The SAVE Act solves nothing, the EPA loses its mind, and SB 236 rises from the grave (but gets buried again)

Hoosier Health Matters
Season 2, Episode 7
Date: 2/20/2026
Title:  The SAVE Act is dumb, the EPA loses its mind, and SB 236 rises from the grave (but gets buried again)

00:00- Intro

1:30- The SAVE Act is a dumb bill because voter fraud with current processes is very very rare, as proven by our Attorney General

4:29- The Trump administration no longer thinks Greenhouse Gases can hurt humans

7:48- New study shows that expanding medicaid leads to less breast cancer deaths

8:54- Anti-vaccine groups targeting state-level school vaccine mandates

9:47- FDA reverses decision and will review the Moderna flu mRNA vaccine (and Gabe predicts this)

12:07- Judge reverses public health cuts to 4 states (and the vindictive nature of our current federal government is nauseating)

14:22- SB 91 (syringe service bill) was a good bill, amended to become a bad bill, re-amended to a meh bill

16:50- SB 275 (a bad bill which would allow cuts to home health rates for medicaid waivers) weakened with amendments in committee, is better but still not great

18:00- SB 139 (breastfeeding jury duty bill) continues it's unanimous tear through the statehouse

18:54- SB1 (a bad bill that will kick people off of medicaid and SNAP) to be voted on by the house next Tuesday (call your representative about this one)

19:14- Tracey introduces the word "germane" in discussion the death of SB 236 (a good thing)

22:13- things to do this week: be on alert for action alerts via email and call your rep about SB1

23:14- Wrap up

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Transcript

Tracey (00:00)
Right, right, Banana. Okay. I meant to bananas. know, meant to say bananas. I know. Banana. ⁓

Good Trouble Indiana (00:06)
Wait, did you say banana? Like singular? You said singular banana. Banana. That is a banana.

Hello and welcome to Who's Your Health Matters for Friday, February 20th, 2026, brought to you by the Good Trouble Coalition. I'm Gabriel Bosslett, pulmonary critical care physician and former and founding president of Good Trouble. I'm joined as always by Tracy Wilkinson, pediatrician, health services researcher and Good Trouble board member to talk about all things public health in Indiana, hopefully in 24 minutes or less. Hi Tracy.

Tracey (00:48)
Hey Gabe, I am loving this weather this week.

Good Trouble Indiana (00:51)
I'm sure you are. You know...

Tracey (00:53)
I mean, I'm

only wearing three layers.

Good Trouble Indiana (00:57)
You literally are. You have a vest on. It's like, you know what? It was 73 degrees when I was driving home today.

Tracey (01:00)
and a sweater and a tank top.

I but the sun just feels so good. And walking out without a jacket, I will take it. Even though I know this is the only first spring and we will have a more winter to go.

Good Trouble Indiana (01:08)
Hanna.

Yeah,

It will be a high of 32 on Sunday and Monday.

Tracey (01:20)
I reject that.

Good Trouble Indiana (01:21)
Well, you can, that's fine. Doesn't make it'll be as a difference.

Tracey (01:22)
Ha

So Gabe, let's talk about the news so we can talk about the legislative session because it's been a busy week. But you wanted to talk about the SAVE Act. So I'm going to hand the microphone over to you.

Good Trouble Indiana (01:35)
I do want to talk about the SAVE Act. we've repeated civic health is public health. And I agree with this. And so I want to talk briefly about the SAVE Act. We don't talk for a long time about it, but the SAVE Act was passed in the House of Representatives, the federal House of Representatives. It probably doesn't have a chance in the Senate, but we should talk about

it anyways, because what would the SAVE Act do? Do you know what it would do, ⁓

Tracey (01:57)
No, I'm wondering if you could

tell me what it stands for.

Good Trouble Indiana (02:00)
Damn, good question.

Tracey (02:00)
I don't, I don't,

Good Trouble Indiana (02:02)
so the SAVE Act stands for the Safeguard American Voter Eligibility Act.

So here's what the save act does. The save act would require that in order to register to vote.

you have to physically present to an election officer either your birth certificate with your official name or your passport.

if you're a woman who changed her name with her marriage, you'd have to present your marriage license. So yes. So right now we have a system in which you register to vote. can do it online. and you have to attest, at

risk of perjury and felony that you are a U S citizen. This act would mean that you have to present birth certificate or your passport to someone in person.

Tracey (02:45)
This is insane.

Good Trouble Indiana (02:46)
This is insane.

Good Trouble Indiana (02:47)
Here's how know this is insane. In 2024, attorney general Todd Rokita asked the department of homeland security to review

Good Trouble Indiana (02:58)
voters in the state that he marked as high risk for being non-citizens. These were people who like didn't have some of the documentation or were abroad or other things.

Tracey (03:10)
Yeah.

Good Trouble Indiana (03:10)
So

there's a lawsuit about it. don't need to get into that. so they got the results back and out of the 585,000, 165 of them were non-citizens and 21 of those had ever cast a ballot.

Tracey (03:16)
Yeah.

Good Trouble Indiana (03:26)
So that is 0.02 % were non-citizens and 0.003 % had ever cast a ballot. And this is in a high risk pool. So we have to think that in the, the actual full voter roll that you're probably talking about, a hundredth of a thousandth of a percent of people who are non-citizens who are registered to vote in Indiana. This is a non-issue.

Tracey (03:36)
Right.

Yeah.

Yeah, it's like a bill looking for a problem that doesn't

Good Trouble Indiana (03:55)
It's

That's exactly correct. So the save act is a dumb bill that probably won't go anywhere in the Senate, thankfully, but I wanted to point out how dumb it was.

Tracey (04:08)
Yeah, also remember, Gabe, that a lot of bills get proposed that seem like fringe. And then as time passes, as legislation has been proposed multiple times or in different venues, they don't seem so fringe. And they become mainstream.

Good Trouble Indiana (04:24)
Do you know what

Tracey (04:25)
just,

Good Trouble Indiana (04:26)
Yep. Yep.

Tracey (04:27)
All right. Let's also talk about environmental health really fast, I do want to flag that the Trump administration has changed a rule. Is that what it was?

Good Trouble Indiana (04:38)
So it eliminated the endangerment finding, meaning that the EPA and the federal government no longer considers gases to be a danger to public health. Therefore, the EPA can no longer regulate them. Therefore, all of the CAFE standards, which have set car manufacturers' efficiency,

standards over the years are null and void.

Tracey (05:06)
That's insane.

Good Trouble Indiana (05:08)
It's insane. so this goes back to Congress writing this law, the clean air act. Okay. And in the clean air act, says, and I'm going to read this, it's not long, but I'll read it anyways.

Tracey (05:13)
Right.

Good Trouble Indiana (05:17)
so the Clean Air Act says the administrator, meaning the APA, shall by regulation prescribe in accordance with the provisions of this section, standards applicable to the emission of any air pollutant from any class or classes of new motor vehicles or new motor vehicle engines, which in his judgment cause or contribute to air pollution.

which may reasonably be anticipated to endanger public health or welfare. That's what's written in the Clean Air Act. So what happened was the EPA read this and they had to interpret this, right? And they interpreted this to mean to include greenhouse gases, which is widely agreed upon contributing climate change, more severe weather, all of these things that lead to bad human outcomes.

the written ruling that the EPA put out last week says the EPA further determines

that greenhouse gas emission standards for new motor vehicles and engines do not impact in any material way the public health and welfare concerns identified in the administrators prior findings in 2009. Meaning greenhouse gases do not have an adverse effect on public health. This is an absurd conclusion.

Tracey (06:37)
Yeah, it's also terrifying the amount of health conditions that are linked to air pollution, Gabe, and what we're going to see for years after this ⁓ as a result of this decision.

Good Trouble Indiana (06:52)
Yeah. And it'll be interesting to see what the car companies do with this because the fact of the matter is the world is moving on from engines. China has electric vehicles all over the world that you and I don't get to drive that are becoming more and more and more popular. There are countries out there where the vast majority of new cars sold are electric vehicles, and this is only going to continue. So if we stay in our bubble.

Tracey (06:56)
Yeah.

Good Trouble Indiana (07:18)
and we continue to develop combustion engine this will have major economic ramifications for the car industry. It's relatively easy to see. So we'll see what happens.

Tracey (07:26)
Yeah.

Yeah, and a few days after this decision was announced, there was a coalition of environmental groups that did file a federal lawsuit challenging this change. And so we'll continue to watch that ⁓ and hope that there might be a legal challenge to stop this change from going into action.

I did want to talk about a national study that was released on breast cancer survival rates because it was really impressive looking at states with and without Medicaid expansion. And what was impressive was that they found that there was a lower overall mortality for breast cancer, no matter disease stage, race or ethnicity or neighborhood income. And so a lot of times we see health disparities.

based on those demographic categories. And so it's really impressive to see a public health idea, which is Medicaid expansion leading to better public health outcomes, which is breast cancer survival rates.

Good Trouble Indiana (08:28)
Yeah, this was a mortality rate improvement of about 5%. That's one out of 20. That's huge. I mean, look, it seems pretty intuitive, right? If people have healthcare, they're going to do better.

Tracey (08:32)
It's... yeah.

Yes, if they're getting screening, if they're doing all these it's always nice to have data when people think that ⁓ it doesn't actually lead to changes in outcomes. OK. Yeah, I know. I know. wanted to talk a little bit about vaccines just because there was a national story that there is work happening with groups that are anti-vaccine mandates.

Good Trouble Indiana (08:51)
Yeah, 100%. It's a cool study.

Tracey (09:06)
focusing on state level requirements for school vaccines. And I just wanted to flag this because I suspect that this will be something that we continue to talk about, and something that everybody should know is being organized more broadly. And we'll definitely start to trickle down to the state level.

Good Trouble Indiana (09:24)
you know, if there are states that tie their school vaccine mandates to CDC guidelines, ⁓ there may be changes coming ⁓ because there are at least four vaccines that are no recommended for all children. And they're recommended under this quote unquote shared decision-making model, which is

Tracey (09:32)
Yeah.

Good Trouble Indiana (09:43)
frustrating use of language, which we've talked about before.

Tracey (09:45)
Well, and speaking of vaccines, I wanted to quickly say that I read a story about the FDA-Moderna battle that we talked about last week where the FDA refused to review their randomized control trial study with over 40,000 participants.

And what I learned was that the company paused phase three trials for other vaccines that they're doing right now, which were vaccines for herpes, shingles, and Epstein-Barr virus. And so that made me really sad, Gabe. These are all viruses I would love to have vaccines for.

Good Trouble Indiana (10:17)
I agree. Do you want me to give you my impression of what I think is going to happen? I think the FDA is going to back down. I think they're going to, at the very least, I think they're going to review these data. Yes. This has been, this has been the, the MO of this health and human services department since this new administration took over. They make these changes. There's a huge public outcry and they backtrack. They did this with NIH funding. They did this with, ⁓

Tracey (10:21)
Sure.

really?

Okay.

Yeah. Okay.

Yeah.

Good Trouble Indiana (10:46)
⁓ What else have they done? Everything, a whole bunch of things. They basically like, you know, move fast and break things, see where people get upset, and then they go back and they repair it. I suspect they're going to review the data at the very least. And I bet that they're going to approve this vaccine, frankly.

Tracey (10:49)
Yeah, yeah.

I mean, I hope you're right because it's clear that mRNA vaccine for flu that they are proposing is going to be available in other countries. And it'll be really sad if we're not able to access it. Yeah.

Good Trouble Indiana (11:14)
Agreed.

Tracey (11:15)
OK, so this is next day, Tracy, coming back and re-recording because moments after we finished recording this podcast, news broke that Gabe was correct and the FDA reversed their decision on the Moderna application for the mRNA flu vaccine. Would you like to speak, Mr. Predictor?

Good Trouble Indiana (11:37)
Yeah, I would. want to thank my family. I want to thank, no, I will say this. Here's what I predict is going to happen. they're going these data. They're going to approve it, but they're going to put some cockamamie asterisk on it for people above the age of 65 because of the issues that, that, that Vinay Prasad had with the trial. But I do think they're going to approve that this vaccine and I think we'll have it for this fall, which is awesome.

Tracey (12:02)
That is good news. Let's hope that all your predictions are correct,

Tracey (12:05)
OK. And then I wanted to just say a story from the CDC that there had been an announcement that they were cutting public health funding for

four states in particular, California, Colorado, Illinois, and Minnesota, ⁓ which was about $600 million in public health funding. And we learned this week that a federal judge has actually halted the stopping of that funding so that the legal fight can continue. But that's a good thing for all these public health programs on the ground.

Good Trouble Indiana (12:38)
Yeah. mean, you, you, I don't, mean, this is, know, our, our government, our, government runs on sort of norms, right? I mean, I think that's the thing that we've realized over the last few years is our government runs on norms on people and, and, and our leaders making decisions with a modicum of good faith and decorum. And, you know, saying that you're going to

Tracey (12:43)
It's very political, obviously.

Yeah.

Good Trouble Indiana (13:05)
block $600 million in public health grants for four states that have governors that are the opposite party and are clearly seen as states that don't align with this administration, is a massive change in norms, right? We, we, we don't hold states, financially hostage by the federal government because those states

Tracey (13:23)
Yep.

Good Trouble Indiana (13:31)
the lab, this laboratory of democracy have chosen to do things differently than what the federal government would, choose. You know, I mean, this is a, you know, a group of humans that are, are all about like states rights, until the states don't agree with them and then they won't give them any money.

Tracey (13:34)
Yeah.

Yeah.

Right, right,

OK. let's switch to the legislative updates. As a reminder, this is the last week of committee hearings. So that means if a bill does not get onto a committee hearing agenda, then it's effectively dead. interesting about this week is Senate health.

actually did not meet. their last committee hearing was last week. And so we were really watching bills that had already been through committee and were on second and third readings, as well as a few bills that were actually in committees this week.

OK, so let's first talk about Senate Bill 91. Because this bill we talked about last week when it was in committee, it had a lot of amendments that fundamentally changed the effectiveness of this bill. And so I wanted to talk about what happened on the House floor because multiple amendments were proposed to kind of fix some of the problems that were brought up in the committee.

Good Trouble Indiana (14:39)
And this is a great example of the way this works. The original bill I was filed in the Senate was a great bill, was a 10 year bill, had really no residency requirements, really no issues. It was amended to make it a really bad bill. Um, two years only a whole bunch of other stuff. And now it's kind of swung back a little bit and is now an okay bill. It's not a great bill, but it's better than it was.

Tracey (15:04)
Yeah, so the first thing that they fixed was kind of expanded the definition of what the residency requirement was. So when it came out of committee, they were requiring that you have to be a resident in the county of the syringe exchange program. They expanded that definition to instead be a county within the state continuum of care, which really gives some more regional aspects to being a resident in a neighboring county that's touching one of the counties with a syringe exchange program.

So good news there. Bad news is they are still requiring a valid identification to be presented at the time. instead of extending these programs for two years, they did get an amendment passed that extended the permission for these programs to exist for five years.

So that's great news because we went from 10 to 2 and 5 is definitely better and it seems like a compromise. then sadly, one of the things that did remain in the bill was the one-to-one exchange requirements. You have to bring needles in order to get needles.

so now we have a bill that's gotten out of both chambers of the legislature, the Senate and the House.

The bill versions that got out of the Senate and the House are fundamentally different. And so it will be up to the bill author on whether there needs to be a conference committee to kind of hash out the final details in the final version of this bill.

Good Trouble Indiana (16:21)
Sort of. So, yes, for the most part, basically what happens is the bill's author can file a motion to concur, meaning I'm fine with those changes, but that motion has to be approved by the full chamber. So in this case, the full Senate would have to agree with the bill's original author in doing that. really, I think they usually do go out with what the bill author wants, especially in the super majority. ⁓ So yeah, it could go to conference committee, but we'll see.

Tracey (16:48)
Yeah. So let's talk about another bill that has moved out of a committee and onto the floor, and that is Senate Bill 275. This is the FSSA Fiscal Matters Bill that we talked about last week that we really wanted to highlight the very short sentence that gave the FSSA director the ability to decrease the reimbursement rate for home health services. Gabe, you testified in opposition to this section of the bill.

And so it left the House committee and went to the full House floor and we had some amendments that made the bill better.

Good Trouble Indiana (17:25)
Yeah. So they did amend this bill. You know, we were concerned about section five B of this bill, which allowed the FSSA director to reduce reimbursement rates for home health services. They left that in, but they sunsetted that to expire June of 27. So a year from now, which isn't great. they did take out the reduction in income limits for those seeking dual Medicare and Medicaid coverage. So that's actually really good.

So overall, I yeah, I think that we did some good with the testimony on this bill. So it could have been better, but I'm proud of us.

Tracey (17:59)
Yeah. Yeah.

So let's talk about SB 139.

This is the bill that was going to permit an exemption for a year for serving jury duty if you were a breastfeeding mother.

was in committee this week, the Courts and Criminal Code Committee. And this bill got out of committee after testimony today unanimously and will be headed to the House floor.

This is exciting because it did get out of the Senate with a unanimous vote, which is pretty unheard of in the state of Indiana to have a bill with that much support.

So we're going to continue watching this bill. And I wanted to give a shout out to Dr. Carrie Rouse, who testified on behalf of Good Trouble Coalition for this bill, and also my friend Emily Wiener, who was a breastfeeding mom, put on a jury, and testified about her real life experience and brought advocacy to the stage.

Good Trouble Indiana (18:50)
Yeah, kudos to everybody. This is a great build.

Tracey (18:53)
Yeah.

Tracey (18:54)
Another bill we want to flag is SB1. It is having its second reading this week in the Indiana House. We had multiple amendments filed, mostly by Democrats, all of which have failed. And the third reading will be next week, which will be the final vote to move this bill.

across the finish line.

Tracey (19:12)
So for the last bill that we're talking about today, Gabe, I wanted to talk about the word germane and how I learned really what it means and how it applies to the legislative session. And I wanted to know if you know what it means.

Good Trouble Indiana (19:26)
I do. Jermaine was the fourth Jackson brother.

Tracey (19:29)
Okay, no, not that germane. We're going to talk about the word that starts with a G. But I looked up the definition of germane and Oxford Language Dictionary says is that it's relevant to a subject matter under consideration. And so why this matters is that during the legislative session, when bills are brought to the full House or Senate floor, amendments can be added to those bills. However,

Those amendments have to be related to the bill and can be deemed non-germane if they are not related.

Good Trouble Indiana (20:02)
Tracy, why is this important right now?

Tracey (20:05)
Okay, it's important right now because bill that we have talked about a lot on this podcast, SB 236, did not receive a committee hearing on the House side, which means that this bill that was going to criminalize the possession of medication abortion, it was going to release terminated pregnancy reports to the Office of Inspector General, and was going to cause a lot of

opportunities for neighbors to report neighbors and be rewarded by a bounty fee, that bill language has turned up as amendments in other bills. Specifically, HB 1358 and HB 1258 had amendments filed with some of the language from SB 236 so that when it got to the Senate floor, people would then vote on those amendments. However,

What we have learned at the time of the recording of this podcast is that both of those attempts to add amendments to those bills were deemed non-germane and therefore the amendments could not be added to the bills.

Good Trouble Indiana (21:11)
Who makes the determination?

Tracey (21:13)
So in the Indiana Senate, that is the president of the Senate. And in the House, it's the speaker of the House makes those determinations.

Good Trouble Indiana (21:21)
So then this was the...

Tracey (21:23)
Senator Bray.

Good Trouble Indiana (21:24)
No, this is on the house side, right?

Tracey (21:25)
No, but these are house bills coming into the Senate floor.

Good Trouble Indiana (21:28)
⁓ yes. So Senator Bray made the determination the language of Senate Bill 236 was not germane to either of the bills that you talked about before. So that bill's dead.

Tracey (21:29)
Yeah, yeah, yeah, yeah, yeah, yeah.

And therefore could not be added.

Yeah.

Good Trouble Indiana (21:42)
forever.

Tracey (21:43)
For now, as of the recording of this podcast, I'm going to say that they're dead. 100 % is going to come up next year. I think they learned a lot, and we learned a lot about the language that might be in this bill, so please stay tuned.

Good Trouble Indiana (21:47)
I mean, it'll probably come up next year, right? mean...

Good Trouble Indiana (21:59)
Wait, Tracy. So is that all the, all the goings on at the state house?

Tracey (22:03)
Yeah, one more week, Gabe.

Good Trouble Indiana (22:06)
and no committee meetings. it's just like the house stuff, or the floor stuff. So, okay. So now's the time where we talk about things you can do this week or a good vibe. What are you going to do?

Tracey (22:09)
Yeah, the floor stuff, yep.

I'm going to do things you can do this week. Be on alert for actions that might be coming from organizations like Good Trouble or other organizations that you follow about legislative things that are happening on the House and Senate floor. Now that there are no committees, there's no testimony, but it's really pushing senators and representatives to vote certain ways now that bills are on the floor.

Good Trouble Indiana (22:42)
Yeah, and those will come fast too, groups like Good Trouble finds out about things with 12 hours notice. So the way that Good Trouble would communicate to you would be via an email. So Look for action alert emails from the Good Trouble Coalition.

Tracey (22:58)
what's your good thing or good vibe?

Good Trouble Indiana (23:00)
Mine is to call your state representative and tell them to oppose Senate Bill 1. It will be voted on in the House on Monday. So a phone call today or Monday would be terrific.

Tracey (23:12)
Yes. So if you enjoyed this episode, please subscribe, rate, and review us wherever you get your podcasts. Also, email us with your thoughts and issues you think we should be covering at GoodTrouble at GoodTroubleIndiana.org. If you aren't already a GTC member, please become one by visiting our website. It's free and easy, and we promise to not overwhelm you with emails. Also, consider becoming a donor. Just $5 a month can help support and grow this work. You can find the links to join and or donate in the show notes.

You can also follow us on all the social media platforms, Blue Sky Facebook and Instagram. Look for our next episode a week from now, which is Friday, February 28th, where we'll continue to discuss health policy happenings at the State House and all other things public health. Thanks again for joining us. Until next time, be safe.

Good Trouble Indiana (23:54)
And be kind.