June Robinson — Multiple speakers addressed Chair Robinson, also referred to as Senator Robinson and Madam Chair, during the committee’s hearing with the Health Care Authority. The mentions are brief courtesies and acknowledgments within the same ongoing discussion and question period.
June Robinson — June Robinson is repeatedly addressed as Chair/Madam Chair throughout a continuous discussion. The speakers thank her, resume the presentation after briefly losing their place, and then continue noting points about the topic, including the complexity of implementation, while directing remarks to Chair Robinson.
June Robinson — Chair Robinson was referenced in connection with the need to align state law with federal regulations.
June Robinson — The speaker thanks Chair Robinson and closes the presentation, indicating that the discussion is complete and inviting the committee to ask any further questions.
June Robinson — Addressed as Chair Robinson.
June Robinson — Referenced as the Chair in a possible question about WIC.
John Braun — Asks how Washington's FMAP compares with the national average or other states and notes he can wait for questions later if needed.
John Braun — Senator Braun asks whether agencies are working on a common solution to verify work requirements, possibly using SNAP capabilities.
Trinity — Health Care Authority staff person described as the speaker's go-to contact for eligibility questions.
Trinity — The speaker repeatedly defers to Trinity for more detailed answers about the issue being discussed, including specifics on reapplication, tracking requirements, and delay details, and then asks Trinity to take notes for follow-up.
Trinity — Trinity is introduced multiple times as one of the presenters who will walk through HR1 provisions, with the speaker handing off to Trinity and Dr. Fetinos to explain the provisions in more detail. The discussion emphasizes that Trinity will specifically cover certain provisions and provide additional detail, including the issue of loss of lawful presence eligibility.
Claudia Kauffman — Asked whether the increase in substance use disorder clients might reflect increased provider operations in the state.
Claudia Kauffman — Asked whether work requirements also apply to the developmental disabilities community.
Steve Conway — Asked whether the figures also include patients in state hospitals.
Steve Conway — Senator Steve Conway is introduced as the next questioner and then follows up by asking about delays in implementing the system, specifically what CMS would consider a legitimate delay in implementation.
Steve Conway — Asked what industries working Medicaid enrollees are employed in and said he was surprised by the statistic.
Steve Conway — Senator Steve Conway asked what portion of the Medicaid expansion population at risk of losing coverage is in rural areas and rural hospitals, noting that many rural residents rely on Medicaid. The discussion then continued with a response clarifying that while rural grant funds exist, they cannot be used to replace lost Medicaid eligibility funding because of specific prescriptive guidelines.
Sandy — Sandy is asked whether she has information about how work requirements are working in other states.
Sandy — Sandy explains that the costs are primarily setup costs, with ongoing staff costs as well.
Sandy — Sandy is referenced as having previously explained FMAP differences affecting the Medicaid share.
Keith Wagoner — Senator Wagoner asks what the implementation costs cover and whether they are for compliance verification and staff/software costs.
Keith Wagoner — Senator Wagoner asks for clarification on which non-citizen adults are affected.
Claire Wilson — Senator Wilson asks whether the state has systems in place to track work requirements across agencies.
Claire Wilson — Senator Wilson raised a question about how proposed changes could affect developmental disability clients, specifically asking whether SNAP and other supports used by this population might also be impacted.
Claire Wilson — Asked where WIC fits within food assistance programs and related state administrative changes.
Maria — Maria presents on DSHS long-term care and developmental disabilities programs, and is briefly interrupted while explaining the pathways for DD and long-term care services.
Josh Hinman — Josh Hinman introduced himself as staff to the committee and began discussing other agencies with Medicaid funding.
Ryan Moran — Ryan Moran introduced himself as the new Health Care Authority director, noting his prior role as Maryland’s Deputy Secretary of Health Care Financing and Medicaid director. He explained that the agency must shift from analysis to implementation planning with sister agencies, and that the required changes will involve major technology upgrades, software investments, and additional state resources. He emphasized the agency’s goal of minimizing coverage loss for participants and preserving provider reimbursement, while also highlighting the broad engagement underway and praising the 1,700 authority employees working on the issue. A later reference credited Ryan’s leadership in guiding the agency’s response.
Dr. Fatinas — Dr. Fatinas is introduced as one of the presenters who, together with Trinity, will walk through the HR1 provisions and explain them individually. The chair later turns the discussion over to Dr. Fatinas and Trinity to continue that presentation.
Sharisa Fatinos — Sharisa Fatinos, the Medicaid and Behavioral Health Medical Director, explained the real-world harm she is seeing from policy changes by describing two patient cases: a homeless 13-year-old who could not get treatment for a broken arm and an elderly woman who waited days for hip surgery. She then discussed the impact of HR1, noting that CMS has provided only limited guidance so far and that the state is trying to minimize harm while preparing for new requirements. She explained that CMS’s corrective action plan requires Washington to automate renewals for both classic Medicaid and MAGI expansion populations by June 2027, and said roughly 620,000 Washingtonians will be affected by work requirements and six-month redeterminations. She also noted that the bill’s immediate prohibition on Medicaid funding for Planned Parenthood took effect upon signing, and that the state is backfilling those funds.
Marcus Riccelli — Asked whether COFA communities are impacted; the response was no, not at this point.
Marcus Riccelli — Asked whether there is a look-back period and retroactive coverage when work requirements are determined.
Annette Cleveland — Senator Cleveland is introduced as having a question and then asks Dr. Frantino whether there is a way to determine how many current Medicaid enrollees are actually working.
Trinity Wilson — Introduced herself as Assistant Director for Medicaid Eligibility and Customer Service at the Health Care Authority and began walking through HR1 Medicaid eligibility provisions.
Noel Frame — Senator Noel Frame is called on and then immediately asks for clarification about the meaning of 'parolee' in this context, noting that the term could be misinterpreted.
Bob Hasegawa — Senator Hasegawa is called on for a question.
Bob Hasegawa — Senator Hasegawa asks whether the report tracks employers of working Medicaid enrollees.
Bob Hasegawa — Senator Hasegawa asked for clarification about whether behavioral health rates are affected.
Bob Hasegawa — Senator Hasegawa asked for clarification about which providers benefit from the tax restrictions.
Chris Gildon — Senator Gildon asked how much funding Washington would receive if approved, and the speaker responded by explaining that the state would receive an annual allotment of $200 million per year.
Chris Gildon — Senator Chris Gildon is introduced as having a question, then asks whether the legislature can provide any assistance to help lower the error rate.
Chris Gildon — Likely the senator being referred to as 'Senator Binky/Banke'; asked whether the eligibility system changes are linked with WOTEC and the Technology Services Board.
Lisa Wellman — Senator Wellman is identified as asking a question about emergency room use when services are taken away.
B. Rector — Introduces themselves as Assistant Secretary in DSHS for Home and Community Living Administration and begins testimony on long-term services and supports impacts.
B — The committee thanks B for joining and transitions away from the health care topic.
Josh — Josh is introduced as the next presenter to begin the food assistance programs portion of the meeting.
Carla Reyes — Carla Reyes, Assistant Secretary for the Economic Services Administration at the Department of Social and Health Services, introduced herself to the committee and began her testimony on the impacts of H.R. 1 on SNAP and food assistance.
Christy Fredrickson — Named as a DSHS witness being brought up to the committee.
Ron Muzzall — Named as the senator asking who determines the error rate.
Christy Fredericks — Introduced herself as the chief technology information officer for the Department of Social and Health Services.