Transcript Highlights:

• Again, we've got additional funds on line 4 for facility improvements, including security infrastructure
• The LFC recommendation assumes the expansion of the program won't happen as quickly as they hope.
• When I created the Office of Broadband Access and Expansion, one of the things I put in that office was
• On line 13, this is a proposed quantum infrastructure investment where, if quantum companies come here
• , they're investing in the heavy infrastructure to get everything operational.

Committees: Senate Senate Finance , Senate House Appropriations & Finance

Transcript Highlights:

• The Joint Committee Report for House Bill 4045 renames the Base Infrastructure Needs and Development
• The funds can be used for infrastructure, and then it adds equipment.
• The equipment, like I said, this is for military infrastructure.
• That is a revolving fund for capital improvements and infrastructure.
• And that kind of growth puts real, real pressure on housing and student infrastructure.

Bills: HB3257 , HB3176 , HB3544 , HB3619 , HB3546 , HB1782 , HB2293 , HB4358 , HB3081 , HB3983 , HB3790 , HJR1023 , HB4139 , HB3297 , HB3041 , HB3673 , HB4105 , HB3338 , HB3048 , SR33 , SCR21 , SCR20 , HB4030 , HB4031 , HB4032 , HB4034 , HB4036 , HB4037 , HB4038 , HB4040 , HB4041 , HB4042 , HB4043 , HB4045 , HB4046 , HB4047 , HB4048 , HB4044 , HB4050 , HB4051 , HB4052 , HB4053 , HB4054 , HB4056 , HB4057 , HB4071 , HB4065 , HB4067 , HB4072 , HB2992 , HB4338 , HB4170

Summary: The Senate opened with roll call, prayer, and several gallery introductions recognizing guests and honorees, including the Medford Cardinals football team for their academic and athletic success, Guthrie Day, the Oscar J. Upham post office designation, the OKC Spark professional softball team, the Elks organization, and the YMCA’s 175th anniversary. Senators also welcomed a new intern and acknowledged Senator Carl McDowell’s return to the chamber. Most of the early floor time was devoted to ceremonial citations and concurrent resolutions, all of which were adopted without recorded opposition. The chamber then moved through a series of Joint Committee Reports and third-reading votes on appropriations and related measures. HB 4031 reauthorized $41 million for previously approved ODAA projects and passed 36-8, declared an emergency. HB 4032 redirected industry fees to the Department of Mines and passed 34-11, emergency. HB 4034 appropriated $142,137 for salary increases for certified shorthand reporters and passed 45-0, emergency. HB 4036 transferred $5 million from the Film and Oklahoma revolving fund to a new sitcom-related revolving fund and passed 30-15. HB 4037 raised the Ethics Commission Fund retention cap from $150,000 to $250,000 and passed 45-0, emergency. Several transportation, health, and public safety measures also advanced. HB 4038 moved $5 million for the eight-year road plan and additional project funding, passing 28-17 and then as an emergency measure after vote changes. HB 4040 set up cash-flow funds for the State Department of Health’s $223 million federal award and passed 45-0, emergency. HB 4041 appropriated $2.25 million to the Attorney General, including $2 million for a trafficking victim pilot program and $250,000 for a public safety technology fund, and passed as an emergency. HB 4042 appropriated $500,000 for the Commerce census revolving fund and passed 35-9. HB 4043 transferred $1 million to Emergency Management for Oklahoma Task Force 1 and passed 44-0, emergency. The most extended debate centered on HB 4045 and HB 4046, which expanded and funded the Military Readiness, Innovation, Education, and Aviation program. Supporters said the measures would help military bases, schools, infrastructure, simulation training, and defense-related economic development; critics questioned the broad language, lack of detail, and whether the projects fit a broader strategy. HB 4045 passed 37-7 and HB 4046 passed 39-7, both as emergency measures. HB 4047 funded Commerce projects including housing for aged-out foster youth, the State Fair, a university upgrade, and a COG-related economic development request; it passed 30-16 and then 40-6 as an emergency. HB 4048 appropriated $13 million for transportation infrastructure, drew criticism for bypassing the eight-year plan, and passed 36-10 before being declared an emergency. Finally, HB 4030, the Education Budget Limits Bill, was explained in detail, including $43.75 million for the Strong Readers formula, $5 million for literacy coaches, and $5 million for a charter school revolving loan fund; after questions about bonds, charter schools, and the revolving fund, it passed 39-5 and was declared an emergency measure.

Transcript Highlights:

• Our agency supported the city of Aurora with a Community Infrastructure Grant totaling $2 million.
• Our agency supported the city of Aurora with a Community Infrastructure Grant totaling $2 million.
• Our agency is fully prepared to support the expansion of existing businesses or the relocation of new
• </c><00:48:43.640><c> of</c><00:48:43.920><c> existing</c> support the expansion of existing support
• the expansion of existing businesses<00:48:45.119><c> or</c><00:48:45.280><c> the</c><00:48:45.440><c

Committee: Senate Jobs and Economic Development

Transcript Highlights:

• CCTR slot expansion is also contingent on a request for applications.
• And now I'll turn it over to the Deputy Director for the infrastructure grant. Thank you.
• And the Child Care Infrastructure Grant Program, it does seem like it would cover different years.
• This is related to the DSH funding infrastructure program.
• We have real concerns around the lack of meaningful investment in county infrastructure.

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:

• Creating infrastructure for a new health care corporation is incredibly difficult, time-consuming, and
• So it really would be those infrastructure costs that would help them set up and scale up to provide
• I'm wondering what guardrails are going to be in place to track if infrastructure is growing.
• I just want to share that the infrastructure for trans health care is collapsing in real time, and we
• patients. ...continuing providing essential health care services to transgender and gender-expansive

Transcript Highlights:

• We built the expertise, the planning infrastructure, and the public engagement processes to lead this
• We built the expertise, the planning infrastructure, and the public engagement processes to lead this
• And so I think this is a good bill to build the infrastructure to meet those goals that we set.
• California has ambitious goals for our environment and for our energy infrastructure.
• building in 1996, the original expansion of judicial review through then Senator Charles Calderon.

Committee: House Utilities and Energy

Summary: The committee heard several energy and utility bills. AB 1016, by Assembly Member Gonzales, would let certain counties with geothermal elements locally permit geothermal plants up to 150 megawatts through a five-year pilot program. Imperial County and other supporters said the bill would speed clean energy development, create jobs, and bring major tax revenue, while labor groups opposed it unless amended to preserve skilled-and-trained workforce standards. The author committed to continue working with labor, and the bill passed 10-0 to Natural Resources with the commitment to take amendments there. AB 1020, by Assembly Member Schiavo, would require investor-owned utilities to disclose taxpayer-funded loans and grants to the Public Utilities Commission and ensure the benefits are passed through to ratepayers. TURN supported the bill as a way to prevent utilities from “double dipping,” while PG&E said it already provides transparency and the bill was unnecessary. Wildfire survivors opposed it unless amended to direct any non-ratepayer funds first to victims. The bill passed 8-1 to Appropriations, with some members raising questions about the treatment of grants, loans, and ratepayer benefits. AB 881, by Assembly Member Wicks, would establish state safety standards for carbon dioxide pipelines to allow carbon capture and sequestration projects to move forward despite delays in federal rulemaking. Supporters, including SMUD and the Carbon Solutions Coalition, said the bill is needed to meet climate goals and access federal funding; environmental justice groups and local residents urged stronger protections and amendments. The bill passed 11-0 to Natural Resources with the commitment to take amendments there. AB 1156, by Assembly Member Wicks, would update the solar use easement program to allow solar development on water-constrained agricultural land; rural counties and farm groups remained opposed but said amendments moved the bill in the right direction. It passed 17-0 to Agriculture. AB 1222, by Assembly Member Bauer-Kahan, would bar utilities from recovering the costs of challenging CPUC decisions from ratepayers and give greater weight to ALJ proposed decisions; utilities opposed it, citing delay and fairness concerns, while supporters said it would protect ratepayers. It passed 10-3 to Judiciary. The committee also began hearing AB 1260, by Assembly Member Ward, on community renewable energy, with supporters arguing it would improve access for renters and low-income households and correct the CPUC’s implementation of prior law.

Transcript Highlights:

• First we have the Hawaii Green Infrastructure Authority in support, not here.
• </c> 1395 Hawaii green infra infrastructure 1395 Hawaii green infra infrastructure Authority<00:31:55.360
• SB 1083 relating to support infrastructure. First up, we have DLNR in support.
• Next up, we have SB 1083, SD2, relating to port infrastructure.
• Next up, we have SB 1083, SD2, relating to port infrastructure.

Committee: House Water & Land

Summary: The Committee on Water and Land met on March 18, 2025, and heard testimony on several measures related to state funds, public lands, wastewater, port infrastructure, and other land and water issues. Early in the hearing, SB 1395, relating to state funds and climate mitigation financing, drew support from the Governor’s office, the Hawaii Climate Advisory Team, the State Energy Office, and others, while the Tax Foundation of Hawaii urged the committee not to revert to the original version because of concerns about a special fund and compliance with state statutes. After discussion, the chair said the bill would be deferred because of budget uncertainty and the need to preserve reserves, and members agreed to that recommendation. The committee then took up SB 1393, SB 1669, SB 102, SB 1511, SB 1083, and SB 946, among others. SB 1393 and SB 1669 received support or comments from agencies including the Attorney General’s office, the State Energy Office, and other departments; SB 1669 was sent on with amendments and to Finance for further review. SB 102, concerning a third-party review process, prompted questions about who would select consultants and whether the bill would affect staffing and permitting costs; it was advanced with amendments, with one member noting reservations about the shift to private third-party review. SB 1511, SB 1083, and SB 946 also moved forward, generally with amendments or as amended, and several members noted reservations tied to budget impacts or statutory language. The committee also heard testimony on HB 1393, which involved public lands and school facilities, where the Department of Education sought a change to the deletion language and the School Facilities Authority said it stood on its written comments. For SB 146, relating to the Ali Canal, the University of Hawaiʻi and DLNR supported the measure, and a member asked about the estimated annual cost, which was described as $125,000 per year. On SB 946, members discussed whether removing the term “person” could narrow the law too much; after that discussion, the committee agreed to restore the term and proceed with an HD1. The meeting ended with the committee recessing after completing its agenda and adopting the chair’s recommendations on the measures considered.

Transcript Highlights:

• Creating infrastructure for a new health care corporation is incredibly difficult, time-consuming, and
• So it really would be those infrastructure costs that would help them set up and scale up to provide
• I'm wondering what guardrails are going to be in place to track if infrastructure is growing.
• I just want to share that the infrastructure for trans health care is collapsing in real time, and we
• Continuing to provide essential health care services to transgender and gender-expansive patients who

Summary: The joint hearing focused on access to gender-affirming care in California, with members of the Senate and Assembly budget subcommittees hearing first from the Department of Justice, Department of Managed Health Care, and Department of Health Care Services. State officials described California’s legal protections against discrimination, privacy protections, shield laws, and Medi-Cal and commercial plan coverage requirements for medically necessary gender-affirming care. They also outlined ongoing litigation and advocacy against federal actions and proposed rules that could restrict care, including challenges to executive orders, HHS declarations, and federal reimbursement rules, as well as a temporary restraining order protecting care at Rady Children’s Hospital. Committee members pressed the agencies on why some hospitals that had stopped providing care had not been sued, how the state measures network adequacy and equitable access, whether the $15 million previously allocated for gender-affirming care had been used, and what additional statutory changes might be needed. DMHC and DHCS said they regulate health plans rather than providers directly, rely on complaints and independent medical review to address denials or delays, and do not track utilization or have a specific provider category for gender-affirming care. DOJ said it is focused on the federal government as the source of pressure on hospitals and providers, while members discussed possible shield-law expansions and, if federal rules are finalized, the possibility of state-only funding to preserve access. The second panel featured a physician, clinic leaders, parents, and a transgender teen describing how families navigate care and the effects of hospital closures and insurance barriers. Dr. Johanna Olson-Kennedy gave a history of transgender health care, described puberty blockers and hormones as established treatments, and said minors need parental consent for medical interventions. J.M. Jaffe of Lyon Martin Community Health Services said community clinics are absorbing patients after hospital programs closed and asked for $26 million in state funding to expand capacity. Parents and youth testified about delays, out-of-network referrals, lost coverage, and the emotional strain of uncertainty, while also urging the Legislature to stabilize access and protect continuity of care.

Transcript Highlights:

• comments in the overview that this is a workload budget, and so there haven't been significant expansions
• What existing infrastructure does the administration propose to repair?
• How were these infrastructure projects chosen?
• The comments around the O.F. stating that we have access to an expansion of federal credits, we can only
• The comments around the OF stating that we have access to an expansion of federal credits, we can only

Committee: House Budget

Transcript Highlights:

• Medicaid expansion, which would otherwise prohibit this.
• I mean, this was prior to expansion.
• I mean, this was prior to expansion.
• It may temporarily, but it's not our expansion; it's the national government's expansion.
• I would argue once the system But it's not our expansion; it's the national government's expansion.

Summary: The House first established a quorum after several members were absent, then moved into bills for perfection. House Bill 261, dealing with anti-Semitism in public schools and higher education, drew extensive debate. The sponsor described rising anti-Jewish incidents and said the bill would require educational institutions to adopt nondiscriminatory policies, use the IHRA definition as a guide, and treat failures to address harassment as Title VI issues. An amendment from the gentleman from Pulaski was adopted to clarify that protected First Amendment speech, religious expression, and political viewpoints would not be reported or cataloged. Supporters said the bill was needed to protect Jewish students; opponents argued it singled out one group, could chill speech about Israel and Palestine, and created unequal reporting requirements. The House ultimately ordered the bill perfected and printed as amended. The chamber then took up House Bill 2384 on housing affordability and building codes. The sponsor said the bill would lower housing costs by rolling back energy-code mandates to 2009 standards, setting clearer permitting timelines, and allowing certain multifamily buildings to use a single staircase. Supporters argued current codes raise costs, discourage builders, and contribute to Missouri’s housing shortage. Opponents raised concerns about local control, preemption of municipal energy standards, and public safety, especially the single-stair provision; the sponsor responded that the design has been used safely in other states and cities. A Pulaski amendment requiring municipalities with online ordinances to keep only one hard copy available was adopted, and after debate the previous question was moved and approved. The House then adopted the committee substitute and ordered the bill perfected and printed. House Bill 1766, addressing personal property tax, was also perfected and printed. The sponsor said the bill would apply Hancock/CPI-style tax limitations to personal property tax growth, arguing that rapidly rising vehicle values had created a windfall for political subdivisions and unfairly increased taxpayer burdens. Supporters said the bill would slow growth without eliminating it, while opponents argued local governments need revenue to keep up with inflation and that the measure would reduce resources for schools and other services. Finally, the House began consideration of House Joint Resolution 154, which would place into the Missouri Constitution a Medicaid work requirement mirroring federal policy. The sponsor said adults ages 19 to 64 would need to work, volunteer, participate in a work program, or attend school for 80 hours a month to remain eligible, and the discussion began with questions about whether the constitutional change was necessary and how documentation requirements would work.

Transcript Highlights:

• </c> include replacing aging infrastructure include replacing aging infrastructure pipes<00:20:11.799
• </c><00:21:53.720><c> and</c> communities and green infrastructure and communities and green infrastructure
• </c> fiveyear uh and E is infrastructure fiveyear uh and E is infrastructure investment<00:49:00.880>
• As you were talking, I was really interested in infrastructure, and obviously these buildings have infrastructure
• Public Finance. really interested in infrastructure and really interested in infrastructure and obviously

Committee: Senate Capital Investment

Transcript Highlights:

• There is a fiscal concern with that because the more expansive the immunity is, the more claimants will
• And by taking out the word "directly," the expansion really could be very great for medical devices and
• Since then we have seen a crippling expansion of illegal and unregulated gambling activity across our
• for late payment and provides grants to financially disabled small communities for wastewater infrastructure
• And the best part about it is the infrastructure is available already.

Bills: S0598 , S0934 , S1260 , S1300 , S1452 , S1510 , S1566 , S1580 , S1668 , S7034

Committee: Senate Appropriations Committee on Agriculture, Environment, and General Government

Transcript Highlights:

• </c><00:22:35.679><c> and</c> tech, value ad, that infrastructure and tech, value ad, that infrastructure
• </c><00:23:41.200><c> facilities</c> accessory um infrastructure facilities accessory um infrastructure
• </c> or communities where the infrastructure or communities where the infrastructure exists.<00:35:50.320
• </c> to accelerate large-scale infrastructure to accelerate large-scale infrastructure projects<03:02
• </c> environmental reviews for infrastructure environmental reviews for infrastructure project.<03:02

Bills: HB2118 , HB2473

Committee: House Economic Development & Technology

Summary: The committee heard several bills related to permitting and economic development. On HB 2603, relating to permits, the Office of Planning and Sustainable Development said it supported the measure with comments. Committee discussion focused on the fact that the state’s facilitated permit process appears to have been rarely or never used, the need to identify specific projects that would use it, and whether DBEDT would need dedicated staffing to administer it. DBEDT said it had found no projects under the current process, had no capacity to run the program as structured, and estimated it would need about 7 to 9 FTEs, including permitting, coordination, data, systems, and possibly legal support. The chair suggested exploring a staff assignment and comparing the concept to federal FAST-41-style expedited permitting. On HB 2140, relating to essential permitting positions, the Office of Planning and Sustainable Development again supported the bill with comments. Testimony and questioning centered on a pilot program to help counties pay competitively for permitting staff. A DBEDT representative said the issue of competitive pay affected both county and state permitting offices and that the bill was intended as a temporary pilot, though a more permanent solution would be preferable. When asked how counties would fund the salary support, the witness said that was not yet discussed with the counties and agreed to follow up. The committee also noted the bill applies to participating counties. On HB 2598, relating to the Hawaii Technology Development Corporation, the State Procurement Office and HTDC offered comments, and the Department of the Attorney General raised constitutional concerns. The AG said the bill’s residency-based certification requirements, when tied to procurement, could implicate the dormant Commerce Clause, and that the required 1% contribution tied to state contracts raised unconstitutional-conditions concerns. In questioning, the AG characterized these as legal risks rather than automatic lawsuits. The committee did not take a vote. The committee then heard HB 2141, relating to state enterprise zones. Taxation, DBEDT, HCDA, the University of Hawaii Cancer Center, and HTDC testified in support, while the Tax Foundation noted the program was intended to help economically depressed areas create jobs. HTDC said the bill would help preserve the Maui Research and Technology Center’s enterprise-zone status after rezoning. Committee discussion focused on whether the enterprise zone program is being used effectively, how the bill might attract businesses to areas where the state is investing, and whether the program’s labor requirements are too burdensome for new businesses. DBEDT explained that the program requires a 10% workforce increase in the first year, which must be sustained, and said it promotes the program through county coordinators and in-person outreach. No votes or final actions were taken in the portion provided.

Transcript Highlights:

• Largest investment in infrastructure in Fort Stanton since the WPA era.
• From CAF, a $1.1 million investment in upgraded water infrastructure.
• Much more quickly had it not been for the new water infrastructure.
• But we do use it for critical infrastructure investments, specifically water investments.
• This is for expansion.

Committee: House New Mexico Finance Authority Oversight Committee

Transcript Highlights:

• WE HAVE 30 WE ADDED JUST SINCE THE STATEWIDE EXPANSION STARTED TO COME INTO PLACE.
• WE ARE SIX WEEKS INTO STATEWIDE EXPANSION.
• BUT I THINK IT'S A PRETTY DECENT START SIX WEEKS INTO A STATEWIDE EXPANSION.
• WE ARE SIX WEEKS INTO STATEWIDE EXPANSION. MOST OF THE NEW MEMBERS IS JUST STARTING SERVICES.
• LOT OF THE OUTREACH AND ACTIVITY WAS GEARED AROUND IMPLEMENTATION OF THE STATEWIDE EXPANSION.

Transcript Highlights:

• Enhancing rural behavioral health infrastructure through partnerships and telebehavioral health expansion
• Some other infrastructure or investment that we need to make. So, Senator Lee...
• Some other infrastructure or investment that we need to make. So, Senator Lee.
• We're getting into an infrastructure bill. I appreciate it. Thank you.
• Public health infrastructure that will make meaningful differences in those communities.

Committees: Joint Human Services , Joint Human Services Committee

Transcript Highlights:

• Young working-class individuals, again, because of the ACA expansion, are covered by Medicaid.
• The industry has created high-paying jobs in engineering and infrastructure.
• It provides the support, safety, and launch assets to advance commercial expansion.
• Infrastructure and our assets in Alaska remain at the cutting edge.
• More and more companies are making technologies so we can have space infrastructure.

Transcript Highlights:

• Whether it be the infrastructure needs, or running utilities and water.
• Power out to these sites, I think, without the infrastructure, without the roads.
• Thank you, that is quite expansive, and I appreciate that explanation.
• They've invested in physical infrastructure in the state.
• And represent just an expansion of the current programs that you already had.

Committee: House House Appropriations & Finance

Transcript Highlights:

• However, we had stood up the infrastructure to have a hospital-at-home program, and therefore she was
• That meant that we provided the telehealth infrastructure that she needed to be served in this model.
• The infrastructure that we require as a health system to provide efficacious and higher quality care
• Our mission is to support the advancement and expansion of telehealth in Massachusetts.
• Our mission is to support the advancement and expansion of telehealth in Massachusetts.

Committee: Joint Joint Committee on Financial Services

Summary: The committee held a public hearing with testimony on several health care bills, with most of the discussion focused on primary care access, community health center reimbursement, midwifery and birth centers, telehealth, hospital-at-home, direct primary care, and trans-inclusive health care access. Chair Feeney and Chair Murphy opened by noting the large number of signups and asking testifiers to keep remarks brief because of time constraints. Legislators and witnesses repeatedly emphasized that Massachusetts’ primary care system is under strain and that federal policy changes and reimbursement gaps are worsening financial pressure on providers. On community health centers, Representative Blay, Senator Lovely, Michael Curry, Bethany Keeley, Jag Deep Trevetti, Sean Cahill, and Christina Severin all supported H. 1096/S. 711, which would require commercial insurers to pay federally qualified health centers at least the MassHealth prospective payment system rate. They argued that commercial plans currently reimburse health centers below Medicaid rates, threatening sustainability, staffing, and access, especially as federal cuts and coverage losses could increase uncompensated care. Testifiers said the bill would stabilize health centers, protect primary care access, and not cost the state money. A second major topic was H. 1117/S. 784 on sustaining birth centers and the midwifery workforce. Senator Lovely, Senator Miranda, Emily Anesta, Rebecca Orden, Catherine Rushworth, Nishira Burrill, Joel Sutherland, Rachel Blessington, Joelle Ward, and others described the 2024 maternal health omnibus as an important first step, but said birth centers and midwives still face low reimbursement, workforce shortages, and financial instability. They urged reimbursement parity, a workforce development fund, and support for freestanding birth centers, citing improved outcomes, lower C-section rates, better patient experience, and racial equity in maternal health. Several speakers shared personal birth stories and said the bill would help preserve and expand birth options in communities like Roxbury, Worcester, and the North Shore. The committee also heard support for H. 1343 on direct primary care from Dr. Garofalo, Dr. Altman, Dr. Nair, Stephanie Cameron, Dr. Haley Moke-Blessed, and others, who said current insurance rules force patients to use a separate in-network primary care doctor for referrals and sometimes prevent physicians from dispensing medications. They argued the bill would reduce delays, administrative burden, and costs while improving continuity of care. In addition, Dr. Miklides and Sue Stempeck supported H. 1141 on hospital-at-home parity, saying the model has strong outcomes and should be reimbursed at the same rate as brick-and-mortar hospital care. Heather Myers and Katrina Cook testified on telehealth and digital health equity, urging broader coverage for asynchronous care, remote monitoring, interpreter services, and digital literacy supports. SEIU Local 509 supported H. 1188/S. 681 on trans-inclusive health care access, saying it would remove arbitrary insurance barriers to gender-affirming care. No votes or committee actions were taken during the hearing.

Transcript Highlights:

• Medicaid expansion itself is not in statute in Washington.
• things that we are working on collectively, but again, the major things that really impact that expansion
• It will impact our adult expansion population, so those able-bodied adults ages 19 to 65, for which we
• So we have a really unique IT infrastructure with our eligibility and enrollment systems here in the
• And then two broader buckets: one around investing in critical technology infrastructure and maintenance

Committee: Joint Joint Select Committee on Health Care and Behavioral Health Oversight

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.