Transcript Highlights:

• Then number four is with DHS Division of Aging, Adult, and Behavioral Health Services.
• Number 9, DHS Division of Aging and Adults and Behavioral Health Services with ATA Services.
• Number 12, DHS Division of Aging, Adults, and Behavioral Health with Lennon King.
• Number 12, DHS Division of Aging, Adults, and Behavioral Health with Lennon King.
• Jay Hill, Division of Aging Adult Services with DHS.

Committee: All ALC-REVIEW

Summary: The subcommittee reviewed multiple methods of finance and construction items, including projects for Arkansas State University, Black River Technical College, UAMS, the University of Arkansas at Pine Bluff, and UCA. The UAPB Allied Health and Sciences Building appeared both as a method of finance and as an alternative delivery construction project, with East Harding Construction selected and AMR Architects as designer. Members approved the methods of finance, the alternative delivery project, and several discretionary grants, including Department of Health grants for a heart attack center designation and community health worker training, and DHS grants related to homeless services, behavioral health transition support, and an enabling technology pilot. The committee then reviewed service contracts, including RFQs, construction-related contracts, intergovernmental agreements, and a large number of out-of-state and in-state contracts. Testimony focused heavily on DHS staffing and state hospital contracts, the Arkansas State Police seatbelt survey, AEDC’s lithium supply chain analysis, and Shared Administrative Services’ new SuccessFactors performance-management contract. Members asked detailed questions about contract nursing costs, turnover, hiring timelines, and whether some contracts were being renewed or amended beyond their original projected costs. DHS and Veterans Affairs officials explained staffing shortages, retention incentives, and the use of contract labor as a supplement to state employees. Several contracts drew scrutiny and were held for further review. Representative Wardlaw raised concerns about projected costs and repeated amendments on the Department of Education security contract and on DHS staffing contracts, arguing that some had exceeded their original projected totals. The committee voted to hold contracts 5, 7, and 8 until Friday, while adopting the remaining contracts. The meeting ended after informational reports on service contract amendments without material change, executed contracts, and emergency procurements were presented, with no further business before adjournment.

Transcript Highlights:

• for older adults and people with<00:04:39.919><c> disabilities</c><00:04:40.919><c> according</c><00
• and parents, 17% of older adults, and 28% of people with disabilities.
• </c><01:08:05.839><c> mental</c> adult mental health initi adult mental adult mental health initi adult
• So it's similar to an adult basically accessing, um, the long-term care continuum.
• </c> needs so it's similar to an adult needs so it's similar to an adult basically<01:20:45.080><c> accessing

Committee: House Human Services Finance and Policy

Transcript Highlights:

• Shortened enrollment windows mean slower access to care for frail older adults.
• with disabilities, and older adults.
• There's just not going to be anybody there to serve adults or kids.
• There's just not going to be anybody there to serve adults or kids.
• in our community are losing adult dental in July.

Summary: The Assembly Budget Subcommittee on Health began with a hearing on the impacts of H.R. 1 on California health programs, focusing first on reproductive health state investments. HCAI outlined five state-funded reproductive health programs created after Dobbs, including uncompensated care, practical support, capital and clinical infrastructure, and workforce programs. Essential Access Health and Planned Parenthood testified that these funds have served hundreds of thousands of patients, but warned that the uncompensated care program is fully awarded and needs renewal, and that Title X and Medicaid-related federal uncertainty continues to threaten access. Members questioned who the uncompensated care program serves, why Medi-Cal covers a large share of abortions, and whether Planned Parenthood could expand prenatal services; public commenters urged continued support for reproductive health access. The committee then took up long-term care services and supports, starting with the HCBA and Assisted Living Waiver programs. DHCS reported large wait lists for both programs and said enrollment is limited by workforce and provider capacity, while LAO noted that increasing slots alone may not increase access without additional programmatic changes. Members pressed the department on whether more slots should be added given the lower cost of home- and community-based care compared with skilled nursing facilities, and public testimony argued that the wait lists should be reduced and that staffing concerns do not fully explain unused capacity. The committee also heard testimony on congregate living health facilities, where providers and a patient family described the homes as critical, lower-cost alternatives to nursing facilities for younger, medically complex people. Witnesses requested short-term bridge funding, while DHCS said it is proposing to transition CLFs into a managed care benefit by January 1, 2028, which would remove caps and expand access statewide. The final long-term care topic was PACE. DHCS explained that it has paused new PACE applications and service expansions for at least two years to reassess oversight capacity and develop a statewide strategic growth framework, while existing programs continue operating. CalPACE supported the pause as a planning measure but asked for four additional state nurse positions to reduce delays in level-of-care determinations and speed enrollment for frail older adults. Members shared personal stories about how PACE has helped family members and asked how the state will meet growing demand; DHCS said stakeholder engagement will begin later in the year and that some existing applications already in process will continue. Public commenters broadly supported PACE, HCBA, and CLF funding requests. The hearing then moved to the Department of Health Care Services’ 2026-27 Medi-Cal budget and related trailer bills. DHCS said Medi-Cal spending has grown due to coverage expansions, higher acuity, rising utilization, and especially pharmacy costs, and it described proposals to extend the current skilled nursing facility financing framework for one year while the state develops a new value-based payment strategy. LAO said most recent Medi-Cal spending growth has been driven more by higher per-enrollee costs than by caseload growth, with pharmacy spending growing especially quickly, and recommended better and more timely data to analyze the drivers. Members expressed concern about the rapid rise in Medi-Cal spending and asked for more detail on the largest cost increases.

Transcript Highlights:

• </c> foster youth um who don't have any adult foster youth um who don't have any adult advocate<00:32
• </c> As Senator Clark noted, young adults As Senator Clark noted, young adults should<01:16:40.040><c
• multiple</c><01:16:51.040><c> application</c> young adult may pay multiple application young adult may
• , the young adult has done nothing<01:17:23.880><c> wrong.
• There's also a adults in the household.

Committee: Senate Judiciary and Public Safety

Transcript Highlights:

• Our collaboration in the past has clarified that this bill will apply only to adult repeat offenders.
• Existing law supports the transfer of youth to adult court for serious conduct.
• I mean, so one, the answer to that question is no, it's just an adult court, right?
• The juvenile can be transferred to adult criminal court for the commission...
• Or transferred to adult court.

Committee: House Public Safety

Transcript Highlights:

• I’m also dual board certified as an adult gerontology acute care nurse practitioner and a family nurse
• So what is Florida's Medicaid income eligibility limit for an adult who is not pregnant or disabled?
• There is a very small contingent of adults, adults with older kids, that are eligible.
• children, able-bodied single adults do not qualify for Medicaid in Florida because we didn't expand.
• children, able-bodied single adults do not qualify for Medicaid in Florida because we didn't expand.

Bills: S0036 , S0864 , S0268 , S0844 , S0514 , S1404 , S0914 , S1758

Committee: Senate Health Policy

Summary: The committee first considered SB 268, a public records exemption for emergency physicians. Senator Rodriguez’s strike-all amendment narrowed and clarified the exemption, and testimony from an emergency physician described threats, harassment, and safety concerns tied to mandatory reporting and patient encounters. The committee adopted the amendment and reported the bill favorably as a committee substitute. Members then heard SB 514, creating the Dula Support for Healthy Births Pilot Program in Broward, Miami-Dade, and Palm Beach counties for pregnant and postpartum women affected by substance use disorder. Senator Osgood explained the pilot would provide non-medical doula support and data collection, and an amendment changed the funding source to specific appropriations in the General Appropriations Act. Supporters said doula care can improve maternal and infant outcomes and complement medical providers. The committee adopted the amendment and reported the bill favorably as a committee substitute. The committee also approved SB 36 on use of professional nursing titles after extensive debate over whether nurses with doctoral degrees should be allowed to use “doctor” in clinical settings, with concerns raised about patient confusion and the need for clearer identification. The bill was amended to align with the House version and then reported favorably as a committee substitute. The committee next approved SB 864, a public records exemption for uterine fibroid research data, after a technical amendment setting a July 1, 2026 effective date; Senator Sharif said the exemption is needed so the Department of Health can collect sensitive data for the related research bill. SB 844, requiring continuing education on sickle cell disease care management for certain licensed physicians and nurses, was also reported favorably after emotional testimony from patients and advocates describing delayed care and bias. Later, the committee approved SB 1404 on memory care, after a strike-all amendment creating a new memory care specialty license for assisted living facilities that advertise or provide specialized memory care services, while allowing optional supportive services without the new license. Supporters from the senior living industry backed the clarification. The committee then passed SB 914, which clarifies that licensed occupational therapists may perform dry needling, after an amendment adjusting supervision and continuing education language. Finally, the committee took up SB 1758, a broad Medicaid and SNAP reform bill that would strengthen fraud enforcement, impose Medicaid work requirements for certain able-bodied adults, expand behavioral health services, modernize drug purchasing and prior authorization, and require SNAP fraud-reduction measures. Several amendments were adopted, and members questioned the work requirement, implementation costs, EBT card photo identification, and due process concerns; debate continued as the transcript ended.

Transcript Highlights:

• and adults living with disabilities.
• . ...almost leading the nation in the number of older adults, a number of people over 65, and we have
• We are adult protective services.
• So within the IAAA, there are 21 senior centers and four adult day centers.
• daycare services so that those older adults can actually stay in their home and community.

Committee: House House Government, Elections & Indian Affairs

Transcript Highlights:

• Older adults must be able to recognizes a practical truth.
• Older adults must often experience government through frontline encounters.
• just as aging policy requires anticipatory young adults.
• As a way of background, currently we are serving 28,000 children and young adults.
• We have a fully staffed adult autism team at this point that is working on these things.

Committee: Joint Joint Committee on Ways and Means

Transcript Highlights:

• now you're an adult, you can make your own decision.
• I'll point out 72% of adults with serious...
• Outpatient treatment funds for adults and kids.
• Adults who receive those services.
• 292, 200 for adults and 92 for pediatrics.

Committee: Senate Health & Human Services

Transcript Highlights:

• It's people who meet... the adult dental the adult dental plan.<00:18:44.559><c> Um</c><00:18:45.039>
• > will</c><00:28:21.600><c> end</c> adults.
• The adults typically will end adults.
• We chose 45 days and to for the adults.
• Some younger adults choose to stay in school till age 22.

Summary: The committee first handled roll call and approved the prior meeting minutes. Members discussed attendance and substitutions, then moved to the DHS commissioner’s update, which focused on New Hampshire’s Medicaid 1115 waiver and the new community re-entry initiative for people leaving correctional facilities. The presenter explained that the waiver lets the state cover certain services not normally covered under Medicaid, including substance use disorder treatment, serious mental illness services, adult dental benefits, and the new community re-entry component. She also noted that a separate youth re-entry component is federally required, with youth defined up to age 21 and foster-care-related coverage extending to age 26. The update described how the adult re-entry program works for incarcerated individuals with behavioral health needs, providing up to 45 days of pre-release services, care coordination with managed care organizations and DOC staff, telemedicine assessments, discharge prescriptions, insurance cards, and connections to community mental health, primary care, and substance use providers. For youth, the program includes more intensive case management, 30 days of pre-release services, and 30 days of post-release care coordination, with a stronger emphasis on screening, diagnosis, and holistic assessment. The presenter said New Hampshire received the adult waiver in July 2024, has implemented the program in state correctional facilities, and is beginning work at the youth center. Members and the presenter discussed why the program is structured as a waiver rather than a standard Medicaid benefit, with the explanation that CMS is allowing this as a newer policy area and that states generally pursue waivers for certain services. The chair and others emphasized the need for real cost and outcome data, and the presenter said an independent evaluator and evaluation plan are required under the 1115 waiver. Early results cited included 30 adults enrolled so far, 10 released, five youth enrolled with one released, and anecdotal early successes such as housing, employment, and better continuity of medication and treatment. The committee did not take any additional votes or formal actions beyond approving the minutes.

Transcript Highlights:

• After one traumatic incident at school, I confided in an adult I trusted, and they told me, Jake, you
• they’re different, but how do we adapt what we know and have learned for adults and make it work for
• Inevitably, young adults are going to learn about drugs, and some will experiment with them.
• And then in regards to the age of patients, it would be for adults only.
• So, similar to Column Health, it would be adults only.

Committee: Joint Joint Committee on Mental Health, Substance Use and Recovery

Summary: The Joint Committee on Mental Health, Substance Use and Recovery opened its first public hearing of the 2025–26 session with remarks from the Senate and House chairs outlining the committee’s priorities. They noted recent work on addiction and recovery legislation, the ongoing youth behavioral health crisis, and that members might need to leave periodically for floor votes. The chairs explained hearing procedures, including three-minute testimony limits, written testimony deadlines, and reporting deadlines for Senate and House bills. The hearing then focused on several bills related to youth mental health, overdose prevention, and psychedelic treatment research. A major portion of the hearing centered on bills to improve youth crisis response and overdose prevention. Testimony strongly supported bills to print the 988 Suicide and Crisis Lifeline on student ID cards, with speakers from mental health organizations, crisis centers, and individuals sharing personal stories of depression, suicide attempts, and the importance of making 988 as familiar as 911. Another set of bills would require schools to stock naloxone and provide overdose prevention education. Physicians, harm reduction advocates, students, and grieving family members testified that school-based Narcan access and education could save lives, reduce stigma, and help students recognize overdoses and understand Good Samaritan protections. Senator O’Connor and Tamika Perry also testified for a bill to strengthen substance use prevention education and reduce overdose abandonment, emphasizing the need to teach students about overdose risks and the legal protections for calling 911. The committee also heard testimony on a bill to authorize a pilot program for psychedelic treatment in licensed facilities. Senator Friedman and several medical and behavioral health professionals argued the proposal was a narrow, research-based approach distinct from the broader ballot question rejected in 2024. They said the bill would allow only a small number of supervised clinics to use psychedelics for conditions such as depression, PTSD, anxiety, and substance use disorders, with data reporting and Department of Public Health oversight. Supporters described it as a cautious way to study promising treatments while avoiding unsupervised or commercialized use. Finally, the committee heard support for a bill to create a special commission and five-year strategic plan for children’s behavioral health services, with testimony that the current system is fragmented, difficult for families to navigate, and strained by workforce and funding challenges. No votes or final actions were taken during the hearing; the committee primarily received testimony and questions on the bills.

Transcript Highlights:

• </c><00:37:00.880><c> Moderately</c><00:37:01.359><c> for</c><00:37:01.599><c> adults,</c> it is to adults
• Moderately for adults, it is to adults.
• </c><00:42:26.240><c> use</c> portion of tax revenues from adult use portion of tax revenues from adult
• For adults, it makes sense, their own whatever.
• If an adult certificate sufficient.

Bills: SB2211 , SB2025 , SB2038 , SB2050 , SB2051 , SB2090

Committee: House Health

Summary: The House Committee on Health held its first hearing of the session and opened with housekeeping notes, introductions of members, and an explanation that the agenda would be taken out of order to accommodate a sign language interpreter. The committee first heard HB 469, relating to parking for disabled persons. Testimony from the Disability and Communications Access Board and the State Council on Developmental Disabilities supported the bill, explaining that a travel placard would help people with disabilities who must travel interisland or to the mainland for medical care. Members asked about emergency travel, misuse prevention, and how to distinguish the travel placard from existing disabled parking placards; witnesses said the bill would need to be tied to administrative rules, and agreed the placard should clearly show an expiration date and likely be a different color. No vote was taken. The committee then heard HB 218, relating to hospital surgical smoke. The Department of Health supported the measure, and the Healthcare Association of Hawaii supported it with amendments, saying hospitals already follow existing standards but that any new policy should account for different procedures and provider safety. A committee member questioned the proposed amendment language and whether it was too flexible; the witness explained the intent was to allow case-by-case application because some procedures generate only brief exposure. Members also asked what surgical smoke is, and the witness explained it is produced when electrical or cauterizing tools are used on tissue and creates vapor or fumes. The bill remained under discussion with no final action reported. The committee next took up HB 814, which would fund a public information campaign and related services on cannabis use among youth. The Department of the Attorney General said the bill should be amended to clarify whether the funding would be used for contracts or grants and to include proper grant standards if grants are intended. The Department of Health supported the bill and said the funds would expand prevention, treatment, recovery, and public education efforts, including social media outreach, PSAs, and school-based youth services. Multiple organizations and individuals testified in support, emphasizing the harms of youth cannabis use and the need for prevention and treatment resources. Members asked what the department currently does, whether it is fulfilling existing law on science-based cannabis information, and what kinds of treatment would be provided; the department said services would mainly be intensive outpatient, outpatient, counseling, and related youth-focused supports. No vote was taken during the hearing.

Transcript Highlights:

• They may not have adults that they trust. And so, what is it that we're doing after?
• And it's also how many of them end up in the adult system.
• If We look at the adult side of things, and again, children are treated very differently from adults
• And then for adults, the same thing.
• We deal with these cases on the adult side over and over again if their case began as an adult because

Committee: House Courts, Corrections & Justice Committee

Transcript Highlights:

• Threatening children with adult prosecution does not prevent crime.
• The press, you know, press releases are much more common for adult criminal justice hearings.
• Missouri's juvenile system is intentionally different from the adult system.
• Missouri's juvenile system is intentionally different from the adult system.
• Adults in jail get bond and preliminary hearings.

Committee: House Children and Families

Transcript Highlights:

• For example, according to PPC's November 2025 statewide survey, 30% of California adults report that
• So, for example, the participation rate is higher for children than adults.
• older adults...
• We are serving a historical high of older adults.
• That gain in serving older adults makes up a lot of the participation increases over the year.

Summary: The joint informational hearing focused on CalFresh enrollment, food insecurity in California, the recent federal shutdown’s disruption of SNAP benefits, and the long-term effects of H.R. 1 on eligibility, benefits, and state and county costs. Opening remarks emphasized that millions of Californians rely on CalFresh, that the shutdown briefly delayed benefits for the first time in the program’s history, and that state and local governments, including Alameda County, stepped in with emergency food aid and funding. Members also framed the issue as both a hunger and affordability problem, with several noting that California’s agricultural abundance contrasts sharply with persistent food insecurity. The first panel presented research and advocacy perspectives on food hardship. PPIC’s Tess Thorman described food insecurity rates, disparities affecting households with children and Black and Latino households, and the role of nutrition programs in reducing poverty. Nourish California’s Betzabel Estudio argued that hunger is a policy choice and highlighted campaigns to expand state-funded food assistance for immigrants, support reentry populations, and continue the CalFresh fruit-and-vegetable incentive program. The California Association of Food Banks’ Josh Wright said food banks are seeing sustained high demand, lower federal food supplies, and cannot replace CalFresh, while urging more state support for food purchasing, school meals, and SunBucks. The second panel reviewed CalFresh operations and participation. The California Department of Social Services reported that CalFresh participation has risen over the past decade, with the state closing much of the participation gap through outreach, simplified applications, and demonstration projects such as the Elderly Simplified Application Project and a minimum nutrition benefit pilot. Alameda County Social Services described local caseloads, application trends, and emergency food distributions during the shutdown, while also warning that H.R. 1’s work requirements, immigrant eligibility restrictions, and possible cost-sharing could reduce enrollment. A student CalFresh ambassador testified about the burdensome application and recertification process and urged more funding for campus basic-needs centers and outreach to reduce stigma and administrative friction. In the final panel, county, food bank, and policy witnesses described the shutdown response and the expected impact of H.R. 1. Alameda County Community Food Bank and the County Welfare Directors Association said counties, food banks, and community partners mobilized emergency funds, pop-up pantries, and food purchasing to bridge the shutdown gap, but warned that hundreds of thousands of Californians could lose benefits under the new federal rules. The California Budget and Policy Center began outlining the scale of federal cuts, noting that H.R. 1 will significantly reduce SNAP funding and shift costs to states. No votes or formal committee actions were taken; the hearing was informational and concluded with discussion of possible state responses, including backfilling benefits, preserving outreach funding, and improving administrative systems to protect enrollment.

Transcript Highlights:

• The most important thing it does, unfortunately, is it excludes adults.
• The original bill had included adults with severe and profound hearing loss, and, not that that's not
• the original Bill had it excludes adults the original Bill had included<00:09:50.480><c> adults</c><
• with severe and profound included adults with severe and profound hearing<00:09:53.600><c> loss</c><
• and the original fiscal excluded adults and the original fiscal Bill<00:15:03.920><c> included</c><00

Summary: The committee first took up Senate Bill 27, as amended by committee substitute, which would create a Kentucky Parkinson’s disease research registry. The sponsor said the substitute was developed with UK, U of L, the Michael J. Fox Foundation, and Parkinson’s in Motion to better define a movement disorder center, add Parkinson’s experts from both universities to the advisory committee, require automated reporting, and delay implementation until 2027. Testimony emphasized the need to track diagnoses and testing while protecting confidentiality and allowing people to opt out. The committee adopted the substitute and then voted unanimously to pass SB 27 with a favorable expression. The committee then heard Senate Bill 93, dealing with hearing aid coverage for children. A parent described the high cost of hearing aids for her son and the financial burden created by insurance limits, while a pediatric audiologist explained that early identification and treatment improve language outcomes and that families can spend about $30,000 on hearing aids from birth to age 18. The committee substitute removed adults from the bill and added an in-network requirement for pediatric audiologists, along with a replacement interval consistent with Medicaid guidelines and repair/loss coverage provisions. After questions about costs, replacement timing, and insurer practices, the committee voted unanimously to pass SB 93 with a favorable expression. Finally, the committee considered Senate Bill 153, a transparency and due-process bill concerning Medicaid prepayment review. The sponsor and witnesses from Addiction Recovery Care and Frontier Behavioral Health said prepayment reviews can be imposed with little notice or explanation, disrupt cash flow, and burden rural and smaller providers; they argued the bill would require clearer notice, reasons, and timelines without stopping legitimate reviews. Members asked about managed care organizations, contract issues, and whether the bill would conflict with existing agreements, and the sponsor said it would not. After discussion and an explanation of vote from Senator Douglas, the committee voted to pass SB 153 with a favorable expression.

Transcript Highlights:

• Chairman, that 18 is the legal age of being an adult.
• That's where it could be minors or adults. You're recognized for a follow-up.
• This is not saying that you can't have these procedures even after once you become an adult.
• You've highlighted children, but you've also talked about adults. So, can you help us understand?
• And as an adult, if you wish to have that, then you're free to Seeing no more questions.

Bills: HB3057 , HB3130 , HB3310 , HB3314 , HB3985 , HB4113 , HB4486

Committee: House Government Oversight

Keywords: government reporting, information technology, child welfare, environmental policy, state agency compliance, gender transition, minors, health services, punitive damages, parental rights, health care providers, purchasing, compliance, state employees, longevity pay, contract management, marijuana tax, public service impact tax, county funding, voter approval

Transcript Highlights:

• Today, we will be discussing MAT services for incarcerated individuals, both youth and adults.
• However, the money has been slow to roll out, and few adults have received services in comparison to
• how many adults need the services.
• So, when we focus on adults, there are three touch points to focus on where they can receive MAT if they
• It's worth noting that adult treatment courts declined by 33 between FY19 and FY25.

Transcript Highlights:

• I'm a marriage and family therapist, and I've been practicing in Birmingham for 25 years with adults
• Any age verification process is going to sweep in adult users as well as children; it is inherent in
• It, in the background, already knows your birthday and can verify that to ensure you're an adult.
• So that's all done in the background; it's simple for the adults.
• It's spread out, and it's an adult because, you know, we don't know if that child has been raised...

Bills: HB285 , HB317

Committee: House Children and Senior Advocacy

Keywords: HB285, TJ's Law, traffic infraction, traffic ticket, uniform traffic ticket and complaint, minor driver, juvenile driver, parent notification, guardian notification, emergency contact, law enforcement, citing agency, traffic citation, driver safety, youth safety, Alabama traffic law, Section 12-12-56, Children and Senior Advocacy, House Judiciary, reasonable effort

Transcript Highlights:

• than adults who reported incomes of $50,000 or greater.
• than adults who reported incomes of $50,000 or greater.
• than adults who reported incomes of $50,000 or greater.
• </c> among higher in um higher earning adults among higher in um higher earning adults decreased<00:28
• </c><00:28:50.320><c> who</c> compared to less educated adults who compared to less educated adults who

Committee: House Health

Summary: The House Health Committee held its first hearing of 2025, with Chair Greg Takayama and Vice Chair Representative Leoy opening the meeting and outlining housekeeping rules, including a two-minute limit for testifiers and Zoom etiquette. The committee first heard HB 303 on health care preceptors. The Department of Health, Department of Taxation, University of Hawaiʻi, Hawaii State Center for Nursing, and several health care organizations supported the bill, saying the existing preceptor tax credit program has been successful and that expanding eligibility to additional professions and students would help address workforce shortages. In response to questions, the Department of Health said the annual tax credit cap is $1.5 million, about 650 to 670 credits are currently used each year, and the bill applies only to unpaid preceptors. The committee then moved on to HB 441, which would raise cigarette taxes. The Attorney General, Department of Health, University of Hawaiʻi Cancer Center, Hawaii Public Health Institute, American Cancer Society Cancer Action Network, and others supported the measure as a way to reduce smoking, especially among youth, and to support tobacco control and cancer-related programs. Opponents, including the Taxpayers Protection Alliance and the Cigar Association of Hawaii, argued the tax is regressive and unreliable as a revenue source. The Department of Health noted the last cigarette tax increase was in 2011, and one witness urged a larger increase than proposed. No vote was taken on either bill in the portion of the hearing provided. The committee also heard HB 557 on telehealth. The Department of Health supported the bill so long as it did not displace executive budget priorities, and the Hawaii State Health Planning and Development Agency and Hawaii Primary Care Association supported it. HPCA said the bill would conform state insurance law to recent Medicare changes expanding audio-only telehealth coverage beyond mental health services, and it emphasized access for rural residents, kupuna, and people with disabilities. HMSA opposed the bill as written, saying it strayed from the intent of Act 107 and that audio-only telehealth should remain limited because of quality-of-care concerns, though it supported continued access and asked for a different amendment approach. A telehealth provider also testified that payment disparities limit provider expansion and that audio-only access remains important for patients with serious illness. The hearing ended in the excerpt before any committee action or vote on HB 557.