Bills: SB2271, HB1216

Keywords: adult residential facilities, care services, Medicaid, payment rates, elderly care, health services, North Dakota, prescription drugs, drug affordability, copay assistance, copayment accumulator, deductible accumulator, out-of-pocket maximum, health insurance, health benefit plan, self-insured health plan, self-funded plan, third-party payment, manufacturer assistance, patient assistance program

Summary: The Appropriations Committee met with a quorum and took up three bills. House Bill 1216, dealing with prescription drug expense co-pay accumulators in health plans, was presented by Rep. Karen Carl’s, who explained it would prevent insurers from refusing to count third-party assistance toward deductibles for patients using high-cost, non-generic drugs. An amendment was offered to clarify effective dates, including a delayed January 1, 2026 start for PERS coverage. PERS testified that the amendment would align with its calendar-year benefit structure and likely reduce the fiscal note. The amendment was adopted 16-0, and the bill was set aside for further discussion later. House Bill 1199, creating a criminal justice data-sharing system and missing persons/missing Indigenous people task force, was introduced with a committee amendment changing the Attorney General reference to the Attorney General or designee. The committee noted the bill includes a $250,000 general fund appropriation for ongoing costs. The amendment passed 16-0, and the amended bill received a do pass recommendation by a 15-1 vote, with one no vote from Senator Magrum. House Bill 1531, appropriating $75,000 for an irrigation expansion study by the Agriculture Commissioner, was supported as a way to update older economic-impact studies on irrigation and assess opportunities for expansion. Members discussed its relationship to broader study pauses and the history of irrigation development in the state, including Garrison Diversion and remaining authorized acres. The bill passed 16-0. The committee then discussed scheduling for the coming week, noting a heavy bill load and plans for daily morning meetings before adjourning.

Transcript Highlights:

• Would not have to apply to plans that are HSA-compatible.
• I am also a member of the American Bankers Association HSA Council.
• So what HSAs do is simply give people greater spending power.
• , as Eric mentioned, it disqualifies the HSA.
• apply to HSA-qualified plans.

Keywords: 995, all

Summary: The Joint Committee on Financial Services held a hearing with Chair Jamie Murphy and Senate co-chair Senator Feeney presiding. Members asked witnesses to keep testimony to three minutes and noted that written testimony could still be submitted. The committee heard testimony on several health insurance and pharmacy-related bills, including a proposal to allow controlled prescriptions to be transferred between pharmacies within the same chain, legislation affecting health savings account (HSA)-compatible plans and future insurance mandates, a bill on small business health insurance incentives, and H. 1212 on emergency insulin access. Several parents and patients testified in support of emergency insulin access, describing severe diabetes emergencies, diabetic ketoacidosis, prescription delays, and the need for pharmacists to dispense insulin in urgent situations when doctors or insurers are unavailable. A parent also described the burden of repeatedly obtaining new prescriptions for ADHD medication when pharmacies are out of stock. Witnesses supporting the HSA bill argued that state coverage mandates can unintentionally disqualify HSA-qualified plans and that the bill would preserve tax advantages for enrollees while avoiding repeated legislative fixes. A representative of the Retailers Association supported the small business health insurance incentives bill, saying it could help retain small employers in the merged market by allowing carriers to offer financial incentives tied to cooperative purchasing and utilization efforts. One witness, Kathleen Demarest, testified against a co-pay assistance restriction, saying a state rule had unexpectedly cut off her drug assistance before a generic was actually available, leaving her with very high out-of-pocket costs. Committee members asked a few clarifying questions about HSAs, insulin dispensing, and school support for diabetes care. After all scheduled witnesses had testified and no additional testimony was offered, the committee voted to close the hearing.

Transcript Highlights:

• > Absolutely. >> Yeah. >> And this basically just removed some of the wording in the definition of HSAs
• > Absolutely. >> Yeah. >> And this basically just removed some of the wording in the definition of HSAs
• > Absolutely. >> Yeah. >> And this basically just removed some of the wording in the definition of HSAs
• . co-pays or cost accumulators that could harm existing HSAs.
• The wording in the definition of HSAs. That was simply not needed. LSA and DOI confirmed that.

Bills: HB300, HB40, SB19, HB283, HB179, HB296, HB300, HB40, SB19, HB283, HB179, HB296

Keywords: HB300, Choctaw County, probate court, probate judge, recording fee, filing fee, deed tax, mortgage tax, deeds, mortgages, property records, recordation, county local act, local legislation, technology upgrades, digitalization of records, recordkeeping, county treasury, special fund, court administration

Transcript Highlights:

• Um, am I correct that the key difference between an HRA and an HSA is that an HSA you keep the money
• 51.760> an the key difference between an HRA and an the key difference between an HRA and an HSA
• <01:53:52.719> is<01:53:53.040> that<01:53:53.440> an<01:53:53.679> HSA<01
• is that an HSA you keep the money if HSA is that an HSA you keep the money if you<01:53:56.480> change
• So the the >> An HSA is preunded, right?

Keywords: 1191, senate, all

Transcript Highlights:

• with a health savings account from future state insurance benefits mandates that conflict with federal HSA
• That conflict with federal HSA law.
• Well, with the big beautiful bill, the definition—sorry—it's just protecting your pre-tax HSA dollars
• Well, with the big beautiful bill, the definition—sorry—it's just protecting your pre-tax HSA dollars
• It's just protecting your pre-tax HSA dollars.

Bills: SB170, SB177, SB207, SB208, SB215, HB27, SB219, SB247, SB232, SB81

Keywords: 923, senate, all

Transcript Highlights:

• But we tried an experiment with an HSA for ERS, I believe.
• So HSAs are available to ERS, but it's capped by salary.
• Porter, I mean, I love the idea of HSAs.
• "So you can actually use HSA-like vehicles for individuals.
• HSAs, you bypass it all, and you get an open market.

Keywords: 1185, senate, all

Transcript Highlights:

• differential between the premium from the PPO plan and the high deductible plan is directed into an HSA
• So if you are a family plan, you get $289.36 added to your HSA every single month.
• And if you're a single plan, you can have $119.62 added to your HSA every month.
• So if you are a family plan, you get $289.36 added to your HSA every single month.
• And if you're a single plan, you can have $119.62 added to your HSA every month.

Summary: The Employee Benefits Committee met to approve prior minutes, hear presentations on state employee health insurance, compensation, leave, and related policy issues, and then recess for lunch. PERS reviewed the history and structure of the state health plan, noting the long-standing state-paid family coverage, cost-control measures, wellness incentives, the current grandfathered PPO and high-deductible options, and the effects of recent benefit mandates such as insulin caps, prosthetic coverage, medication management, prescription copay changes, and ambulance balance-billing limits. Committee members questioned the fiscal impact of adding benefits and the possible cost of moving to a non-grandfathered plan, while PERS and HRMS emphasized that health insurance remains the top-ranked employee benefit and that any major plan changes should be considered carefully. HRMS also presented compensation comparisons showing state pay generally below private-market benchmarks, discussed targeted market equity adjustments, identified ongoing recruitment and retention concerns in fields like nursing, IT, engineering, and attorneys, and reviewed leave policies, tuition reimbursement, and family leave comparisons with neighboring states. Job Service provided labor market data showing low unemployment, high labor force participation, and wage growth that still trails some neighboring markets, and OMB explained that prevailing wage requirements apply to federally funded projects under Davis-Bacon, not to ordinary state contracts. After lunch, the committee took up the required process for health insurance mandate bills and adopted an amendment to Joint Rule 211. The amendment clarified that the deadline for submitting mandate measures is intended to allow time for all required reports, including both the cost-benefit analysis and any Employee Benefits Committee actuarial report, while leaving the existing deadline unchanged. The amendment was adopted on a roll call vote, with several members voting yes and a few no votes recorded. The committee then moved into its jurisdiction review of bill drafts, beginning with a bill that would automatically renew pre-tax dental and vision elections; members debated whether it had any actuarial or administrative impact on PERS or the state, and the chair explained that the committee’s role was only to decide whether further analysis was needed before later testimony and recommendations.

Transcript Highlights:

• So patients can use their HSA funds for direct primary care monthly membership fee as well.
• So patients can use their HSA funds for direct primary care monthly membership fee as well.
• impacting HSA eligible healthcare impacting HSA eligible healthcare spending<00:19:07.280> with
• So patients can use their HSA care.
• So patients can use their HSA funds<00:19:11.520> for<00:19:11.919> direct<00:19:12.240

Bills: HF2400, HF1724, HF3437, HF4333, HF2874, HF4052

Keywords: real estate, appraisers, disciplinary actions, sanction matrix, Minnesota Statutes, direct primary care, healthcare agreements, medical services, patient care, health insurance, mortgage fees, residential loans, commercial loans, finance regulations, investment properties, insurance, supplemental health insurance, short-term care, home health care, nursing care

Transcript Highlights:

• That's a high-deductible, HSA-qualified plan.
• , and you can use a portion of those HSA dollars to buy direct primary care contracts.
• Patients will now be able to apply their HSA funds to a portion of their direct primary care fees, too
• By allowing HSAs to cover part of the monthly fee for direct primary care, more patients will be able
• And expanding that with HSAs or HSA-like vehicles, so like medical IRAs, now individuals can have better

Keywords: 1184, house, all

Transcript Highlights:

• HSA. HSA.
• It's $480 that $300 kicked into an HSA. It's $480 a<03:38:25.120> month.
• They're doing HSAs, HAS.
• They're doing HSAs.
• I mean, it has to be HSA-linked to a health insurance program still.

Keywords: 916, all

Transcript Highlights:

• Um, are these music therapy expenses eligible for HSAs, for health savings plans currently, or would
• therapy clinic through things like Seven Counties services and stuff like that have been able to use HSA
• and stuff like that have been able<00:27:10.240> to<00:27:10.480> use<00:27:10.880> HSA
• <00:27:11.520> funds<00:27:11.840> through<00:27:12.159> music able to use HSA
• funds through music able to use HSA funds through music therapy<00:27:12.960> for<00:27:13.200

Keywords: 958, all

Summary: The committee met on October 23, 2025, approved the September 25 minutes, and heard several informational presentations on occupational licensing and workforce access. The first major topic was the dietitian licensure compact, presented by Rep. Vanessa Gracel, Whitney Duddy, and Caitlyn Bison. They said the compact would be revenue-neutral, improve licensure portability, support military families, expand telehealth and rural access, and preserve state regulatory authority. Testimony noted that 15 states had joined the compact, including Ohio and Tennessee, and that Kentucky would have a seat on the compact commission if it enacted the measure. Members asked about bordering states and possible telehealth competition concerns; witnesses said they had not seen evidence of harmful effects in other compacts and described the compact as expanding access rather than displacing local providers. The committee then heard testimony on music therapy licensure, with Chris Millet, Laura Elliot Buckner, and Dr. Kimberly Cinemore speaking in support of Senate Bill 42. They described music therapy as a clinical, board-certified profession requiring formal education, supervised training, and national certification, and argued that state licensure would protect the public, clarify scope of practice, and help retain Kentucky-trained professionals. Witnesses said the bill would not require new state funding, could be administered through a self-sustaining licensing structure, and would not prevent others from using music in their work. In response to questions, they said licensure could help open doors to insurance, waiver, and HSA reimbursement, but would not guarantee coverage. Finally, the committee heard testimony on expanding physician access through a provisional licensure pathway for internationally trained physicians. Adam Meyer of the Cicero Institute said Kentucky faces a severe physician shortage, especially in rural areas, and argued that qualified international physicians should not have to repeat residency if they meet strict criteria, including an employment offer, prior training and experience, good standing, U.S. exam passage, and a three-year provisional period before full licensure. Rapender Carr of Baptist Health supported the concept, saying it could help fill hard-to-recruit positions across the state and improve access in rural markets. No votes were taken on these policy topics during the meeting.

Transcript Highlights:

• Excuse me—HSA is in support. HSA, in support.
• <01:02:52.440> excuse<01:02:52.720> me<01:02:53.720> okay<01:02:54.160> HSA
• <01:02:55.160> in purpose in person excuse me okay HSA in purpose in person excuse me okay
• HSA in support support support hello<01:02:57.359> chair<01:02:57.520> and<01:02:57.640

Keywords: 910, house, all

Summary: The Committee on Education met on January 30 and heard testimony on several bills, beginning with an announcement asking testifiers and members to keep remarks brief because of weather. The vice chair also explained that HB 440, relating to immigration issues in schools and state hospitals, was removed from the agenda because the proposal would not create meaningful legal protections and immigration policy is governed by federal law. The committee then moved through a series of education-related measures, with testimony largely from the Department of Education, the School Facilities Authority, the Attorney General’s office, unions, advocacy groups, and individual testifiers. On HB 330, concerning school impact fees, the School Facilities Authority supported the bill as aligning policy with implementation, while the Tax Foundation of Hawaii said the fee accounts have accumulated large balances, including more than $20 million in impact fee funds and nearly $9 million from predecessor fair-share contributions, and urged that collected money be used rather than left idle. DOE said it would follow up on the balance and why it was not being used. On HB 1188, dealing with workforce housing, DOE and the Charter School Commission offered comments or support, the Attorney General suggested clarifying the phrase “within commuting distance” by using a mileage standard and adding repayment language, and HSTA, HGEA, and others supported the bill, with HSTA saying teachers need housing to be able to live and work in Hawaii. On HB 624 and HB 625, both related to school psychologists, DOE said it would participate in a work group on the pathway bill and supported the incentive program bill; school psychologists and related groups supported the measures, while one testifier said DOE should not lead the work group alone because school psychologists may work in many education settings beyond DOE schools. The committee also heard HB 1314 on youth mental health in schools. DOE described its student support process, universal screening tools, and behavioral health services, saying schools already identify and respond to concerns and that staff are trained to report issues, while the Attorney General warned the bill could expose schools to liability and recommended a broad liability waiver. Testimony was mixed, with several supporters and one opponent. On HB 616, concerning school safety and harassment protections for educational workers, the Attorney General sought clarifying amendments on harassment definitions, temporary restraining order costs, and paid leave, while HSTA, HGEA, and individual teachers strongly supported the bill, describing harassment incidents and arguing for a standardized statewide response. DOE said it already has reporting pathways, visitor codes of conduct, trespass notices, and an ethics hotline, but acknowledged implementation varies by school and that staff can escalate concerns if needed. The committee also began hearing HB 88 on a three-year pilot program for athletic travel, but the transcript cuts off before that bill’s testimony is completed or any votes are taken.

Bills: HB125, HB116, HB183, HB342, HB341, SB280, SB245, SB159, HB125, HB116, HB183, HB342, HB341, SB280, SB245, SB159

Keywords: HB125, sunset law, Alabama Sunset Committee, Alabama State Board of Veterinary Medical Examiners, veterinary medical examiners, veterinary board, veterinary licensing, veterinary regulation, professional licensing board, state board continuation, sunset review, regulatory board, animal health, veterinarians, disciplinary authority, HB116, Alabama Sunset Law, sunset bill, Alabama Professional Bail Bonding Board, bail bonding

Transcript Highlights:

• 32.599> course<01:04:33.599> um<01:04:34.440> so Sarah Milan Laan, on behalf of HSA
• I'm Sarah Milan Laan, on behalf of HSA.
• laan<01:05:41.480> on<01:05:41.599> behalf<01:05:41.880> of<01:05:42.160> HSA
• <01:05:43.160> um<01:05:43.319> just Milan laan on behalf of HSA um just Milan laan
• on behalf of HSA um just being<01:05:43.720> honest<01:05:44.039> with<01:05:44.160>

Keywords: 912, senate, all

Transcript Highlights:

• If you change the drug payment system to an EBT card, an HSA card, you allow the patient to make the
• can decide what to do with that rebate money, whether it's returned and recharged on the patient's HSA
• 58.279> patient's returned and recharged on the patient's returned and recharged on the patient's HSA
• <01:02:00.240> it<01:02:00.359> to<01:02:00.520> pay<01:02:00.720> down HSA
• card or whe they use it to pay down HSA card or whe they use it to pay down the<01:02:01.160> patient

Keywords: 1191, senate, all

Transcript Highlights:

• differential between the premium from the PPO plan and the high deductible plan is directed into an HSA
• So if you are a fan, If you are a family plan, you get $289.36 added to your HSA every single month.
• And if you're a single plan, you can have $119.62 added to your HSA every month.

Keywords: 908, all

Transcript Highlights:

• the basic plan has some of those advantages as well, and that's sort of where I'm interested in the HSA
• I'm interested in the HSA contribution to a member's account is significant, I believe that's $240 a
• you know, the basic plan has never really talked about at all, the higher-deductible plan with the HSA

Keywords: 908, all

Summary: The House convened with prayer, roll call, and a quorum present, then took up several procedural motions, including suspending House rules for three legislative days and replacing conference committee members on Senate Bill 2282 and SCR 4007. The chamber also recognized visiting student groups from Grafton/Pleasant Valley and Shiloh School. Later, the House agreed to several conference committee reports and moved a number of measures through final passage or final disposition. House Bill 1428, which would have created a sales tax exemption for clothing sold by thrift stores or nonprofit corporations, drew extensive debate over tax policy, revenue loss, and possible conflicts with streamlined sales tax rules. Supporters argued it would help lower-income shoppers and nonprofit thrift stores, while opponents said it created an unfair advantage and could reduce state and local revenue. The conference report was adopted, but the bill ultimately failed on final vote, 37-54. House Bill 1440, relating to cigar lounges, was amended in conference and then passed 75-17. House Bill 1460, concerning adult foster care for private-pay adults, electronic monitoring, and a legislative study, was also adopted and passed overwhelmingly, 91-1. The House then passed Senate Bill 2224, which revises gaming commission structure and gaming stamp requirements, adds Attorney General enforcement provisions, and includes a $25,000 general fund appropriation, by a vote of 88-0. Senate Bill 2327, which expands uses of the agriculture diversification and development fund and appropriates $15 million to it, passed 74-17 after a member was excused from voting due to a personal interest. Senate Bill 2267, creating a regulatory framework for on-site wastewater treatment systems and shifting licensing authority to the Department of Environmental Quality, passed 82-10, and Senate Bill 2276, addressing joint water resource boards for cross-county projects, passed 90-1. The most contentious debate centered on Senate Bill 2160, which would move the state employee health plan from grandfathered status to a non-grandfathered ACA-compliant plan and appropriate about $6.6 million for the transition. Supporters said it would give the PERS board more flexibility, expand preventive and other benefits, and potentially slow premium growth without charging employees premiums. Opponents warned it could raise out-of-pocket costs, add mandated benefits, and shift costs to employees, while also arguing the bill had not been adequately studied. After extended debate, the House passed SB 2160 by a vote of 55-37. The chamber also concurred in Senate amendments to House Bill 1318, a pesticide labeling bill, and placed it on final passage, but the transcript ends before the final vote on that measure.

Transcript Highlights:

• are actually pinging their contacts with the federal departments that we have money from, you know, HSA
• are actually pinging their contacts with the federal departments that they have money from, you know, HSA
• are actually pinging their contacts with the federal departments that they have money from, you know, HSA
• are actually pinging their contacts with the federal departments that they have money from, you know, HSA

Keywords: 912, senate, all

Summary: The Health and Human Services committee heard several gubernatorial nominations and appointments, beginning with Sunshine Cho and Barbara Tom for the Language Access Advisory Council. Both nominees said they stood on their written testimony and expressed interest in continuing to serve, and multiple organizations testified in strong support. No opposition or questions were raised on either nomination, and the committee moved on after hearing the testimony. The bulk of the meeting focused on GM 642, the nomination of Ryan Yamane to be Director of the Department of Human Services. Yamane gave an extensive opening statement describing his social work background, long public service career, and philosophy of compassionate, balanced leadership. He emphasized DHS’s role in helping people from keiki to kūpuna with dignity and support, and shared personal stories from disaster response and family-service work to illustrate his approach. Support testimony came from a wide range of state officials, agency directors, community organizations, health systems, advocacy groups, and former colleagues, who praised his leadership, problem-solving, communication skills, and empathy. One witness, Moani Kiala Katherine Tu Alun, testified in opposition, raising concerns about retaliation and safety issues affecting foster youth and alleging harmful treatment within Child Welfare Services. Another witness, Angela Melody Young, supported the nomination and said Yamane could help overcome barriers for vulnerable communities and improve DHS programs such as financial assistance, SNAP, and disability services. The committee also heard from DHS staff and related officials about the uncertainty surrounding possible federal funding and staffing cuts; Yamane said the department is gathering information, coordinating with Budget and Finance and federal partners, and preparing to prioritize services and adjust if federal changes affect programs. No votes were taken in the portion of the meeting provided.

Transcript Highlights:

• I don't think it's an exact model like an HSA that you can say it's an HSA, you know, for home maintenance
• You just put your name on... >> spreading the wealth. think it's an exact model like an HSA think it's
• an exact model like an HSA that<01:46:18.800> you<01:46:18.960> can<01:46:19.119> say
• <01:46:19.760> it's<01:46:20.000> an<01:46:20.159> HSA,<01:46:21.360> you
• <01:46:21.520> know, that you can say it's an HSA, you know, that you can say it's an HSA,

Keywords: 919, house, all

Summary: The task force approved the minutes from the previous meeting and then reviewed the structure and statutory requirements for its final report. Staff explained that the report must go to the commissioners of commerce, housing finance, and economic development, as well as relevant legislative leaders, and must include a summary of task force activities, adopted findings and recommendations, tort reform recommendations to reduce insurance costs, any draft legislation, and other necessary information. A draft report, likely excluding recommendations and draft legislation, is expected to be circulated before the first January meeting. Most of the meeting focused on the Fair Plan and whether it could be expanded to help homeowners associations, affordable housing, and common interest communities that are struggling to obtain coverage. Supporters said these groups are facing availability problems and often end up in the surplus lines market, which lacks the consumer protections of the admitted market. They argued the Fair Plan could serve as a third-market option with stronger protections and better access, especially for properties that are having difficulty getting quotes. Several members and witnesses raised concerns that the Fair Plan was never intended to be a broad affordability solution and warned against using it to artificially lower prices below risk-based levels. They said doing so could shift losses onto other policyholders through assessments and potentially weaken the broader insurance market. The Fair Plan administrator explained that any expansion would require substantial research, staffing, actuarial and underwriting expertise, reinsurance planning, IT changes, and likely assessments or other capitalization decisions, and that the plan would need to focus on a limited subset of properties rather than the entire market. No votes were taken on policy recommendations, and the discussion ended with agreement that more information and scoping work are needed before any formal recommendation is made.

Transcript Highlights:

• cash payments, a gift card, or a deposit into the health reimbursement arrangement. ...an HRA or an HSA

Keywords: 1185, senate, all