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“Moving to a mandate instead of an advisory is stepping things up although at least so far, it just seems to be a change in language rather than a change in de facto enforcement," a health care advocate says.

The relentless rise of health care costs, which account for nearly one-fifith of the economy, is a bane to the country, but experts disagree about how to stem them to bring the United States in line with other industrialized countries, which spend far less on health care.

A group of surgical technologists, or scrub techs, pushed House Bill 2876 to require standards for their profession and close a potential gap in patient safety. They’ve been after education and certification requirements for at least 15 years, and now a law is likely to take effect next year.

Sen. Bates said federal match money may be available to expand programs to help providers in rural and underserved communities. Dentures for new Medicaid members will be available Jan. 1, thanks to the lobbying of Advantage Dental. Grants for $10 million will be available to safety-net clinics who serve uninsured immigrant children.