Amend CSHB 1 in Article II on pages II-75 by striking Rider 
No. 44 and substituting the following:
	"44. Medicaid Reform Waiver. Contingent on findings that a 
Medicaid reform waiver is cost effective and feasible, the Health 
and Human Services Commission shall seek a Medicaid reform waiver 
or waivers from the Centers for Medicare and Medicaid Services.  The 
Medicaid reform waiver(s) should incorporate the following 
principles without reducing the health benefit plan for children's 
Medicaid:
	(a)  efficiently leverage state, local, federal and other 
funding to:        
		(1)  increase state flexibility in its use of Medicaid 
funding;             
		(2)  allow the state to be a more prudent purchaser and 
payer of health care;
		(3)  build on private market approaches and 
insurance-based premiums;       
		(4)  reduce the state's uninsured through private 
market-based solutions and the expansion of Medicaid;
		(5)  promote the transition of consumers from public 
insurance to private insurance.
	(b)  support the increased personal planning and investments 
in long term care needs;
	(c)  support consumer empowerment and choice;]                                 
	(d)  create incentives for healthier behaviors;                                
	(e)  align state policy and financial incentives by creating 
a more transparent, systematic, and efficient approach for 
allocating available funding within the health care system; and
	(f)  solicit broad-based stakeholder input.                                    
	Further it is the intent of the Legislature that Medicaid 
reform waiver(s) recognizes the unique needs of the state's rural 
providers, trauma centers, and primary care residency programs.