Transcript Highlights:

• It's that vital for the survival of rural Kentucky, and people understand that if rural Kentucky fails
• </c> not rural not rural Kentucky<00:59:42.319><c> okay</c><00:59:42.559><c> we're</c><00:59:42.799><
• </c> several people here that were impacted several people here that were impacted this<01:00:12.680>
• </c> to know this but we know what the impact to know this but we know what the impact is<01:04:16.079
• So it's not just rural areas.

Keywords: 00:00:00 Call to Order/Roll Call 00:01:19 Discussion of 25RS HB 785 00:30:25 Roll Call Vote on 25RS HB 785 00:32:15 Discussion of 25RS HB 61 00:36:42 Roll Call Vote on 25RS HB 61 00:38:07 Discussion of 25RS HB 788 00:51:01 Discussion of 25RS SB 14 01:11:09 Discussion of 25RS HB 685 01:44:57 Adjournment, 958, all

Summary: The House Standing Committee on Health Services met with a quorum and took up House Bill 785, as amended by a committee substitute that combined language from HB 785 and HB 787. The bill was described as addressing Medicaid managed care organization (MCO) audits, provider contract notice and amendment procedures, mental health parity compliance, and related transparency requirements. Supporters said the measure would tighten notice to providers, limit repeated contract amendments and rate reductions, require more standardized audit procedures, and add reporting on Medicaid claims, appeals, and grievances. It also includes a provision requiring coverage of at least two evaluation-and-management billable services per physician per recipient per date of service, and a section addressing narcotic/opioid treatment program licensing and reimbursement language. Testimony in support came from Representative Kim Moore, John Inman of BrightView Health, Michelle Sandborne of the Children’s Alliance, and Kelly Cormic of RYSE. They argued that MCOs often use audits and recoupments in ways that are burdensome, opaque, and financially damaging to providers, especially smaller and rural ones. They cited examples of multiple audit requests in short timeframes, large record requests with short deadlines, delayed or absent feedback, and recoupments taken before appeals are resolved. They also said parity laws are not being consistently enforced and that the bill would give the Department of Insurance authority to suspend or revoke an MCO certificate of authority for willful or repeated parity violations. Committee members generally expressed support for provider protections and transparency, while asking for clarification on the narcotic treatment and E/M billing provisions. Tom Stevens of the Kentucky Association of Health Plans testified in opposition, saying the bill is complex to implement and should be handled through the broader Medicaid oversight work of House Bill 9, the MOAB. He said the issues raised were better suited for that bipartisan stakeholder process and noted the committee substitute had not yet been fully reviewed by his group. After discussion, the committee adopted the committee substitute and then moved to a vote on the bill; the roll call began, with several members recorded as voting yes, but the transcript cuts off before the final vote result is shown.

Transcript Highlights:

• What timelines you have, impact on the timelines.
• That had, you know, an impact as well. There was no funding at that time.
• Is there a study on that impact so that we're not going on a gut feeling? Mr.
• We have a tremendous amount of data on the economic impact.
• Just a few things, first of all, to indicate representing rural New Mexico.

Keywords: 996, all

Transcript Highlights:

• And in my 12 rural counties, there are rural facilities, and what I've found in dealing with other rural
• That didn't directly impact that negotiation. It didn't directly impact the costs that we pay.
• The impact is on mandates.
• But that isn't the only impact of 340B. The other impact is harder to... ...rebates.
• , you recognize... ...probably have been impacted or know someone who's been impacted by stroke.

Keywords: 1184, house, all

Transcript Highlights:

• to care and provide recruitment and retention in rural areas.
• Telehealth is an affordable and effective way for our rural community.
• And I know how important health care is in our rural community.
• Our concern is patient impact.
• So this is where the patient impact is.

Summary: The Assembly Health Committee met on March 17 and first approved a consent calendar of several bills, then heard AB 1540 by Assemblymember Mark Gonzalez, which would restore the 988 “Press 3” LGBTQ youth crisis line. Supporters, including suicide prevention advocates, behavioral health groups, and local governments, argued the service is a vital, identity-affirming suicide prevention tool for LGBTQ youth. Opponents, including detransitioners and conservative advocacy groups, argued it would steer vulnerable youth toward organizations they viewed as harmful. The committee approved the bill on a due-pass-as-amended motion to the Communications and Conveyance Committee, with several no votes; the bill was later held on call and then advanced. The committee next heard AB 1671 by Assemblymember Tangipa, creating a Rural Medical Provider Grant Program to help providers serving rural communities with operational costs, equipment, workforce needs, and related expenses. Supporters said the bill would help retain providers and improve access in areas where patients travel long distances for care; committee members also discussed telehealth as an important rural access tool. The bill passed on a due-pass-as-amended motion to Appropriations. The committee then took up AB 1876 by Assemblymember Addis, the Fair Care for All Act, which would codify federal health care nondiscrimination protections into California law, including protections related to race, color, national origin, age, disability, sex, and gender identity. Supporters said the bill is needed because federal protections are vulnerable to rollback and because patients, especially transgender and intersex Californians, face coverage denials and care disruptions. Opponents argued the bill would force coverage of gender-affirming care and raised concerns about detransitioning. The committee approved the bill on a due-pass motion to Judiciary, with some no votes, and later held it on call before it advanced. Finally, the committee heard AB 1629 by Assemblymember Haney, which would require dental plans to honor assignment-of-benefits requests and improve reporting on network adequacy. Supporters said the bill would reduce upfront costs for patients and improve transparency, while opponents, including Delta Dental and dental plan groups, warned it could weaken networks and increase out-of-pocket costs. After discussion about network participation and patient access, the committee passed the bill on a due-pass motion to Appropriations. The committee then completed the remaining votes, including the consent items, and adjourned.

Transcript Highlights:

• to care and provide recruitment and retention in rural areas.
• Another $300 million in loans to 17 facilities, many of them rural.
• And I know how important health care is in our rural community.
• Our concern is patient impact.
• So actually, this is where the patient impact is.

Keywords: 988, house, all

Transcript Highlights:

• snatched up, to the impacts on people's pocketbooks from impacts on tariffs.
• snatched up, to the impacts on people's pocketbooks from impacts on tariffs.
• snatched up, to the impacts on people's pocketbooks from impacts on tariffs.
• snatched up, to the impacts on people's pocketbooks from impacts on tariffs.
• impacts on tariffs.

Keywords: 1183, house

Transcript Highlights:

• So it’s a high impact on our community.
• So it’s not just limited to rural areas.
• The way I— it does say rural, but it also...
• The impact reaches far beyond the individual responders.
• The impacts are... has an impact on our tax revenue, is offset very conservatively at $81 million dollars

Keywords: 996, all

Transcript Highlights:

• So one of the things that we're going to do in red is I would like to highlight our rural areas.
• In rural Arizona, we are desperate in need of affordable housing.
• In rural communities...
• to bring back and deploy in our rural communities.
• Rural-adjacent. It’s rural-adjacent. Vice Chair Lopez? Yes. Chair Martinez.

Summary: The committee began with short video presentations highlighting historic sites in Prescott, including the Arizona Pioneer Home and the Charlotte Hall Museum/First Territorial Governor’s Mansion, with members discussing the value of showcasing district landmarks and rural history. The committee then took up HB 2804, a bill to create a state rural development and housing tax credit tied to the federal low-income housing tax credit for projects in counties under 800,000 population. Supporters, including the Flagstaff mayor and several affordable-housing developers, said the bill would help finance rural and workforce housing, especially for seniors, veterans, and low-income residents, while opponents from the Arizona Free Enterprise Club argued the program is inefficient, hard to police, and benefits intermediaries more than residents. Members debated the policy at length, but the bill was ultimately passed on a 7-0 vote with a due pass recommendation. The committee then considered HB 2388, which would appropriate unspecified funds to the Arizona Commerce Authority to study the economic benefits of small modular reactors and data centers for the state and local governments. The sponsor described it as a study bill to gather information on a topic already drawing significant attention, and a representative from the Libre Initiative supported it as a way to assess workforce and economic opportunities. Members discussed possible amendments, including adding data on utility-rate impacts and other costs, and the sponsor said she was open to that conversation. The bill passed on a 6-1 vote, with one member opposed and others expressing support contingent on possible amendments.

Transcript Highlights:

• Impact those things.
• How does this impact **Plano**? How does this impact **Anna**?
• Did you look into the impact in your study on The impact in your study on school takeover and the impact
• Is coastal under rural? No. Is coastal under rural? That is a good question.
• our rural schools.

Keywords: 1184, house, all

Transcript Highlights:

• One, mandate impact mitigation.
• So what are the impacts of this?
• the impact.
• rural?
• and roadway impact fees.

Summary: The committee held a hearing on high-capacity groundwater wells proposed in Anderson, Henderson, and Houston counties, with members framing the issue as one of local water supply, fairness, and the need to modernize groundwater law while protecting private property rights. Opening remarks focused on the scale of the proposed Redtown Ranch and Pine Bliss projects, the potential export of tens of thousands of acre-feet of groundwater annually, and concerns that the applications lacked sufficient technical detail and could harm nearby landowners, cities, agriculture, and manufacturing. Members also noted the broader context of the recent flooding tragedy in central Texas and the Legislature’s intent to address water-related loss of life in the upcoming special session. Witnesses from the Texas Alliance of Groundwater Districts and the Texas Water Development Board explained the current groundwater management framework. They described groundwater conservation districts as the state’s preferred management method, the role of groundwater management areas and desired future conditions, and how the Water Development Board uses those conditions to calculate modeled available groundwater. They emphasized that districts rely on local data, monitoring wells, and planning processes, but that information is often more limited in areas without a district, where the rule of capture applies. Members pressed witnesses on recharge rates, export permits, subsidence, the effect of pumping on nearby wells, the age and real-time availability of model data, and whether the proposed project would exceed modeled available groundwater in some counties. TCEQ explained its limited oversight role over groundwater conservation districts, including inquiries, compliance actions, and, in extreme cases, dissolution authority. Water Development Board staff also outlined funding programs, saying the New Water Supply for Texas Fund is limited to projects such as brackish desalination, reuse, ASR, and other new-supply projects, and does not fund fresh groundwater exports alone. They said the project at issue had not applied for board funding. A water lawyer then testified on the rule of capture, ownership in place, and district regulation, arguing that districts must use permitting and other tools to manage production within modeled available groundwater and that the Legislature could consider additional authority over groundwater exports under current law.

Transcript Highlights:

• impacts for students in small schools compared to large schools.
• And you can see impacts there emerged earlier.
• So a very specific question on impacts to LCAP participation.
• I lead the California Rural Ed Network, elevating voices of rural educators.
• Rural educational leaders often say that because schools are the center of rural communities, the integration

Keywords: 988, house, all

Transcript Highlights:

• is starting to have as we work through the impacts.
• Those impacts are in station operations, obviously how we serve Californians, the impact on our role
• This is impact on content.
• So to your question about the service in those rural areas: rural areas have a particular, you know,
• So, how the student experience can be impacted is really how any position at KPBS can be impacted.

Summary: The hearing focused on the impact of the federal rescission of Corporation for Public Broadcasting funding on California public media, with Assemblymember Chris Ward and Senator Akilah Weber Pierson framing public media as essential civic infrastructure for education, local news, arts, emergency alerts, and underserved communities. Local officials from San Diego and La Mesa voiced support, emphasizing public media’s role in trusted information, children’s programming, and community arts access. Panelists from PBS SoCal, KCRW, Rebuild Local News, NPR, KPBS, Radio Bilingüe, and KVPR described significant budget losses, layoffs, reduced programming, and threats to rural and specialized services. They highlighted impacts on children’s educational content, local journalism, arts coverage, science and documentary production, and emergency alert systems. Several speakers noted that smaller stations in rural or low-broadband areas are especially vulnerable, while larger stations are also cutting staff and delaying projects. They also discussed possible responses such as shared services, cost reductions, philanthropy, and state support, while warning that one-time bridge funding is not a long-term fix. Committee members asked about operational changes, alternative revenue sources, the role of state programs, and whether public pressure could restore federal funding. Witnesses said the loss is already being felt, that restoration appears unlikely in the near term, and that any state support should be structured to protect editorial independence and provide stable, timely funding. The hearing concluded with a shift to labor and production testimony and then to station-specific testimony from KPBS, Radio Bilingüe, and KVPR, followed by public comment.

Transcript Highlights:

• They reported in 2024 that, quote, the Renaissance Zone program has made significant impacts on our rural
• They reported in 2024 that quote, the Renaissance Zone program has made significant impacts on our rural
• Your department and USDA Rural Development.
• So they are impacted most greatly.
• Again, all of them, however, raised long-term concerns about how the impact of the cap would even impact

Keywords: 908, all

Summary: The committee met to continue its tax reform and relief study agenda, approved the December 3, 2025 minutes, and announced a new subcommittee to examine property tax statement issues with counties, auditors, and the tax office. Representative Headland was named chair, Senator Rummel vice chair, and Representatives Dressler and Dr. Dr. and Senator Patton were also assigned. The chair noted the group may need an additional meeting and thanked staff and attendees. A major portion of the meeting focused on economic development incentives. The Department of Commerce presented on the Renaissance Zone program and TIF districts, describing Renaissance Zones as locally tailored tools that combine local property tax relief with state income tax incentives. Commerce said the program has supported thousands of projects since 1999 and cited examples from Beach and Mandan showing increases in property and taxable value, business retention, housing, and downtown revitalization. Committee members raised concerns that smaller rural communities often lack the staff and expertise to apply, and Commerce said it provides outreach through conferences, office hours, and one-on-one assistance. League of Cities and local officials from Bismarck and Ellendale echoed the capacity issue, discussed how the programs have worked in their communities, and suggested possible reforms or more targeted support for small towns. Ellendale’s mayor also described two TIF districts, one for industrial infrastructure in Oaks and one for housing infrastructure tied to a data center project in Ellendale. The committee then turned to stripper oil taxation. The Tax Department gave a comparison of oil and gas tax structures in selected states, noting that most have some form of stripper or marginal well provision, while Alaska does not appear to have a specific stripper-well exemption. Members asked for more detail on definitions and North Dakota’s annual adjusted rate. The Department of Mineral Resources followed with a detailed presentation on North Dakota stripper wells, explaining the statutory thresholds, the 12-consecutive-month production test, and the fact that once a well qualifies it remains on stripper status even if production later rises. DMR said about 11,332 stripper wells are active, representing roughly 54% of wells and about 16% of state production, and emphasized that stripper status can extend well life, preserve tax revenue, and reduce orphaned wells. Committee members and industry witnesses discussed refracs, the economics of keeping marginal wells active, and the competitive disadvantage created by North Dakota’s oil price discount. No votes were taken on these informational items.

Transcript Highlights:

• From rural communities, as well as tribal communities.
• Social workers, specifically for rural New Mexico.
• Thank you also for the Rural Health Care Delivery Fund.
• that there has been a direct impact from the fires.
• But I do wonder about some of the underlying things that keep our rural, especially our rural people

Transcript Highlights:

• The economic impact of.
• That definitely impacts the overall health and well-being.
• It takes a very long time in rural communities.
• I think that's what rural communities really need.
• I'm just going to continue to speak for rural communities.

Transcript Highlights:

• So this bill This bill impacts both of those organizations.
• Those same rural areas have already been exempted from driver's education courses.
• I just looked up in 2024, 74% of fatal accidents were in rural areas.
• So I'm not so concerned about the urban versus rural aspect.
• I understand the rural areas because the rural areas don't have access to any professional education.

Summary: The committee first took up House Bill 663, which would allow Idaho Agriculture in the Classroom to redesign its specialty license plate and shift plate design authority from Food Producers of Idaho to the organization’s board of directors. The sponsor and Cassidy Plum, the state director, said the plate provides about 75% of the program’s funding and supports teacher workshops, grants, and ag-literacy curriculum. Samantha Parrott also testified in support, saying the redesign could help increase sales and that Food Producers of Idaho supports the bill. Representative Harris raised the idea of involving students in the design, and Plum said the organization may hold a student competition. The committee voted to send HB 663 to the floor with a due pass recommendation. The committee then heard House Bill 628, which revises Idaho’s driver’s education law to expand parental instruction options and remove the prior rural-only limitation, while also adjusting language related to approved online course providers. Representative Mendive said the bill is the latest step in a multi-year effort to give families more flexibility and to allow school districts to offer driver training if they choose. Robert Scoville, a Caldwell science teacher and driver’s ed instructor, testified in opposition, arguing that removing school-based instruction would reduce safety and increase teen crash risks, citing crash and fatality statistics and the value of professional instruction. In response, supporters argued parents are already responsible for much of the training, that private instruction remains available, and that the bill increases freedom and reflects what is already happening in many districts. After discussion, the committee debated whether the bill would improve parental choice or weaken driver safety. Several members supported the measure as a matter of local control and family discretion, while others expressed concern about urban safety and the loss of professional instruction. The committee ultimately voted to send HB 628 to the floor with a due pass recommendation, and the meeting adjourned.

Transcript Highlights:

• And then what is the anticipated impact of these actions once they are made?
• And then the rural classifications, which are a lot of our hospitals in our state, and the rural, less
• This slide shows the rural composite measure of the 10 rural acute stroke measures.
• I think about what is the impact on the patient and also what's the impact on the family and community
• Senator Lee said the rural emergency hospital designation is intended to serve rural areas, and he does

Summary: The committee first approved the previous meeting minutes and then heard a detailed annual report from Dr. Thomas Arnold, chair of the Maternal Mortality Review Committee, on maternal mortality trends and policy issues. He explained the committee’s review process, confidentiality protections, and national and North Dakota data showing that most maternal deaths are preventable and that mental health conditions, substance use, cardiovascular issues, infection, hemorrhage, and embolism are the leading causes. Members asked about suicide, domestic violence, midwife training, home births, and whether pregnancy testing at death scenes should be expanded; Dr. Arnold said better coroner education, more investigation of unexplained deaths, and possible post-mortem pregnancy testing could improve case identification, especially in rural areas. He also noted that deaths often occur well after 42 days postpartum and that mental health-related deaths remain a major concern. The committee then heard from State Fire Marshal Dr. Matthew Clark on cigarette reduced-ignition-propensity standards and related fire prevention issues. He recommended updating the state’s cigarette propensity law to current national standards and also raised a separate recommendation to require fast-breakaway oxygen tubing for home oxygen users, citing fatal fires linked to smoking around oxygen. Members asked about implementation, cost, insurance coverage, and whether the standards apply in tribal communities; Dr. Clark said he would provide follow-up information and was willing to help with any legislation, but no agency bill had yet been planned. Next, Christine Greff of the Department of Health and Human Services reported on the North Dakota Stroke System of Care. She described the statewide network of stroke-ready hospitals, registry-based quality improvement, and performance data showing continued improvement in stroke recognition, imaging, thrombolytic treatment, transfers, and EMS pre-notification. She highlighted new quality measures for inter-facility transfers and intracerebral hemorrhage care, and said the system remains strong but depends on continued legislative and hospital support. Committee members asked about participation by the VA hospital and were encouraged to consider outreach to include it more fully in the stroke system. Finally, the committee began a presentation on prior authorization and non-opioid pain treatment from Taha Khan of Vertex Pharmaceuticals. He argued that prior authorization can delay access to non-opioid acute pain medications, especially in the 24- to 72-hour post-discharge window when pain is most severe, and said delays can push patients toward opioids. He emphasized that prior authorization has a role in utilization management but should not create barriers in acute pain care, and he noted that current use of the company’s non-opioid product remains very low. The discussion was still underway when the transcript ended.

Transcript Highlights:

• I think many of these, well, probably upwards of half of them are rural.
• The programs in rural areas are particularly vulnerable.
• Notably, graduates from rural programs are more likely to practice in rural areas.
• Our membership is very diverse; some are rural, and some are urban.
• State and throughout the nation have been negatively impacted by that.

Keywords: 988, house, all

Transcript Highlights:

• Yet for our small, isolated rural population, this number represents devastating impacts.
• Did the floods impact the road to any extent?
• on rural Arizona that this has become.
• We have a very, very big need in rural medicine, in rural health care in general.
• There was a... ...very, very big need in rural medicine, in rural health care in general.

Bills: SB1063, SB1118, SB1153, SB1154, SB1209, SCM1001

Keywords: appropriation, transportation, safety improvements, Route 70, infrastructure, housing, zoning, middle housing, urban development, duplexes, triplexes, fourplexes, townhomes, historic preservation, Grand Canyon, Grand Canyon National Park, special license plate, special plate, license plate, vanity plate

Transcript Highlights:

• would be impacted.
• There's folks in the rural areas.
• </c> to real economic needs in rural to real economic needs in rural Colorado.<06:39:40.680><c> Rural
• Rural Colorado deserves Colorado.
• our rural and our rural resort communities that are feeling the brunt of climate change.

Keywords: 981, all