Transcript Highlights:

• This study assumed that reimbursement would be a mix of fee-for-service and then bundled payments in
• So this study looks at doing that bundled payment.

Summary: The committee began with an extended work session on the long-term care workforce. DSHS Assistant Secretary B. Rector described the new Home and Community Living Administration and outlined major workforce pressures: Washington had about 126,000 long-term care workers in 2022, with demand expected to outpace supply as the 85-plus population and dementia prevalence rise sharply. She emphasized that direct care workers are largely women, people of color, and immigrants, and that family caregivers are also a major part of the system. She highlighted recruitment and retention efforts funded through federal Money Follows the Person dollars, including high school training partnerships, a retention toolkit, transportation support, caregiver newsletters, tribal workforce navigators, and a remote caregiving pilot. Committee members asked about career pathways, technology use, and turnover drivers; Rector said wages, benefits, unstable hours, and workplace support are key issues and promised follow-up data. Aidan Swain of the Washington Health Care Association said skilled nursing and assisted living facilities face acute RN vacancies, wage pressures, and Medicaid reimbursement that does not cover costs, and urged modernization of training, better reimbursement, and continued support for facility-based care. Maddie Fouch of SEIU 775, representing about 55,000 caregivers, said low wages, weak benefits, lack of voice, and certification delays are driving turnover and shortages, and argued for higher compensation, better worker protections, and more transparent reimbursement. Catherine Smith of Behavioral Health Solutions described growing behavioral health needs in nursing homes, the role of expanded behavioral supports programs, and credentialing delays that slow hiring. No votes were taken; the panel was informational only. The second agenda item was an overview of the palliative care benefit work group report required by 2024 legislation. Nico Jansen of the Office of the Insurance Commissioner explained that the work group, convened with the Health Care Authority, studied a potential palliative care benefit for fully insured commercial plans and also Medicaid, PEBB, and SEBB. He said palliative care is a philosophy of care focused on symptom management, coordination, and support for serious illness, and is distinct from hospice because it can be provided alongside curative treatment. The actuarial analysis concluded that creating a new benefit would likely increase costs, estimating about a 28-cent per member per month increase overall and roughly $2.6 million to $4.5 million in annual state Medicaid costs if implemented in 2027. Jansen said the consultants did not find sufficient evidence to assume savings from avoided hospitalizations or long-term care, though several work group members disagreed and submitted response letters. Senators asked about other states, Medicare, health homes, and whether more research could clarify cost savings; OIC said some states, including Hawaii, are moving ahead with Medicaid palliative care benefits, Medicare covers some related services but not in the same way, and further evidence may emerge over time. OIC did not take a position on whether the Legislature should create the benefit. The final presentation covered health care price transparency tools in Washington and federally. Evan Klein and HCA Chief Data Officer Vishal Chaudry reviewed federal hospital and health plan transparency rules, the state all-payer claims database, prescription drug price transparency, the Health Care Cost Transparency Board, the Prescription Drug Affordability Board, and other reporting systems. They explained that the APCD contains claims from fully insured commercial plans, Medicaid, and public employee programs, but not self-insured employer data except for limited voluntary submissions. They also described how machine-readable files, consumer price tools, and aggregated dashboards are used, and noted that data limitations, delays, and complexity remain significant. Senators asked about voluntary self-insured participation, the role of AI in making data more usable, and whether transparency can really help consumers given access barriers and medical debt. HCA said AI is increasingly used by private entities to mine large transparency datasets, but state agencies still face limits in data access and analytic capacity. The committee did not take action; the session was informational and ended with a discussion of how transparency data might better inform policy and purchasing decisions in the future.

Transcript Highlights:

• So I would pull that one from the bundle. Okay, that's perfect. Let me see. That one is...
• So I would pull that one from the bundle. Okay. That's perfect. Let me see. That one is...

Summary: The Texas Ethics Commission met on March 11, 2025, first in executive session and then in open session. The chair announced that, in light of Texas Attorney General Opinion KP-484, the commission would conform its practices to the opinion and move to repeal tolling rules for sworn-complaint deadlines. The chair also said the commission would dismiss 36 pending sworn-complaint cases in which the 120-day settlement deadline had been exceeded, even though the delay had been tolled under prior TEC rules. The commission then set future meeting dates for June 12 and September 17 and approved prior meeting minutes. The commission adopted a new criminal-referral rule clarifying that, once jurisdiction over a complaint is accepted, commissioners may vote to make a criminal referral. It also adopted revised advisory-opinion rules, with a clarifying amendment from a commenter, and republished proposed changes to the definition of “principal purpose” for political committees after staff recommended a 49 percent political-activity threshold and further public input. The commission published for comment proposed changes to ethics training rules, facial-compliance review procedures, late-filing waiver and reduction rules, and sworn-complaint procedures, including tighter discovery limits, a default-order set-aside process, and removal of tolling language inconsistent with KP-484. It also republished Chapter 28 rules on Speaker-candidate reporting. The commission adopted several advisory opinions. It declined to give an affirmative defense on whether certain school-district communications were political advertising because related litigation had already addressed the issue. It reaffirmed that a House member may use donated district-office space if it is not reimbursable with public funds and was accepted before the contribution moratorium. It also concluded that a judge may use political funds for travel to a Navy-hosted event as a local dignitary, that legislators’ use of a corporate aircraft for a border-region fact-finding trip could be permissible but would likely trigger reporting obligations, that a TCEQ commissioner’s revolving-door restrictions apply only to matters actually placed before the commissioner, and that a part-time legislative staffer may not take outside employment assisting a registered lobbyist. The commission then heard and acted on numerous fine-waiver appeals, granting several full waivers or reductions and approving staff recommendations on others, and terminated a number of inactive campaign treasurer appointments. Finally, the executive director briefed the commission on the 2025 legislative session, noting that staffing requests are tied to Sunset recommendations and that the House had preliminarily recommended about half of the commission’s appropriations requests.

Transcript Highlights:

• They could potentially question... what the payment rate, bundling, those sorts of things. would be,

Bills: HB138, HB335, HB388, HB138

Keywords: health impact analysis, cost analysis, coverage mandates, health insurance, legislative analysis, health care data, education, funding, classroom resources, teacher support, student outcomes, health benefits, provider dentists, payment reimbursement, insurance code, noncontracting, dental care, reimbursement, health benefit plans, noncontracting providers

Transcript Highlights:

• This is part of the agreed-upon bundle of bills involving prescription drugs this session.

Bills: SB1475, SB1447, HB2288, SB1521, SB592, SB1533, HB1276, SB201, SB1477, SB1232, SB1255, SB1327, SB1525, SB1721, SB667, SB1436, SB1317, SB604, SB1325, SB1496, SB2007, SB1567, SB2112, SB1980, SB1735, SB1558, SB1491, SB1287, SB1378, SB1369, SB1441, SB137, SB483, SB843, SB1433, SB1257, SB1365, SJR49, HJR1090, HJR1091, HJR1092, HJR1093, HJR1095, HJR1094

Keywords: memorial, infrastructure, transportation, dedication, Toby Keith, employees insurance, contract awarding, certifications, state procurement, insurance plan, teachers, retirement, postretirement employment, earnings limitations, Oklahoma, artificial intelligence, AI, generative AI, chatbot, conversational AI

Transcript Highlights:

• Um, they could, um, Potentially question um what um what the the payment rate bundling, those sorts of

Bills: HB138

Keywords: voter registration, application rejection, transparency, election integrity, state law

Transcript Highlights:

• Senate Bill 1090 by Hughes, relating to bundling and downcoding practices conducted by certain providers

Summary: The Senate met briefly and referred a large number of first-reading bills and resolutions to standing committees. The measures covered a wide range of topics, including hemp regulation, dementia research funding, parental rights and public education, municipal library funding, tax and local government issues, criminal justice, health care, education, transportation, natural resources, and election law. Several constitutional resolutions were also referred, including proposals related to the Dementia Prevention and Research Institute of Texas and a severance tax revenue fund. Most of the transcript consists of the reading of bill captions and committee referrals, with no substantive debate or testimony recorded. The listed measures included proposals on school uniforms, charter schools, Medicaid fraud remedies, insurance practices, occupational licensing for people with criminal convictions, water and sewer utility cybersecurity, agricultural protections, public meeting broadcasting, and various local and state governance matters. No votes were taken on the bills in this segment. The only formal action reflected was referral of the bills and resolutions to the appropriate committees, followed by adjournment of the Senate until the next scheduled meeting.

Transcript Highlights:

• We actually didn't intend for this amendment to be bundled up in the way it is, but it is.
• We actually didn't intend for this amendment to be bundled up in the way it is, but it is.
• We actually didn't intend for this amendment to be bundled up in the way it is, but it is.
• We actually didn't intend for this amendment to be bundled up in the way it is, but it is.
• We actually didn't intend for this amendment to be bundled up in the way it is, but it is.

Bills: HF4382, HF2929

Keywords: child care, day care, child care center, family child care, family day care, group family day care, licensed child care, licensing modernization, early childhood education, preschool, infant care, toddler care, school-age care, drop-in child care, night care, sick care, community-based child care, provider training, staff ratios, group size

Transcript Highlights:

• HB 1035 bundles this all together: firearm restrictions, taxpayer-funded feticide, speech policing, policing
• Don't ask us to bless the whole bundle at once.
• HB 1035 bundles this all together: firearm restrictions, taxpayer-funded feticide, speech policing, policing
• Don't ask us to bless the whole bundle at once.
• Don't ask us to bless the whole bundle at once.

Keywords: 981, all

Transcript Highlights:

• So what happens is they bundle the events with some smaller ones to get the bigger ones.
• So what happens is they bundle the events with some smaller ones to get the bigger ones.
• ><01:34:26.880> happens<01:34:27.199> is<01:34:27.440> they<01:34:27.760> bundle
• <01:34:28.080> the So we what happens is they bundle the So we what happens is they bundle

Keywords: 1187, senate, all

Transcript Highlights:

• Then there's a different type of PSAO which bundles items, drugs, over-the-counter items, vials, and
• There are certain PSAOs that will bundle<01:38:30.080> insurance bundle insurance bundle insurance
• They bundle my insurance LeaderNet.
• It's approaching the size of WRAID. groups out there that that bundle or or groups out there that that
• bundle or or have<01:41:18.320> um<01:41:18.560> as<01:41:18.880> members<01:41

Keywords: 928, house, all

Summary: The committee first heard Senate Bill 47, sponsored by Sen. Regina Birdsell at the request of the Insurance Department. The bill would codify the department’s interpretation that a birth mother’s health insurance is the primary coverage for a newborn, unless the mother has no insurance or coverage under an employer-sponsored plan. Birdsell and Insurance Commissioner DJ Benton Court said the measure is a clarification of existing practice and intended to protect vulnerable newborns; a question from Rep. Miles clarified that if a young woman is on her parents’ policy, the newborn would generally be covered under that family coverage. The hearing on SB 47 was then closed. The committee then took up Senate Bill 121, introduced by Grant Bosi for Sen. Kevin Avard, which would require insurers to notify the Insurance Department when they stop writing an entire line of business or, in some cases, Medicare Advantage plans. Commissioner Benton Court said the bill arose from disruption in the Medicare Advantage market, where consumers, brokers, and the department were confused by carriers changing or ending offerings; he said the department wanted a simple notification requirement so it could better advise consumers. Members discussed network adequacy, county-based service areas, and the fact that the bill would make notice a condition of licensure, with possible fines or license action for noncompliance. Witness Paula Rogers of AHIP said her group supported the bill if amended, and the department indicated it would support a change from a 120-day notice period to 90 days to align with state rules; the committee planned to work on an amendment in subcommittee. Finally, the committee heard Senate Bill 247, introduced by Rep. Brian Cole, which would prohibit network exclusion of pharmacies that refuse to dispense prescriptions when PBM reimbursement is below acquisition cost. Cole argued the bill is meant to stop pharmacies from being forced to sell drugs at a loss, describing PBMs as middlemen and saying the measure is a compromise that protects local pharmacies. Members questioned whether consumers would pay more and whether pharmacies voluntarily enter PBM contracts; Cole responded that the bill would let pharmacies refuse unprofitable fills while consumers could still obtain the drug through mail order or other channels. He also said the issue has changed over time because the practice now affects a much larger share of generics and is concentrated among a few PBMs. The hearing remained open as questions continued, with no vote taken in the excerpt.

Transcript Highlights:

• The second was Blandin came back to the Minnesota Tax Court and said, listen, our bundle of rights has
• and said um to the Minnesota tax court and said listen<00:58:07.280> our<00:58:07.480> bundle
• of<00:58:08.039> Rights<00:58:08.319> has<00:58:08.440> been listen our bundle
• of Rights has been listen our bundle of Rights has been eroded<00:58:09.640> uh<00:58:09.760>

Keywords: 1187, senate, all

Transcript Highlights:

• start off by thanking the committee for their work, happy to accept the amendments to allow the bundling
• to increase affordability of these simple designs, SB 1107 allows multiple shade structures to be bundled

Summary: The Assembly Education Committee heard a long slate of education bills, beginning with SB 685 on nonpublic schools for students with disabilities. Senator Cortese and the California Department of Education described the bill as a response to the Ninth Circuit’s Laughman decision, removing the obsolete “non-sectarian” requirement while preserving secular use of public funds, nondiscrimination protections, background checks, credentialing, and incident reporting. There was no opposition, and the bill later passed 7-0 to Appropriations. The committee also heard SB 1181, a pilot grant program for violence prevention, student wellness, and school safety in Central Valley and other schools. Supporters framed it as a prevention measure, while opponents from EFF, ACLU Cal Action, and community advocates warned it could increase law enforcement involvement, surveillance, and use of fusion centers; despite those concerns, it ultimately passed 5-0 to Appropriations. Members then considered SB 1067, which would create a statewide framework for annual K-2 math assessments starting in 2028-29 to identify students needing early intervention. The author and supporters argued California faces a serious math achievement crisis and that early assessment would help close gaps, while CTA and several educators and administrators sought additional clarity and amendments to ensure alignment with existing diagnostic practices and limits on high-stakes use. The bill drew broad support from educators, parents, and advocacy groups and passed 7-0 to Appropriations. SB 1107, a school shade-structure bill, would expand eligible shade projects and allow bundling through design-build to reduce costs; it received support from LAUSD, school boards, and climate-focused groups and passed 7-0. SB 1128, on take-home devices and screen time for kindergarteners, was presented as a modest first step to give families more flexibility and reduce early screen exposure, with support from early childhood advocates and no opposition, and it passed 7-0. The committee also approved SB 1048, creating a voluntary State Seal of Climate Literacy for students who complete climate coursework and hands-on projects. Supporters, including Ten Strands, students, teachers, and county offices, said it would recognize real-world climate learning and green career readiness; it passed 7-0. SB 1140, sponsored by CFT, would require LEA construction contractors to follow campus security provisions during school projects to reduce unauthorized access; it drew support from labor and gun violence prevention groups and passed 7-0. SB 930, requiring end-to-end encryption for proctoring companies handling K-12 exam data, was presented as a student privacy measure in response to cybersecurity risks and passed 6-0. Finally, SB 1083 was introduced by Senator Perez as a follow-up to last year’s Safe Learning Environments Act, with extensive committee amendments to refine the statewide misconduct data system, disclosure rules, contractor fingerprinting, and access requirements; the transcript cuts off before the bill’s full hearing and vote are shown.

Transcript Highlights:

• start off by thanking the committee for their work, happy to accept the amendments to allow the bundling
• to increase affordability of these simple designs, SB 1107 allows multiple shade structures to be bundled

Keywords: 988, house, all

Transcript Highlights:

• So that information will now be bundled back to their school... ...now be bundled back to their school

Keywords: 916, all

Transcript Highlights:

• So by the metrics, when you look at the first projects we took over, it was the 62 bridge bundle from
• So out of the 62 bridge bundle, 31% complete through construction.

Keywords: 965, house, all

Summary: The House Transportation Committee met for an information-only hearing with no votes or formal actions. DOTD Secretary Glenn LaD and Deputy Secretary Beau Black outlined the department’s transformation efforts, emphasizing faster project delivery, improved transparency, and use of technology. They reported major reductions in contractor payment processing time, from roughly 35 days to 15 days or less, and change-order approvals from about 40–45 days to around five days. They also described new tools such as inspection tablets, a project delivery dashboard, e-ticketing, a customer service portal, and a pilot using sensor technology on department vehicles to identify potholes and damaged assets. The department said it is reorganizing district staffing, replacing the old area engineer model with district points of contact for construction, maintenance, and operations, without increasing total staff. Members focused heavily on local maintenance concerns, including potholes, drainage, culverts, mowing, overgrown ditches, and utility-related delays. Several legislators asked how to get quicker responses on routine maintenance and how to distinguish state responsibility from local jurisdiction. DOTD said it would meet with district administrators to address specific problems and clarify jurisdiction, and that the new customer service portal should help track complaints electronically. Members also asked about contractor accountability, utility relocations, and public communication on long-running projects; DOTD said it is improving internal KPIs, coordinating more closely with district staff and public information officers, and considering broader public updates beyond the website. The department also reviewed highway planning and funding. Officials said the Highway Priority Program is being reworked into a more fiscally constrained, staged process that starts earlier in concept development and gives legislators and constituents more feedback before the annual road show. They said the department is using new IDIQ contracting authority to bring in outside help for bridge maintenance and other work, and that bridge maintenance backlogs remain significant. DOTD reported that LTIF 1.0 and 2.0 together cover 91 projects statewide totaling more than $534 million, with over 40 complete, and that LTIF 3.0 adds 39 projects and about $165 million. Combined with other funding sources, the department said its upcoming construction program will include 385 projects worth about $1.73 billion. Legislators generally praised the department’s progress but raised concerns about lingering local problems and the need for clearer communication. Questions were also asked about a barge strike on the Black Bayou Pontoon Bridge, with DOTD saying divers and staff were inspecting the damage and that emergency repairs would likely be needed. After the DOTD update, the new Office of Louisiana Highway Construction, led by Archie Chesson, gave its own update on its first year, describing a small staff, heavy use of consultant and contractor pools, emergency procurement authority, and rapid delivery of rural bridge and roadway projects.

Transcript Highlights:

• When you figure the bundle of shingles that you’re looking at there, different codes and factors out
• mean, I think that insurers and just the number of losses that we pay, knowing what the cost of a bundle

Bills: HF4881, HF4867, HF4422, HF4223

Keywords: healthcare, insurance, regulation, financial institutions, prescription drug affordability, consumer protection, restitution account, financial compensation, attorney general, distributions, property insurance, homeowners insurance, fire and allied lines, hail insurance, appraisal clause, loss adjustment, alternative dispute resolution, insurance claims, claim valuation, actual cash value

Transcript Highlights:

• Part of that is because it is under one bundle, but the other part of that is also in respect for providers
• a number of people that we understand are getting multiple services, but they're being put into a bundled

Transcript Highlights:

• He bundled together 10 projects on community and faith-based organizations across the Twin Cities.
• He bundled actually doing 10 projects.
• He bundled together<00:36:07.600> 10<00:36:07.840> projects<00:36:08.360> on<00:

Keywords: 1187, senate, all

Transcript Highlights:

• SB213 by Wes, relating to prohibiting insurance from requiring the bundling of personal lines property
• This is a practice of forced bundling of home and auto insurance.
• Senate Bill 213 establishes that forced bundling restricts competition in the insurance business, and

Bills: SB4, SB23, SB3, SJR2, SJR85, SB34, SB60, SB75, SB706, SB1814, SB1220, SB523, SB565, SB1253, SB840, SB764, SB2383, SB2155, SB1535, SB1405, SB1423, SB1566, SB1804, SB1728, SB1816, SB1952, SB1948, SB2037, SB2068, SB1455, SB213, SB243, SB627, SB646, SB670, SB896, SB917, SB1184, SB971, SB1255, SB1261, SB1283, SB1358, SB991, SB1733, SB21, SB231, SB739, SB1252, SB1371, SB664, SB40, SB9, SJR1, SB687, SB1332, SB458, SB482, SB927, SB984, SB651, SB1620, SB2124, SB2448, SB841, SB843, SB402, SB2662, SB2053, SB2332, SB2112, SB745, SB1247, SB1789, SB27, SB207, SB2938, SB1901, SB1227, SB1248, SB912, SB1321, SB2143, SB2145, SB1497, SB1239, SB2180, SB1388, SB1662, SB1951, SB1537, SB493, SB378, SB1020, SB1018, SB992, SB958, SB920, SB1350, SB1762, SB552, HCR109, SB2185, SB4, SB23, SB3, SJR2, SJR85, SB34, SB60, SB75, SB706, SB1814, SB1220, SB523, SB565, SB1253, SB840, SB764, SB2383, SB2155, SB1535, SB1405, SB1423, SB1566, SB1804, SB1728, SB1816, SB1952, SB1948, SB2037, SB2068, SB1455, SB213, SB243, SB627, SB646, SB670, SB896, SB917, SB1184, SB971, SB1255, SB1261, SB1283, SB1358, SB991, SB1733, SB21, SB231, SB739, SB1252, SB1371, HB2970, HB 109, SB2308

Keywords: property tax, homestead exemption, school funding, state aid, constitutional amendment, elderly, disabled, ad valorem taxation, school district funding, SJR 2, Senate Joint Resolution 2, property tax relief, school property tax, ad valorem tax, residence homestead, school district taxes, Texas Constitution Article VIII, public school finance, homeowner exemption, elderly exemption

Transcript Highlights:

• In other words, creating efficiencies by bundling together.

Keywords: 914, all