Video & Transcript Research : 'rate decoupling'
Page 96 of 500
MN
Transcript Highlights:
- For us to enter the market, we are requesting that the rate be raised, and it does not cost very much
- You know, something like this certainly is a worthy thing to raise the rates.
- We always talk about the rates being so bad that the Minnesotans who need this coverage are getting it
- The problem is we pay that rate, and somebody can get zero care or zero dental care, and we're going
- to talk about that some more, and we are still paying for it because we're paying that capitated rate
NH
New Hampshire 2025 Regular Session
House Science, Technology and Energy (03/04/2025)
Science, Technology and Energy
Transcript Highlights:
- <00:13:22.680>
payer <00:13:22.959>savings rate it used to read rate payer savings - rate it used to read rate payer savings now<00:13:23.560>
it <00:13:23.720>reads <00:13: - <00:27:27.080>
payer best that they can for the rate payer best that they can for the rate - This is part of setting rates. The PUC is the one who sets the rates.
- part of that rate.
NM
New Mexico 2026 Regular Session
House - Appropriations and Finance Jan 30th, 2026 at 09:51 am
House Appropriations & Finance
Transcript Highlights:
- Rate increases. Ms. Care services in the Medicaid program rate increases. Mr.
- So this is the rate there.
- Chairman, the department has a rate-setting methodology... Well, Mr.
- Chairman, the department has a rate-setting methodology for the child care rates now, and I think folks
- Some of those savings were redeployed into the rates within behavioral health.
TX
Texas 89th 2nd C.S.
Senate Committee on Water, Agriculture, and Rural Affairs May 11th, 2026
Water, Agriculture and Rural Affairs
Transcript Highlights:
- your rate covers the operation.
- rate covers the operation. and you first have to be able to... and making sure that your rate covers
- Talking about individual water rates? Yeah, like who has the highest rates?
- Lowest rates in the state. Okay. Lowest rates in the state. Okay.
- Those rates, some of them have water supply, but then also wastewater involved in that same rate.
TX
Transcript Highlights:
- The rating system in our Texas public schools, says the passage of HB 22, full accountability ratings
- ratings that we've seen abused in recent lawsuits.
- Being rated on a statewide basis is prohibited. Since the deadline for issuing new ratings...
- There's a strong relationship between the economically disadvantaged rate and the overall rating score
- and increasing burnout rate.
MA
Massachusetts 2025-2026 Regular Session
Joint Committee on Education Jun 21st, 2026 at 01:00 pm
Joint Committee on Education
Transcript Highlights:
- Yeah, so I may defer to the mayor on the actual reimbursement rate. Yeah, yeah.
- We couldn't have anticipated the inflation rates that we've had now.
- I implore all of you to support this act to adjust the inflation rate.
- In fact, our expenses have only gone up, and at a rate far exceeding that of 2.75%.
- rate was closer to 8% a few years ago.
Summary:
The Joint Committee on Education opened a hybrid public hearing on a large slate of bills related to school buildings, school finance, technology, data privacy, safety, and related education issues. Chairs Jason Lewis and Ken Gordon outlined procedures for the hearing, including two-minute testimony limits and the plan to group similar bills together. Several bills drew no testimony and were closed without further discussion, while others drew extensive testimony from legislators, school officials, parents, advocates, and educators.
A major theme was school safety and student well-being. Lori Al-Hadeth testified in support of bills on alert systems in public schools, describing the loss of her daughter in the Parkland shooting and urging adoption of Alyssa’s Law-style panic alert technology. Representative Gallagher and disability advocates also supported a bill authorizing, but not requiring, airway clearance devices in schools, arguing they could save lives in choking emergencies and provide an option for people who cannot use the Heimlich maneuver. Another bill on reducing cafeteria waste drew support from a legislator and a Lexington sustainability official, who said installing dishwashers during construction would reduce waste and long-term costs.
Much of the hearing focused on Chapter 70 school funding and the inflation cap. Senator Pavel Payano, Senator Sal DiDomenico, Representative Senna, and multiple local officials and school committee members from Bridgewater, Chelsea, Groton-Dunstable, and other districts argued that the 4.5% cap on inflation adjustments has left schools underfunded during years of high inflation, forcing layoffs, larger class sizes, and cuts to programs and student supports. They urged bills to eliminate the cap, restore lost funding, increase the Commonwealth’s share of the foundation budget, or create commissions to study reforms. Testimony also highlighted the impact on special education, English learners, and low-income students, with Chelsea witnesses saying the cap has cost their district about $7 million annually.
School construction and MSBA reform were the other major topic. AIA Massachusetts, Boston Public Schools, Lynn officials, and AFT Massachusetts described aging facilities, overcrowding, deferred maintenance, and the difficulty of financing new schools under current reimbursement rules. Boston officials said the district has many pre-World War II buildings and has only built a handful of new schools in decades, while Lynn leaders said reimbursement rates have fallen well below the statutory 80% because of caps and ineligible costs. Witnesses urged modernization of the MSBA program, higher reimbursement rates, and more resources for school construction. The committee also heard support for a bill to study the adequacy and equity of the school building program, and chairs indicated some bills would be closed after no one signed up to testify.
MN
Transcript Highlights:
- and the adjusted rate?
- The rate is $45, but the adjusted rate is 67.50? What, over overtime? I didn't mean to answer it.
- and the adjusted rate?
- The rate is $45, but the adjusted rate is 67.50? What, over overtime? I didn't mean to answer it.
- <00:10:43.000>
so rate is actually the overhead rate so rate is actually the overhead rate
NH
New Hampshire 2025 Regular Session
House Finance Division III (03/05/2025)
Transcript Highlights:
- <00:27:54.399>
and Met um partially into rates and Met um partially into rates and partially - directed payments and uh payment rates directed payments and uh payment rates is<00:37:12.839>
- under um the the enhanced payment rates under um the the enhanced payment rates and<00:37:32.359
- voluntary because our capitation rates voluntary because our capitation rates already<01:38:35.920
- years in terms of their uninsurance rate years in terms of their uninsurance rate um<02:07:24.239
Summary:
The House Finance Division 3 work session continued its review of the Department of Health and Human Services’ Medicaid budget and related policy issues, with CFO Nathan White and Medicaid Director Henry Litman presenting updated materials. The discussion focused on a crosswalk between the adjusted FY 2025 Medicaid budget and the governor’s FY 2026 recommendation, plus handouts showing service additions, eligibility changes, dental rates, and other Medicaid changes since 2019. The department also said it would provide a clearer breakdown of the pharmacy cost-sharing item by general, federal, and other funds.
Members asked detailed questions about the Medicaid enhancement tax, the 80% plan, and how funds are allocated between hospital payments, directed payments, and DSH uncompensated care. The department explained that the MET is being used more toward rates and directed payments to better align with federal matching rules, while DSH remains important for uncompensated care. They also noted that a pending Senate Bill 249 would keep the 80% structure and move to Senate Finance. On the trigger law, the department identified the governing provision as Chapter 342:12, Laws of 2018, and explained that if the federal match for Medicaid expansion falls below 90%, the state must notify legislative leaders and participants and the program would sunset after 180 days unless the legislature acts.
The committee also reviewed current Medicaid expansion enrollment and program trends. Officials said enrollment was just under 59,000 as of March 3, with about 87,000 people enrolled over the past year and more than a quarter-million residents having used the program over its lifetime. They said enrollment has fallen from a post-pandemic high of nearly 97,000 and may eventually settle in the low 50,000s. Finally, the department discussed federal DSH funding risk, saying New Hampshire could face a significant reduction if Congress does not extend current protections, which is part of why the state has shifted more funding toward payment rates and directed payments.
MN
Minnesota 2025-2026 Regular Session
How will federal law affect Medicaid in Minnesota? 2/24/26
Minnesota House Floor Meeting
Transcript Highlights:
- corresponding rate increase if approved. corresponding rate increase if approved.
- providers are taxed at a higher rate providers are taxed at a higher rate than<00:28:19.279>
- Um this healthcare rate increases.
- <00:29:32.399>
in up to the average commercial rate. in up to the average commercial rate. - match rate, which is just over 50%. match rate, which is just over 50%.
Summary:
The Department of Human Services briefed the committee on how the federal HR1 law will affect Minnesota Medicaid and related programs. Budget Director Elise Bailey said the 900-page bill makes sweeping changes that will reduce coverage, increase administrative complexity for counties and tribal governments, raise uncompensated care for providers, and reduce federal funding. She reviewed current Medicaid spending and enrollment, emphasizing that the largest impacts will fall on the adult expansion group (adults ages 21-64 without children), which currently receives a 90% federal match.
Bailey walked through several major provisions: work and community engagement requirements for the adult expansion group beginning January 1, 2027; six-month renewals for that same group; shorter retroactive coverage periods; new cost-sharing requirements for expansion enrollees above 100% of poverty; narrower Medicaid eligibility for certain lawful noncitizens; limits on provider taxes and state-directed payments; a reduced federal match for emergency medical assistance; and tighter federal rules on payment error penalties. She said many provisions require state law changes and additional federal guidance, and she cited research from Georgia suggesting work requirements increased administrative burden and caused coverage losses without increasing employment.
The department estimated fiscal effects including reduced Medicaid spending in some areas but higher state costs in others, such as MinnesotaCare, emergency medical assistance, administrative systems, and provider uncompensated care. Bailey said the immigration-status changes would shift some people from Medical Assistance to MinnesotaCare, and that provider-tax and state-directed-payment changes could reduce future funding to hospitals and other providers. No votes or formal committee actions were taken in the portion provided; the presentation was informational and the department indicated it would return with proposed state-law language as needed.
MN
Minnesota 2025-2026 Regular Session
Committee on Health and Human Services - 02/20/25
Health and Human Services
Transcript Highlights:
- <00:25:01.120>
of while Minnesota has lower rates of while Minnesota has lower rates of pregnancy - <00:27:17.279>
of <00:27:17.440>pre-term highest rates of pre-term highest rates of - <00:47:56.040>
of <00:47:56.359>disparity <00:47:56.839>I rates of disparity I rates - <00:54:23.559>
and because of poor reimbursement rates and because of poor reimbursement rates - "I believe it's an incidence rate, but I will let Dr. Chef answer it." "Dr.
NH
New Hampshire 2025 Regular Session
House Criminal Justice and Public Safety (01/15/2025)
Criminal Justice and Public Safety
Transcript Highlights:
- We're back to that normative departure rate at retirement and the same separation rate when people self-select
- Illustrated us having a really high rate Illustrated us having a really high rate of<00:44:26.520
- back to that normative uh departure rate back to that normative uh departure rate at<00:47:03.240
- <00:50:47.720>
of have a high prevalence rate of have a high prevalence rate of individuals - <01:31:27.679>
are even those rates are even those rates are low<01:31:30.040>top <
NH
Transcript Highlights:
- If this rate is above 6%, rate below 6%.
- aspect of this that mostly the rate aspect of this that mostly the error<00:46:25.119>
rate <00 - So, error rate, excuse me.
- significant reduction in the error rate, significant reduction in the error rate, which<00:47:38.079
- threshold monitored by rating agencies. threshold monitored by rating agencies.
KY
Kentucky 2025 Regular Session
Budget Review Subcommittee on General Government, Finance, Personnel and Public Retirement (8-20-25)
Transcript Highlights:
- That rate, as the auditor has mentioned, has not changed in any number of years.
- <00:37:37.920>
for establishing a single blended rate for establishing a single blended rate - >
charge <00:37:49.280>to in that the rates that we charge to in that the rates that we - That rate, as the auditor $84 per hour.
- for a partner versus one rate for an associate versus one rate, let's say, for a summer law clerk.
Keywords:
Meeting Start 00:00:00
Attendance Roll Call 00:00:30
Personnel Cabinet 00:03:25
Department of Veterans Affairs 00:12:40
Auditor of Public Accounts 00:22:39
State Treasurer 00:42:24, 958, all
Summary:
The committee first heard from Personnel Cabinet officials on House Bill 6, which required the Kentucky Employees Health Plan to offer a qualified high-deductible health plan by the 2026 plan year. Officials said the plan was already added for 2025, described it as the lowest-premium option with higher deductibles, and explained that federal rules prevent first-dollar coverage except for limited preventive services. They said 264 members had selected the plan out of about 142,000, and noted it also allows health savings accounts. Members asked about the plan’s benefits, what “catastrophic” meant, the deductible amounts, and whether employees were aware of the option; the cabinet said it would continue to highlight the plan in communications and that the deductible is above $8,000 for individuals and above $16,000 for families.
The committee then received an update from the Kentucky Department of Veterans Affairs on the Bowling Green veterans center. Officials said the current target is to move into the building on October 28, with first admissions about two months later, pending final fixes and certification steps for Medicare, Medicaid, and the VA. They explained that about $7 million in FY25 appropriations lapsed because of construction delays, staffing ramp-up was postponed to avoid unnecessary spending, and the unspent funds should be considered in the next budget request. Members praised the project and asked about annual operating costs; officials said the current operating budget is about $15 million, though they do not expect to spend all of it this year. The commissioner also announced the fifth annual state commanders conference in Lexington, focused on veterans issues and featuring state, federal, and advocacy leaders.
State Auditor Allison Ball then outlined her office’s budget priorities. She said the office is primarily a billing agency that charges audited entities for its work, and warned that some agencies are now signaling they may refuse to pay for audits related to kinship care and the medical cannabis application process. She said the office plans to continue requesting outlier credits for unusually burdensome county audit fees, funding for the ombudsman office’s transition and expanded in-office operations, and revenue replacement for local government audits and possibly state audits and special examinations. Ball also said the office conducts about 500 audits, reviews, and examinations a year and wants to restore performance audits with seed funding, as well as add investigators to the ombudsman office to focus more on child abuse and neglect cases. Members discussed the value of performance audits, the possibility of raising certain board thresholds to account for inflation, and the need for additional capacity to handle more audits.
WA
Washington 2025-2026 Regular Session
Joint Legislative-Executive Committee on Budget Transparency and Fiscal Sustainability Jul 20th, 2026
Joint Legislative-Executive Committee on Budget Transparency and Fiscal Sustainability
Transcript Highlights:
- being actuarially sound, and that can drive some spending around rates, whereas much of rates in the
- being actuarially sound, and that can drive some spending around rates, whereas much of rates in the
- state budget can be discretionary. rates, whereas much of rates in the state budget can be discretionary
- And then I already mentioned vendor rate increases.
- So we use the growth rates in those more complicated models.
Summary:
The committee held its first meeting, with co-chairs and members introducing themselves and staff outlining the committee’s statutory mandate under the 2025-27 supplemental operating budget. Staff explained that the Joint Legislative-Executive Committee on Budget Transparency and Fiscal Sustainability will receive technical assistance from a nonpartisan organization, with work split into two phases: first on revenue growth, spending assumptions, and cost drivers in the four-year outlook, and later on staffing, overhead, performance management, and public reporting. Members broadly said they hoped the committee would build a shared factual understanding of the state’s fiscal situation, structural deficits, and budget processes, and identify a sustainable path forward for the operating budget.
Staff then gave a detailed presentation on operating budget basics. They reviewed the size and composition of the operating budget, noting that most spending is concentrated in grants/client services and salaries/benefits, with K-12, DSHS, HCA, DCYF, DOC, and higher education making up most NGFO spending. They explained the distinction between constitutional, federal, statutory, and discretionary spending, using examples such as K-12, Medicaid, collective bargaining agreements, court-driven obligations like McCleary and Trueblood, and one-time appropriations. They also walked through how the state uses incremental budgeting, carry-forward and maintenance-level calculations, caseload and per-capita forecasting, and the four-year balanced budget outlook, including reserve calculations and the budget stabilization account.
Members asked extensive questions about what is and is not included in the outlook, especially future collective bargaining agreements, health care and compensation growth, tort and other liabilities, and whether the state could better distinguish mandatory from discretionary spending. Staff explained that current CBAs and other already-enacted obligations are included, but future CBAs are not; some liabilities are reflected as expenditures when appropriated, while broader long-term liabilities are not fully captured in the outlook because they depend on future policy choices. Staff also noted that the legislature and ERFC can adopt assumptions such as reversions and growth factors, and that an outlook accuracy report is produced every five years to compare projected and actual maintenance-level spending. The committee agreed to follow up on some of the more complex liability and assumption questions.
After a short break, Josh Goodman of the Pew Charitable Trusts began a presentation on Pew’s role and approach to state fiscal sustainability. He described Pew as a nonpartisan organization with long-standing state fiscal research, emphasizing its 50-state comparative data, interviews with state officials and experts, and focus on long-term sustainability, reserve policies, and recession preparedness. The presentation was ongoing when the transcript ended.
NH
New Hampshire 2026 Regular Session
Governor's Capital Budget Hearing (06/16/2026)
Transcript Highlights:
- The first is the tax rate setting process.
- That's a total of over 1,000 rates that we set on a yearly basis.
- So when you have county tax rates, you have Have county tax rates, you have cooperative school districts
- So we currently So we currently have a tax rate setting portal for setting tax rates and an equalization
- The tax rate is set once a year. Thank you. Good morning.
TX
Texas 89th Regular
Senate Committee on Health and Human Services Apr 30th, 2025
Health & Human Services
Transcript Highlights:
- The breastfeeding rates, I'm sorry.
- So I just... you know, your in-network rates come down. Fair statement. Fair statement.
- Or reducing Medicaid reimbursements well below the state-determined rate for eye care services.
- that is no lower than 95% of the state-determined rate.
- do it through the budget process, not by setting rates in statute.
Bills:
HB136, HB451, SB425, SB466, SB905, SB1986, SB2311, SB2450, SB2805, SB2826, SB2919, SB3001, HB136
Keywords:
Medicaid, lactation, healthcare, consultation, reimbursement, maternal health, infant care, commercial sexual exploitation, child sex trafficking, human trafficking, child welfare, foster care, DFPS, Department of Family and Protective Services, juvenile probation, risk assessment, needs assessment, trauma screening, child abuse prevention, exploitation screening
VT
Vermont 2025-2026 Regular Session
Senate Session - 2026-01-06 - 10:00AM
Vermont Senate Floor Meeting
Transcript Highlights:
- fund to artificially lower the rate.
- A note about the phrase buying the rate down.
- we're still going to be buying the rate we're still going to be buying the rate down<00:22:12.960
- When we say we're buying the rate down.
- And I don't have to tell any of you the rate at which education spending is going, like the rate of other
TX
Transcript Highlights:
- Yeah, when you look at the accountability ratings, like in your district, y'all did very well.
- As long as an assessment is the dominant factor in school rates...
- About the fact that we don't factor in these other components that impact that rating, and that rating
- F-rated. I can tell you.
- There's a campus not too far from here that has just been rated an F after...
Bills:
HB8
Keywords:
HB 8, Texas public school accountability, school accountability, public school transparency, STAAR, state assessments, instructionally supportive assessment program, Student Success Tool, Texas Education Agency, TEA, accountability ratings, A-F ratings, through-year assessment, benchmark testing, norm-referenced assessment, college career military readiness, CCMR, local accountability plan, school district performance, campus turnaround
CA
California 2025-2026 Regular Session
Assembly Budget Subcommittee No. 1 on Health Mar 3rd, 2025
Transcript Highlights:
- We offer competitive interest rates, ranging from two to four percent.
- Also, attrition rates in early retirement play a factor.
- As pointed out on the panel, California has the highest rate of retention.
- It would have set rates on providers—specifically, it would have established the rates that providers
- Being targeted with a growth rate lower than other hospitals and lower than the inflation rate will seriously
FL
Transcript Highlights:
- African-American graduation rate of about 40%.
- Our overall graduation rate was 82%.
- African-American graduation rate of about 40%.
- Our overall graduation rate was 82%.
- My rates went up. I have about 200-something people on insurance. You know why my rates went up?
Summary:
The Senate Education Pre-K-12 Committee met to discuss the needs of rural school districts and the role of Florida’s three regional education consortia: the Panhandle Area Education Consortium, Northeast Florida Educational Consortium, and Heartland Educational Consortium. Executive directors and several rural superintendents described the consortia as member-led organizations that provide shared services, professional learning, leadership development, grant support, cooperative purchasing, risk management, IT/cybersecurity help, and back-office assistance that small districts could not afford to provide on their own. They emphasized that rural districts are often very small, have limited staff, and must still meet the same state reporting and compliance requirements as large urban systems.
Testimony focused heavily on teacher recruitment and retention, alternative certification, and the difficulty of staffing specialized roles such as CFOs, MIS directors, IT staff, and content-area teachers. Superintendents said many new hires are career changers or alternatively certified teachers who need consortium-supported training, and several argued for more flexibility in funding so districts can raise salaries and compete with neighboring districts and nearby states. Members also asked about the impact of declining enrollment, homeschooling, and voucher-related school choice; superintendents said those trends are reducing FTE and creating budget instability, while also requiring districts to right-size staff and programs.
Several speakers described the financial strain on rural districts, including rising insurance costs, transportation costs, and the challenge of forecasting budgets when enrollment changes after the school year begins. One superintendent recounted major hurricane damage and said consortium risk-management support was essential to recovery. Others said the consortia help districts pool resources for property and health insurance, payroll, student data systems, and procurement, and that this shared approach saves money and improves services. No votes or formal committee actions were taken during the meeting.