Committee adopts substitute requiring legislative approval for Medicaid expansions, with interim LCC process (Substitute for House Bill 2,240)

The Committee on Government Efficiency approved a substitute for House Bill 2,240 that inserts the contents of Senate Bill 161. The substitute would require legislative approval before state agencies may seek or implement any Medicaid state plan, state plan amendment, demonstration or waiver that expands coverage or would increase state costs.

David Weese summarized the substitute, noting it would add a new section of law to prohibit agencies from acting on such Medicaid changes unless the legislature “expressly consents to such action.” The provision would not affect any state plan amendment or waiver already implemented before July 1, 2025. The substitute also broadened language so the requirement could apply to other public assistance program changes included in prior amendments.

Committee members later adopted an amendment to address how agencies should proceed when the legislature is not in session. The amendment requires agencies to make a formal request to the Legislative Coordinating Council (LCC). The LCC must meet and respond within 14 calendar days. The LCC may approve a waiver, or it may designate a standing or special committee to review the request and make recommendations to the LCC.

Senators expressed mixed views. The chair moved the content substitution and the motion was seconded; a subsequent motion to adopt the LCC time‑frame amendment passed. Senator Holscher said she appreciated the amendment but continued to have “overall concerns with the bill in terms of adding inefficiencies and just impeding the state's ability to respond to potential crises.” The committee voted to pass the substitute as amended.