Transcript Highlights:

• take to see the patient?
• I can't tell you the oral health status of a patient.
• It's hard to find a dentist accepting new patients.
• So do you show the ones that are and are not taking patients? Yes.
• That are taking patients. We show their status.

Keywords: 962, all

Summary: The Care Management Meeting opened with a DSS update on the PCMH program. Staff reported the program remained steady at 124 practices, 553 sites, and 2,548 providers, with some month-to-month fluctuation driven by practice consolidation, retirements, and a few practices leaving the program because NCQA requirements were burdensome. Members asked about declining provider and site counts, member attribution trends, and whether PCMH practices overlap with behavioral health homes; DSS said attribution changes are largely due to members becoming ineligible, moving, or getting other insurance, and that PCMH and behavioral health homes are separate programs that coordinate informally. The committee also discussed why some smaller practices leave the program and whether the requirements could be made easier to support retention. The committee then resumed a detailed presentation on the Husky Dental program. The presenter described the dental benefit’s history, the importance of preventive oral health, workforce and consolidation pressures in dentistry, and the lack of interoperability between dental and medical records. Network data showed year-over-year declines in enrolled dental practitioners and service locations, with access gaps concentrated in rural and eastern parts of the state. Appointment availability surveys showed average waits of 38 days for adults and 23 days for children, but much longer waits at FQHCs than private fee-for-service practices. The presenter said Connecticut remains above the national median on CMS pediatric dental quality measures, though sealant rates remain a concern, and noted that preventive care is associated with lower per-member costs. Members raised concerns about provider participation, large practices dropping Medicaid, mobile dental care, and whether the public directory accurately reflects which dentists are actually accepting new patients. The presenter said the plan uses secret-shopper calls, tracks appointment availability, and has begun using place-of-service coding to better identify school-based dental care. She also noted a new MOU with 20 Head Start programs to share data and provide oral health literacy and navigation support. The final major topic was implementation planning for HR1. DSS said CMS guidance was expected in early June and proposed using upcoming meetings to cover medical frailty, communication strategy, and data integration/ex parte verification. Committee members urged the department to create a dashboard to track disenrollments and other impacts of HR1, to build a process for complaints and problem resolution, and to think through cost-sharing, caregiver verification, exemptions, and notices. Members also asked about using existing eligibility structures such as the working-disabled program as a model. The committee agreed to move the next meeting to June 10 by Zoom, with the agenda to be circulated in advance and any PCMH Plus quality data shared if available.

Transcript Highlights:

• I would rarely see uninsured patients.
• Uncertainty for our patients leads to harm and even death when our patients cannot get access to care
• , but as uninsured self-paying patients.
• For rural hospitals, that means fewer insured patients and more uninsured patients.
• When coverage disappears, patients don't.

Summary: The joint informational hearing of the Senate and Assembly Health Committees focused on the “cost of uncertainty” in health coverage, access, and affordability amid federal policy changes. Opening remarks from committee leaders and members emphasized that California’s gains under the Affordable Care Act and Health for All policies—high coverage rates, consumer protections, and lower uninsured rates—are now threatened by federal rollbacks, including the expiration of enhanced premium tax credits and H.R. 1. Members repeatedly cited rising premiums, skipped care, medical debt, and the risk of coverage losses, especially for low-income Californians, workers, seniors, and immigrant communities. The first panel featured federal policy and state implementation experts, including Don Joyce, Jessica Altman of Covered California, and Elizabeth Lansberg of HCAI’s Office of Health Care Affordability. Testimony described the ACA’s coverage expansions and the current federal threats: shorter open enrollment, more verification requirements, loss of enhanced subsidies, and changes affecting immigrants and preventive coverage. Covered California reported that average monthly premiums could nearly double without the subsidies, new enrollment is down sharply, and more consumers are shifting into bronze plans with higher deductibles. HCAI explained its affordability strategy through spending targets, consolidation review, and primary care investment, while members asked about the impact of federal cuts on provider taxes, uncompensated care, and whether California can sustain coverage without new revenue. The second panel, with UC Berkeley Labor Center’s Miranda Dietz and California Health Care Foundation’s Christoph Stremikis, broadened the discussion to statewide cost drivers and consumer impacts. They highlighted that more than half of Californians under 65 rely on job-based coverage, yet premiums, deductibles, and out-of-pocket costs have risen faster than wages. They also pointed to medical debt, administrative waste, market consolidation, and underinvestment in primary care as major drivers of unaffordability. Members asked about the 25% of health spending that does not improve patient care, the role of fraud versus administrative friction, the effect of cost growth targets on workers, and the need for preventive care and possible revenue solutions. The hearing then moved to a third panel on human impacts, beginning with testimony from a Central Valley promotora describing how families are choosing lower-tier coverage, struggling with diabetes care, and facing higher premiums after subsidy losses.

Transcript Highlights:

• Often, the only way they find out about patient cases is once patients are symptomatic, or in another
• So by Michelle going there and maintaining that level of patient care, it keeps the patient living at
• All of these patients' emails and texts told the same story, with different specifics: patients need
• </c> pharmacies will close leaving patients pharmacies will close leaving patients with<00:53:51.000>
• </c> form the backbone for critical patient form the backbone for critical patient care<01:06:50.960>

Committee: House Health Finance and Policy

Keywords: 1183, house

Transcript Highlights:

• “I want to begin with access to care because this is where the system is failing patients.
• over $650 a year for that patient.
• Very often a patient will come to their three-month visit...
• I saw this patient in July 2025 and I'm still waiting.
• It's difficult for patients to access a lot of these medications.

Bills: S2732 , S2738 , S2739

Committee: Joint Joint Committee on Financial Services

Keywords: healthcare, direct primary care, insurance, referrals, network providers, payment denial, insurance costs, manufactured homes, homeowners insurance, affordability, state regulations, insurance market, consumer protection, mobile homes, firefighting, water supply, cistern program, rural areas, urban interface, state funding

Transcript Highlights:

• patient safety, privacy, with a quality of Without compromising patient safety, privacy, or the quality
• Our patients cannot continue to suffer. Our pharmacies cannot continue to disappear.
• Nothing in SB 41 will lower the cost of prescription drugs for patients.
• Patients have to pay—usually they're $2,000 deductible at the beginning of the year.
• If we don't take those contracts, then we don't get patients.

Summary: The committee heard several health-related measures. SB 27 by Senator Umberg would revise and expand California’s CARE Court by limiting the expansion to people with bipolar I disorder with psychotic features, clarifying the definition of “clinically stabilized,” and narrowing the role of nurse practitioners and physician assistants. Supporters, including behavioral health officials and family members, said the bill would reduce dismissals and better serve people with severe illness; opponents warned the expansion would strain county staffing and housing resources and could undermine voluntary engagement. The bill passed on a do pass motion to the Committee on Public Safety. SB 503 by Senator Weber Pierson would require AI tools used in health care facilities to be identified, monitored, and mitigated for bias when used in clinical decision-making or resource allocation. The author and supporters from Kaiser Permanente and the California Medical Association said the bill would help prevent discriminatory outcomes and improve trust and safety. The committee discussed the need to clarify developer and deployer responsibilities, and the bill passed as amended to Privacy and Consumer Protection. SB 68 by Senator Menjivar would require restaurants to provide written allergen information for the top nine food allergens, with tiered flexibility for smaller establishments. The bill was supported by patients, families, nurses, and allergy organizations, who described severe reactions and the difficulty of relying on verbal disclosures alone. The California Restaurant Association opposed unless amended, seeking broader use of the national model food code and additional liability language. The bill passed as amended to Appropriations. The committee also heard SB 403 by Senator Blakespear, which would remove the sunset from the End of Life Option Act; supporters described the law as a compassionate, well-functioning option for terminally ill patients, while faith-based groups opposed it. The bill passed to Judiciary. Later, SB 41 by Senator Wiener was introduced to rein in pharmacy benefit manager practices that steer patients to mail-order pharmacies and reimburse community pharmacies below cost; community pharmacists and several health organizations testified in support, describing pharmacy closures and patient access problems.

Transcript Highlights:

• And that's by patient reporting.
• You're asking about patient rights, and I agree 100%.
• It killed a lot of my constituents and a lot of my patients.
• informed consent, which is a basic patient right.
• And patients are not told that. That's a lack of informed consent, which is a basic patient right.

Bills: HB18 , HB37 , HB116 , HB18 , HB37 , HB 116 , HB388 , HB879 , HB913 , HB 1151 , HB2216 , HB2358 , HB2809 , SB577 , SB1590 , SB1782 , SB1887 , SB2744

Committee: Senate Health & Human Services

Keywords: HB 18, Texas Legislature, quorum break, quorum-busting, legislative walkout, absent legislators, political contributions, campaign finance, political expenditures, legislative caucus, specific-purpose committee, Texas Ethics Commission, civil penalty, show cause order, district court, Fifteenth Court of Appeals, session fundraising, travel lodging food expenses, legislative session, compelled attendance

Summary: The committee first reopened testimony on House Bill 2216, which would strengthen child welfare requirements by expanding “active efforts” to help families avoid removal and support reunification, while also raising standards related to removals and terminations. Supporters from child welfare and family defense groups said the bill would better protect families and align Texas more closely with ICWA-style principles, but several warned it would require significant new funding, staffing, and community services such as mental health care, housing, child care, and substance use treatment. The committee then left HB 2216 pending. The committee next heard Senate Bill 1782, aimed at boarding and group homes. Senator Miles said the bill closes enforcement gaps left by prior law by requiring retention of background-check records and creating misdemeanor penalties for failing to conduct or keep them, or for knowingly hiring people with serious convictions. Harris County sheriff’s investigators testified in support, describing illegal boarding homes, operators who evade permits and background checks, and exploitation of vulnerable residents; the bill was left pending. The committee also took up Senate Bill 481 on emergency preparedness for nursing facilities and assisted living facilities, adopted a new committee substitute that softened some requirements and removed the fiscal note, and left the bill pending. The committee then heard House Bill 388, which would require the Texas Department of Insurance to create a single standardized coordination-of-benefits form for dual health plans to reduce errors and surprise bills; it was left pending. Senate Bill 1590 would move paternity registry searches for adoptions to an electronic process with a 10-day target, and House Bill 2809 would track child suicide attempts in managing conservatorship and require related reporting and parental notice; both were left pending. The committee also heard Senate Bill 1887, which would prohibit administering mRNA-containing products for immunization for 10 years, with exceptions for cancer and genetic disorders. Supporters argued the bill was needed for safety, informed consent, and medical freedom, while opponents from the medical, research, and public health communities said mRNA vaccines are well-studied, save lives, and that the bill would harm access, research, and Texas’s biotech economy. The bill remained under discussion as testimony concluded.

Transcript Highlights:

• We co-manage patients every single day.
• </c> both in treatment and in patient both in treatment and in patient outcomes<00:10:10.959><c> during
• Optometric improvements to our patients.
• It creates long patient wait times us.
• </c> patients every single day. patients every single day.

Keywords: 1183, house

Transcript Highlights:

• Another situation, while inventorying patient belongings, the patient had turned over all prescription
• patient belongings the patient inventory patient belongings the patient had<00:23:36.240><c> turned</
• </c> colleagues we need help our patients colleagues we need help our patients need<00:24:50.640><c>
• </c><00:24:54.480><c> and</c> protect hospital staff patients and protect hospital staff patients and
• </c> would I would say that that patient would I would say that that patient probably<00:36:35.040><c

Keywords: Meeting Start: 00:00:00 Roll Call: 00:00:09 SB 64: 00:01:20 SB 73: 00:05:33 HB 662: 00:09:40 HB 320: 00:20:17, 958, all

Summary: The House Judiciary Committee met with a quorum and first approved Senate Bill 64, as amended, on a 14-0 vote. The bill was described as a copper theft prevention measure aimed at protecting key infrastructure assets, including telecommunications and electrical highway infrastructure. Testimony in support came from Senator Brandon Storm and representatives from Charter Communications and law enforcement, who said copper theft and related vandalism are damaging fiber and other infrastructure across the state. A committee substitute was adopted before the vote. The committee then considered Senate Bill 73, relating to sexual extortion. Senator Julie Rocky Adams and Kentucky Youth Advocates testified that sextortion is a fast-growing crime against children and that the bill would make sexual extortion a felony, create civil remedies for victims, and require school-based education and resources. The bill passed 15-0 and was reported favorably for floor consideration. House Bill 662, relating to personally identifiable information, was also approved after discussion and a committee substitute. Representative John Blanton said the bill would help protect judges and certain medical review personnel from public disclosure of personal information while preserving provider access needed for appeals and communications. The Kentucky Medical Association supported the concept but stressed the need to preserve provider-facing information so doctors can conduct peer-to-peer reviews and appeals. The bill passed 15-0 with one pass vote. House Bill 320, relating to controlled substances on hospital property, was taken up for discussion only and no vote was taken. Representative Mike Klein and a St. Elizabeth nurse testified that hospitals are seeing illicit drug use and trafficking on campus and argued for a drug-free zone to protect staff, patients, and visitors. Committee members raised concerns about how the bill would apply to unconscious overdose patients, lawfully prescribed medications, emergency situations, and whether possession should be treated differently from trafficking. The chair ruled a motion out of order because the item was for discussion only, and the bill remained under consideration.

Transcript Highlights:

• Yet growth of the profession has not kept pace with increasing patient demand.
• Complexity without delivering meaningful improvements for patients.
• patients of access to health care.
• AB 2457 streamlines before they're able to see a Medi-Cal patient.
• About one in five of those patients has no insurance.

Committee: House Health

Keywords: 988, house, all

Transcript Highlights:

• But we hear from patients across the state often.
• But we hear from patients across the state often.
• But clinicians now can give patients hope, which is something they didn't have before.
• They've got so many patients. They're doing the best they can.
• patients or the new concerns.

Committee: All ALZHEIMER'S DISEASE AND DEMENTIA ADVISORY COUNCIL

Summary: The Arkansas Alzheimer’s Disease and Dementia Advisory Council met to introduce members, adopt its rules and procedures, approve prior minutes, and authorize the co-chairs to approve special expenses. The main discussion focused on updating the Arkansas State Plan for Alzheimer’s disease and dementia, with David Cook of the Alzheimer’s Association outlining major changes in prevalence, caregiving burden, diagnostics, and treatment since the prior plan. He noted rising disease and caregiver numbers in Arkansas, the expansion of amyloid PET access, the growing use of blood-based biomarkers, and the availability of FDA-approved treatments such as Leqembi and Kisunla, while emphasizing that access, insurance coverage, and provider education remain major barriers. Members and presenters also discussed the need to better reach rural primary care providers, who may not be aware of new diagnostics and therapies, and the bottlenecks caused by limited specialists and infusion capacity. There was concern about overreliance on blood tests without confirmatory evaluation, and several members stressed the importance of collaboration, public education, and promoting brain health through exercise and diet. The council also heard about existing programs such as the dementia services coordinator, the BOLD grant, caregiver respite grants, workforce training, and a pilot dementia resource center with UAMS Centers on Aging. The council approved a new four-part outline for the next state plan: advancing risk reduction and brain health/early detection, strengthening family caregiver support, improving access to diagnostics and treatment, and supporting access and quality of care, including workforce and crisis response. Members also agreed to consider future agenda items on new treatments, brain health and lifestyle prevention, workforce training, and possible legislative changes to the enabling statute. The meeting ended with discussion of scheduling the next meeting, tentatively set for August 12 in Hot Springs, and adjournment.

Transcript Highlights:

• And the industry just wants information to charge patients.
• patient assessment, diagnosis, clinical decision-making, patient education, and handoff communication
• beings who provide patient care.
• vulnerable patients among us from further harm.
• The nurse knows through her professional judgment that the patient needs care sooner than the AI. patient

Committee: House Privacy and Consumer Protection

Keywords: 988, house, all

Transcript Highlights:

• </c><00:03:23.080><c> for</c> The average annual cost per patient for The average annual cost per patient
• Consider my patient Derek.
• We often want to use a lower patients.
• ><c> Coalition</c><00:13:25.960><c> or</c> Diabetes Patient Advocacy Coalition or Diabetes Patient Advocacy
• </c><00:13:53.960><c> don't</c> When coverage is cut off, patients don't When coverage is cut off, patients

Keywords: 1183, house

Transcript Highlights:

• </c> she is probably the world's most patient she is probably the world's most patient build<00:03:58.680
• </c><00:04:25.720><c> care</c> year four to ensuring that patient care year four to ensuring that patient
• </c><00:06:33.720><c> care</c> unnecessary delays in patient care unnecessary delays in patient care
• </c> ensuring that when a Medicaid patient ensuring that when a Medicaid patient receives<00:24:48.279
• </c> promotes fairness improves patient promotes fairness improves patient access<00:26:23.240><c> and

Keywords: Meeting Start: 00:00 Roll Call: 00:13 HB423 Discussion: 01:38 HB423 Vote: 12:30 HB415 Discussion: 13:50 HB415 Vote: 15:13 HB390 Discussion: 16:30 HB390 Vote: 21:48 HB3 For Discussion Only: 23:15, 958, all

Summary: The committee first took up House Bill 423, a prior authorization reform measure sponsored by Representative Kim Moser. A committee substitute was adopted to clarify that the bill’s prior authorization exemption program does not apply to Medicaid. Supporters, including the Kentucky Medical Association, said the bill would reduce red tape, improve transparency, and let providers spend more time on patient care. The bill would create a framework for insurers to establish a gold carding or waiver program for certain health services, exclude prescription drugs, prohibit retrospective reviews based solely on an exemption, and require annual reporting by the Department of Insurance and the Department for Medicaid Services. After questions about how exemptions would work and whether the bill addressed repeat prior authorizations, the committee voted to pass HB 423 with favorable expression. The committee then considered House Bill 415, sponsored by Representative Pollock and supported by AFLAC representatives. The bill was described as clarifying that health insurance coverage mandates are generally intended to apply only to primary major medical policies. With no substantive opposition or questions, the committee voted to pass HB 415 with favorable expression. Finally, the committee heard House Bill 390 from Chair Meredith, presented with support from multiple insurance industry representatives and the Department of Insurance. The bill would move motor vehicle insurance verification data from the old system to the CAVIS database and shorten the reporting turnaround from 30 days to a ceiling of seven days, with the possibility of a shorter period by regulation. After brief discussion and no objections, the committee voted to pass HB 390 with favorable expression. The committee also heard House Bill 3 for discussion only, sponsored by Representative Neighbors and supported by the Kentucky Pharmacists Association. The bill would require Kentucky Medicaid to reimburse pharmacists for covered clinical services they already provide, aligning Medicaid with existing commercial insurance policy. Supporters argued it would improve access, especially in underserved areas, and could reduce emergency room use and improve outcomes; the bill was not voted on during this meeting.

Transcript Highlights:

• It hurts patients. They're paying more out-of-pocket.
• The main revenue, of course, for hospitals is patient delivery, delivery of patient care.
• where we get to the adjusted patient revenue.
• Net patient revenue.
• And then what happens to the net patient?

Committee: House Legislative Health & Human Services Committee

Transcript Highlights:

• with gaining access to appropriate health care settings when that patient presents to the emergency
• and collaborative partners. help establish that relationship between such patients and collaborative
• So one of the plans actually said, “We’re going to assist that patient in making an appointment.”
• . the patients, managed care organization, and coordinate that assignment as well.
• I still see patients, even though I'm the CEO of the health center.

Summary: The committee met to receive implementation updates on recently enacted health care laws from AHCA and the Department of Health. AHCA reported on rural emergency hospitals, explaining the new Class 4 hospital designation, rule changes completed June 1, 2025, and that no Florida hospitals have yet converted, though one North Walton/DeFuniak Springs-area hospital has expressed interest. AHCA also reviewed the non-emergent care access plan requirement for hospitals with emergency departments, saying 83 plans had been received since July 1 and 63 approved, with plans emphasizing patient education, referrals to primary care or urgent care, and coordination for Medicaid managed care enrollees through the Florida HIE/ENS system. Members asked about HIE capacity, data collection, and whether the plans would identify shortages or trigger accountability measures; AHCA said it had moved to a new HIE vendor and would continue gathering data. AHCA also updated the committee on the TEACH workforce program, reporting $6.8 million in FY 2024-25 spending across 59 parent organizations and 229 facilities, with more than 1,800 students and nearly 380,000 clinical hours reimbursed, and said a federal 1115 workforce waiver was unlikely to move forward under CMS. On KidCare, AHCA said House Bill 121’s expansion to 300% of the federal poverty level remains blocked by federal litigation and CMS action tied to premium nonpayment rules, and members and public witnesses urged prompt implementation and asked for enrollment/disenrollment data and the rural health transformation funding outlook. Public testimony largely supported the NCAP and TEACH programs and pressed for action on KidCare. Representatives from health centers said NCAP has strengthened hospital-health center relationships and improved care coordination, including reduced recidivism in some hospitals. A Bond Community Health Center physician said TEACH is helping offset the burden of training students and could help address workforce shortages, especially in rural and underserved areas. Advocacy groups urged the committee to push for implementation of the KidCare expansion, citing children in the coverage gap and rising uninsured rates. The Department of Health then presented on several programs from the 2024-25 session. It reported on the Florida Reimbursement Assistance for Medical Education (FRAME) program, including 78 dentists and 15 dental hygienists funded under the dental track and nearly 1,300 medical professionals funded overall, with 123 dental applications and 71 funded dentists in the most recent cycle. DOH also updated the Screening and Services Grant Program, the Health Care Innovation Revolving Loan Program, the statewide telehealth maternity care program, and the swimming lesson voucher program, noting strong participation and outcomes such as reduced ER visits and improved postpartum follow-up in the maternity program. Finally, DOH said implementation of the HIV prevention drug/pharmacist dispensing law is underway, with three certification courses approved and five certifications issued. Members asked about barriers to wider use of HIV prevention drugs, more detailed maternal outcome data, and the dental workforce program report; DOH said more detailed reports would follow.

Transcript Highlights:

• I remember I had one patient.
• I believe in patient choice.
• This does not require every patient to choose this. It doesn't require a patient to fill this out.
• safety, and they do not want harm to come to a patient.
• That's no care for those patients.

Committee: Senate Appropriations Committee on Health and Human Services

Summary: The committee met with a quorum and considered several health-related bills. SB 398, by Senator Burgess, would create a statewide Alzheimer’s and dementia awareness campaign through the Department of Elder Affairs, focused on early detection, brain health, risk reduction, clinical trial access, and community resources. Supporters said Florida has a large and growing Alzheimer’s population and that the campaign would help families and vulnerable communities; the bill was reported favorably after a roll call vote. The committee also adopted an amendment to SB 714, by Senator Burton, which would create non-opioid advanced directives and add liability protections for providers in medical emergencies involving opioids. Supporters framed it as a patient-choice measure, while opponents argued it was vague and could interfere with appropriate pain treatment; the amended bill was then reported favorably. The committee also approved CS/SB 756, which removes the current age-eight diagnosis requirement for autism-related insurance coverage and extends coverage beyond age 18 for those diagnosed with autism. Senator Burton said the bill would help families whose children are diagnosed later or whose needs continue into adulthood. There was brief discussion about existing lifetime benefit caps, but the sponsor said the bill did not change those limits. The committee then took up SB 734, a proposal by Senator Yarbrough to repeal Florida’s wrongful death exception that bars certain parents and adult children from recovering non-economic damages in medical negligence cases. The sponsor and supporters described the current law as discriminatory and unjust, especially for families of older adults and disabled individuals, while opponents warned it would raise malpractice costs, increase premiums, and worsen provider shortages. The bill drew extensive public testimony from both grieving family members and health care/insurance representatives, and members debated whether caps or other safeguards should be added. No final action on SB 734 is reflected in the transcript excerpt.

Transcript Highlights:

• are for in-state patients.
• Uh, it also caregiver or patient.
• </c> how much is would 2 ounces a patient? how much is would 2 ounces a patient?
• </c> allow patients uh to get what they need. allow patients uh to get what they need.
• have um sorry, the that non-patients have um sorry, the patients<01:42:07.920><c> have.

Committee: Senate Judiciary

Keywords: 1191, senate, all

Transcript Highlights:

• If a patient... ...added the delivery of epinephrine injection devices.
• I've said before, we are here because we are standing up for patient safety.
• I have patients yearly who will come back and say, you might have saved my life.
• And that's not unique to me, but there have been patients.
• The patients of Missouri gained better access to care, and nobody died.

Committee: House Professional Registration and Licensing

Keywords: 959, house, all

Transcript Highlights:

• The current maximum amount is 6% of net patient revenue.
• The current maximum amount is 6% of net patient revenue.
• It just delays them until patients are...
• There were too few providers and too many patients going without care.
• As a direct contact to the patient, County.

Summary: The subcommittee heard a lengthy Department of Health Care Services presentation on the governor’s Medi-Cal budget, including a $229.1 billion total-funds proposal, projected Medi-Cal enrollment declines as redeterminations continue, and several major cost drivers such as managed care growth, Medicare-related costs, pharmacy spending, and changes tied to federal policy. Members focused heavily on the elimination of Prop. 56 dental supplemental payments beginning July 1, 2026, questioning the likely impact on provider participation and utilization. DHCS said it is completing the required rate reduction/access analysis for CMS, has been holding stakeholder meetings and issuing provider bulletins, but could not yet quantify the real-world effect. The committee also discussed a $50 million savings proposal tied to new hospice utilization management authority and asked about possible effects on emergency dental care and provider participation. The hearing then moved through the November 2025 family health estimate and several county and program administration issues, including CCS, GHPP, and Every Woman Counts. DHCS said family health costs are rising despite slight caseload declines because of higher utilization and medical costs, and members raised concerns about CCS website accessibility, county administrative funding, and the transition of youth aging out of CCS. The department said most CCS beneficiaries are also on Medi-Cal, that counties have long raised funding concerns, and that it had clarified use of maintenance-and-operations dollars to address some county workload issues. Members also asked about Every Woman Counts potentially seeing higher demand as Medi-Cal changes take effect; DHCS said that is possible and that the program has multiple funding sources including General Fund. A major portion of the hearing focused on provider taxes and federal changes under H.R. 1, especially the Medi-Cal managed care organization tax and the hospital quality assurance fee. DHCS explained that H.R. 1 restricts new or increased health care-related taxes, phases down allowable tax levels over time, and tightens “generally redistributive” rules, which could sharply reduce the state’s ability to use the MCO tax for Medi-Cal financing. Members asked whether the Legislature could amend Prop. 35 or whether voters would need to act; DHCS said a three-fourths legislative amendment may be possible if it aligns with the measure’s purpose, but the department is still evaluating options. The committee also discussed hospital financing, with DHCS describing recent increases in state-directed payments and the effect of H.R. 1 in capping those payments at Medicare levels, and the LAO noting the tradeoff between preserving provider taxes and maintaining Medi-Cal funding. The subcommittee also reviewed a series of DHCS budget change proposals and trailer bill items, including managed care final-rule implementation, managed care operations, a hospital value strategy, a one-year extension of skilled nursing facility financing, long-term care payment transparency, and interoperability/prior authorization requirements. Members repeatedly questioned the use of limited-term versus permanent positions, the overlap among proposals, and the timing of new financing reforms. DHCS said the SNF extension would preserve current workforce standards, sanctions, growth limits, and the SNF quality assurance fee while the department develops a broader 2027-28 redesign. No votes were taken; items were repeatedly held open for later action. Covered California then presented on the expiration of the federal enhanced premium tax credit and the resulting affordability crisis. The agency said Californians will lose about $2.5 billion in premium assistance for 2026, average premiums could nearly double for many enrollees, and as many as 400,000 people could eventually leave marketplace coverage. Open enrollment ended with 1.9 million sign-ups, down 3% from the prior year, with especially steep declines among middle-income consumers and increased movement into bronze plans. Covered California said the state’s $190 million affordability subsidy is helping lower-income enrollees retain coverage, but cannot fully replace the lost federal assistance. Members also asked about the Health Care Affordability Reserve Fund, repayment of loans from that fund, the status of federal review of California’s essential health benefits benchmark, and implementation of the new gender-affirming care benefit under AB 144.

Transcript Highlights:

• I don't have the ability to check up to examine patients within 90 days.
• And the patient is there for the one who ultimately can suffer.
• And from the patient perspective exactly what you said, Sen Gate for a patient who has put their trust
• This is about patient access.
• like a lot, but for patient and perhaps a patient with transportation issues, 20 miles can be half a

Keywords: 999, senate, all