Transcript Highlights:

• implementing a paid leave program through an actuarial analysis of Hawaii's workforce and a legal analysis of ERISA
• Hawaii's workforce and legal analysis of Hawaii's workforce and legal analysis of ERISA<01:14:52.560>
• > prepaid</c><01:14:53.120><c> healthcare</c><01:14:53.600><c> and</c><01:14:53.840><c> family</c> ERISA
• prepaid healthcare and family ERISA prepaid healthcare and family leave<01:14:54.480><c> laws.

Transcript Highlights:

• government plans, you have to do so very thoughtfully and very carefully so that you avoid potential ERISA
• Azis and his team have done a very good job of exploring some of those ERISA constraints and figuring
• And things like data reporting is one of those areas that you're more likely to be preempted because ERISA
• My colleague Sam Halamire will get more into the ERISA issues that we see, including self-insurance plans
• All those laws would now apply to self-funded plans, and due to federal ERISA law, we think that the

Committee: Senate Health and Human Services

Transcript Highlights:

• We have an ERISA exemption, the only ERISA exemption that states have, and it has to do with our prepaid
• And we do not want to risk losing that ERISA exemption.

Bills: HB20 , HB2612 , HB2404 , HB2459 , HB2194 , HB1880 , HB2284 , HB1969 , HB2458 , HB1546 , HB2161 , HB1721 , HB1641 , HB2137 , HB1782 , HB2360 , HB1965 , HB1897 , HB1513

Committee: House Consumer Protection & Commerce

Summary: The committee heard testimony on HB 20, which would create a lava zone insurance subsidy/fund. The Insurance Division opposed the bill, arguing that lava zones 1 and 2 are the highest-risk areas, that a subsidy would not reduce the underlying risk or loss costs, that it could invite similar subsidy requests for other hazards, and that the bill may conflict with HICV by diverting funds from the CRF. Members discussed the lack of authorized homeowners insurance in those lava zones, the role of HPIA and the surplus market, and the difference between the proposed lava-zone subsidy and the Hawaii Hurricane Relief Fund. The chair noted 37 submitted testimonies in support and one in opposition, and the committee then moved on without taking a vote on HB 20 in the portion provided. The committee then took up HB 2612, relating to mortgages, which would clarify that a mortgage does not exist independently of the debt it secures and is not independently enforceable from that debt. The Hawaii Credit Union League and Hawaii Financial Services Association opposed the bill, while several individuals testified in support, arguing it would restore Hawaii’s long-standing lien-state rule and prevent so-called “zombie mortgages” after the Hawaii Supreme Court’s White decision. Supporters said the bill would protect borrowers from delayed foreclosures and predatory lending practices, while opponents and the Insurance Division emphasized that foreclosure actions still require proof of standing and possession of the note, and that lenders generally pursue foreclosure without seeking deficiency judgments. Committee members questioned the Insurance Division about how the current market works, whether lenders could wait out the statute of limitations and then foreclose only on the mortgage, and whether equitable tolling or later defaults could allow refiling. The division said it is still trying to attract authorized insurers back into the lava-zone market, but has seen little progress. No vote or final action on HB 2612 was taken in the excerpt provided.

Transcript Highlights:

• By the way, I should note that the business community did litigate that on ERISA grounds, and San Francisco

Summary: The Assembly Health Committee held an informational hearing on the impact of federal H.R. 1 and related state budget actions on California’s health care system. Opening remarks framed the federal changes as a major threat to Medi-Cal, Covered California, hospitals, clinics, and the broader safety net, with warnings that millions could lose coverage and that costs would shift to providers, counties, and consumers. Testimony from the California Health Care Foundation and the Legislative Analyst’s Office focused on implementation challenges, the administrative burden of work requirements and more frequent renewals, the loss of federal funding, and the need for California to consider long-term structural changes to Medi-Cal, county safety-net programs, and cost containment. A Covered California enrollee, Chas Franklin, described sharply rising premiums for his family after losing subsidies, illustrating the personal impact of federal policy changes. Committee members raised concerns about whether premium increases were driven by H.R. 1 or insurer pricing, the cost of rebuilding county-based indigent care systems, and the need to account for the cost of inaction. Dr. Hernandez pointed to pre-ACA models such as Healthy San Francisco as examples of coordinated local safety-net care, while also emphasizing the importance of primary care, data interoperability, and the Office of Health Care Affordability in reducing waste and improving access. Department of Health Care Services officials then outlined the state’s implementation plan for H.R. 1, including work requirements, six-month redeterminations, reduced retroactive coverage, cost-sharing, and immigration-related eligibility changes. They said the department would try to automate eligibility checks, expand outreach, and train counties and partners, but estimated up to 2 million Californians could lose coverage over time. Covered California reported that the expiration of enhanced federal premium tax credits and new federal marketplace rules are already raising costs and reducing enrollment, with an estimated 400,000 enrollees at risk of dropping coverage. County, hospital, and safety-net representatives warned that coverage losses will increase uncompensated care and strain local systems, while one coalition proposed a temporary state-funded coverage option as a bridge if full-scope Medi-Cal cannot be maintained. The hearing concluded with a policy analyst urging stakeholder engagement, immigrant protections, and new state revenue options to preserve coverage and offset federal cuts.

Transcript Highlights:

• By the way, I should note that the business community did litigate that on ERISA grounds, and San Francisco

Committee: House Health

Transcript Highlights:

• If you added the amendment back in that allowed her to pay the delta, she was an ERISA plan.
• ERISA could be preempted in the case of PBMs because PBMs are contracted by insurance companies.
• It has no bearing whatsoever on ERISA plans, Medicare, Medicaid, or uninsured population.
• What I see is a risk pool like an ERISA plan, you know, a self-insured plan that is putting the risk

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

Transcript Highlights:

• control over what is legislated and regulated for the fully insured market, leaving out Medicaid, ERISA
• They're paying more than Medicare, more than Medicaid, more than, uh, even ERISA.
• Uh, we can't touch ERISA or Medicare; those are entirely federal.

Summary: The subcommittee first took up several bills and repeatedly chose to retain or table them rather than advance them. House 167, dealing with past wax, was voted ought to pass; House 312 was retained because members said NCAA-related advertising and uniform policy issues were still unresolved; House 434, requiring insurers to provide rental cars for at least seven days, was voted inexpedient to legislate; and House 454, on biodegradable packaging claims, was also voted inexpedient to legislate after members said the proposal lacked a workable enforcement mechanism and would likely be only a symbolic state-by-state measure. House 721, making gold legal tender, was retained, with members saying the bill needed more work and that the issue was less compelling in New Hampshire because the state has no sales tax. The committee then discussed House 310, which was amended to create a study commission on blockchain and related regulatory issues. The amendment expanded the commission’s charge to include legal, regulatory, financial, technological, and environmental considerations, added review of federal developments, included blockchain-based trust and stable token issues, broadened membership, and extended the repeal and report dates by a year. Members said the commission would help New Hampshire develop expertise and a report for future legislation, while also noting that federal action could affect the state’s role. The amendment was adopted 8-1, and the bill itself was then retained. Finally, the subcommittee heard a revised amendment to House 406 on business filings and registered agents. The Secretary of State’s office explained that the amendment, drafted with input from the Business and Industry Association, narrows the bill to address fraudulent or unauthorized entity filings after a written complaint and sworn statement, sets minimum requirements for registered agents, bars use of commercial mail-drop addresses as registered offices, and allows removal or cancellation of fraudulent filings with penalties for false filings. Members asked about which entities must maintain registered offices and how the rules would affect home-based businesses; the sponsor said most New Hampshire business entities must have a registered office, with some exceptions such as domestic nonprofits and trade names. The discussion emphasized concerns about synthetic entities, identity misuse, and the need for a physical in-state registered agent address.

Transcript Highlights:

• We have also provided funding through ERISA that has allowed Mexico to bring on additional staff to help

Summary: The joint hearing focused on preparedness for the New World screwworm threat and brought together the House Committees on Culture, Recreation, and Tourism and Agriculture and Livestock. USDA officials, Texas Department of Agriculture Commissioner Sid Miller, and Texas Animal Health Commission leadership described the pest as a serious risk to livestock, wildlife, rural economies, and beef prices, and emphasized coordination among federal, state, industry, and Mexican partners. Witnesses repeatedly stressed that Texas is currently seeing no confirmed U.S. detections, but that recent confirmed cases in northern Mexico, including Nuevo León, remain a concern because of their proximity to the border. USDA testimony outlined current surveillance and response efforts, including more than 120 screw worm-specific traps along the Texas border and neighboring states, thousands of additional dual-purpose traps, wildlife inspections, weekly coordination with Mexico’s Senasica, and a new USDA New World Screwworm Directorate. Officials said the existing Panama sterile fly facility is maxed out at about 100 million flies per week, while a dispersal facility in Tampico is helping move flies farther north in Mexico. They also described plans for a retrofitted sterile fly facility in Metapa, Mexico, expected to come online in 2026, and a new domestic production facility at Moore Air Base, with phase one targeted for late 2026 or early 2027 and phase two adding substantially more capacity later. Members pressed USDA on timelines, production capacity, the reliability of Mexican reporting, the risk from wildlife, and whether modular or mobile facilities could be deployed faster. USDA said it is also exploring innovative technologies, including a genetically engineered sterile male fly, but that such tools still require EPA review and field validation. Commissioner Miller highlighted Texas biosecurity efforts, five permanent inspection stations, cooperation with FDA and EPA on treatments such as Exzolt, and other pest issues affecting Texas agriculture. He also noted research into fly bait and private-sector efforts to speed sterile fly production. Texas Animal Health Commission officials described extensive state preparedness work, including weekly coordination calls, field response trainings, outreach to producers and veterinarians, and a Texas Screwworm Response Team. They said Texas has trained more than 100 inspectors and other personnel, with additional trainings planned, and that the state is expanding its cattle fever tick rider program. No votes or formal committee actions were taken during the hearing; the main action was the exchange of testimony and questions about readiness, surveillance, and facility timelines.

Transcript Highlights:

• So those things, such as vaccinations available through ERISA plans, would still look to federal law

Transcript Highlights:

• I think, as you all know, federal ERISA law states that the state government cannot regulate self-insured

Committee: Joint Joint Committee on Health Care Financing

Summary: The Joint Committee on Health Care Financing held a public hearing on a large docket focused on primary care, workforce development, and medical debt. Chairs Cindy Friedman and John Lawn outlined hearing procedures and noted that testimony would be taken on 17 matters. The committee first heard testimony on bills to establish a community health center nurse practitioner residency program and to strengthen mental health centers. Senator Keenan, Rep. Keefe, and health center leaders described the Worcester nurse practitioner residency as a successful pipeline and retention strategy, citing workforce shortages, training needs in community health centers, and the cost of the program. Rep. O’Day also supported the mental health centers bill, saying it would raise payment rates, improve reimbursement for behavioral health services, and help clinics retain staff and expand access. The committee then took testimony on bills to address medical debt through hospital financial assistance reform. The Attorney General’s Office, Health Care for All, Health Law Advocates, the Leukemia and Lymphoma Society, and individual patients supported the measure, arguing that hospital financial assistance policies are inconsistent, hard to find, and difficult to navigate. Witnesses said the bill would standardize eligibility criteria, create a uniform application, improve notice requirements, and expand access to discounted care up to 400% of the federal poverty level. Several personal stories described medical bills being sent to collections, confusion over insurance billing, and the burden of debt on low-income and chronically ill patients. Committee members asked about hospital concerns, the role of the health safety net, and whether the bill addressed root causes of medical debt; testimony emphasized that the proposal was meant to improve transparency and access rather than replace broader insurance reforms. The hearing also focused heavily on “Primary Care for You” legislation, H. 1370 and S. 867, which would increase primary care investment and create a new payment model. Rep. Haggerty, physicians, a patient, community health center leaders, and the Massachusetts League of Community Health Centers described a primary care crisis marked by low reimbursement, staffing shortages, long waits, burnout, and difficulty recruiting clinicians. Supporters said the bills would shift spending toward preventive, team-based care, improve access and equity, and reduce long-term costs. The Massachusetts Association of Health Plans said it was directionally supportive of increased primary care investment but warned that any new spending must stay within the cost growth benchmark and preserve existing contracting structures. The hearing ended with additional testimony on a community health center workforce and loan repayment grant bill from Rep. Stanley, and with further discussion from Dr. Alan Garo about the need for payment reform in primary care.

Transcript Highlights:

• oversee the two government programs, Medicare and Medicaid, and we do not oversee self-funded, right, ERISA
• oversee the two government programs, Medicare and Medicaid, and we do not oversee self-funded, right, ERISA

Summary: The committee heard testimony from Insurance Commissioner DJ Bettencourt on the New Hampshire Insurance Department budget. He said the department is self-funded through assessments on insurers based on New Hampshire premium volume, with about $8 billion in premiums written in the state and a department budget of roughly $15.5 million. He explained that the department has 88 authorized positions, eight vacancies, and that three full-time positions were unfunded after the governor’s requested 4% reduction exercise. He also said the department is trying to balance staffing needs with not overburdening carriers during a hard insurance market. A major topic was the department’s $2.6 million rebate to industry from the prior fiscal year, which Bettencourt described as a credit against the next assessment rather than a direct cash payment. Members questioned why that credit was not reflected as a reduction in the upcoming budget, and Bettencourt and staff explained that the budget assumes full staffing and full spending, with any year-end surplus returned to insurers. The commissioner said the department had added staff in recent years for succession planning and to preserve institutional expertise, and that the rebate reflects careful budgeting rather than excess spending. Members also asked about staffing changes by division, including positions unfunded in fraud, property and casualty examinations, life and health examinations, and tax. Bettencourt said fraud investigations remain strong and that the department can use outside contractors for examinations, with those costs billed to the company being examined. He also described the department’s examination process, including periodic financial exams and targeted market conduct reviews triggered by consumer complaints or trends. Additional questions covered OIT transfers, the department’s oversight of fully insured health coverage, the insurance premium tax and fines going to the general fund, and the department’s limited role in auto repair reimbursement disputes, where he said complaints have recently declined.

Transcript Highlights:

• The Senate bill focuses more on ERISA. The House bill is more on commercial insurers.
• The requirements for those types of plans fall under ERISA and are very different from the health insurance
• The member then asked whether UnitedHealthcare did something to ERISA and said he did not know that United

Committee: House Commerce and Consumer Affairs

Transcript Highlights:

• the end of the day, the risk pools are cities and towns that have come together and joined like an ERISA-like

Summary: The committee took up several insurance-related bills. Senate Bill 47, concerning health insurance policies related to the birth of the mother, was moved ought to pass with no amendments and was approved on a 6-0 vote. Senate Bill 121, dealing with Medicare Advantage plan notice requirements, was amended to reduce the required notice from 120 days to 90 days and to remove a federal citation; the department said the change was to avoid conflict with federal notice rules. After discussion about the stress caused when carriers leave the Medicare Advantage market, the committee voted ought to pass as amended, 7-0. The committee then heard a detailed explanation of the continuing care retirement communities bill, described by the Insurance Department as a rewrite of a 1989 law to modernize oversight, require quarterly financial reporting as an early warning system, create a bill of rights for residents, and clarify issues such as entrance fees and removal of dangerous residents. A member recalled the bill’s original purpose as protecting solvency because residents pay substantial upfront fees. The bill was moved ought to pass and approved unanimously, 7-0. The final major discussion concerned a pooled risk organizations bill. Members debated whether oversight should remain with the Secretary of State or be moved to the Insurance Department. Supporters of moving it argued the issue is solvency, citing concerns about reserve levels, prior insolvencies, and the Insurance Department’s expertise. Opponents said the Secretary of State’s office had historically overseen the entities and that the bill would fundamentally change how they operate. A straw vote favored an amendment, but the committee ultimately voted to retain the bill for further work, with plans to revisit it later in the session.

Bills: SB835 , SB3070 , SB22 , SJR59 , SB926 , SB1494 , SB251 , SB456 , SB500 , SB1307 , SB2615 , SB2995 , SB2321 , SB973 , SB974 , SB865 , SB506 , SB781 , SB1522 , SB1558 , SB510 , SB667 , SB763 , SB2073 , SB1858 , SB1660 , SB505 , SB2900 , SB1433 , SB1540 , SB1964 , SB1300 , SB1644 , SB2217 , SB2373 , SB2431 , SB1758 , SB2480 , SB3039 , SB3047 , SB3073 , SB2920 , SB2781 , SB826 , SB766 , SB2460 , SB527 , SB1946 , SB2885 , SB1243 , SB2610 , SB2595 , SB857 , SB37 , SB8 , SB10 , SB227 , SB261 , SB12 , SB15 , SJR27 , SB552 , SB835 , SB3070 , SB22 , SJR59 , SB25 , SB57 , SB127 , SB293 , SB441 , SB3059 , SB512 , SB241 , SB1718 , SB140 , SB2055 , SB2075 , SB2018 , SB1534 , SB1567 , SB785 , SB1233 , SB1580 , SB1663 , SB413 , SB447 , SB519 , SB467 , SB1579 , SB1191 , SB1021 , SB1838 , SB2807 , SB2835 , SB546 , SB2121 , SB2167 , SB2035 , SB2024 , SB1032 , SB1049 , SB1266 , SB1400 , SB1302 , SB401 , SB1596 , SB1281 , SB1242 , SB1343 , SB310 , SB1346 , SB2753 , SB2703 , SB2221 , SB1719 , SB2177 , SB800 , SB790 , SB748 , SB571 , SB1957 , SB1923 , SB1896 , SB1760 , SB1335 , SB2368 , SB2477 , SB2587 , SB2972 , SB2986 , SB2965 , SB1563 , SB1467 , SB1164 , SB1137 , SB614 , SB705 , SB961 , SB918 , SB955 , SB869 , SB850 , SB863 , SB1610 , SB1055 , SB2206 , SB457 , SB2337 , SB1362 , SB926 , SB1494 , SB251 , SB456 , SB500 , SB1307 , SB2615 , SB2995 , SB2321 , SB973 , SB974 , SB865 , SB506 , SB781 , SB1522 , SB1558 , SB510 , SB667 , SB763 , SB2073 , SB1858 , SB1660 , SB505 , SB2900 , SB1433 , SB1540 , SB1964 , SB1300 , SB1644 , SB2217 , SB2373 , SB2431 , SB1758 , SB2480 , SB3039 , SB3047 , SB3073 , SB2920 , SB2781 , SB826 , SB766 , SB2460 , SB527 , SB1946 , SB2885 , SB1243 , SB2610 , SB2595 , SB857 , SCR9 , HB5560 , HB762 , HB 107 , HB 114 , HB300 , HB138 , HB4386 , HB2495 , HB581 , HB3348 , HB5323

Keywords: sexual abuse, nondisclosure agreements, confidentiality agreements, public policy, victim rights, lottery, bingo, regulation, Texas Lottery Commission, Department of Licensing and Regulation, criminal offenses, state administration, audits, transfers, Texas, moving image industry, incentive program, film production, grant funding, job creation

Transcript Highlights:

• And unfortunately, ERISA preempts this body from doing anything about that.

Committee: Senate Energy, Utilities and Communications

Summary: The committee heard several energy, water, and utility bills. SB 919 by Senator Grayson would extend the biomethane monetary incentive program through 2030 and authorize additional funding to support renewable natural gas projects by reducing interconnection costs. Supporters said high interconnection costs and the current tax treatment are major barriers to methane reduction projects; opponents, including TURN and environmental groups, raised ratepayer cost concerns and objected to rate-basing and additional public funding. The author said amended language would remove the rate-basing provisions and instead urge the CPUC to act quickly on its pending decision. SB 931 by Senator Laird would reauthorize the Community Impact Mitigation Program for the Diablo Canyon plant through 2030 to continue funding local emergency preparedness, fire protection, public safety, and school district costs. The County of San Luis Obispo and labor groups supported the bill, while TURN opposed it as a statewide ratepayer subsidy that could be funded from existing PG&E revenues instead of higher rates. Members discussed the bill in the context of the 2022 Diablo Canyon extension deal and the possibility of a future longer extension. SB 1215 by Senator Cortese would direct the CPUC to set deployment targets for EV charging in multifamily housing and evaluate progress, with amendments aimed at affordability and limiting system upgrade costs. Supporters said renters are largely locked out of home charging and that prior utility programs proved cost-effective; no opposition testified. SB 1359 by Senator Stern would require more deliberate CPUC review before major gas system investments, emphasizing electrification and non-pipeline alternatives. Gas utilities and several industry groups opposed it, arguing it could undermine the obligation to serve, create safety and reliability risks, and change the regulatory compact. The committee also heard SB 1125 by Senator Menjivar, presented by Senator Gonzalez, which would establish a statewide low-income water rate assistance program upon appropriation. Water agencies, environmental groups, and local governments supported the measure, while one member expressed concern that it lacked a funding source and could not overcome Proposition 218 limits; the bill was moved to Appropriations and the roll was left open. Finally, SB 1098 by Senator Perez would restrict the use of long-running memorandum and balancing accounts by investor-owned utilities, require exceptional circumstances for new accounts, and add sunset and cost-sharing requirements. Consumer advocates and large energy users supported tighter oversight, while the utilities and business groups opposed the bill as too rigid and potentially harmful to flexibility for wildfire, emergency, and safety-related costs.

Committee: Senate Health and Human Services

Transcript Highlights:

• If you added the amendment back in that allowed her to pay the delta, she was an ERISA plan.
• ERISA could be preempted in the case of PBMs because PBMs are contracted by insurance companies.
• It has no bearing whatsoever on ERISA plans, Medicare, Medicaid, or uninsured population.

Summary: The committee first heard Senate Bill 47, sponsored by Senator Regina Birdsell at the request of the Insurance Department. The bill would clarify that a birth mother’s health insurance is the primary policy for a newborn’s care unless the mother has no coverage or no employer-sponsored coverage. Birdsell and Insurance Commissioner DJ Benton Court said the measure simply codifies the department’s long-standing interpretation of existing law. Representative Miles asked whether the coverage would extend to a grandchild if a young woman on her parents’ plan had a baby, and Birdsell said it would. The hearing on SB 47 was then closed. The committee next heard Senate Bill 121, introduced by Grant Bosi for Senator Kevin Avard. The bill requires insurers to notify the Insurance Department when they stop writing an entire line of business or, in some cases, when they change Medicare Advantage offerings. Benton Court said the bill was prompted by disruption in the Medicare Advantage market, where consumers and the department were confused by carriers exiting, changing plans, or narrowing offerings. He said the department does not regulate Medicare Advantage itself, but does license the carriers, and the notice requirement would help the department advise consumers; he also said noncompliance could affect a carrier’s license and could lead to fines. Members discussed the notice period, and the department and AHIP indicated support for changing it from 120 days to 90 days to align with federal timing. The hearing was closed with plans to work on an amendment in subcommittee. Finally, the committee heard Senate Bill 247, introduced by Representative Brian Cole, which would prohibit network exclusion for pharmacies that refuse to dispense prescriptions when PBM reimbursement is below acquisition cost. Cole said the bill is meant to stop pharmacies from being forced to sell at a loss. Members questioned whether pharmacies voluntarily enter PBM contracts, whether the bill would raise consumer prices, and whether it would mainly affect independent pharmacies. Cole and others said the issue has changed over time because PBMs now control a much larger share of the market, and that the bill would let pharmacies refuse loss-making fills and direct patients to mail order instead. The discussion also noted that the bill excludes Medicare and Medicaid and that the current proposal does not create a middle-ground option for patients to pay a premium at the counter.

Transcript Highlights:

• And unfortunately, ERISA preempts this body from doing anything.

Committee: Senate Energy, Utilities and Communications

Transcript Highlights:

• The Texas Association of Business Administrators manage ERISA and other self-funded health plans.

Bills: HB3000 , HB2622 , HB2283 , HB541 , HB1776 , HB1803 , HB1669 , HB2588 , HB220 , HB3415 , HB50 , HB1314 , HB 107 , HB220 , HB50 , HB107

Committee: House Public Health

Keywords: ambulance service, rural healthcare, grants, financial assistance, qualified counties, mental health, patient transport, female attendants, security measures, healthcare regulation, epinephrine, anaphylaxis, health care, school safety, training, emergency response, direct patient care, healthcare, physicians, medical services

Transcript Highlights:

• it be in this market or individuals who have MinnesotaCare or Medicare or a commercial plan or an ERISA-style

Committee: House Commerce Finance and Policy