Vermont Legislature SmartTranscripts:

[Rep. Robin Scheu (Chair, House Appropriations Committee)]: Good morning. This is the House Appropriations Committee. It is Thursday, 05/21/2026. It's 10AM. And we have today, I think, our final three bills. Don't hold me to it, but that seems to be the case at the moment. So we are going to do, right now, S-one 190, which is related to the Green Mountain Care Board and reference based pricing. It's a health care bill. At 11:15, Chair Bayraung and others are coming in with a large amendment to the cannabis bill. So it's just as well we didn't hear it the other day because it's all changed anyway. So now we're going get the bill we will need to vote on. And then this afternoon, there is a committee of conference scheduled for one hundred fifteen in case you're interested in checking that out. I think it'll be fairly short. And at 02:15, we're going to have S-three 23, the miscellaneous ag bill, and we have a couple of amendments, instances of amendment to that bill Nothing as terrifically major, some just verification and corrections as far as I can remember. So in the meantime, we're going to start with S 190, and we have Judge Council, Joanne Fiscal, and Chair Black from the Committee on Healthcare and other assorted vouchers. So I think you're ready to go. So Jen, when you're ready, you can explain what it is

[Unidentified participant (diarization mixed)]: we're Abby doing.

[Jen Harvey (Office of Legislative Counsel)]: Okay. Good morning. Jen Harvey from the Office of Legislative Counsel. And I just sent that separate document to in response to your Zoom link you sent me. That is the other document you can post for now. So we are looking at S-one 190, which is a bill that came out of the House Health Care Committee. This is a strike all amendment. And as I mentioned before we started, I will be flipping between two documents over the first couple of sections because there is a proposal of amendments that will come up on the floor So for you to be able to understand what that is in context, I will share that with you. I just sent it to Autumn, so that will be going up, I think, on your web shortly.

[Unidentified participant (diarization mixed)]: But if

[Jen Harvey (Office of Legislative Counsel)]: you don't see it yet, that's fine.

[Rep. Robin Scheu (Chair, House Appropriations Committee)]: Okay. So we're going to have the bill, we're going hear what the amendment is that they're going be posting on the floor, and we're also going to hear what our amendment is so we have various pieces of Hopefully,

[Unidentified committee member]: we'll do

[Jen Harvey (Office of Legislative Counsel)]: that third piece last because I'm waiting to get it back from editing later. Okay, great.

[Unidentified participant (diarization mixed)]: Yeah, then.

[Unidentified committee member]: So tell me about the amendments from the committee. Or were they going to be in our emails? Or how

[Rep. John Kascenska]: are we going to be

[Unidentified committee member]: able to reference them? Are you going have to put them

[Autumn (Committee Assistant)]: on the screen? I just posted it.

[Jen Harvey (Office of Legislative Counsel)]: Yes, we sent it to Autumn. She has posted it.

[Rep. Robin Scheu (Chair, House Appropriations Committee)]: Okay, so we're going to start with the bill draft three Yes, point

[Jen Harvey (Office of Legislative Counsel)]: with 3.3, which is the full committee report. Okay. And this is S-one 190 as recommended by the Committee on Healthcare. As it came from the Senate, it is an act relating to the Green Mountain Care Board reference based pricing and studying the creation of a public employee health benefit authority. But as with the bill that we went over together yesterday, there will be a title change by the time we get to the end of the bill that takes out the reference to that public employee health benefit authority because that is not in the house that House Health Care's recommended version. We start off dealing with reference based pricing, which some of you may remember from previous discussions, is the idea of having as it's, as it was spelled out in last year's act 68 would have the Green Mountain Care Board establish the maximum amount that hospitals could receive for various services. And so that would put caps on what the money flowing into hospitals from payers in the system. Just to back up, last year we passed a bill to say, let's get started on reference. Exactly.

[Rep. Robin Scheu (Chair, House Appropriations Committee)]: That was step one. This is step two.

[Jen Harvey (Office of Legislative Counsel)]: Step two or step one and a half. So we are amending start up by amending the statute that authorizes and directs the the implementation of reference based pricing. As you can see, the existing law says the board shall establish reference based prices, the prices based on a percentage of a reference that represent the maximum amounts that hospitals can accept as payment in full for items provided and services delivered in Vermont. This is current law, but just reminding you what that looks like. And new language on page two would direct the board to use reference based pricing to reduce hospital prices incrementally until they equal national median prices by hospital type by calendar year 2030 using high quality nonpartisan data showing prices as a percentage of Medicare to evaluate progress toward reducing hospital prices in Vermont to the national median. In the language passed last year, it directed the board to begin implementing reference based pricing as soon as practicable, but not later than hospital fiscal year 2027. Hospital fiscal years run on the federal fiscal year. So that's probably a concept this committee is familiar with, but that starts in October. Fiscal year 2027 starts in October of this year. And so this would require for provider contracts that enter into amended or renewed beginning on or after 01/01/2028. Hospitals and insurers would begin expressing as a percentage of Medicare or another benchmark, if that's what the Board chooses, the rates for items and services identified through a collaborative process between the board and representatives of Vermont hospitals. So this section and this next language we're going to look at is starting to move the way we express prices to using, I'll say, Medicare benchmark price, percentage of Medicare as the benchmark. It may not. We express those prices too. So in this case, it's provider contracts, so hospitals and health insurers. But the next one, starting on line 13, is, that when making public the charges for items and services as required by federal law, so this is public facing, hospitals shall include in their machine readable files pricing information shown as a percentage of Medicare rates as well as actual dollar amounts. It's aggregated by payer and by plan. That's a little more public facing too. Yeah. Right. And then it says for purposes of those two pieces, the provider contracts and the public price transparency, a hospital may express rates as a percentage of Medicare based on the hospital's own experience of Medicare, the hospital's actual reimbursement rates that they receive from Medicare until such time as the Green Mountain Care Board adopts, a meaning establishing the methodology for determining Medicare rates kind of on a standardized basis across the board as a benchmark in establishing reference based price. Then it requires hospitals to apply for, obtain, and use a unique national provider identifier on all claims filed after 10/01/2027, for reimbursement or payment for services delivered at an off campus department of the hospital that is distinct from the one that's used for the main campus of the hospital or any other off campus hospital department. So it starts to become easier to determine where whether services that are delivered through the hospital are being delivered at the hospital or in an off campus site of the hospital. This is, there's a federal requirement that this begin in October, I'm sorry, January 2028. So the original date in the bill had been earlier, but the hospital is asked to put it closer to when they're going to be required to do this to comply with federal law. Sections two and three as passed the House Health Care Committee are the ones that are going to change in the or proposed to be changed in the amendment that we're going to look at. So we're going to look at this language a bit, but then we're going to jump over to the amendment so that you can understand what the the difference is. So we're now in 18 BSA chapter two twenty one subchapter seven, which is the hospital budget review process. And this would amend the subchapter. So doing statutory language here in the amendment, you'll see it's not changing statute. It's just a short term one year session law provision. So this would add a definition of Medicare adjusted base rate. This is what I was mentioning is kind of the future version that is a standardized Medicare payment amount for hospital inpatient, outpatient, or professional service as determined under the Medicare program calculated prior to the application of any hospital specific, patient specific, or policy based payment adjustments reflecting only the core federal methodology used to establish baseline payment levels, which include adjustments for geographic factors such as wages. So this is different from in the first part of the bill, when we said hospitals, for now, you can use your own actual Medicare rates to calculate the percentage of Medicare. This is thinking about using a standardized Medicare adjusted base rate that would be the same across the state, and then the individual calculations would reflect what the specific hospitals percentages of that standard rate are. And then it talks about how to do that a little bit, how to do it for a critical access hospital. Basically use it as though you were not a critical access hub so then we'd have 9,459 would be a new section with limitations on hospital reimbursements for qualified health benefit plans and plans covering school employees Qualified health benefit plans are the plans offered through Vermont Health Benefit Exchange or Vermont Health Connect.

[Rep. Robin Scheu (Chair, House Appropriations Committee)]: Those were the QHP. And this is the group that the federal government eliminated the premium tax credits or some of the

[Jen Harvey (Office of Legislative Counsel)]: So this is so a couple of pieces there. This is the individual and small group are both purchased qualified health benefit plans or two HPs is what we call them for short. But subsidies are only available in the individual market, so part of that market. And the subsidies that or the the premium tax credits that went away were the enhanced premium tax credits available through some of the COVID era legislation. So there are still premium tax credits, but they are back to the regular ACA standards.

[Rep. Robin Scheu (Chair, House Appropriations Committee)]: Okay. But the QHPs is where people who we hear about people's insurance rates went up dramatically. They were in the QHP market, probably. To be fair, there

[Jen Harvey (Office of Legislative Counsel)]: are a lot of insurance rates that are going up pretty dramatically. Yes, But yes, that's the ones that you, I think, that you talk a lot about in this committee and in this building and that you hear about a lot in the news are, yes, are these QHP rates in the individual and small group market. I'm just working off the amendment. Okay, I'm not there yet. So don't work up the amendment yet because I'm not

[Unidentified committee member]: Yeah, go on with the language. However, what I'm asking is the qualified health benefit plans, which seems to be in here as well. Anyway, the point of it is those were the people who had Health Connect subsidies. Is that correct?

[Jen Harvey (Office of Legislative Counsel)]: Those are the people who purchase plans that are offered through Rivermont Health Connect. For individuals with incomes below 400% of the federal poverty level for purchasing qualified health plans, they are eligible for federal subsidies. Okay. So that's a subset different from an FQHC? Is that what you just said?

[Unidentified committee member]: Yeah. Federally qualified health centers.

[Jen Harvey (Office of Legislative Counsel)]: Yeah. That's a different yep. That's a location

[Rep. Robin Scheu (Chair, House Appropriations Committee)]: Different where beach.

[Jen Harvey (Office of Legislative Counsel)]: Right. That's a location where services need to be provided. Not an insurance. For individuals and who was the other Individuals and small groups. Okay. Yes. And last year, you permanently unmerged the individual and small groups. So they are not combined together in a single risk pool. But, yes, we have individuals and small groups who purchase or are eligible to purchase qualified health benefit plans through the exchange. And then we also are talking about plans covering school employees. So these are the, what you may hear referred to as the BIHI plans. These are the plans offered through BIHI. So we have various definitions in here of benefit association that's talking about the Intermunicipal Insurance Association that BIHI is organized under and regulated by DFR. In this version, hospital doesn't mean it means hospitals that are not a critical access hospital or classified as a Medicare dependent hospital under federal law or participating in a specific program, the Rural Community Hospital Demonstration Program through the Centers for Medicare and Medicaid Services. So we're talking about a subset of hospitals in this version. That's going to change in the other. Qualified health benefit plan, we'll call it QHPs for now, has the same meaning as in the statutes on those. Registered carriers are insurers that offer plans through Vermont Health Connect, offer the QHVs, and school employee has the same meaning as is used for the Commission on Public School Employee Health Benefits. So this version addresses fiscal years, hospital fiscal years 2027, 2028, and 2029. And this says in establishing fiscal 2027 hospital budgets, the board, meaning the Green Mountain Care Board, may direct an amount equal to 3.5% of the hospital's combined commercial net patient revenue based on approved fiscal year twenty twenty six hospital budgets. So we're going for 3.5% of a defined pool, a defined amount toward reducing commercial reimbursement rates for the QHPs and the BHIP plans based on a percentage of the Medicare adjusted base rate determined by the board for each item provided and service delivered in Vermont to enrollees in these plans. I'll pause here for a minute to sort of recap this one. This is saying for fiscal year hospital fiscal year 2027, the board can direct an amount, a specific dollar amount that is arrived at in a particular way, to reducing commercial reimbursement rates, for QHPs and BHi using reference based pricing. So this is doing some limited reference based pricing for these plans for hospital fiscal year 2025. Sort of easing in.

[Rep. Robin Scheu (Chair, House Appropriations Committee)]: It's easing in. In other words,

[Jen Harvey (Office of Legislative Counsel)]: not just Yeah. So the Green Care Board has to adopt a rule for rate setting. It has to adopt rules under the Administrative Procedures Act to spell out what reference based pricing looks like. This is starting them off with a defined amount and a defined of defined set of hospitals and the defined set of payers.

[Rep. John Kascenska]: John has a question. Yeah, just real quick. I may jump in with a couple of questions along the way here too, just in terms of the potential impact or predicted impact it would actually have on hospitals. You're gonna talk numbers.

[Jen Harvey (Office of Legislative Counsel)]: Gonna be just on friends. Okay.

[Rep. John Kascenska]: So I just don't know if that was information that was discussed. Maybe that'd a question.

[Unidentified participant (diarization mixed)]: So

[Jen Harvey (Office of Legislative Counsel)]: then for fiscal year twenty eight and twenty nine budgets, again, this is the bill that came out of Addison Health Care. It allows the board again to limit commercial reimbursement rates for QHPs and BHIM plans to not more than the following percentages of the Medicare adjusted base rate for items and services delivered in Vermont to enroll within those plans. So for hospital fiscal year twenty twenty eight, that would be not more than 300% of the Medicare adjusted base rate. And for hospital fiscal year twenty twenty nine, not more than 250% of the Medicare adjusted base rate.

[Rep. Robin Scheu (Chair, House Appropriations Committee)]: So this is how much they can charge?

[Jen Harvey (Office of Legislative Counsel)]: This is right. How much they can get paid by the

[Rep. Robin Scheu (Chair, House Appropriations Committee)]: communities Not and the same thing.

[Jen Harvey (Office of Legislative Counsel)]: Right. We're actually going to get to a portion of that issue with the Unique Bill. And then it directs the carriers and VHI not to reimburse or agree to reimburse a hospital more than that cap that that percentage of the Medicare adjusted base rate set by the agreement and care board for the applicable hospital fiscal year, for any item or service delivered in Vermont to someone who's in a QHP or a VHI plan. And it goes into some of the specifics about if it's not a pay for service basis, then how does that work? Do have a question?

[Rep. John Kascenska]: Yeah. Instead skipping over, define the difference between paid and charged. I think I know. But in the quest I'll ask another question maybe if you

[Jen Harvey (Office of Legislative Counsel)]: Okay. So to give a very sort of blunt example, I would think of it a little bit like car prices where the MSRP is not maybe what you end up paying in the end. So the hospitals have a charge master list of all of their charges, And that is generally a starting off point for negotiations with insurers and others about what percentage of that is actually going to be paid.

[Rep. John Kascenska]: Do they need to get a tax deduction for the rest of the day that they don't get?

[Jen Harvey (Office of Legislative Counsel)]: I don't believe that's how that works. Nonprofits. Right, from their own that's right. Nonprofits.

[Rep. Robin Scheu (Chair, House Appropriations Committee)]: Interesting, though. But so, for example, I had some procedure done, they said their rate was $1,100 and Medicare said it would pay $300 So there's the charge and there's what they're getting reimbursed and then my amount I pay was $30 or something like that. So when you get your explanation of benefits or EOBs, you see all of those numbers and I'm always astounded by what the hospital's charging versus what Medicare is willing to pay.

[Jen Harvey (Office of Legislative Counsel)]: Yeah. You're going to see that specific issue come up at the end of the bill. Okay.

[Unidentified committee member]: So what I hear you saying is that you're using language here like on line two or line four of page seven. You're on

[Unidentified participant (diarization mixed)]: page seven. Yes. See where you are.

[Unidentified committee member]: Is that basically the adjust base rate is really the Medicare payment. I mean, it's not this I mean, right now, it's probably not the same thing. If you're using chargemaster, then they pay you whatever Medicare pays, but you're using the Medicare payment as the goes with the 300%.

[Jen Harvey (Office of Legislative Counsel)]: Yes. And that's the concept of reference based pricing So as should it all just say Medicare payment? No, because each hospital has a different experience of what they actually receive from Medicare depending on the type of hospital that they are. So that is where we come up with this concept of the Medicare adjusted base rate is trying to come up with a kind of a standard, we can consider to be, you know, everybody's using the same numbers as the rate by which to calculate percentages on

[Unidentified committee member]: top. So what I see is that you're taking it, you're decreasing what they're going to get paid, and you go from 3.5% of the net patient revenue, 300% of to 250%, that's a Right.

[Jen Harvey (Office of Legislative Counsel)]: It's not 3.5% their actual medication revenue. But yes, it is. And I think I've heard it's somewhat close to 350% of the Medicare adjusted base rate. So you could sort of find it more helpful to think of it, especially since it's going to be proposed to change completely and what I'm going to show you in a few minutes from Don't

[Rep. Robin Scheu (Chair, House Appropriations Committee)]: get too attached to what we're hearing, Intergol. All right.

[Jen Harvey (Office of Legislative Counsel)]: So we have told the payers not to pay more. On page seven at the bottom, prohibits a hospital who's getting reimbursed in accordance with those provisions from balance billing. They're not allowed to collect more from the patient than except the cost sharing that's allowed under the plan, but they're not allowed to try to make up for what they didn't get based on the percentage of Medicare from the patient. And then it says if a hospital is required by the board's budget order to reduce its commercial reimbursement rates by more than what would be achieved by using that reference based pricing, Then the hospital is directed to reduce its commercial reimbursement rates that are more than 500% of the Medicare adjusted base rate, or if it doesn't have any commercial rates that are more than 500%, then by reducing its commercial reimbursement rates that are the highest in relation to the Medicare adjusted base rate. So the hospital is still supposed to take more money out of its commercial rates than it's directed to focus on the highest ones in relation to Medicare.

[Rep. David (Dave) Yacovone]: I apologize. Could you repeat that for me? The beginning of it was most.

[Jen Harvey (Office of Legislative Counsel)]: Sure. So in their budget orders, the board may direct hospitals to reduce their commercial reimbursement rates. If they're being directed to read, if a hospital is being directed to reduce its commercial reimbursement rate by more than what's going to be achieved, so I have to take more money out of their rates than what will be achieved by using the reference based pricing that they were being directed to do. Some hospitals were being directed to use. Then the hospital's directive from the legislation is to focus on their commercial reimbursement rates that are the highest in relation to Medicare. Anything over 500%, reduce those ones first or anything else that is higher. Thank you.

[Rep. John Kascenska]: Okay, John. So would that be something like that happen due to a periodic review, a once a year review or if they're I don't care where it's tracking this because they get all their information here.

[Jen Harvey (Office of Legislative Counsel)]: Well, do an annual budget. I mean, do an annual budget review and Outside

[Rep. John Kascenska]: of that.

[Jen Harvey (Office of Legislative Counsel)]: This is really in

[Rep. John Kascenska]: mean, all the hospitals put a budget together based on the budget guidelines here that But

[Rep. Robin Scheu (Chair, House Appropriations Committee)]: can prove that at one

[Rep. John Kascenska]: as time goes beyond that, is there something in here that could identify when that check may happen as you just referenced in the language you just read?

[Jen Harvey (Office of Legislative Counsel)]: What would

[Rep. John Kascenska]: Adjusting come commercial rates of a hospital with what they're charging.

[Jen Harvey (Office of Legislative Counsel)]: I think I have to defer to the board on the timing of

[Rep. John Kascenska]: It'd be nice to get that information.

[Jen Harvey (Office of Legislative Counsel)]: They would just have to

[Rep. Robin Scheu (Chair, House Appropriations Committee)]: do it if they're They would probably know right away from the budget orders, right, whether Well, So

[Rep. John Kascenska]: the budget gets approved, hospitals move on with their operations for year. But if there's something that's exceeding what you just referenced and the like, which I mean,

[Jen Harvey (Office of Legislative Counsel)]: I think it's all about complying with their Would that

[Rep. John Kascenska]: commercial rate be reduced?

[Jen Harvey (Office of Legislative Counsel)]: I would presume for the next provider contract, but I'd have to look at, I'm looking to Devin Green from the hospital sitting behind you. So I would I would imagine for the next provider contract, I don't know if you want Devin to weigh in if she has information.

[Unidentified participant (diarization mixed)]: And their rulemaking authority how they're going to do reference to the pricing after 2027. Yes, so maybe doing that through

[Rep. John Kascenska]: '20 That's not over. Yeah, yeah, correct. So when would that happen?

[Jen Harvey (Office of Legislative Counsel)]: When would the rulemaking happen? Well, the rulemaking process is has already I mean, I think they are in sort of preliminary rulemaking now.

[Rep. John Kascenska]: In relation to this?

[Jen Harvey (Office of Legislative Counsel)]: Not in relation to this because this doesn't

[Rep. Robin Scheu (Chair, House Appropriations Committee)]: So we have a representative from the Green Mountain Care Board's organization.

[Unidentified participant (diarization mixed)]: Process that we're talking about that happens once a year, July 1, the hospitals submit their budgets. In August, there's a hearing and by October 1, the board states their orders. Hospitals have the ability and a matter of fact, there's a few right now that are in that process of saying mid year, you just do a BAA adjustment, if they need to come to the board and say, I'm doing their, I need it too low or too high, a hospital can request for an adjustment to their budget. That's a separate process. The reference based pricing piece is in law last year.

[Unidentified Green Mountain Care Board representative]: The Justice was in Act 58 and is in the process of the rulemaking right now going forward. But you also wanted us to start in 2027. And so what you have before you is that measure of the beginnings of it.

[Rep. Robin Scheu (Chair, House Appropriations Committee)]: So there may not be an answer yet to your question. Would Chair Black like to say something? And then I see Dave Sand also go ahead.

[Unidentified participant (diarization mixed)]: I was going to, Elisa Black, I was going to make the point when I do speak, but the impetus for this bill was because we tasked Green Mountain Care Board to end record face pricing of fiscal year twenty seven. However, they have not completed their rule making process yet. So in order for them to proceed and meet our legislative intent and what we did last year in Act six eighty, they need authority from us to begin this reference based pricing because they've not quite completed the rule making process.

[Rep. Robin Scheu (Chair, House Appropriations Committee)]: Which we expected that

[Rep. Alyssa Black (Chair, House Health Care Committee)]: would be the The will have easily been done by FY twenty eight, which you'll see the amendment is just for this year. And that's when this will apply. So maybe we'll keep going and see if some of the

[Rep. Robin Scheu (Chair, House Appropriations Committee)]: questions get answered as we get all of it. Dave?

[Rep. David (Dave) Yacovone]: I apologize, I'll be quick. As a former provider and as a former regulator, trying to strike a good balance. And I'm a little bit concerned because on the one hand we're saying, we're instituting this reference based pricing. We, the government has determined that the reference should be Medicare plus a percentage. But in the part I asked Jen to repeat, it sounds like if the board for some reason wants to reduce further, they have the latitude to do that. And then the provider will go to its highest commercial rates and start reducing them. But is there any criteria anywhere? They just arbitrarily? Maybe it's not arbitrary, but we wanna drive down premiums further, because what I've learned is all sides of it predictability. And the predictability from a system is gone. You can play by the rules and try to do the reference based pricing, but then all of a sudden somebody says, I want more. That would seem to create quite an unstable environment. And maybe I'm digressing from the principles and the purpose of

[Jen Harvey (Office of Legislative Counsel)]: the Certainly a number of speaking of principles, a number of principles that the Green Mountain Care Board are directed to follow in guiding their work. And some of that is that balance between Oh, dear. You need to all go for it?

[Rep. Robin Scheu (Chair, House Appropriations Committee)]: Have no idea what that's about, hang on.

[Rep. David (Dave) Yacovone]: A good charm.

[Rep. Robin Scheu (Chair, House Appropriations Committee)]: Oh, let's see I got something.

[Rep. John Kascenska]: It's not on S-two 30.

[Unidentified participant (diarization mixed)]: S230? X230. What is that? Parenteroinflamming practices. Retinatory, coveted using. Okay. So,

[Rep. Robin Scheu (Chair, House Appropriations Committee)]: is there a place where it makes sense? Can we just finish section two, and then let's go upstairs? And then as soon as we're done voting and of course, we have the last person to vote on our committee, so we'll come down as soon as we start sending them. But let's just finish section two.

[Jen Harvey (Office of Legislative Counsel)]: Briefly, yes, think there are some parameters in place that are supposed to guide the board's deliberations and how they approach hospital budgets and they issue their guidance as well. Okay. And then sort of finally for our purposes in this section, this other piece relates to language in here, but it doesn't relate to the language in the amendment. And it So I will move to this, which is that in its reviews of premiums and the reviewing health insurance proposed premium rates for the QHPs and for VHI, respectively, The Green Mountain Care Board and Department of Financial Regulation are directed to ensure that the limitations on reimbursements in this section are appropriately reflected in the premiums for those plans, meaning this is putting downward pressure on what gets what the carriers, what the insurers pay for QHP for services delivered to QHP and Beehive enrollees. The legislature in this is saying to the regulators, make sure that shows up in the rates. So it may not literally reduce the rates, but it may reduce the growth in the rates below what it would have otherwise been. Is the end of Section seven So zero if

[Rep. Robin Scheu (Chair, House Appropriations Committee)]: you want, you can bring up we can't use our electronics, but you can read the bill while we're up stairs. And there's an amendment from various people on House Health Care. And Audubon posted our amendment to the board, which is a very short one. That's a

[Unidentified committee member]: big one.

[Rep. Robin Scheu (Chair, House Appropriations Committee)]: We're just taking