of Commerce and Industry representative described Missouri’s recent voter-approved minimum wage increase to $13.75, rising to $15, along with paid sick leave provisions. She said the chamber opposed the measure because it would raise business costs, hurt rural communities and youth employment, and force some employers to cut hours, reduce hiring, or close. She cited examples from Missouri businesses facing significant added costs and warned that a future ballot initiative could create a patchwork of local minimum wages. In response to questions, she said Missouri’s law did not distinguish by age or industry, that businesses had raised concerns about union contracts and compliance, and that the chamber viewed the measure as harmful to competitiveness. Peter Hansen of NFIB presented the final major testimony, summarizing an NFIB study projecting that a higher Oklahoma minimum wage would produce some short-term GDP gains but longer-term losses, with GDP turning negative by the early 2030s and job losses growing over time. He said businesses respond to higher wage mandates by raising prices, trimming jobs, converting full-time positions to part-time, reducing benefits, and shifting investment toward automation or other capital. He argued that the burden falls most heavily on vulnerable workers such as young or marginal employees, who are less likely to be hired when labor costs rise. In questioning, he acknowledged that higher wages can improve pay for some workers and may have some short-term positive effects, but maintained that the long-term employment and investment effects are negative. No votes or formal actions were taken in the meeting.

Transcript Highlights:

• cost-and-market impact review.
• We can do a deeper cost-and-market impact review.
• This may include rural hospitals, critical access hospitals, clinics, including FQHCs, rural health clinics
• Dialysis center is not being available in rural areas.
• What about on the funding for the rural areas?

Summary: The hearing began with a stakeholder presentation from Let California Kids Hear urging coverage of pediatric hearing aids for children in the large group market. Advocates described the issue as a long-running developmental emergency, argued that existing state efforts have been inefficient, and said the new proposal would cover about 70% to 80% of affected children without new spending by redirecting existing dollars. Public commenters, including parents, audiologists, and children’s advocates, strongly supported the proposal and emphasized the need for timely access to sound. The chair thanked the group and noted hope for a future fix, including continued work on the exchange market. The Department of Finance then gave a broad budget warning about the state’s more than $20 billion structural deficit and said new investments must be weighed against out-year shortfalls. HCAI followed with an overview of its programs, including CalRx insulin and naloxone, reproductive health grants, the Office of Health Care Affordability, seismic hospital compliance, workforce programs, and the Data Exchange Framework. Members asked about geographic targeting of workforce funds, behavioral health pipeline programs, the status of the 21st Century Nursing Initiative, and future CalRx products such as EpiPens and GLP-1s. HCAI also described its enforcement approach for health care spending targets, saying the board would not change the targets in response to H.R. 1, and outlined the diaper access initiative, which will distribute diapers through hospitals in higher-need areas. Several HCAI budget items were discussed and held open, including additional expenditure authority, the transfer of the Data Exchange Framework and Office of the Patient Advocate, long-term care payment transparency staffing, and reporting on health care worker waiting periods. The department also presented its Behavioral Health Services Act workforce initiative and a proposed $100 million General Fund offset, which both the LAO and the chair questioned as unclear and potentially one-time in nature. HCAI said the final workforce plan would be adjusted after stakeholder consultation if the offset proceeds. The department also described the Rural Health Transformation Program, saying California received $233.6 million in federal funds, had to revise its proposal to satisfy CMS, and must obligate the money by October 30; the program will fund rural care models, workforce development, and technology, with grants rolled out on a phased basis. The Department of Managed Health Care then presented its budget and three legislative implementation requests: SB 41 on PBM reform, SB 306 on prior authorization transparency, and AB 1041 on provider credentialing timelines. Finally, the administration outlined a menopause care proposal requiring coverage and education for menopause-related services, provider training, and an outreach campaign, with DMHC requesting staffing and funding to implement and enforce the new requirements. Throughout the hearing, most items were held open for later action, and no final votes were taken in the portion provided.

Transcript Highlights:

• Um, how we're reimagining capital outlay that can focus on rural communities or rural pro projects and
• And lastly, I'll just mention grocery stores in rural areas, we don't have them.
• mentioned, to discuss how federal, state, local, and rural, uh, uh, rural tribal governments can support
• As a rural and economic rural development committee, how we can help the food banks and because rural
• It's not really fair to our people in the rural areas.

Transcript Highlights:

• Then a few observations updating from last year regarding H.R. 1 impacts.
• How does that impact that?
• rural health services as defined by the Health Resources and Services Administration.
• I mean, obviously rural, but yeah.
• Number two, I mentioned the concept around this rural technical assistance center.

Summary: The Assembly Budget Subcommittee on Health heard updates on five health-related budget items. First, members reviewed state support for distressed hospitals and health facilities. The California Health Facilities Financing Authority and HCAI described the Distressed Hospital Loan Program as a lifeline for 16 hospitals, many of which remain financially strained and are expected to seek loan forgiveness rather than repayment. Speakers cited reduced contract labor, new service lines, strategic partnerships, and the reopening of Madera Hospital as signs of progress, but also warned that federal policy changes under H.R. 1 will likely increase uncompensated care and pressure emergency departments. Public commenters from hospital, dental, and consumer groups supported additional funding, including a request to refresh the program with another $300 million. The committee then heard HCAI’s update on the California Rural Health Transformation Program, a five-year federal initiative funded at $233.6 million for California. HCAI said the program will focus on rural care models, workforce development, and health technology, with grants to be rolled out on a fast timeline and all funds obligated by October 30, 2026. Members raised concerns about rural provider capacity to apply for grants, and HCAI said it will use a third-party administrator, a technical assistance center, webinars, and other supports to help applicants. HCAI also presented its budget request for the health care payments database, seeking ongoing non-General Fund support to continue operations and expand data, including pharmacy benefit manager data. The Emergency Medical Services Authority presented three budget change proposals: funding to replace disaster medical services fleet vehicles, funding for IT security work, and additional positions for HR, enforcement, and legal workload. A member also raised concern that EMSA has not yet completed the annual ambulance rate reporting required by AB 716, and EMSA said it remains committed to the requirement but lost prior funding through later budget reductions. Covered California reported that it is still finalizing its own budget, but expects a lower operating budget due to efforts to reduce baseline costs and align spending with actual expenditures; it also projected enrollment declines tied to the expiration of enhanced premium tax credits, H.R. 1, and federal rule changes, while noting that revenues may still rise because premiums are expected to increase. Finally, the Department of Managed Health Care outlined budget proposals tied to menopause coverage and education, PBM licensure and enforcement under AB 116 and SB 41, credentialing reforms under AB 1041, and prior authorization reporting under SB 306. Public testimony generally supported the menopause and PBM proposals, while also urging clearer language and attention to Medi-Cal parity. The hearing concluded after public comment, including additional advocacy for sickle cell services and rural health workforce funding.

Transcript Highlights:

• cost-and-market impact review.
• And so we absolutely want to impact premiums over time.
• This may include rural hospitals, critical access hospitals, clinics, including FQHCs, rural health clinics
• Dialysis center is not being available in rural areas.
• What about the funding for the rural areas?

Keywords: 987, senate, all