Video & Transcript Research : 'copay accumulator adjustment'

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LA

Louisiana 2026 Regular Session

Health and Welfare Mar 18th, 2026

Health and Welfare

Transcript Highlights:
  • that oversight versus us having to come set a fee every year as market conditions change, they can adjust
  • have a scheme that the PBM, the insurance company, have built that aspirin is going to have a $25 copay
  • they know if they roll that up into the benefit, they can end up going back around and get the $25 copay
  • And Mark Cuban, for that same—what you're paying $25 as a copay—may only charge you $10 cash just to
  • So you move on the pharmacy, and while this particular drug may cost $50 as a copay, they may find an
HI

Hawaii 2026 Regular Session

HLT-HHS Informational Briefing 03-06-2026

Hawaii Senate Floor Meeting

Transcript Highlights:
  • go to the doctor for the first time, get a cavity filled, get a prescription filled without a $75 copay
  • go to the doctor for the first time, get a cavity filled, get a prescription filled without a $75 copay
  • go to the doctor for the first time, get a cavity filled, get a prescription filled without a $75 copay
  • So, what's critical when I talk about transformation is adjusting future budget years to maybe support
  • So, where are we... transformation is adjusting future transformation is adjusting future budget<00:10
Bills: HB20, HB276, HB644, HB812, HB816, HB916, HB1131, HB1247, HB1518, HB1525, HB1537, HB1541, HB1546, HB1553, HB1562, HB1565, HB1566, HB1576, HB1577, HB1591, HB1605, HB1612, HB1613, HB1614, HB1618, HB1620, HB1650, HB1656, HB1658, HB1661, HB1664, HB1668, HB1676, HB1707, HB1711, HB1713, HB1715, HB1718, HB1727, HB1749, HB1756, HB1774, HB1776, HB1801, HB1802, HB1805, HB1813, HB1815, HB1831, HB1838, HB1853, HB1854, HB1859, HB1863, HB1871, HB1872, HB1918, HB1920, HB1952, HB1965, HB1966, HB1967, HB1969, HB1972, HB1973, HB1974, HB1975, HB1980, HB1985, HB2005, HB2023, HB2031, HB2033, HB2062, HB2113, HB2114, HB2116, HB2138, HB2139, HB2156, HB2158, HB2159, HB2171, HB2208, HB2268, HB2270, HB2272, HB2273, HB2276, HB2289, HB2310, HB2315, HB2335, HB2338, HB2339, HB2340, HB2343, HB2361, HB2384, HB2387, SB2338, SB2431, SB2438, SB2593, SB2907, SB2671, SB2321, SB3084, SB2401, SB3033, SB2972, SB3032, SB2806, SB3014, SB2108, SB2981, SB2973, SB2423, SB2078, SB2322, SB2397, SB2896, SB2088, SB2347, SB2408, SB2970, SB2851, SB2713, SB2697, SB2312, SB2192, SB2363, SB2530, SB3028, SB2024, SB3007, SB2599, SB2596, SB2662, SB2930, SB3334, SB2378, SB3019, SB3231, SB2240, SB2372, SB2175, SB2046, SB2298, SB2922, SB2835, SB3263, SB2174, SB2128, SB2006, SB2489, SB3134, SB2982, SB2425, SB2849, SB2797, SB2795, SB2575, SB2521, SB2765, SB2386, SB2852, SB2022, SB2117, SB2277, SB2387, SB2688, SB2885, SB3132, SB3219, SB2169, SB2591, SB2090, SB2983, SB888, SB3249, SB2611, SB2429, SB2463, SB3154, SB3131, SB3152, SB3315, SB2448, SB2054, SB2140, SB2520, SB2377, SB2986, SB2010, SB2189, SB2026, SB3010, SB2818, SB2002
TX

Texas 89th Regular

Delivery of Government Efficiency May 7th, 2025

Delivery of Government Efficiency

Transcript Highlights:
  • sector is that people are choosing this model when the employee chooses to go there and waives the copays
  • But if they go to someplace other than those. ...that are contracted, they will pay the traditional copays
TX

Texas 89th Regular

Pensions, Investments & Financial Services Apr 28th, 2025

Pensions, Investments & Financial Services

Transcript Highlights:
  • So, insurance-driven clinics, for example, you come in, pay your copay, and they ask you all kinds of
  • constitutional amendment was passed that raised the bond limit to $4 billion, there has not been an adjustment
TX

Texas 89th 2nd C.S.

Delivery of Government Efficiency May 7th, 2025

Delivery of Government Efficiency

Transcript Highlights:
  • Um, when, when the employee chooses to go there and waives the copays and deductibles, then, um, and
  • but if they go to someplace other than those, um, that are contracted, they will pay the traditional copay
LA

Louisiana 2026 Regular Session

House and Governmental Affairs Apr 28th, 2026

House and Governmental Affairs

Transcript Highlights:
  • provide for the salary and other compensation of elected officials and provides for an automatic adjustment
  • And so this bill attempts to alleviate a problem. adjustment at the beginning of each new term of office
  • And so this bill attempts to alleviate a problem that is created by political disincentive to adjust
  • And it also accounts for a CPI adjustment mechanism.
  • And it also accounts for a CPI adjustment mechanism.
AZ

Arizona 2026 Regular Session

03/17/2026 - House Commerce

Commerce

Transcript Highlights:
  • Character is the accumulation of choices made over time by the people who live in a place.
  • Character is the accumulation of choices made by time, made over time, by the people who live in a place
NM

New Mexico 2026 Regular Session

House - Judiciary Feb 11th, 2026 at 05:05 pm

House Judiciary

Transcript Highlights:
  • But when you adjust that for inflation, it's $64,000.
  • And when they don't do well, then our salaries are adjusted down.
  • And when they don't do well, then our salaries are adjusted down every four years.
  • And when they don't do well, then our salaries are adjusted down every four years.
NM

New Mexico 2026 Regular Session

House - Judiciary Feb 11th, 2026

House Judiciary

Transcript Highlights:
  • But when you adjust that for inflation, it's $64,000.
  • And when they don't do well, then our salaries are adjusted down every four years.
Summary: The committee first took up House Bill 99, a medical malpractice reform measure. Sponsor Chair Chandler and Minority Leader Armstrong described months of stakeholder negotiations aimed at balancing patient compensation with concerns from physicians, hospitals, and insurers about litigation costs, punitive damages, and access to care. The committee substitute kept the existing monetary damage caps but changed several provisions, including definitions of “occurrence” and “value of medical care,” treatment of future medical expenses, a higher clear-and-convincing standard for punitive damages, a two-step process before punitive damages can be pled, and a lower punitive-damages cap for smaller providers versus a higher cap for large hospital systems. Supporters said the bill would help recruit and retain doctors and stabilize the malpractice market; opponents argued it weakens accountability, especially for corporate and out-of-state hospital systems, and several speakers urged a stronger amendment to preserve patient rights. After debate, the committee voted 10-0 to give the House Judiciary Committee substitute for HB 99 a do-pass recommendation. The committee then heard House Joint Resolution 5, which would amend the state constitution to allow legislative compensation. Sponsors and supporters said paying legislators would make service more accessible to working people, parents, rural residents, and others without independent wealth, and would broaden representation. Several advocacy groups and individual commenters backed the proposal, while members raised questions about the pay formula, with the resolution tying compensation to the state median income. Some members supported the idea but preferred a salary commission or a different mechanism. The committee approved HJR 5 on a 7-3 vote. Finally, the committee began hearing House Memorial 39, which calls for a task force to study the current state of sexual assault examination kits and report on backlog progress. Sponsor Rep. Ferrari and the New Mexico Coalition of Sexual Assault Programs explained that a prior task force a decade ago found more than 5,000 untested kits and led to policy changes, including the Sexual Assault Survivors Bill of Rights and a statewide tracking system. The memorial is intended to reassess whether backlogs remain and recommend further fixes.
NM

New Mexico 2026 Regular Session

Senate - Judiciary Feb 11th, 2026

House Judiciary

Transcript Highlights:
  • As we're trying to, you know, adjust the next year, in 2024 they were $54 million.
  • The file is open and it's assigned to an adjuster.
  • The way this works, our involvement is the adjuster requests claim documents.
  • And the adjuster presents their case and requests settlement authority, either from their supervisor,
  • Let's see, the adjuster, they get approval and attend the mediation or ask just, you know, purchase,
Summary: The committee first took up a lengthy informational presentation on the Patient Compensation Fund (PCF) and New Mexico medical malpractice insurance. Teresa Hassey, a plaintiffs’ attorney, described the PCF’s origin in the 1976 Medical Malpractice Act, its role as a state-backed excess coverage system, and her view that it was mismanaged when hospital participation expanded without individualized risk assessments. She argued that hospitals underpaid surcharges, that the fund was depleted by claims, and that the 2021 amendments and later legislative infusions were meant to shore up deficits and phase hospitals out. Superintendent of Insurance Alice Kane and LFC analyst Julia Rodriguez presented a different perspective, emphasizing recent general fund infusions, current surcharge collections, the use of actuarial reviews, and the PCF’s budget and settlement activity. Kane said the market is highly concentrated, New Mexico’s malpractice costs and defense expenses are high, and the fund still provides lower-cost coverage than the open market, while also noting ongoing issues with future medical claims, TPA transition, and investment management. Committee members questioned the presenters at length about why New Mexico malpractice premiums are so high, whether defense costs were being conflated with claim payouts, how the PCF works with primary coverage and excess coverage, and whether hospitals were properly assessed when they entered the fund. Several senators raised concerns about punitive damages, corporate practice of medicine, and whether the state’s legal environment is driving doctors away. Others challenged the data comparisons, noting differences between one-year figures and multi-year averages, and asked why New Mexico’s costs remain far above neighboring states. Kane and Hassey disagreed on the causes, with Kane pointing to high claims and defense costs over time and Hassey arguing that hospital participation and punitive-damage exposure distorted the market. The chair concluded the discussion by saying the committee had not exhausted the topic and that he still wanted a clear path to reducing doctors’ insurance costs. After a break, the committee moved on to Senate Bill 41. Senator Charlie introduced the bill, which would eliminate the statute of limitations for the most serious sexual crimes in New Mexico. He argued that trauma, coercion, fear, and delayed disclosure often prevent survivors from reporting promptly, and said the law should reflect that reality. The bill was presented as a response to survivor testimony heard in a prior hearing, and the sponsor framed it as part of a broader effort to modernize the justice system for sexual violence cases.
NH
Transcript Highlights:
  • the insurance company covers chiropractic, yes, you can get 12 visits a year, with deductibles and copays
  • and you know year and with deductibles and you know you<00:25:32.000><c> know</c><00:25:32.720><c> copays
  • and</c><00:25:33.320><c> whatever</c><00:25:34.000><c> and</c><00:25:34.120><c> that's</c> you know copays
  • speaks, the $22 was based on the unamended bill when it included the exemption from deductible and copay
  • copay copay so<00:38:57.079><c> with</c><00:38:57.560><c> the</c> so with the so with the amendment<
Keywords: 928, house, all
Summary: The subcommittee first reviewed its schedule, noting that 13 bills were being executed the next day and that additional subcommittee work would be scheduled around Town Meeting Day and the following session days. The chair explained that the committee would not meet on Town Meeting Day, would handle the remaining bills on the next available subcommittee day, and would continue any unfinished items later in the month. The committee then took up House Bill 774, which concerned Medicare-related coverage issues. Members discussed the bill’s purpose and the differences between Medicare standard and Medicare Advantage, with one member saying the proposal was informative but did not offer a workable solution. The committee also moved to inexpedient to legislate on House Bill 185, and the motion passed on a 6-0 vote. House Bill 241, relating to alternatives to opioids, was retained for further work. Members said the bill raised concerns about insurers effectively practicing medicine and about the lack of evidence on the efficacy of some alternative treatments, while also noting that chiropractic coverage mandates already exist in statute. The committee voted to retain the bill, with the motion passing 6-0. The most extended discussion was on House Bill 648, which would expand insurance coverage for glucose monitoring. Testimony and committee comments focused on whether coverage should be tied to insulin use or instead to a physician’s medical judgment, the role of continuous glucose monitoring for people with type 2 diabetes who are not on insulin, and the potential cost impact. An insurance department fiscal analyst said the original $22-per-member estimate was based on the unamended bill and that the amended version would require updated analysis; members agreed to retain the bill to narrow the eligible population and revisit the language later.
NH

New Hampshire 2025 Regular Session

House Finance Division III (02/27/2025)

Transcript Highlights:
  • We can always adjust that. So with that, welcome to Division 3, and you may start at your leisure.
  • c> so</c><00:05:26.280><c> with</c><00:05:26.520><c> that</c><00:05:27.039><c> welcome</c> always adjust
  • that so with that welcome always adjust that so with that welcome to<00:05:27.680><c> division</c><00
  • to be looking at some numbers, and you're going to be seeing some differences between actuals and adjusted
  • You see $4.9 million adjusted authorized, and then when you scroll over, you see $7.9 next to that.
Keywords: 928, house, all
Summary: The House Finance Committee’s Division 3 held a public work session on the Behavioral Health budget on February 27, 2025. The chair opened by explaining the schedule, materials, and deadlines for the budget process, and noted there would be no motions or votes in the division that day. Division of Behavioral Health Director Ktia Fox and DHHS CFO Nathan White then walked the committee through the division’s mission, structure, and budget materials, describing the division’s four bureaus: Mental Health Services, Children’s Behavioral Health, Drug and Alcohol Services, and Homeless Services, along with the policy unit. They emphasized the division’s role in oversight, technical assistance, quality assurance, contracting, and the continuum of care from prevention and early intervention through crisis and residential services. Much of the discussion focused on major programs and funding lines, including the 988 Lifeline contract with Headrest, a technical assistance contract with UNH, Medicaid pass-through payments to New Hampshire Hospital and Glencliff, crisis response services, cold-weather homeless responses, housing supports, and the children’s system of care. Members asked about the UNH contract, the 988 program, crisis stabilization centers, and the peer certification program; Fox explained that the peer certification is a training-and-credentialing pathway for people with lived experience to enter community-based behavioral health work, not a volunteer program. The committee also discussed the “Choose Love” program, which Fox said was created after the Sandy Hook tragedy to build resilience and strength-based emotional regulation in schools and communities. On the children’s side, Fox described the system of care account as the place where many contracted services are budgeted, including community mental health centers, care management entities, rapid response services, and residential programs. Members asked about temporary staffing, and Fox said roughly $500,000 in temporary staff costs shown in the current year would not be spent next year because the money came from a nonlapsing appropriation in HB 1573 for oversight of children’s residential services. She also said provider rate increases were a prioritized need but were not funded in the governor’s current budget, and that the Children’s Behavioral Health Resource Center was not funded, resulting in about a $1 million reduction. The session ended while the division was still moving through the children’s behavioral health slides, including questions about the Fast Forward high-fidelity wraparound program and medication management.
WY

Wyoming 2026 Regular Session

Health Insurance Affordability Task Force, June 17, 2026 - AM

Health Insurance Affordability Task Force

Transcript Highlights:
  • Chairman, did you say what this was adjusted for inflation already or not?
  • So there's risk adjustment and age rating.
  • Yes, so you had risk adjustment from a different method.
  • </c> had risk So, you had risk adjustment had risk So, you had risk adjustment from<02:04:32.840><c>
  • ,</c><02:04:51.600><c> which</c> itself and then risk adjustment, which itself and then risk adjustment
Keywords: 916, all
MS

Mississippi 2026 Regular Session

Public Health and Welfare - Room 216, 3 March, 2026; 3:00 PM

Public Health and Welfare

Transcript Highlights:
  • need<00:41:29.440><c> some</c><00:41:29.560><c> time</c><00:41:29.880><c> to</c><00:41:30.040><c> adjust
  • </c><00:41:30.720><c> to</c><00:41:31.200><c> to</c> need some time to adjust to to need some time to
  • adjust to to dig<00:41:33.080><c> into</c><00:41:33.440><c> it</c><00:41:34.160><c> and</c><00:41:34.520
  • one of the things that it talks about in here is the cost of if a prescription is only $10 and the copay
  • is 25, then the only $10 and the copay is 25, then the patient<01:07:55.920><c> would</c><01:07:56.120
MO

Missouri 2026 Regular Session

Health and Mental Health Feb 12th, 2026

Health and Mental Health

Transcript Highlights:
  • Oh, so Representative Action. of those three copays because you pay co-pay for each month. Oh.
  • So Representative Action copay that you would if a patient had utilized the mail order pharmacy for say
  • Express Scripts says that you only pay two co-pays then Walgreens would have to also only charge two copays
  • Yeah, but to me, that charge two copays for you three. That would be the intention. Yeah.
  • They're $2, $4, and you have a $25 copay.
Summary: The committee first took testimony on House Bill 1681, which would require health carriers and pharmacy benefit managers to count amounts paid by or on behalf of an enrollee for certain medications toward out-of-pocket maximums when no generic substitute is available. The sponsor described the bill as helping patients with serious illnesses afford needed drugs. The committee then adopted a substitute that rolled HB 1681 together with House Bills 1941 and 2279, including an ERISA-related labor exemption, and passed the combined committee substitute by a vote of 15-2. The committee next heard House Bill 2365, which was also combined with related bills through a substitute that changed terminology to “delivery systems.” That substitute was adopted by voice vote, and the House Committee substitute for House Bills 2365, 2490, and 2249 was then approved unanimously, 18-0. After that, the committee heard House Bill 2149, the dementia care coordinator bill. The sponsor and supporters from the Alzheimer’s Association and family caregivers argued the state needs a central point person to coordinate resources, improve early detection, support caregivers, and connect rural residents to services. Members raised concerns about the fiscal note, whether the work duplicates existing Area Agencies on Aging and Alzheimer’s Association services, and whether two FTEs would be effective statewide. No vote was taken on HB 2149 during the portion provided. The committee also heard House Bill 2309, which would prohibit Missouri insurance coverage for organ transplants or related services involving organs taken from prisoners of conscience in China. The sponsor and supporters framed the bill as a human-rights measure aimed at condemning organ harvesting and abuse of Falun Gong practitioners and other prisoners of conscience. Members asked whether there was documentation of such transplants in Missouri and whether federal oversight exists; the sponsor said there is no reporting mechanism and no known opposition. No action was taken on the bill in the excerpt. Finally, the committee began testimony on House Bills 1975 and 1850, pharmacy benefit manager reform bills. The sponsors said the measures are intended to protect local pharmacies, improve transparency, limit harmful audit practices, and create a critical access pharmacy program. Supporters, including a pharmacy business group, argued PBM practices drive up drug costs and close pharmacies. Opponents, including a carpenters’ health plan representative, warned the bills could increase costs for self-funded plans, limit network and mail-order arrangements, and shift more administrative burden onto plan sponsors. The hearing continued with questions and testimony, but no final vote is shown in the provided transcript.
MA

Massachusetts 2025-2026 Regular Session

Joint Committee on Financial Services Jun 21st, 2026 at 10:30 am

Joint Committee on Financial Services

Transcript Highlights:
  • insurance carriers fail to pay the cost for any number of reasons ranging from the patient must pay a copay
  • My daughter would not have missed the last year and a half of school, and we would not have accumulated
  • My daughter would not have missed the last year and a half of school, and we would not have accumulated
Keywords: 995, all
Summary: The Joint Committee on Financial Services held a lengthy public hearing with more than 70 people signed up to testify, focusing mainly on health insurance and health care access bills. Early testimony centered on H.1257/S.712, which would require insurance coverage for medically necessary treatment of genetic craniofacial conditions. Supporters included legislators, dentists, and medical experts who said these conditions are not cosmetic, can severely affect eating, speech, pain, and social functioning, and often create major financial hardship because insurers deny coverage. A related dental bill, H.1262/S.676, drew technical testimony from the Life Insurance Association of Massachusetts about implementation issues with the 2022 dental loss-ratio law, while the Massachusetts Dental Society supported H.1306/S.696 on transparency in dental network leasing and opposed H.1262. Representative Gentile also testified for H.4013, which would ban for-profit acute care hospitals and for-profit health insurers in Massachusetts, arguing that profit incentives undermine patient care. A major portion of the hearing was devoted to H.1261/S.799, a bill to protect patients from surprise ambulance bills. Municipal fire chiefs, Boston EMS, nonprofit ambulance providers, and the bill’s Senate sponsor said the measure would require insurers to pay ambulance providers directly and promptly, cap patient out-of-pocket costs, and reduce confusion caused by out-of-network billing. Witnesses described ambulance services as essential public health infrastructure and said current billing practices can discourage people from calling 911 or leave municipalities and nonprofits unable to recover costs. Committee members asked about unpaid debt, municipal billing burdens, and how the bill would affect rates and reimbursement. No votes were taken during the hearing. The committee also heard extensive testimony on H.1249/S.805, which would require screening for PANS/PANDAS in medical and clinical settings. Legislators, clinicians, parents, a teen with the condition, and educators described PANS/PANDAS as an infection-triggered inflammatory illness that can present as sudden psychiatric symptoms and is often misdiagnosed as a mental health disorder. Supporters said routine screening at well visits, emergency rooms, and other clinical settings would help identify children earlier, reduce unnecessary psychiatric treatment and hospitalizations, and improve outcomes. Testifiers repeatedly urged favorable action, emphasizing the personal and financial toll on families and the potential for early treatment to prevent long-term harm. The hearing concluded with continued testimony on these bills; no committee action or votes were announced.
TX
Transcript Highlights:
  • So you have a specialist copay. It costs you $50 to go to see a specialist.
  • But the reality is the insurance company pays that excess amount over their copay.
  • So depending what happens at the federal level is how we can adjust what we could do potentially with
  • I gave that X-ray example, where it's twice as much, the copay."
  • And so there might be some adjustments that when we get that data.
Keywords: 1185, senate, all
KY

Kentucky 2026 Regular Session

House Legislative Session Day 36 (2-27-26)

Kentucky House Floor Meeting

Transcript Highlights:
  • In addition, it adjusts timelines and makes technical changes and corrections throughout the bill.
  • So that gives time for adjustments and, if there's not any questions on this amendment, Mr.
  • So that's this gives<00:23:08.320><c> time</c><00:23:08.559><c> for</c><00:23:08.799><c> adjustments<
  • </c><00:24:06.240><c> and</c> that businesses have time to adjust and that businesses have time to adjust
  • </c><00:28:26.320><c> might</c> for a healthy individual, a copay might for a healthy individual, a copay
Keywords: 958, all
NM

New Mexico 2025 Regular Session

House - Chamber Meeting Mar 21st, 2025

Transcript Highlights:
  • license fees than New Mexico despite the rising administrative costs we have, The fee has not been adjusted
  • biggest concern being on the health committee because even though it did take away the office visit copay
  • If you look at your office visit copay, it's usually going to be the price of your PCP visit, especially
  • Knowing that the health insurance plans do have to pick up that zeroed out copay, it is going to be shared
WA

Washington 2025-2026 Regular Session

Senate Ways & Means Feb 6th, 2026 at 01:30 pm

Ways & Means

Transcript Highlights:
  • The starting point for determining taxable income is federal adjusted gross income, or AGI.
  • The bill provides a number of adjustments... Gross income, or AGI.
  • The standard deduction amount is adjusted for inflation.
  • And this would happen without any meaningful adjustment to the state's business taxes.
  • She said these experiences accumulate and lead to bad outcomes for kids.