Transcript Highlights:

• Under the new federal rule, we are expecting forthcoming federal guidance, which may help the administration
• Under the new federal rule, we are expecting forthcoming federal guidance, which may help the administration
• CMS provided this direction through their review and audit of our quarterly claim for federal funding
• But there still would be a federal drawdown.
• ongoing eligibility for federal funding.

Summary: The committee first heard May Revision child care and human services items. The Department of Child Support Services described two technical adjustments, which the analyst supported. The Department of Social Services then walked through child care proposals, including a reduction in federal and Proposition 64 funding absorbed through a shift from General Child Care to the Alternative Payment program, a 2.01% child care COLA, disaster-related infrastructure grants, a new administrative support cost structure for Alternative Payment agencies, the removal of prospective pay funding after a federal rule change, a reappropriation for existing infrastructure grants, and estimates of unspent child care funds. The Legislative Analyst’s Office recommended asking for more justification for shifting reductions to CAP, supported the COLA reduction but wanted consistency across programs, recommended removing prospective pay funding, opposed the administrative cost shift, and suggested further review of disaster grant alignment. Members pressed the administration on why more slots would be cut for the same savings, why the COLA was reduced, and whether the administrative percentage would grow over time. The administration said the changes were intended to avoid disrupting currently enrolled families, reflect point-in-time relinquishments and unspent funds, and stabilize contractor operations. Public commenters, including providers, advocates, and county representatives, urged full COLA funding, rejection of child care slot reductions, preservation of prospective pay, and continued investment in child care infrastructure and access. The subcommittee then recessed before moving to health items. In Part B, the Department of State Hospitals presented its May Revision proposals, including a central utility plant replacement project at Metropolitan State Hospital, funding for a continuum electronic health record system, reduced county bed billing authority to reflect phase-in of additional LPS beds, limited contract exemption authority for online clinical subscription services, reversion of prior-year unspent operating funds, and a workforce development proposal to use Behavioral Health Services Act funds instead of General Fund for training programs. The department said the EHR would modernize records and improve continuity of care, and that the contract exemption would prevent delays in essential clinical information services. No votes were taken in the excerpt provided.

Transcript Highlights:

• More federal funding are leveraged in the state when tribal clinics can provide more care.
• Federal funding are leveraged in the state when tribal clinics can provide more care.
• This legislation adds a definition for traditional Indian medicine, directs HCA...
• That does leverage more federal funds, and so we need to be accounting for that.
• HB 2658 moved the state in a different direction before that work has even gone live.

Summary: The House Health Care and Wellness Committee held public hearings on four bills and then took executive action on three measures. HB 2555 would require the Health Care Authority to apply for a Medicaid waiver to cover traditional health care practices provided through Indian Health Service, tribal, and urban Indian facilities. Supporters, including the prime sponsor, tribal health leaders, and the Health Care Authority, said the bill would recognize traditional medicine, expand access, and leverage federal funding, though HCA noted the July 1, 2026 waiver deadline and urban Indian reimbursement questions may be difficult to resolve. HB 2685 would codify tribal data sovereignty principles for state agencies, require reporting of notifiable conditions to tribal health jurisdictions, and exempt certain tribal data from public disclosure. Tribal representatives supported the bill as necessary for access, governance, and better public health planning, while the Washington Coalition for Open Government and HCA raised concerns about the breadth of the PRA exemption, undefined ownership interests, and implementation details. HB 2658 would require health carriers to submit standardized public data on behavioral health and other coverage and access metrics, with the Insurance Commissioner posting the information on a public dashboard. Supporters said the bill would improve transparency about mental health parity and help families, employers, and policymakers compare plans; opponents argued it duplicates or complicates recent parity reforms and could be misinterpreted. HB 2683 would shorten carrier credentialing timelines from 90 days to 30 days and require carriers to post billing and coverage information online. Supporters said it would reduce delays for providers and patients, while opponents warned the shorter timeline could be hard to meet and that posting information without login protections could raise privacy concerns. In executive session, the committee adopted two amendments to HB 2168, which concerns overdose mapping data, then reported the substitute bill out with a due pass recommendation by a vote of 16-1. It rejected an amendment to HB 2196 that would have extended PANDAS/PANS coverage to public and school employee plans, then advanced the substitute bill with a due pass recommendation by a vote of 15-2. Finally, the committee passed HB 2545, which would allow ambulatory surgical facilities to perform elective percutaneous coronary interventions, by a vote of 13-4, after members discussed safety, access, and cost savings.

Transcript Highlights:

• Maximizing federal funds means bringing in the highest possible amount of available federal resources
• </c><00:14:14.600><c> funds</c> legislation uh maximizing federal funds legislation uh maximizing federal
• </c><00:15:10.360><c> pay</c> supporting our work around direct pay supporting our work around direct
• </c> know that uh navigating the federal know that uh navigating the federal funding<00:15:20.199><c>
• </c><00:25:02.600><c> and</c> billion dollars in both Federal and billion dollars in both Federal and

Committee: Senate Capital Investment

Keywords: 1187, senate, all

Transcript Highlights:

• This is why the SPACE Act directs the Administrator of the G.S.A. to identify barriers to Federal agencies
• This is why the SPACE Act directs the Administrator of the G.S.A. to identify barriers to Federal agencies
• This is why the SPACE Act directs the Administrator of the G.S.A. to identify barriers to Federal agencies
• This is why the SPACE Act directs the Administrator of the G.S.A. to identify barriers to Federal agencies
• H.R. 3425, a bill to direct the Director of the Federal Protective Service to establish processes to

Keywords: U.S. House of Representatives Floor Proceedings on Monday, September 8, 2025, 1012, house, all

Transcript Highlights:

• So on the federal rescheduling...
• So on the federal rescheduling...
• And so, I mean, it really seems like a compliance nightmare for the federal level.
• States with regulated adult-use markets remain non-compliant with federal scheduling, meaning federally
• changes based on those final federal regulations that are still pending.

Keywords: Cannabis Retail Market, Joint Commission to Oversee the Transition of the Commonwealth into a, 976, house, all

Transcript Highlights:

• or joint federal-state.
• But again, overall, All federal or joint federal-state.
• Again, Florida's CHIP program has been in existence and federally approved since 1998, and the federally
• We've submitted the federal 1115 demonstration waiver; however, we have yet to receive federal approval
• We've submitted the federal demonstration 1115 waiver; however, we have yet to receive federal approval

Summary: The committee received a briefing from AHCA Deputy Secretary Brian Meyer and Florida Healthy Kids CMO Ashley Carr on implementation of HB 121, which was enacted in 2023 to expand Florida’s KidCare/CHIP eligibility from 200% to 300% of the federal poverty level and replace the sharp premium “benefits cliff” with a tiered premium glide path. Sponsor Rep. Bartleman described the bill as a bipartisan effort to help working families keep children insured while moving toward economic self-sufficiency. The presenters explained that the program remains a joint federal-state structure, with Medicaid unchanged and the bill affecting only the CHIP-related portions of KidCare. AHCA said implementation has been delayed by federal CMS actions. The agency reported that CMS first rejected a state plan amendment approach, then required revisions to the premium tiers under a new maintenance-of-effort interpretation, and later issued a new interpretation of continuous 12-month eligibility that would prevent disenrollment for nonpayment of premiums. AHCA said it submitted an 1115 waiver, but negotiations over special terms and conditions reached an impasse, and the state has filed litigation challenging CMS’s interpretation. Members asked about the cost of litigation, the effect on future bills, the review process for CMS documents, disenrollment and reenrollment rules, and whether any additional legislative action is needed; AHCA said no further state action is needed at this time and that the key issue is the pending federal litigation. Several members and the sponsor emphasized the need for immediate implementation and asked about possible interim relief. AHCA said current coverage remains in place under the preexisting program, that there is a 30-day grace period for premium payment, and that reenrollment does not require a penalty or back payment, though coverage is not active during lapsed periods. The committee also heard public comment from Nicholas Hessing of the Children’s Services Council of Broward County and the Florida Alliance of Children’s Councils and Trusts, who supported HB 121 and said the expansion could make about 17,600 additional children eligible in Broward County alone. The meeting ended with Rep. Bartleman thanking staff and expressing hope that the new federal administration would allow the program to move forward, and the chair adjourned the meeting.

Transcript Highlights:

• Based on the federal designation.
• So I think that's a federal issue predominantly. So that's a federal issue...
• That's a federal regulatory issue for that specific issue.
• Actually, that was in the federal.
• Now that might be absurd to the other direction.

Committee: Senate Rules

Summary: The Senate Rules Committee met to consider several governor’s appointees and routine committee actions. Members approved, by unanimous 5-0 votes, three not-required-to-appear appointments: Hampus Eitsiter to the Boating and Waterways Commission, Peter Stern to the California Horse Racing Board, and Dean White to the State Mining and Geology Board. The committee also approved references of bills to committees and floor acknowledgements, each by 5-0 vote. The committee then heard testimony on Tyler Sadwith’s appointment as Chief Deputy Director of Healthcare Programs at the Department of Health Care Services. Sadwith emphasized protecting Medi-Cal access for 14 million Californians, navigating federal changes, and continuing CalAIM and behavioral health reforms. Senators focused heavily on hospital financial distress, rural access, Medi-Cal redeterminations, work requirements, provider reimbursement, fraud oversight, dental access, labor and delivery closures, and the effectiveness of CalAIM and community supports. Public commenters from county, hospital, and provider groups largely supported the nomination, citing his experience and collaborative approach. The committee voted 5-0 to send his appointment to the full Senate. The committee also considered Chris Thayer’s appointment as director of the Office of Environmental Health Hazard Assessment. Thayer described OEHHA’s role as providing transparent, science-based health assessments, improving risk communication, and supporting tools such as CalEnviroScreen and Prop 65 guidance. Senators raised concerns about reliance on models versus real-world data, PFAS, environmental justice, wildfire and battery-fire impacts, and whether CalEnviroScreen and Prop 65 are working as intended. Public testimony from environmental and health organizations supported the nomination and highlighted OEHHA’s scientific role. The committee approved Thayer’s appointment 3-1, with one senator not voting, and forwarded it to the Senate floor.

Transcript Highlights:

• We have seen various gyrations at the federal level with our ability to access federal funding, and we
• First, the shift of direct submission to DDS.
• Department of Labor, which initiated federal regulatory rollbacks that would impact the federal rules
• No changes to the directives, because the directives were made by professionals, and they're more than
• No, changes to the directives, because the mesas directives were in the men of professionals, and they're

Summary: The Assembly Budget Subcommittee on Human Services heard testimony on Department of Developmental Services (DDS) and related budget and trailer bill proposals, with a major focus on the impacts of H.R. 1 on people with intellectual and developmental disabilities (IDD). DDS and the Department of Social Services (DSS) said H.R. 1 could affect Medi-Cal and CalFresh access, but that people with disabilities and caregivers are exempt from the work requirements; the administration is working on data matching and automation through the statewide eligibility system to identify exemptions, with June 1, 2026 as the implementation date for CalFresh changes. Witnesses and advocates warned that any loss of Medi-Cal could create fiscal pressure on regional centers and households, while public commenters described the real-life consequences of losing services. Committee members repeatedly expressed concern about cost shifts to counties and asked for harm-mitigation strategies before the May Revision. The committee also reviewed the governor’s IHSS-related proposals. DSS said the budget would set a baseline for authorized hours, align IHSS disenrollment/reinstatement with Medi-Cal eligibility processes, and eliminate the IHSS backup provider system, while emphasizing that individual service hours would still be based on assessed need. DDS said if a person loses IHSS or Medi-Cal, regional centers may have to step in as payer of last resort for some services, potentially at higher state cost. Members and the Legislative Analyst’s Office questioned whether counties could absorb the proposed shifts without reducing services, and asked for more detail on implementation, data quality controls, and how regional centers could help families navigate disruptions. A separate trailer bill on DDS rate reform and the Quality Incentive Program drew mixed reactions. DDS proposed extending a contract exemption and delaying final rate reform regulations to 2030, saying the changes are budget-neutral and needed for implementation. DDS reported that about 81% of providers had completed the current Quality Incentive Program requirements, but providers and advocates argued the 90-10 structure can function like a penalty and may destabilize services if providers lose 10% of funding. Committee members asked for clearer assistance to providers, possible flexibility for good-faith efforts, and a redlined version of the language before the May Revision. The committee also heard DDS’s proposed trailer bill on regional center governance and provider capacity. DDS said the language would consolidate regional center contracts and performance measures, strengthen board training and oversight, require consumer advisory committees, expand independent legal support, raise the threshold for board approval of contracts, and remove barriers such as physical-office requirements and duplicate vendorization. DDS said the goal is to improve accountability and efficiency while preserving person-centered services, and members indicated they wanted further refinement and stakeholder input before moving forward.

Transcript Highlights:

• </c> collateral damage in federal decisions. collateral damage in federal decisions.
• </c> drawing down federal funds. drawing down federal funds.
• </c> experiencing the loss of federal funds. experiencing the loss of federal funds.
• the federal law where the federal where the federal law sort<00:20:22.600><c> of</c><00:20:22.680><c
• </c> direction and support. direction and support.

Committee: Senate Health and Human Services

Keywords: 1187, senate, all

Transcript Highlights:

• </c> level and Medicare at the federal level. level and Medicare at the federal level.
• Remember Anthem as a matter of<00:31:31.200><c> federal</c> of federal of federal legislation<00:31:33.200
• </c> there are already federal requirements. there are already federal requirements.
• </c> federal guidance is going to be. Right. federal guidance is going to be. Right.
• The problem is there was a federal directive over the last several years for both hospitals and plans

Committee: Senate Health and Human Services

Keywords: 1191, senate, all

Transcript Highlights:

• It's a federal mandate, and that is why we're bringing it to you.
• This directs us to seek that waiver, but will not begin services until JFAC appropriates it.
• at some later date get the appropriation for the program to begin as directed by Congress.
• It's defined in federal law. An eligible juvenile is someone who's under the age...
• Chairman, my recollection is the federal law directs states to seek a waiver, and I can answer that a

Committee: House Health and Welfare

Keywords: 989, all

Transcript Highlights:

• But federal funds make up that more than 50% taxes than we get back, but federal funds make up that more
• because of erratic federal action and due to the impacts of federal tariffs that have caused a lot of
• So this is the elimination of that RAP that's federally required for the federal Medicaid population,
• It doesn't receive federal funding.
• . ...in federal funds.

Summary: The Assembly Budget Subcommittee on Health held the first of several hearings on the Governor’s May Revision for health care, with opening remarks focused on the state’s projected $12 billion deficit, looming federal Medicaid changes, and the potential impact on Medi-Cal, public health, reproductive health, and safety-net providers. Several members criticized the proposal as balancing the budget on vulnerable Californians, while others defended the need for cost containment and questioned the administration’s assumptions. The chair set ground rules for respectful, focused questioning and outlined three topics: the Medi-Cal proposals, Proposition 35, and Proposition 56. DHCS Director Michelle Baas presented the May Revision’s Medi-Cal package, saying the department’s budget totals $200.6 billion overall, including $45.2 billion General Fund, and that the proposals are intended to address rising caseloads, pharmacy costs, and managed care spending. She described proposed changes for adults with unsatisfactory immigration status, including a freeze on new full-scope enrollment for those 19 and older, $100 monthly premiums beginning in 2027, elimination of adult dental and long-term care coverage, removal of PPS/RAP payments to FQHCs and rural health clinics for that population, and a pharmacy rebate aggregator. Other proposals included eliminating certain OTC drug classes, removing GLP-1 coverage for weight loss, prior authorization and step therapy changes, reinstating the Medi-Cal asset test, eliminating acupuncture as an optional benefit, allowing utilization management for hospice, raising the managed care minimum medical loss ratio to 90%, reducing PACE capitation rates toward the midpoint of the actuarial range, eliminating the skilled nursing facility workforce and quality incentive program, and suspending the SNF backup power requirement. The LAO said the revised Medi-Cal spending estimate is about $2.5 billion higher than the Governor’s Budget in the budget year, and that the increase appears driven more by higher per-enrollee costs than by caseload alone. The LAO said the budget solutions are concentrated in a few areas, are largely ongoing, and should be considered in light of federal uncertainty, but suggested the Legislature could explore alternatives such as more targeted income thresholds for the undocumented expansion and simpler asset-test rules. Department of Finance officials said the proposals are difficult but necessary to address a third consecutive deficit and rising Medi-Cal costs. Members then pressed the administration on the methodology and impacts of the proposals, especially the enrollment freeze, premiums, asset test, hospice controls, PACE reductions, and the elimination of benefits and provider payments. No votes or formal actions were taken at this hearing.

Transcript Highlights:

• ><c> brackets</c><00:48:08.480><c> double</c> federal level, most tax brackets double federal level,
• </c> receive a marriage bonus at the federal receive a marriage bonus at the federal level.<00:48:30.880
• Advantage of a direct loan program.
• </c> impact of other state and federal impact of other state and federal policies.<01:06:27.599><c> The
• </c> incentive program, the federal incentive program, the federal residential<01:06:49.119><c> clean

Committee: Senate Taxes

Keywords: 1187, senate, all

Transcript Highlights:

• That financing is tax-exempt federally and at the state level.
• We anticipate launching this direct-to-consumer option this spring.
• This includes maximizing federal Medicaid funds and data user fees.
• information processing standards and other state and federal rules.
• will lose federal premium support entirely.

Keywords: 988, house, all

Transcript Highlights:

• Recent actions by the federal government have increased this urgency to a fevered pitch.
• As part of HR 1, the federal government significantly accelerated the phase-out of federal clean energy
• This is typically a state-regulated activity, and it's a rare directive to FERC.
• This is typically a state-regulated activity, and it's a rare directive to FERC.
• So our task was to look at, track federal funding, available federal funding, share it with colleagues

Committee: House Utilities and Energy

Keywords: 988, house, all

Transcript Highlights:

• And this is related to state direct payments.
• to direct a managed care plan to pay a provider a certain amount.
• The state directed payments have to be linked to states quality strategy.
• Section 7, 1, 1, 3, federal payments to prohibited entities.
• Those steps at the agency took to translate your legislative direction.

Transcript Highlights:

• And historically, the federal government covered these.
• And then if the error rate is above 10 percent, that will be 15 percent direct state costs for direct
• federal level that allowed individuals with validated claims of stolen SNAP benefits to receive a federal
• That's a federal requirement. It just doesn't make sense.
• There are federal waivers to some of those standards that the federal current administration is encouraging

Keywords: 996, all

Transcript Highlights:

• </c> amendments is an update on the federal amendments is an update on the federal change<00:02:29.760
• </c> at, the purposes of your state directed at, the purposes of your state directed payments,<00:08:
• I think the consistent theme of HR1 is that it gets at federal cost drivers: the enhanced 90% federal
• And then finally federal matters.
• </c> have limits on state directed payments. have limits on state directed payments.

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:

• This directive and its immunities match what we have in other current statute for other health directives
• </c><00:08:04.080><c> that</c> agreements Andor the U directives that agreements Andor the U directives
• This is already in federal Medicaid law, so this is mirroring that federal law and adding that to state
• </c> assistance this is already in federal assistance this is already in federal Medicaid<00:20:44.159
• </c> um and for CCAP there is no federal um and for CCAP there is no federal anti-kickback<00:20:51.960

Bills: HF1379 , HF1596 , HF2260 , HF1429

Committee: House Judiciary Finance and Civil Law

Keywords: nonopioid directive, opioid refusal, opioid-free care, pain management, health care directive, advance directive, patient autonomy, informed consent, substance use disorder, opioid epidemic, prescriber immunity, provider liability, emergency medical services, EMS, health record, Minnesota Department of Health, health care agent, medical power of attorney, Metropolitan Council, Minnesota government data practices

Transcript Highlights:

• </c> program or expand federal control. program or expand federal control.
• to</c><04:00:59.760><c> do</c> unless a federal court directs it to do unless a federal court directs
• government and non-federal the federal government and non-federal partners.<04:27:35.359><c> Catastrophic
• a study of wildfire mitigation efforts across federal and non-federal lands.
• Joe Neguse, would direct the Government Accountability Office, or GAO, to study the existing federal

Keywords: U.S. House of Representatives Floor Proceedings on Tuesday, June 2, 2026, 1012, house, all