Insurance & Commerce- House
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Transcript
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Bills discussed (29)
| Bill | Title | Sponsor | Status |
|---|---|---|---|
|
HB1930
· 6 mentions in agenda, chapter, transcript
Matched: “…RY PRACTICES; AND TO PROVIDE FOR ENFORCEMENT OF VIOLATIONS. HB1930 Wardlaw TO MANDATE MINIMUM REIMBURSEMENT LEVELS FOR HEALTHC…”
|
TO MANDATE MINIMUM REIMBURSEMENT LEVELS FOR HEALTHCARE SERVICES. | Wardlaw | Died on House Calendar at Sine Die adjournment. |
|
HB1009
· 2 mentions in chapter, agenda
Matched: “HB1009 A. Collins TO ALLOW PREGNANCY TO BE A QUALIFYING EVENT FOR…”
|
TO ALLOW PREGNANCY TO BE A QUALIFYING EVENT FOR ENROLLMENT IN CERTAIN HEALTH BENEFIT PLANS. | A. Collins | Died in House Committee at Sine Die adjournment. |
|
HB1014
· 2 mentions in chapter, agenda
Matched: “HB1014 A. Collins TO REQUIRE COVERAGE OF IN VITRO FERTILIZATION UN…”
|
TO REQUIRE COVERAGE OF IN VITRO FERTILIZATION UNDER THE STATE AND PUBLIC SCHOOL LIFE AND … | A. Collins | Died in House Committee at Sine Die adjournment. |
|
HB1295
· 2 mentions in chapter, agenda
Matched: “HB1295 L. Johnson TO CREATE THE HEALTHCARE COST-SHARING COLLECTION…”
|
TO CREATE THE HEALTHCARE COST-SHARING COLLECTIONS TRANSPARENCY ACT. | L. Johnson | Died in House at Sine Die adjournment. |
|
HB1354
· 2 mentions in agenda, chapter
Matched: “…TO REGULATE SECURITY MEASURES AT RETAIL CONVENIENCE STORES. HB1354 Lundstrum TO REGULATE PHARMACY BENEFITS MANAGERS; TO AMEND…”
|
TO REGULATE PHARMACY BENEFITS MANAGERS; TO AMEND THE LAW CONCERNING THE STATE AND PUBLIC SCHOOL … | Lundstrum | Recommended for study in the Interim by the … |
|
HB1409
· 2 mentions in chapter, agenda
Matched: “HB1409 Long TO AMEND THE LAW REGARDING ENERGY; AND TO CREATE THE E…”
|
TO AMEND THE LAW REGARDING ENERGY; AND TO CREATE THE ELECTRIC RELIABILITY ACT. | Long | Died in House Committee at Sine Die adjournment. |
|
HB1443
· 2 mentions in agenda, chapter
Matched: “…EPARTMENT FOR FIREFIGHTING SERVICES BASED ON TIME ON SCENE. HB1443 Pilkington TO CREATE THE SECOND AMENDMENT FINANCIAL PRIVACY…”
|
TO CREATE THE SECOND AMENDMENT FINANCIAL PRIVACY ACT; TO PROHIBIT FINANCIAL INSTITUTIONS AND PAYMENT NETWORKS … | Pilkington | Died in House Committee at Sine Die adjournment. |
|
HB1533
· 2 mentions in agenda, chapter
Matched: “…D TO AMEND THE LAW CONCERNING CERTAIN HEALTH BENEFIT PLANS. HB1533 Gramlich TO CREATE THE DECENTRALIZED UNINCORPORATED NONPROF…”
|
TO CREATE THE DECENTRALIZED UNINCORPORATED NONPROFIT ASSOCIATION ACT. | Gramlich | Recommended for study in the Interim by the … |
|
HB1625
Act 974
· 2 mentions in chapter, agenda
Matched: “HB1625 Barnett TO AMEND THE LAW CONCERNING INSURANCE REQUIREMENTS…”
|
TO AMEND THE LAW CONCERNING INSURANCE REQUIREMENTS FOR LICENSED HOME INSPECTORS. | Barnett | Notification that HB1625 is now Act 974 |
|
HB1659
· 2 mentions in chapter, agenda
Matched: “HB1659 S. Meeks TO AMEND THE UNIFORM COMMERCIAL CODE; AND TO CLARI…”
|
TO AMEND THE UNIFORM COMMERCIAL CODE; AND TO CLARIFY THE PRIORITY AMONG SECURITY INTERESTS AND … | S. Meeks | Died in House Committee at Sine Die adjournment. |
|
HB1813
· 2 mentions in agenda, chapter
Matched: “…P RECOVERABLE DEPRECIATION UNDER PROPERTY AND CASUALTY LAW. HB1813 Gramlich TO ADOPT THE FAIR AND EFFICIENT TRANSMISSION COMPA…”
|
TO ADOPT THE FAIR AND EFFICIENT TRANSMISSION COMPACT. | Gramlich | Recommended for study in the Interim by the … |
|
HB1868
· 2 mentions in agenda, chapter
Matched: “…HE USES OF THE CONSTRUCTION ASSISTANCE REVOLVING LOAN FUND. HB1868 L. Johnson TO REQUIRE AN INSURER TO PAY A FAIR AND REASONAB…”
|
TO REQUIRE AN INSURER TO PAY A FAIR AND REASONABLE SERVICE FEE DIRECTLY TO A … | L. Johnson | Died in House Committee at Sine Die adjournment. |
|
HB1905
· 2 mentions in chapter, agenda
Matched: “HB1905 Lundstrum TO CREATE THE BUYER BEWARE ACT; AND TO REQUIRE A…”
|
TO CREATE THE BUYER BEWARE ACT; AND TO REQUIRE A REAL ESTATE LICENSEE REPRESENTING A … | Lundstrum | Died in House Committee at Sine Die adjournment. |
|
HB1949
· 2 mentions in chapter, agenda
Matched: “HB1949 Schulz TO ADD MEDICAL, EMERGENCY MEDICAL, AND AMBULANCE SER…”
|
TO ADD MEDICAL, EMERGENCY MEDICAL, AND AMBULANCE SERVICES TO THE LIST OF PROFESSIONAL SERVICES FOR … | Schulz | Died in Senate Committee at Sine Die adjournment. |
|
HB1955
· 2 mentions in agenda, chapter
Matched: “…estrictions designating areas as 'Members and Staff Only'. HB1955 S. Meeks TO REPEAL THE SHIELDED OUTDOOR LIGHTING ACT. HB195…”
|
TO REPEAL THE SHIELDED OUTDOOR LIGHTING ACT. | S. Meeks | Died in Senate Committee at Sine Die adjournment. |
|
SB331
· 2 mentions in agenda, chapter
Matched: “…TO AMEND THE LAW CONCERNING THE INVESTMENT OF STATE FUNDS. SB331 G. Leding CONCERNING COVERAGE FOR GENETIC TESTING FOR INHER…”
|
CONCERNING COVERAGE FOR GENETIC TESTING FOR INHERITED CANCER MUTATIONS; AND TO CREATE THE GENETIC TESTING … | G. Leding | Died in House Committee at Sine Die adjournment. |
|
SB480
Act 739
· 2 mentions in chapter, agenda
Matched: “SB480 K. Hammer TO AMEND THE LAW CONCERNING THE INVESTMENT OF STA…”
|
TO AMEND THE LAW CONCERNING THE INVESTMENT OF STATE FUNDS. | K. Hammer | Notification that SB480 is now Act 739 |
|
SB519
Act 958
· 2 mentions in agenda, chapter
Matched: “…ION, AND STATE-OWNED PROPERTY; AND TO DECLARE AN EMERGENCY. SB519 J. Boyd TO AMEND THE STANDARD NONFORFEITURE LAW FOR LIFE IN…”
|
TO AMEND THE STANDARD NONFORFEITURE LAW FOR LIFE INSURANCE; AND TO REGULATE THE PAYMENT OF … | J. Boyd | Notification that SB519 is now Act 958 |
|
SB544
Act 775
· 2 mentions in chapter, agenda
Matched: “SB544 M. Johnson TO AMEND THE ARKANSAS PHARMACY BENEFITS MANAGER…”
|
TO AMEND THE ARKANSAS PHARMACY BENEFITS MANAGER LICENSURE ACT. | M. Johnson | Notification that SB544 is now Act 775 |
|
HB1159
· 1 mention in chapter
Matched: “HB1159 J. Richardson TO CREATE THE RETAIL CONVENIENCE STORE SECURI…”
|
TO CREATE THE RETAIL CONVENIENCE STORE SECURITY ACT; AND TO REGULATE SECURITY MEASURES AT RETAIL … | J. Richardson | Died in House Committee at Sine Die adjournment. |
|
HB1177
· 1 mention in chapter
Matched: “HB1177 M. Brown TO AMEND THE ARKANSAS FRANCHISE PRACTICES ACT; AND…”
|
TO AMEND THE ARKANSAS FRANCHISE PRACTICES ACT; AND TO CLARIFY THE APPLICABILITY OF THE ARKANSAS … | M. Brown | Died in House Committee at Sine Die adjournment. |
|
HB1308
· 1 mention in chapter
Matched: “HB1308 Steimel CONCERNING UNFAIR PRACTICES RELATED TO RESIDENTIAL…”
|
CONCERNING UNFAIR PRACTICES RELATED TO RESIDENTIAL REAL ESTATE REPAIR CONTRACTS; AND TO REGULATE SOLICITING RESIDENTIAL … | Steimel | Recommended for study in the Interim by the … |
|
HB1408
· 1 mention in chapter
Matched: “HB1408 Pilkington TO ALLOW QUALIFYING PATIENTS OR DESIGNATED CAREG…”
|
TO ALLOW QUALIFYING PATIENTS OR DESIGNATED CAREGIVERS TO PURCHASE MEDICAL MARIJUANA USING A FLEXIBLE SPENDING … | Pilkington | Died in House Committee at Sine Die adjournment. |
|
HB1811
· 1 mention in chapter
Matched: “HB1811 Steimel TO AMEND PROPERTY AND CASUALTY LAW; AND TO REQUIRE…”
|
TO AMEND PROPERTY AND CASUALTY LAW; AND TO REQUIRE REASONABLE PROOF OF PAYMENT OF A … | Steimel | Recommended for study in the Interim by the … |
|
HB1950
· 1 mention in chapter
Matched: “HB1950 Torres TO PROTECT LICENSED FAMILY CHILDCARE HOMES FROM TERM…”
|
TO PROTECT LICENSED FAMILY CHILDCARE HOMES FROM TERMINATION OF HOMEOWNERS INSURANCE COVERAGE; AND TO PROHIBIT … | Torres | Recommended for study in the Interim by the … |
|
HB1956
· 1 mention in chapter
Matched: “HB1956 S. Meeks TO CREATE THE ARKANSAS NIGHTTIME ENVIRONMENT PROTE…”
|
TO CREATE THE ARKANSAS NIGHTTIME ENVIRONMENT PROTECTION ACT. | S. Meeks | Died in Senate Committee at Sine Die adjournment. |
|
SB420
Act 736
· 1 mention in chapter
Matched: “SB420 Hester TO EXPAND ELIGIBILITY FOR WATER DEVELOPMENT STATE PR…”
|
TO EXPAND ELIGIBILITY FOR WATER DEVELOPMENT STATE PROGRAMS; TO AMEND THE WATER AUTHORITY ACT; AND … | Hester | Notification that SB420 is now Act 736 |
|
SB481
Act 779
· 1 mention in chapter
Matched: “SB481 Gilmore TO CREATE A MORE SUSTAINABLE SYSTEM OF PROPERTY INS…”
|
TO CREATE A MORE SUSTAINABLE SYSTEM OF PROPERTY INSURANCE FOR PUBLIC SCHOOLS, STATE-SUPPORTED INSTITUTIONS OF … | Gilmore | Notification that SB481 is now Act 779 |
|
SB483
Act 957
· 1 mention in chapter
Matched: “SB483 Irvin TO REPEAL CERTAIN REPORTING REQUIREMENTS FOR THE STAT…”
|
TO REPEAL CERTAIN REPORTING REQUIREMENTS FOR THE STATE INSURANCE DEPARTMENT AND THE STATE SECURITIES DEPARTMENT; … | Irvin | Notification that SB483 is now Act 957 |
Machine transcript
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- October 2, 2026
Representative Bart Schulz
Unverified
0:15
and proceed with your bill, please. Representative Bart Schultz, District 28, Sharpstone, Lawrenson, Independence Counties. Committee, I ran a bill very similar to this 2 years ago that we passed unanimously out of the house, but our friends in the city Senate, uh, decided not to let it out. We made a few changes, uh, but basically what this is,
Speaker 5
0:33
To give you a little backstory, I spent 12 years on a quorum court previous to being here. And I also am in the ambulance business. Well, I always had a
Representative Bart Schulz
Unverified
0:45
quandary. If a county has a contract. With an ambulance service. If they put out bids for this ambulance service, it is strictly lowest bidders. That's all they can look at. Whoever's the cheapest. Well, if you want somebody taking care of your family, do you want the cheapest or do you want the best? That was the way I always looked at it. So when I got down here, some folks brought this idea to me. Currently, if a county Submit for contracts for Financial services,
architectural services, engineering, construction management, land surveying. Or professional consultant services. They go through an RFQ process. All I'm proposing with this bill. is we change ambulance services over to this same RFQ process as all these professional entities. And with that, I would answer any questions. We do have a question, Representative Baker.
Representative Sonia Eubanks Barker
Unverified
1:46
Yeah. Thank you, thank you, Professor Schultz, for bringing this to us, um, how does this kind of relate to our current procurement process because I've kind of run into my own troubles and understanding how we procure or review procurement for contracts with EBD, so what's kind of the how this would change or is the current procurement process still? Well, thank you for that question. How
Representative Bart Schulz
Unverified
2:11
it currently works is With all these other entities
that I named, you ranked the top 3123. And You go to number one. And you negotiate a contract. If you can come up with a fair negotiation, that's the end of it. Number one gets it. If that doesn't work, you go to number 2, repeat the process, then the number 3. So we would just be adding ambulance services to that same. Process. Thank you. Any
Speaker 13
2:42
further questions from the committee? saying none to anyone in the
she's like in the audience who would like to speak against this
Representative John Maddox
Unverified
2:50
bill. And anyone that I speak for this bill, saying no one you're recognized to close for your
Speaker 15
2:55
bill, representative. I'm closed for my bill and I would
Speaker 1
2:58
appreciate a good vote. What a motion do pass by Representative Ladyman, all in favor say aye. I say no. Congratulations, you've passed your bill. Thank you committee. Representative Wardlaw. Thank you for your patience. I That's
Representative Jeff Wardlaw
Unverified
3:19
I have no patience. When it comes to you represent Maddox. I just see hearts and flowers.
Representative John Maddox
Unverified
3:54
be found. OK, thank you, members. So my My remembrance of this matters that we were, you presented, um, and we were now in the 4 and the against, um, so I believe we are now in the The next is a 4, is my recollection. So the next one I think would be Steven Webb. Um, 4.
Speaker 1
4:25
And if there's Certainly do not have to. If anyone who wants to join
Representative Jeff Wardlaw
Unverified
4:31
him, that's fine. So, Mr. Chair, I, I think what we'll do. I If
you don't mind, let's, let's hear all the against first, and then I'll calculate how many of the 4 we need to hear from because there's no reason to hear from all the hospital administrators that are here. I just would put on the record that we have a number of them here to speak in favor of the bill. I don't want to belabor
the time of the committee, uh, by possibly hearing some of the same things over and over. If that's amenable to you. I do appreciate that.
Representative John Maddox
Unverified
5:01
So what I'll do, I don't know if we'll do it exactly that way, but we'll go to the against now. Thank you. So the next one on the against. I think
Speaker 24
5:12
they've decided to pull um That Why don't we, why don't we just
Representative John Maddox
Unverified
5:26
go back to Blue Cross. Blue Cross, why don't you go back to the end of
Speaker 1
5:44
the table? Thank you. Thank you. And go ahead and just briefly introduce yourselves again, please.
Speaker 26
5:49
David Manne's Arkansas Blue Cross. Alicia Birkmeyer, Arkansas Blue Cross. Thank you. So
Representative John Maddox
Unverified
5:54
members, most of you were here, but some of you
had left and they were in the midst of taking questions. I want to make certain that any member has a
question for Blue Cross, has the ability to, to ask that question. So if you have any, um, now would be the time to ask it. Where
Representative Sonia Eubanks Barker
Unverified
6:14
Baker. Thank you, Mr. Chair. Thank you both for being here. Um, just for clarification. Who are you representing today with, with your testimony?
Arkansas Blue Cross. OK. Um, so I guess my first question is if um This is something where you guys are helpful in giving us data on how this will impact you're helpful and. Articulating how those Cost impacts will happen, um, so I guess if, if you're position is that these will just pass through. To the end user. I guess why Why do you have a position on this? Mm
Speaker 29
7:02
That's actually a, a, a very good question. Um, so last
Speaker 31
7:08
year we had 125 small businesses drop coverage. And those small businesses did not pick up coverage anyplace else. For, for Blue Cross. You know, we're here to, we, we were established by the Arkansas
Hospital Association by the Arkansas Medical Society and by Farm Bureau. And, and our mission is to Sorry. Our mission is to serve all three of those. And so in order to have a working Healthcare system. We need a, we need a payer. The only other payer beyond commercial is government.
And so, um, what we see happening in the market is a move toward a single funded. Healthcare payer system where government is the only payer. Um, our job is to figure out how to balance those three, try and have affordable health insurance rates. But also have a system that works for people. So We have 3200 employees.
That rely on the health care system. I lost a little brother to cancer. And Arkansas Children's Hospital did their best. My dad About 4 weeks ago. Had quadruple bypass surgery. And fortunately, he's recovering well. But we would not, I mean, we, every one of our employees have stories like I do.
It's our employees. It's their immediate family members. It's their, their, their parents, their aunts and their uncles and cousins that they love them. If you add all that up, it's about 50,000 people. That's, that's affected. And so our mission is to serve everyone, and so that's why we're testifying. Follow it. Thank you. That, that's,
Representative Sonia Eubanks Barker
Unverified
9:31
that, that's very helpful. That helps clarify a lot of the motives because again when I when I see that, you know, the, the playing
field is leveled and you guys serve as the in between. It kind of begs the question like, you know. Where's your position in this, um, you know, I heard you say that for a functional healthcare system, it has to have a functioning payer, but also we would agree that it also has to have functioning providers. I mean, it doesn't matter how cheap it is if there's nowhere to go. Right, and so I'm sympathetic and I appreciate you sharing that and thank you for your answer. Baker. Any further questions?
Representative Robin Lundstrum
Unverified
10:11
Is in lustro recognized. Thank you. You mentioned that Blue Cross is helping our hospitals and
doctors with increased payments. Can you elaborate how you are helping them with that? I'd be
Speaker 39
10:25
happy to talk a little bit where we've discussed Arkansas Blue Cross and Blue Shield along with other payers partnering with Medicare. We have been really invested in increasing the value-based reimbursement and trying to bring additional payments outside of just fee for service. So looking at both quality, cost, utilization and partnering with the hospitals. I briefly
mentioned earlier that many of the hospitals in the state, we work collaboratively with those hospitals, meeting on a regular basis on a population to truly look at the metrics. What we see is working in that collaboration with our clinical teams, with executive teams, actuarial teams, really seeing some good outcomes through those. There there's been um many incentives have been received through those hospitals through some of those collaboratives and the risk arrangements we've had both upside and upside and downside shared risk opportunities. I
actually got a text just recently from one of the doctors, a primary care doctor, that talked about since we've been in invested in these value-based programs. back to 2012, that the incentives and the bonuses that are receiving had quite grown, and he was very pleased with the
Representative Robin Lundstrum
Unverified
11:29
program. Um, one question, I understand hospitals negotiate for these fee services or for the payments. Are y'all helpful in those negotiations? Do you participate in the negotiations, right, thank you.
Representative John Maddox
Unverified
11:44
Thank you. Um, I do have a question. I, I have some clarification
just for me, so Um Before we broke, you were talking about the increase in premiums that, that could occur if this passes. I just want to make certain that we're, had you seen the amendment where it only has to be at the 45% for January of 2026. I, I wanna make sure you'd
seen that and that was still accurate and correct. If you could just talk about that for a moment,
Speaker 31
12:10
yeah, so I actually spoke with Representative Johnson after
Speaker 29
12:15
our, um, after our meeting and um after
Speaker 31
12:20
the first part of the meeting. The way we read the language, it seems to It seems to us that the language says that If whatever the reimbursement rate is for for the average state that we would pay 45% of that in year one and then pay that out separately. If I understand correctly the way maybe it's intended from
Representative Johnson is that Instead of that, it would be whatever the average rate is for from the around the surrounding states if you are 45% of that, uh, and above, then you wouldn't pay it. Um, so I think that I'm not, you know, I think, you know, he, I'm not sure if that's the way it, you know, if that's what it's intended to be.
Representative Lee Johnson
Unverified
13:16
Representative Johnson would, I would say I'm not the bill sponsor. I would have to defer to the bill sponsored for intent, the way I read the bill is 45% of the minimum reimbursement level. For the first year, which would be the minimum reimbursement levels defined in the in the bill, if I understand correctly, and that's created through this process that the commissioner sets through RAND, so the way I read that bill is, yes, it would be 45%, which I think is what is related to the testimony that was given that would said, hey,
you know, the at this particular point, only a small percentage of carriers are paying less than that amount. I think that's the intent, wouldn't
Speaker 31
13:57
you agree? I don't know what the intent is when I, when I read it, we, we read it differently if, if that's the intent, it doesn't look like it would provide any meaningful reimbursement. Go ahead. If I could have a follow-up question, were
Representative Lee Johnson
Unverified
14:10
you here when I asked, uh, Mr. Ra, that question, if that
Speaker 50
14:17
would help hospitals, and he said indeed it would. So,
Speaker 31
14:23
you know, so when you and I had the conversation afterward, um, I think, you know, so we're the largest payer, right in the state. And so if it's at 45%, that wouldn't. Affect us as a pair. So I,
Representative Lee Johnson
Unverified
14:37
I guess I have a question. Do you know what the average commercial rate
Speaker 31
14:44
is? So I think in order to find the commercial, the average
commercial rate the way that we read the bill, it's looking at each, each of the codes. So there are thousands of codes, And so, You know, it's an average rate for each code, so you're asking, it sounds like what you're asking is, do I know the average rate for each
Speaker 49
15:04
of those codes and I, I guess, I guess my question is if you're going to
Representative Lee Johnson
Unverified
15:09
make a reasonable expectation of what premium increases would be. The only way I think you could make that is if you at
some point through your actuaries made an accurate assessment of what the average rate was and then
applied that across the board based on the original draft of the bill, which was 85%, 95%, 100%, um, I don't see how you. can't, I don't see how you can make that calculation if you don't know what the average commercial rate is, I don't know it. I just Do you know, do
your actuarials know that? Did they calculate that when they were looking at the they went, they
Speaker 47
15:42
went through the bucket of codes and then made an estimate from there,
Speaker 31
15:47
and that's what they provided me with and then their
interpretation was how I explained it earlier, which is that You take the average rate. And you know, to get us up to that point, we would only pay 85% of that the first year, which was that big number. But if it's calculated separately, we'd have to go back and really dig into the numbers a lot further to do
Speaker 29
16:12
that that whole calculation differently. OK, so that, that was kind of
Representative John Maddox
Unverified
16:22
my, my question I ask you is if the premium increases you were discussing, were reflective of the amendment at 45% and I guess it's gonna take you
some more time. You got some more time to go back and look at it again because I, I guess
Speaker 31
16:37
you've learned now the intent is different. Is that accurate? It, it seems to be, um, and, and again, I didn't have an in-depth conversation with our actuaries when we went back, but um, it sounded as if If it's at 45%.
And then I was at 55 and then 65 and 75 that it might not have any meaningful revenue impact. From the payers that we, that, uh, from our folks until maybe year 4, that that makes sense to me, Representative Johnson. So
Speaker 1
17:08
does that mean it wouldn't would also not
Representative Lee Johnson
Unverified
17:10
have any impact on premiums. That's correct. So you your testimony at the moment is based on the bill's current draft, it wouldn't
Speaker 49
17:17
have any effect on premiums, which means there will be no revenue to all of our rural hospitals that we're trying to
Representative Lee Johnson
Unverified
17:26
help. I don't know that that was the testimony from the hospital association that we don't know if we don't know what the average If we don't currently know what the average reimbursement rate is, I think it's hard to say whether it's going to be revenue net positive or not, it wouldn't be revenue net positive maybe for Blue Cross Blue Shield, but for some carriers, it sounds like it might be.
Speaker 31
17:47
You don't know the rates for United or other carriers, correct? So we're the, we're by far the largest, uh, carrier in the state other than Medicare and Medicaid, and so our our premiums are based on
what we're going to be paying out. And so if we're not going to be paying out, then we wouldn't increase. the premiums.
Representative John Maddox
Unverified
18:05
Thank you. That was, that was kind of the issue I was trying trying to get to. I appreciate that. It sounds like y'all are gonna have to
Representative Jim Wooten
Unverified
18:15
go do some more work and I apologize for that. But any further questions from the committee repston? Uh, Mr. Man, you, you gave me a number of uh $3,00011 that the premium would increase. In other words, it
would be upwards of 20,000. Is that correct? That's correct. Now, now. If I calculated it correctly, it'd be 130045. If it's 45%. So, so
that number that I gave
Speaker 31
18:45
you was based on how we calculated at 45% based on the previous understanding of What that 45% meant.
Representative Jim Wooten
Unverified
18:59
So the 3,011 is based on the 45%. It was, yes. Thank you, Mr. Chair. Thank you. Any, any
Representative John Maddox
Unverified
19:04
other questions? I thank you committee, and thank you for your testimony. The next
person signed up to speak against is Randy Zook. With the state chamber, sir, we all know you, but if you don't
mind, just introduce yourself and who you're with for the record and proceed
Speaker 64
19:38
with your testimony. Thank you, Mr. Chairman. Randy Zook with the Arkansas State Chamber of Commerce. Once again in this committee and others, I find myself on both sides of the issue because I've got members on both sides, at least two sides of the issue. Providers as well as insurers but also especially employers
and employees who pay the bills. Um Somebody earlier said I might be called Mr. Doomsday or referred to people that talk about doomsday effects of these bills. I guess I'll have to wear that title. Uh, let me make a couple of comments and then be happy to take any questions if there are any, uh, in our view, and this was heavily debated at length by our executive committee Friday
morning, so some of the numbers and everything might be a little bit different, but I think we can. At least talk about worst case or or try to mitigate the impact of some of it. HB 1930 in our view, proposes mandating minimum reimbursement levels for health care providers in Arkansas. Although the bill tends to address low reimbursement rates. The language in the bill would cause a significant increase in health care costs for employers,
employees, and self-funded health plans, including those operated by private businesses and nonprofit organizations. It's a cost shift of unreimbursed or unaccounted for revenue loss, uh, due to Medicaid and, and, uh, uh, Medicaid reimbursement rates that are out of whack, but it's a cost shift of those. Um, those avoided revenues to to employers and employees.
If enacted, HB 1930 would have broad and costlier consequences across the state. Private employers and employees and this again, I don't know how. This number may be a little, little bit fuzzy at this point, but we were told that private employers and employees could see a 30% increase in insurance premiums. Now, with the amendment to 45% on the reimbursement, let's just say it's a 20% increase in insurance premiums and this was provided
by I don't want to put words in their mouth, but they very large insurer, probably the largest insurer in Arkansas.
Speaker 66
22:16
So that, that amount now talks that that's now getting to
Speaker 64
22:21
about $1000. Per year for every employee and every employee's dependents who are on their health insurance plans. $1000 call it $100 a month just for round numbers per life.
Applying $1000 to various employee groups, the size groups, the total increase for, for a company that has 10,000 covered lives, that's employees and dependents. This would be a $10 million cost to them. If they have 100 lives, that would be 100,000 lives. I mean, $100,000 per year for our little group at the state chamber office we've got about 25 covered lives and our costs would go up by about $25,000.
That's a couple of $2000 a month to a group of 10 or 12 employees and their dependents. This is real money. This is not just a marginal amount. Now, with the changes and the phase in and all of that, maybe it mitigates the impact and maybe it softens the low for a while, but every one of your companies in your districts and every insured individual, whether they're an employee or a dependent of an employee is gonna feel this in
their pocketbook. A family of 4 would see an annual premium increase we've heard already of about somewhere around $3000. I think that's kind of low based on what we were told earlier. These increases could, and I would say will result in the abandonment of self, some self-funded health plans or benefit cuts at the least. Private businesses and nonprofits will be forced to absorb higher costs, making it harder to provide affordable
coverage to their employees. Some smaller firms we've already heard a number last year without this cost pressure, 120 something small businesses threw in the towel and quit providing group insurance for themselves and their employees. Smaller firms will stop providing health care coverage. This will be a cost shift. This is a thinly disguised tax increase.
At best by any other name. You might call it the Medicaid tax. Rather than strengthening the health care system, HB 1930 risks undermining it by making Arkansas less competitive for business investment, job creation, and talent retention. And while the state chamber and AI support improving access to healthcare, obviously, and totally a state level cost shift is not the right approach. We
are trying to solve a national federal problem with state policy. It's a hill too. It's just a bridge too far. So with that, I'd be happy to take any questions. I just want to stress the point that We are all for more money for the hospitals we're all for everybody getting paid, everybody, but, but it can't just be covered by private group insurance and private health insurance payers with
Half or more of the population. And now with the EBD carve out and the higher ed carve out, even fewer uh people uh are left to pay this this tax, this, this. Bill Well that don't have to take any questions or Thank you, Mr. Zuck, for your for your testimony. There are
Representative John Maddox
Unverified
26:02
a few questions if you're happy to take
some. I'll try. Representative Johnson, you're first in the queue. I'm, I'm just trying to understand the math again. I
Representative Lee Johnson
Unverified
26:16
mean, those are big statements, big numbers. I don't know that anybody's told me what the average commercial rate is. I don't see how you make these calculations without understanding what those are. I mean, it's, I think it's pretty bold to come to the table and spout large numbers without like somebody showed me the math, how it works. I'd like to understand better. Currently based on this legislation with this amendment, it's hard for me to see those big price increases and just do you have evidence to say say that it's going to be the, the ballpark numbers that you're
shooting, or is this just numbers you were given by somebody else. Numbers I was given by somebody else. And do you know how they came to those numbers? I have no clue. So
Speaker 32
26:57
you don't know if they're accurate, not accurate. You don't know what they based it on. It,
Speaker 72
27:05
it was our insurance cover, our provider, and they gave us the number. Representative Viewbanks. Question. Thank you,
Representative Jon S. Eubanks
Unverified
27:10
Mr. Chair. Mr. Zuck in council last year, we sent out tens of millions of dollars to hospitals to
Help them survive, and I don't know that your employers are going to have much success if we don't have hospitals in the state, you know, I, I don't know. What the correct answer is, but I know it's imperative that we have that, that health care available in the various communities around the around the state and I think you know that too. Somebody's going to have to pay for it now. We're going to have to do it one or two ways. I either we're going to have to,
you know, uh, maybe reach into GR and do it, or we're going to try to have to spread it around and You do understand the need for the hospitals in
Speaker 64
28:03
our communities around the state without question, and we recognize that availability of health care is one of the most critical problems facing communities across the state, especially the eastern third, the Delta region. I grew up in southeast Arkansas. In fact, a couple of the hospitals that are probably here to support it or in my home
county of Deshay County. My dad's name is on a wing of one of those hospitals, so I get it about the need for hospitals and small communities, but we can't just put all of the cost on just the private employers and the private employees of those companies in those in those areas. So it's got to be a broader spreading of this cost in our view.
Speaker 13
28:50
Representative Wootton, you're next for a question.
Representative Jim Wooten
Unverified
28:56
Thank you. Mr. So, yeah, you've come to the same conclusion or your group has come to the same conclusion regarding the federal level and the involvement there, which has to be dealt with, which they will not deal with. So what, what do, do you, do y'all have a suggestion relative to how we deal with this mess at this point, no,
Speaker 64
29:18
I wish we did. I wish we had, I wish we had, I guess our, our suggestion would be Spread the costs over a greater
Representative Jim Wooten
Unverified
29:27
portion of the population. Follow up you're the 2nd person that has used the 20%, 25% increase this year, which would be $1000. And if I understood, Mr. Mann correctly. That would mean that it would be 8, about $18,000 a year for a family of 4. So what, what does
that equate to in your group, in the commercial end relative to the group
Speaker 64
30:02
policies. Our our little group is, we've got about 25, maybe, maybe a few more, maybe 26 or 7 lives for a dozen employees who were covered. A couple of us are not, we're on Medicare. Uh, as primary provider, um, but our, our monthly bill is just shy of $14,000 a month. And if that goes up,
I don't know, 1520, 25%. That's a A couple of $2000 a month at least. And I, I don't see it. Our group is at ages, as most groups do, the older your employees become, the more the the
Representative Jim Wooten
Unverified
30:43
premium goes up. So you, your membership understands the the problem that we face, we do. Don't.
Representative John Maddox
Unverified
30:50
Thank you. Representative Eaves, you are right for a question. Thank you, Mr. Chairman.
Representative Les D. Eaves
Unverified
31:01
Brandy, when you read the bill, do you see That at least the way I read it, it seems like we're excluding Any insurer that provides services to the state, so that's going to be a whole bunch of people. We're excluding any plans purchased on the marketplace and we're excluding plans uh provided by a trust. So I'm kind of agreeing with you, I guess. It seems like we've shifted the entire burden of solving this problem onto the backs of mostly private industry. Is that how you read it or am I missing something?
Speaker 64
31:32
That's exactly how we read it, and it's, I mean, you've carved out EBD employee benefits division, so all the state employees are carved out. The federal employees, the largest 2nd largest employee group in the state. They're not covered by this, and then I understand higher ed has been carved out, so there's another probably 100,000 lives. Uh, so you're getting it down to a pretty small pool of of pears.
Representative John Maddox
Unverified
32:03
Thank you, Representatives. Any other questions for Mr. Z? Thank you for
Speaker 64
32:06
your testimony, sir. Thank you very much, and you really have my deepest sympathy in trying to figure this out and if we can be helpful, we'll certainly
Representative John Maddox
Unverified
32:15
try. Thank you for your testimony. We appreciate you. Uh, Jack Hopkins, you'd like to come to the table and introduce yourself and who you're with, and you can proceed with your
Speaker 84
32:28
testimony on this bill. Thank you, Mr. Chair. Jack Hopkins with Qual Choice Health Insurance. I'll keep my comments brief, but
I wanted to touch on a couple of the questions the committee had for the two previous witnesses first Representative Acer, of course, insurance doesn't exist without a provider network, right? And I think that some of the conversation was left out is that um we need our providers to form a network and that's how the market works and that's how we negotiate rates to that end and the questions around whether the the that system is working. I think that it's important. for me to testify, excuse me. To that end in the last 15
months of the seven major health systems in the in the state that represents over 33 hospitals. We've been renegotiated with all with all 7 or all 6 of the 7 we're in the process of the 7th right now, so, um, to the question of Representative Lindstrom and somewhat Representative Eubank's question of whether the system's working. We feel it's moving in the right direction. Has it solved all of the issues of all of our hospitals? No, but I want to dissuade the idea that that that payers are specifically us are remaining. stagnant and not addressing the needs of hospitals. We're moving
in the right direction, even up to the last 15 months of increasing reimbursement on average to our hospitals. Uh, additionally, um, you'll notice in SB 527 in our home program we're also increasing the medical loss ratio from 80% to 85%. So even on that program, which we are a part and so is Blue Cross. We're increasing the mark to reimburse our providers on that. Uh, one further question I think was um what uh what the impact is and how we arrived at our
numbers. So for us, we took the RAND report, we took the average of all the 7 states that are listed, both inpatient, outpatient, and physician rates, and we took the RAND report averages and ran them against our own encounter data. Not premium increase, not margin for the health insurer just pure medical unit cost increase for our plan, which is much smaller than Blue Cross and United, but just for our plan, we see 30% cost increase just based on this language. I, I also want to point out that
to the point of the bill, yes, Arkansas on some of those services are lower than our surrounding states. However, it doesn't take into the full consideration of the market conditions for each state and now Arkansas stands out, how our market is different than Oklahoma, Texas, Mississippi, Missouri, and Tennessee. Additionally, what that ran report and what our own numbers show is that our primary care physician rates are actually higher than most all those states except for Tennessee and Texas. So when you're looking at this, it's not just about one service versus the other,
Chair
Unverified
35:00
it's the whole gamut. Um, with that, I would take any questions. Thank you, Mr. Hopkins. Any
questions? Represent Becker, you're recognized. Thank you, Mr. Chair. Thank you for, um, I,
Representative Sonia Eubanks Barker
Unverified
35:13
I appreciate the perspective and I know that you're offering a perspective kind of statewide because Qual Choice represents a statewide program. I think the concern comes in where you have smaller hospitals where you have smaller provider groups and networks that don't have the ability to leverage. And they get left out. So again, if you're a good actor, which. We have all the evidence he provided here that you are.
We thank you for that service. When we hear stories of UnitedHealthcare kicking out Baptist or Conway Regional or Carti, um, those are large groups, right, that even when they struggle with the capacity to serve patients who have paid into a program and can't find a place to go, that's where this problem comes here for us to solve, so it's not. A reflection of the efforts that you guys have made. It's a reflection of you have a disproportionate amount of leverage across the state with an equal level of necessity for care.
Speaker 84
36:08
Wouldn't you agree? I could be sympathetic to it and and I can't answer for each contract negotiation of all hospitals in the state of Arkansas. I think the main point was that this, the notion that nothing is being done or that we're not moving in the direct in the correct direction is different than what we see in the field. Thank you. Any other questions from the
Speaker 1
36:29
committee? Thank you. Is there anyone else? There's no one
Representative John Maddox
Unverified
36:35
else signed up. Is there anyone else who like to speak against this bill.
OK. My understanding is numerous CEOs are gonna come up at the same time to try to keep this moving as opposed to Calling them one by one. So, um, it's just unfortunate at the end of the session, we are in the time constraint, and I apologize for that, but, uh, that's how we're going to handle it. So whoever's going to speak, once you
get seated, introduce yourself and who you're with and you can proceed with your testimony. Mr. Chair. Yes, sir. I'd like to introduce all the
Representative Jeff Wardlaw
Unverified
37:15
CEOs present before we do that, if that's possible, sure. So members we have with us today, Brian Thomas from Jefferson Regional in Palm Bluff. If you would stand it or wave every time. We have Chad Addo and Angie Longing from CHI Saint Vincent. We have Matt Troop from Conway Regional. Along with Matt, we have Rebecca Fincher. She's over there. We also have Ron Peterson from Baxter Regional. We have Steven Webb from White River.
We have Terry A shot from McGee. He's mine, by the way, and he's Randy Zooks just for the record. You know, it's all fun and fair and games. We have Jeremy Capps from Delta Regional from Dumas. Thank you. Also one of man. We have Jay Quebec from Baptist Regional who represents all small hospitals, um. Around and we have John Hurd who I almost forgot from Lake Village, and I'm sorry. He's
also one close to me. With that, you can see that we brought and asked for a whole wide range of CEOs from across the state. So with that, Mr. Chair, I yield
Representative John Maddox
Unverified
38:27
to the members that are going to speak. OK, thank you, but before we do one correction, it's Jay Qhibido. Um, he used to be mine, so I just want to clarify his last night. So, uh, you gentlemen can introduce yourselves and proceed with your testimony. Good evening.
Matt Troop
Unverified
38:43
My name is Matt Troop and I serve as CEO of Conway Regional Health System. Um, it has been a long day, but
Speaker 88
38:49
I think it's important to go back to 8 hours ago when we first gathered in this room and we heard a discussion about athletics and the desire to have a level playing field, um, an opportunity for athletics to be able to compete at a level with states in the area and at the competitive level to be able to have NIL funds really what this is about is about fairness. It's about a fair and equitable rate here in State of Arkansas and the data is the data. The data quite clearly shows that we are the
most poorly paid state in the country. Let that sink in. We are the most poorly paid state in the country. We have the highest incidence of hospitals at or near closure because of the financial performance of their health care systems, so um we can debate the impact on premiums. I think it's rather a fascinating discussion, the way math works. If 162% is the average commercial rate then well over half, potentially 50%, at least if it's a if it's an
even distribution, half of all employers will have absolutely no effect. by this bill, by the decision you make here tonight and the decision subsequent and when it when it gets voted on. The other half will be impacted, um, those hospitals will become stronger. One of the many hats that I get to wear in my community is I, I, I'm chair of our chamber of commerce. Um, every time we bring a new business into Conway. Every time we try to recruit someone into our community, health care is is typically top 1 or 2 items that
we talked to them about, um, and more and more it's becoming difficult to provide for our patients, for our growing community, not just here in Conway, but, but for others as well. This notion that the market has moved, um is a is a fallacy. We don't see the increases in premiums that are talked about, um. across the state. We don't see those premiums commensurate. And this notion that the market can kind of take care of itself in Arkansas is also a rather fascinating discussion
at Conway Regional in 2023, we terminated United. We went out of network for about 7 weeks. That decision cost us millions of dollars, millions of dollars in uncovered care, um, hours and hours and hours. I can't explain to you how many hours, not just of my time and my team's time, but hospital team trying to find care for patients, patients that were left in a lurch. Um, nobody wants to go to a termination with a pair. The thought of terminating a pair that has 70+% market share in the commercial
world would be catastrophic to the hospitals that certainly that I represent in the hospitals behind me. So this notion that we can just negotiate it out it isn't isn't based upon fact. The fact of the matter is we're in a situation where the rates are unequal with the worst paid state in the country. We have more hospitals at financial distress than any other hospital or any other state in the country, um, and this notion that it's going to impact premiums is just, I mean, we can speculate all day long,
look at the data. There's a 10% delta from high to low on premiums. Between Arkansas and the surrounding states, 10% high to low on average premiums. The average reimbursement to hospitals goes anywhere between 35% to over 50%. Somehow Mississippi can figure this out. Somehow Mississippi can have rates, premiums that are actually lower than Arkansas and yet pay their hospitals 50% more. I think we're smart enough to figure that out, and
Matt Troop
Unverified
42:22
I think our employer community working with hospitals can figure out
Brian Thomas
Unverified
42:26
how we can decrease utilization to protect cost.
Thank you, sir. You can proceed. Thank you. My name is Brian Thomas. I'm president and CEO at Jefferson Regional in Pine Bluff, and Matt did a great
Speaker 93
42:43
job explaining kind of the dynamics of where I think all of our CEOs are coming from, but I thought I'd give a personal testimony of what's going on in the Delta area with, with Jeff Jefferson Regional and Southeast Arkansas. Uh, first of
Brian Thomas
Unverified
42:57
all, I've been there for close to 20 years. I've been in healthcare for close to 30, and, you know, right now there are challenges in Arkansas, and I
Speaker 93
43:05
would say Health care is certainly um escalated to the top of that list in most of our markets. Uh, we currently have close to 30. It's debatable, but at least 30 of our facilities are on the verge of closing. Uh, we've heard some of that testimony earlier. Financial losses have become the norm and our balance sheets have been decimated. As an example of our facility
just since COVID-19 in the last five years, we have lost money on operations consecutively every year. Last year we posted a negative 10% operating margin, uh, no representative Ferguson's heard my spill in our hospital directly a couple of times, but that's that equates to about a $20 million operating loss. We've improved that significantly through a lot of advancements with our cost cutting and other advancements, but we're still finding ourselves upside down. Our cash reserves have gone from
a strong 300 plus days cash on hand, uh, with the intent of investing in our infrastructure for the future. We've got a building that needs a lot of work, but however, we've had to dip into those investments and draw out to be able to fund our operational losses, uh, we're currently, we've gone from 300 days cash on hand now to 160 days cash on hand, which I know a lot of hospitals would love to have, but we're needing that money to fund a lot of our investments for our future for our campus. We find ourselves now Relying on subsidies such as the provider provider assessment
taxes and things like 340B just to make ourselves survive, and I think every CEO would, would agree with that. The circumstances were certainly not created by Arkansas. We all talked about Medicare and things like that, but there are some things that we can address, and I think this is the first time and I come in Representative Wardlow for actually bringing something that's actually useful and can make a difference for our hospital. I appreciate that very much. You've heard about our commercial commercial payments. I won't spend a lot more time on that, but the facts are the facts, and I think Matt did a great job
explaining that, but post COVID, Our facilities, all of our hospitals across the state have seen a skyrocketing cost increase of probably in the neighborhood of 25+%. We're not able to go recoup that from anywhere else, so unlike the coffee shops and the restaurants and the retail, we can't simply pass that cost on because negotiating with our payers and our friends at the payer side, if you want to call that negotiation is very, very difficult and it's been very, very challenging. But if you've heard countless times our
neighboring states. are certainly paid at a much higher level of services for the exact same rates in many cases right across that state line. Some of our states are across the country are reaping as much as 3 times what we're paid from the commercial level. 3 times what we're getting paid and the bill you addressing this evening is simply taking those average rates of our neighboring states and getting as close to half of that, half of that average, so it seems like a very
um mild way to kind of get into that neighborhood of increasing our premium or ability for get getting better payments here. Uh, we recently as a hospital engaged to national firm called Kaufman Hall. They are nationally known for coming in and helping hospitals looked the way to improve. operations and performance. I want to bring a couple of quotes that we're going to report that we got from them. One was that Jefferson Regional is operating its facility at the top of the game with regard to its staffing levels and and negotiating supply chain management services.
This hospital cannot cut its way to prosperity. We found this very interesting, and so did our board of directors. Long-term survival will only come by way of significant improvements with reimbursement and commercial payments. The bottom line is that hospitals can no longer lose money for healthcare. In fact, we're not just losing money, we're subsidizing healthcare in our markets. So let that sink in our health, our health care systems are subsidizing services, not only for the, for the government payers, but also now for the commercial payers, and I think
that's a big deal. Um, we certainly as a hospital support this bill. We appreciate the leadership of Representative Wardlaw and other officials that brought this forward, and I would leave you with this, uh, just 5 years ago. I know everyone quickly forgets what COVID was like, but when COVID-19 hit, we were Really faced with something we'd never seen before in our lifetimes. I'm not sure our health systems would be able to sustain that if we had another pandemic next week, next year, if we couldn't get better
support with our reimbursement plan, so I appreciate the opportunity to be here tonight and speak and uh thank
Representative John Maddox
Unverified
47:47
you for your consideration. Thank you for your testimony. Before we, oh, I'm sorry, did you? No, if you, if you want to go ahead, go
Speaker 96
47:55
ahead and introduce yourself and I'm sorry. No, you're fine. I'm Angie Longing and I started my nursing career at, uh, as a labor and delivery nurse over 30 years ago in Morton, and today I serve as their president, so I took the president role, um,
this past fall and um, you know, since that time, you know, I've come to understand that that, that hospital means everything to the community. Um, we're one of the largest employers. We provide high quality care, great patient experience. Incredible employee engagement. Last year we were named one of the top 100 critical access hospitals in the nation. We achieved pathway to excellence, which is a national nursing excellence designation,
the first and only in the state of Arkansas. So Even though all of these achievements we're at risk as our financial performance has declined over the past several years, and our future is not sustainable. Over the past 5 years, salaries and benefits alone are up 36%. As a result of the nursing and, and staffing shortages locally and across the nation. So even though Saint Vincent Morton experienced these large increases in the cost of
providing care. Our revenue from government and commercial payers has not even approach approached the cost of inflation. In fact, it is down 5% for the same period with the same volumes. So we went from having a slot income that we could reinvest in our facility. To losing $2 million.02 years ago. And over $4 million last year. So now we're looking at services that we have to cut or close. And we're questioning, can we remain a hospital?
The cost of health care is going up, and we've absorbed those increases. But we must have relief with increased reimbursement to remain viable. Thank you for your consideration. Thank you. Thank all of you for your testimony we do have
Representative John Maddox
Unverified
50:02
a couple of questions. I have one for Mr. Troop, just to make sure that I understood you, and I may not have, did you
Speaker 1
50:08
say Mississippi's premiums are less, or did I misunderstand that? Yes, they're about $100 less
according to a Northwest Arkansas study. It's in my notes I can we know about the reimbursement issue, but your testimony
Representative John Maddox
Unverified
50:24
is their premiums are also less. That's uh yes, based upon that study. Thank you. Thank you. There are a couple of questions, Representative Richardson.
Representative R. Scott Richardson
Unverified
50:34
You are next. Thank you, Mr. Chair, and thank you guys for being here. So I just want to follow up, ask a question earlier today about hospitals not paying or not charging the full amount that they're supposed to. Can any of
you give me examples of when any of you have done that? Is that happening in
Matt Troop
Unverified
50:58
your hospitals and what's the cause for that? So Uh, makes me giggle, um, no, not that I
Speaker 88
51:02
know of. Now there are occasions where there may be an error in a in a charge. Maybe we didn't charge for something that might result in a, in a bill going out that was the lesser of, right, the lesser of charge versus the contracted rate, uh, that a payer may, may pay. But what I would submit, what's
illogical to me is if they wanted to pay the higher of the allowable charge versus the actual hospital charge. We be OK with that. Um, it's kind of illogical to say that the solution to this is to charge more. Let's all go back to our communities and talk about hospital charges and that we need to charge more. That that's a, that doesn't make any sense to me. It does happen. It does happen in error sometimes, um, but, but that's a contractual term that we'd love to see change if this body wanted to take action on that and say that
they must pay the higher of, but that's not what we're here to talk about, but that, that's um and it's a very minor issue
Speaker 1
51:57
in the grand scheme of things, I would say as well. Thank you. Representative Representative McGrew.
Representative Richard McGrew
Unverified
52:04
Do you have a question? Yes, thank you, Chairman and thank each one of y'all for the services y'all provide with. It's, it's very important to our communities and I can sympathize and understand the fact that there's not enough money there. The question I have is, is, is what Uh, was brought up with Randy
and Les Eaves that we're not spreading this. Uh, to state employees to higher ed and all that. I, it seems, and we talk about fair and level that doesn't seem fair and level to me. So what is your statement on that as far as it, it not being spread to those other. all the other people. It seems like to me the, the weight on small business and private. Private people is tremendous. My daughter came to me. She, she,
her and her husband have 2 kids. They're paying a tremendous amount for health insurance. She's got a tumor on her hip and it's, it's financially killing them, so a 20, 10%, a 5% increases is terrible on her, but My question to you is, why, what do you feel about it not being spread equally across all our Kansas instead of targeting private business and And maybe that's something that
you can get on closing, Jeff, that they don't, but that's a, that's a concern. I wasn't here
Speaker 13
53:35
earlier. I was in another committee. Thank you, Representative Wootton. You
Representative Jim Wooten
Unverified
53:40
are next with a question. Thank you. First of all, I want to recognize Ms. Longing, everybody else was recognized. She is a Badger, former student and uh in BB so we're proud of her.
My, my question is of either one of the three of you or whoever. We're faced with a real problem, which, which you know better than most. You hear Mr. Zook's comments, Ramsey's comments, relative to what it will do to industry and commercial rights and all that. And we've got to come to grips with it. And the one way to come to grips from your standpoint is to raise
the reimbursement that you're receiving at the hospital level, which we recognize and see, but the back, the downside of that is we're faced with the dilemma of what it does to the taxpayers and to the policyholders of the state of Arkansas. Do you, what, what has Mississippi done that's so different from What we have done, or we could do. Representative Woo, and I would
Brian Thomas
Unverified
54:59
suggest that we really don't know all those facts, and we certainly are going on some assumptions
Speaker 93
55:03
based on the payers that premiums would have to increase. That is an assumption. Other states have clearly figured this out, and I'll echo what Mr. Troop said earlier, surely we can figure this out in the state of Arkansas because our rates are right there in line with the other adjacent states near us, but we've got to figure out how we can get our hospitals and our health systems better reimbursed. But we're
Speaker 107
55:25
not going to have a health system in the state of
Representative Jim Wooten
Unverified
55:30
Arkansas for very long. Well, that's what the point you want to be a part of the solution. We want to be a part of the solution, and so I'm asking you, and you're telling me that you don't know what the other states have done. With, with regards to what they're they're passing regards to the dilemma that we're in, if, if Mississippi has a better program than us or Tennessee. What, what have they done that we're not doing or what have we overlooked or what have we missed. to ask the insurance
Matt Troop
Unverified
56:01
Yeah. I, I'll give you my best answer to that, and I think it's, it's multifactor multifactorial.
Speaker 88
56:09
One of the reasons our rates are so low is because we're largely a rural state and that's that's something we share in common with, with other states. Um, what I think is unique and I come from a perspective of having worked at 4 other states in this country. I've worked in Texas, Oklahoma, Florida, and now, now Arkansas. Um, no other state has a um a market concentration on the payer side
like we have here in Arkansas, um. And also, no other state has as many independents, community-based hospital-based systems like we do. So I think it creates a market environment where we just, it's hard to negotiate rates, rates tend to stay low, um, and as providers we want rates to stay low. We want care to be available and accessible to our, our patients and our community, um, I, I don't know, I can't get into the ins and outs of of Mississippi
healthcare, um, but my, my speculation is It's, it's an economic issue between how their, their payers are structured, um, and their market dynamics of how many providers there
Representative Jim Wooten
Unverified
57:13
are in the market. So You're saying that it's like we have 3 million people
in the whole state and Houston has 11 million, 10 million, so. This in equity as it relates to the spread of the wealth is what
could be contributing to our situation. Could, could, could be, um, they,
Speaker 88
57:40
they have um as providers, more occasion to negotiate rates. At higher rates than we do here in this state. As I said before, the, the thought of taking on a a pair over rates and taking that to contract term is a reality that as hospitals we can't afford to take. I think as Mr. Thomas said, with COVID, um,
I think we would be challenged to take on another pandemic. We'd also be challenged to take on another payer and go to term where, um, we couldn't take care of patients and so um I don't know that those other providers, those other states have
Representative Jim Wooten
Unverified
58:20
that same That same truth. Well, I agree with Representative Hug Banks up. We, we poured. Millions and millions of dollars from the federal government that came into Arkansas. I was in one meeting of the ALC where we
spent $40 million in one. Swerve To help the hospitals, 10 million went to White County and the rest of it came down here to a Baptist, I think, but We We're trying to find a solution and this apparently with representative Warla's assistance. This has been what we've come up with.
Is the problem that we've we've exempt so many from being involved, is that affecting us? And I'll probably pay for asking that question, but, but I mean, you talk about the number of people, and then we talk about exempting x numbers. So somewhere in there there's got
to be a balance. You know, I would answer
Brian Thomas
Unverified
59:32
your question maybe a little differently than
maybe what you're asking how you're framing it. I think if we were going to solve the entire complexity problems of health care, we would be here for a
Speaker 93
59:44
long, long time. I'm not sure we can do that, but this is the first step in the right direction of something that's really substantive that can actually take a step and again an average of all the neighboring states reimbursement at a lesser rate than even 100%. That is a very small step in the right direction. And it is the
very first step of that anybody has made to help the hospital systems in Arkansas, so again, I commend the efforts of all the people that have put this forward, but this is the first step in the right direction that's giving any of our CEOs for your health systems, a glimmer of hope that we've got some prosperity out there to at least improve the situation and the pathway that we're on. Nothing else brought forward before. has even suggested and even Representative Wardlow mentioned earlier in his testimony that
really we're not able to throw money at hospitals and solve anything for a long-term perspective. That's the worst, probably the worst investment, although our hospital would have loved to get some of that money ourselves. That's probably the worst investment for the state of Arkansas to continue to throw money at hospitals. This is the first step towards a solution and being mindful of what we can do to put things in place that in our opinion are reasonable for the state of Arkansas and for the payers as well as the, the employers that are paying the bill.
Representative Jim Wooten
Unverified
1:01:10
Well, I'm the first to say it's not a democratic problem or
a Republican problem. It's a Washington DC problem that should have been dealt with by the federal government years ago. That's all I've
Representative John Maddox
Unverified
1:01:22
got to say. Thank you, Representative. Any further questions from the committee? OK. Representative Baker, your name. Thank you, Mr. Chairman.
Representative Sonia Eubanks Barker
Unverified
1:01:31
Uh, I really appreciate you guys being here and um, you know, I've I've heard some discussion about how, how we've limited the pool, but I think it's important to show
that you guys each have your own health, employee health benefits, right? And I don't imagine that any of you, I mean, we've heard underutilization or drop of coverage. I can't imagine you guys wanting to drop coverage for your own employees. No, and I can't imagine you wanting to limit that employee's use of that plan in any way, right? Right, and so I think it's, it's very telling that you're saying we don't see we're an employer too, like we're not just pulling from the system or participating in it as well, so I appreciate you guys being
transparent with that and I really appreciate what you do for your communities as well. Sergeant Johnson
Representative Lee Johnson
Unverified
1:02:19
question, appreciate that. Yeah, so I, I have a lot of questions, I guess I'm gonna try to limit it just because of time. I want to understand some of the things that were said better. One of the questions I have is around rates. So I assume that you go through negotiations on rates with payers, correct? How, how often and what percent are you getting increases in rates over the last, say, 5 years or 10 years. Is that something that happens every year that you get
Matt Troop
Unverified
1:02:44
a rate increase is that how often is that happening? It varies by pair, uh, traditionally, we meet with each
Speaker 88
1:02:54
pair, um, go over market conditions, things going on in our hospitals, salary rate increases, supply chain drugs, that kind of stuff. Um, with, with some payers, it's a polite listening and then, you know, frankly we get, we get told what's going to happen. Um, and sometimes that's a, that's a mix of a little bit on outpatient services, for example, and a little bit on
inpatient and um they take away in other areas, um, so it, it varies by pair. It's really not until you get to a point of, of, like we did in um August of 2023 where we terminate a payer, can we really get anything substantive Medicare. is going to do anything between 1 and 2, 3%, maybe tops. Um, it does get to be kind of complicated because those aren't just, you know, across the board increases, um, they're they're selective and sometimes they,
they give and take away, um, so it's, um, it, it varies, but I, I can say this without doubt, we don't see rate increases at the hospital being commensurate to what we hear premium increases being that that is definitive and so it varies year by year. Um, but, uh, and by pair, but, but clearly on average it's, it's nowhere near what we see in our premium increases. Mr. Thomas, I appreciate you laying your cards
Representative Lee Johnson
Unverified
1:04:09
on the table regarding cash in hand. I would think that if I'm looking at all
the men behind you and women here at the table, you're in a unique position compared to a lot of the hospitals in the state. Do you, does anyone here at the table, anyone in front of us, do you have an idea of cash in hand
for payers? Do we have an idea of what their surplus is, their risk-based capital from the standpoint of cost we know. I'm not aware of
that. OK. Um, and then you mentioned, uh, it was mentioned that you might be charging less. How much of your time is spent and again anyone
can answer, working through down coding, working through denial of charges, working through prior authorization processes, things that you know how much effort are you spending? How much time and money are you spending
just trying to get the payers to pay what you feel
Brian Thomas
Unverified
1:05:03
like is appropriately contracted rate. Fortunes. We're spending
Speaker 93
1:05:07
fortunes. We've hired probably in excess of 12 individuals just at our hospital to take on mainly Medicare Advantage plans that are denying payments, um, but
these are efforts that your hospitals are having to go through, and this is not just Arkansas, this is nationwide. But that, that whole experience is its own set of issues. It's, it's a completely different situation, but we're having to expend more resources to defend services already rendered, so keep in mind when people hit our doors, they're getting. care, the law says that we have to do it, but we want to do it out of the nature of our, our missions, but we're having to then go fight for those dollars that have already for services that have already been rendered.
So a significant amount, I bet if we were to add up the FTEs just in the hospitals behind us right here, we're probably in close to proximity of 50 people just in these facilities that are being added that have been added just to go defend ourselves to get paid for services that have already been
Representative Lee Johnson
Unverified
1:06:06
rendered. And you mentioned subsidizing one of the thoughts that I've had, and I don't know if this
is a thought others have had, but if, if you have national payers who are paying claims in all the
surrounding states and paying claims in Arkansas. Is there, is it possible that that we are subsidizing some of these lower premium rates by allowing our rates to be so low. Does that make sense to you at all, or is that a wrong way to think about it? I mean, if, if they're paying certain claim rates in Mississippi, Oklahoma. state lines and they're also paying rates here, let's say like United, a large national company in my mind, if those premiums are being kept low in the other states while their rates are high, the money has to come from somewhere. Is it
possible that we're subsidizing those low premiums in the surrounding states.
Speaker 107
1:06:54
That's exactly what we're saying. Especially in the neighboring communities just beyond our borders. All
Chair
Unverified
1:07:03
right. Any other questions from the committee? Representative Lederman, you recognize.
Representative Jack Ladyman
Unverified
1:07:08
Thank you, Mr. Chairman. Uh, well, I'm totally confused. I mean, we're hearing a lot of numbers and uh I I don't know exactly where we're at on cost, but you know, we talk about the
payers. The true payers are the people out there paying the premium. OK, they pay the insurance companies and then they pay you guys. And I understand we got a problem, and I understand where you guys are coming from, uh, but someone was talking and I had a lot of thoughts here. I won't cover them all because we're short on time, but, um, talk about a level playing field, OK. The problem I see with this is that we're, we're requiring a small population to pay for the problem here. And
We've got a level playing field, you know, I've not worked in state government till I got elected to an office. I worked in private industry and when I look around this table, about 50% of the people sitting here are private workers. They work for private industry. So If we implement this thing and I worked at factories, OK? So if I had an electrician working at a factory, he's going to pay more in premium. If premiums go up, and I can't tell whether they're going to go up or not, but if they do, let's assume they do.
That electrician in that factory is going to pay more. An electrician working out at Arkansas State is not going to pay more. Is that right? That's the way I read it, because this is only for commercial people, not for government. Employees. Well, let me go on. Looks like you can't. Maybe Jeff can address this, but Um In order to increase, to decrease the impact on an individual, we need to broaden
the base. As Chamber of commerce said a while ago, that's one way to do it. Uh, so I, I just don't think it's fair. We took out higher ed because it was too expensive for them. And when I worked in private industry and we would see rates increase and taxes increase and all that. We thought, well, why is government paying less than us working for private business. Primarily it's because I don't know how many private
You know, plant managers or people who own their own businesses are here to talk about their side of this. But I can't support a program when we reduce it to only private individuals and we take out all of government employees. That's not fair. We got a problem that we got to fix. One other thing, and I'll quit, but You know, somebody said, well, Oklahoma, they're they're, we're rural state. Well, let me tell you, Oklahoma is r. They got Oklahoma City and Tulsa and everybody else's rule. And I drove through Mississippi last
week. I got relatives who live down there. It's as r as we are. So if they're doing it right, we're doing something wrong, and I don't understand why we can't figure out what they're doing. Look at all the data and everything that's going on there and figure out what we need to do to match them. I understand it's a national problem, but we ought to be able to get closer to what Mississippi and Oklahoma's doing, so. Yeah All right, thank you, Representative. Any other questions from the committee?
See none. Thank you all for your testimony. Is there anyone else here to speak against this bill? Anyone here to speak for this bill. See none. Represent your banks. You're recognized for emotion. Thank
Representative Jon S. Eubanks
Unverified
1:10:53
you, Mr. Chair. I have a motion to expunge a vote by which the amendment was passed.
That is a proper motion. All those in favor say aye aye, I
was opposed. none. Congratulations. The boat has been poed. We
Representative Jeff Wardlaw
Unverified
1:11:10
have a new amendment with a gramical fix, I shouldn't have mentioned that earlier in the committee, but we did find one
and we wanted to make it very clear of higher end's exemptions. So the amendment fixes the gramical fix and makes higher red a very clear and less broad. All right, I'll give everyone a
Representative Jon S. Eubanks
Unverified
1:11:31
chance to take a look at that, and then I'll take a motion on that motion to adopt. That is a proper motion. All those in favor say aye. All the post say no. Congratulations, your amendment is passed. You may present the bill as amended. Close
Speaker 126
1:11:45
for my bill as amended, please. What will the
Representative Jeff Wardlaw
Unverified
1:11:55
committee. So, Mr. Chair. Um, if, if it pleases you, I can take
questions before I close it. I realize the rules don't allow questions after I close, but I'm ready to close if
the committee's ready for that. You recognize the clothes for your bill. If there are no further questions. So sitting and listening to the testimony today. There's been a lot of argument about who we included, why we included, or why we have the ramp up that we have. So let me walk you through it. We're not putting the whole problem. In this bill. We're not fixing the whole problem with this bill.
Nowhere in this bill are we going to get here in 5 years when the whole bill's in effect and go, oo, we got a bunch of money in hospitals, and that's not true. What we're trying to do here is start a conversation. That fixes hospitals on a long-term basis through funding them on a on a multi everyday basis instead of sending one-time dollars, which is what we've been doing the last 5 years to keep our rural hospitals open. It's not sustainable, folks. You want to talk about sending
it through this group of people or that group of people. If you keep it the way we got it, we're taking it straight out of the income tax dollars and sales tax dollars to the state, and we're going to be sending them a check because there's no more federal reserves coming here like Kazak and ARPA. So we have to address this problem one way are the other. Does it cost money? I started my bill presentation off earlier today with the answer, absolutely yes, it costs money. It has to cost money or they can't pay the doctors, they
can't buy the blood, they can't buy the supplies that it costs to keep the hospital open. Yes, it costs money. Will it cost as much as the insurance company sat here and told you the answer is absolutely no. We know that from last session when we got the impacts from all the bills that were passed last session. They told us when we passed the bill, that Representative Johnson brought the done away with prior authorizations and, and I believe it was a gold card that we called it. It's going to cost this many millions of dollars. We, we never seen a single dollar of
that cost because they do it to scare you guys, and they do it to scare you because most of you guys are not in healthcare. Most of you guys have no idea how healthcare works. If I went and sit here and started talking to you about billing practices and healthcare, you'd all blow your minds because you, you wouldn't even understand why we build an X and we collect Y, which is less than 20% of X for the record. Um, It, it's very confusing. I've been in the healthcare business for 25 years. I sit here and quote it all off to you, um.
But we have to address this issue. We have to address it in a very educational way. The question keeps coming up, why did you exclude EBD? Why did you exclude higher ed. I'll tell you right off why EBD was excluded because I did it before we ever got here. I did it when I drafted a bill. We've already initiated millions of dollars of cost this session alone in EBD. I was scared to death to do that again because our reserves was already getting very, very low. So the reason we went to the 5 year ramp up today is because if
you come back in, you come back in two years from now and include EBD, you will not affect the bill at all because the bill will have almost zero impact by that point. That's the reason we started off at 45% of the average. It was spoke a while ago, Can we protect? The 45% average, so we don't have insurance companies drop that reimbursements to the 45% average. Well, I think the protections that's done through the negotiation of the contracts through the hospitals, and if any hospital signs a contract
for less than that, I, I don't know if we don't need to hire a newstrator and probably the whole administrative staff. Um, so The colleges, the same reason. Um, they can be included next session very easy. This bill, we worked on it for 6 months to get to this point, or I'd have filed the thing at the beginning of the session. It's just been a very tough bill to work on. It's been a very tough process. There's no easy way to come to you and tell you people I've spent money. Absolutely no easy
way. But these businesses in the room that testified wouldn't be in the community's area and if they don't have a hospital because I promise you, and that grain bin and McGee, if that man uses his leg in the bottom of it tomorrow, and he has to go all the way to Pam Bluff or all the way to Little Rock. He's either not going to be alive and he's sure not going to be able to get his leg sewed back on. So we need those hospitals in McGee to stabilize them before they transport. We need that hospital in Dumas. We need those hospitals in Camden in case there's, God forbid, some accident out at the government facilities.
These things have to be there. The choice is now on the table. Do we walk away from the issue for another session, or do we start the conversation to get it addressed. Mr. Chair, I'd appreciate a good vote from the committee. Thank you for hearing it. What's the
Representative Jon S. Eubanks
Unverified
1:16:56
will of the committee? that Well Motion do pass as amended. Representative Ebanks, proper motion. Any discussion on the motion? See none. All those in favor say aye.
All the poll say no. Yeah, I
Speaker 85
1:17:16
have it. Congratulations, you passed your
Speaker 129
1:17:28
bill. Thank you, Mr. Mr. Chair and committee.
Representative Jon S. Eubanks
Unverified
1:17:32
Yeah, right, um, I think we're gonna adjourn here uh we do have further business here but uh I believe uh
Speaker 130
1:17:43
I'm just going off of uh Representative Maddox is a call earlier, so we are adjourned. Yeah
Agenda
REGULAR AGENDA
Number Sponsor Subtitle
HB1295 L. Johnson TO CREATE THE HEALTHCARE COST-SHARING COLLECTIONS ACT.
HB1308 Steimel CONCERNING UNFAIR PRACTICES RELATED TO RESIDENTIAL REAL ESTATE REPAIR CONTRACTS; AND TO REGULATE SOLICITING RESIDENTIAL CONTRACTORS AND TREE CONTRACTORS.
HB1811 Steimel TO AMEND PROPERTY AND CASUALTY LAW; AND TO REQUIRE REASONABLE PROOF OF PAYMENT OF A DEDUCTIBLE TO RECOUP RECOVERABLE DEPRECIATION UNDER PROPERTY AND CASUALTY LAW.
HB1813 Gramlich TO ADOPT THE FAIR AND EFFICIENT TRANSMISSION COMPACT.
SB420 Hester TO EXPAND ELIGIBILITY FOR WATER DEVELOPMENT STATE PROGRAMS; TO AMEND THE WATER AUTHORITY ACT; AND TO AMEND THE USES OF THE CONSTRUCTION ASSISTANCE REVOLVING LOAN FUND.
HB1868 L. Johnson TO REQUIRE AN INSURER TO PAY A FAIR AND REASONABLE SERVICE FEE
DIRECTLY TO A FIRE DEPARTMENT FOR FIREFIGHTING SERVICES BASED ON TIME ON SCENE.
HB1443 Pilkington TO CREATE THE SECOND AMENDMENT FINANCIAL PRIVACY ACT; TO PROHIBIT FINANCIAL INSTITUTIONS AND PAYMENT NETWORKS FROM USING CERTAIN DISCRIMINATORY PRACTICES; AND TO PROVIDE FOR ENFORCEMENT OF VIOLATIONS.
HB1930 Wardlaw TO MANDATE MINIMUM REIMBURSEMENT LEVELS FOR HEALTHCARE SERVICES.
SB480 K. Hammer TO AMEND THE LAW CONCERNING THE INVESTMENT OF STATE FUNDS.
SB331 G. Leding CONCERNING COVERAGE FOR GENETIC TESTING FOR INHERITED CANCER MUTATIONS; AND TO CREATE THE GENETIC TESTING ACT.
SB483 Irvin TO REPEAL CERTAIN REPORTING REQUIREMENTS FOR THE STATE INSURANCE DEPARTMENT AND THE STATE SECURITIES DEPARTMENT; AND TO REVISE CERTAIN REPORTING REQUIREMENTS FOR THE STATE INSURANCE DEPARTMENT.
HB1949 Schulz TO ADD MEDICAL, EMERGENCY MEDICAL, AND AMBULANCE SERVICES TO THE LIST OF PROFESSIONAL SERVICES FOR PURPOSES OF PROCUREMENT.
HB1955 S. Meeks TO REPEAL THE SHIELDED OUTDOOR LIGHTING ACT.
HB1956 S. Meeks TO CREATE THE ARKANSAS NIGHTTIME ENVIRONMENT PROTECTION ACT.
SB481 Gilmore TO CREATE A MORE SUSTAINABLE SYSTEM OF PROPERTY INSURANCE FOR PUBLIC SCHOOLS, STATE-SUPPORTED INSTITUTIONS OF HIGHER EDUCATION, AND STATE-OWNED PROPERTY; AND TO DECLARE AN EMERGENCY.
SB519 J. Boyd TO AMEND THE STANDARD NONFORFEITURE LAW FOR LIFE INSURANCE; AND TO REGULATE THE PAYMENT OF INTEREST ON DEFERRED PAYMENT OF ANY CASH SURRENDER VALUE ACCORDING TO THE TERMS OF THE POLICY.
SB544 M. Johnson TO AMEND THE ARKANSAS PHARMACY BENEFITS MANAGER LICENSURE ACT.
HB1177 M. Brown TO AMEND THE ARKANSAS FRANCHISE PRACTICES ACT; AND TO CLARIFY THE APPLICABILITY OF THE ARKANSAS FRANCHISE PRACTICES ACT.
HB1408 Pilkington TO ALLOW QUALIFYING PATIENTS OR DESIGNATED CAREGIVERS TO PURCHASE MEDICAL MARIJUANA USING A FLEXIBLE SPENDING ACCOUNT OR A HEALTH SAVINGS ACCOUNT.
HB1625 Barnett TO AMEND THE LAW CONCERNING INSURANCE REQUIREMENTS FOR LICENSED HOME INSPECTORS.
RE-REFERRED TO COMMITTEE
Number Sponsor Subtitle
HB1905 Lundstrum TO CREATE THE BUYER BEWARE ACT; AND TO REQUIRE A REAL ESTATE LICENSEE REPRESENTING A SELLER TO DIRECT THE SELLER TO THE OFFICE OF THE COUNTY ASSESSOR FOR THE CURRENT ASSESSED VALUE OF A RESIDENTIAL REAL ESTATE PROPERTY.
DEFERRED BILLS
Number Sponsor Subtitle
HB1659 S. Meeks TO AMEND THE UNIFORM COMMERCIAL CODE; AND TO CLARIFY THE PRIORITY AMONG SECURITY INTERESTS AND ENTITLEMENT HOLDERS UNDER THE UNIFORM COMMERCIAL CODE.
HB1009 A. Collins TO ALLOW PREGNANCY TO BE A QUALIFYING EVENT FOR ENROLLMENT IN CERTAIN HEALTH BENEFIT PLANS.
HB1014 A. Collins TO REQUIRE COVERAGE OF IN VITRO FERTILIZATION UNDER THE STATE AND PUBLIC SCHOOL LIFE AND HEALTH INSURANCE PROGRAM.
HB1409 Long TO AMEND THE LAW REGARDING ENERGY; AND TO CREATE THE ELECTRIC RELIABILITY ACT.
HB1159 J. Richardson TO CREATE THE RETAIL CONVENIENCE STORE SECURITY ACT; AND TO REGULATE SECURITY MEASURES AT RETAIL CONVENIENCE STORES.
HB1354 Lundstrum TO REGULATE PHARMACY BENEFITS MANAGERS; TO AMEND THE LAW CONCERNING THE STATE AND PUBLIC SCHOOL LIFE AND HEALTH INSURANCE PROGRAM; AND TO AMEND THE LAW CONCERNING CERTAIN HEALTH BENEFIT PLANS.
HB1533 Gramlich TO CREATE THE DECENTRALIZED UNINCORPORATED NONPROFIT ASSOCIATION ACT.
HB1950 Torres TO PROTECT LICENSED FAMILY CHILDCARE HOMES FROM TERMINATION OF HOMEOWNERS INSURANCE COVERAGE; AND TO PROHIBIT DISCRIMINATION AGAINST LICENSED FAMILY CHILDCARE HOMES BY HOMEOWNERS INSURANCE PROVIDERS.
Documents
| Title | Type | Pages | Source |
|---|---|---|---|
| Agenda — INSURANCE & COMMERCE- HOUSE, Apr 7, 2025 | Agenda | 3 | Official source ↗ |
Speakers
Representative Bart Schulz
Unverified
Speaker 5
Representative Sonia Eubanks Barker
Unverified
Speaker 13
Representative John Maddox
Unverified
Speaker 15
Speaker 1
Representative Jeff Wardlaw
Unverified
Speaker 24
Speaker 26
Speaker 29
Speaker 31
Representative Robin Lundstrum
Unverified
Speaker 39
Representative Lee Johnson
Unverified
Speaker 50
Speaker 49
Speaker 47
Representative Jim Wooten
Unverified
Speaker 64
Speaker 66
Speaker 32
Speaker 72
Representative Jon S. Eubanks
Unverified
Representative Les D. Eaves
Unverified
Speaker 84
Chair
Unverified
Matt Troop
Unverified
Speaker 88
Brian Thomas
Unverified
Speaker 93
Speaker 96
Representative R. Scott Richardson
Unverified
Representative Richard McGrew
Unverified
Speaker 107
Representative Jack Ladyman
Unverified
Representative Trey Steimel Chair
Unverified
Speaker 126
Speaker 85
Speaker 129
Speaker 130