Legislature(2013 - 2014)

2013-04-09 Senate Journal

Full Journal pdf

2013-04-09                     Senate Journal                      Page 1072
SB 49                                                                                                                         
SPONSOR SUBSTITUTE FOR SENATE BILL NO. 49 "An Act                                                                               
defining 'medically necessary abortion' for purposes of making                                                                  
payments under the state Medicaid program" was read the third time.                                                             
                                                                                                                                
Senator Gardner moved that the bill be returned to second reading for                                                           
the purpose of a specific amendment, that being Amendment No. 1.                                                                
Without objection, the bill was returned to second reading.                                                                     
                                                                                                                                
Senators Gardner, Ellis offered Amendment No. 1:                                                                                
                                                                                                                                
Page 1, line 1, following "Act":                                                                                              
     Insert "relating to women's health services and"                                                                         
                                                                                                                                
Page 1, following line 3:                                                                                                       
 Insert a new bill section to read:                                                                                             
"* Section 1. AS 47.07.030 is amended by adding a new subsection                                                              
to read:                                                                                                                        
          (g)  The department shall make available to eligible recipients                                                       
     a program for women's health for the purpose of providing family                                                           
     planning services, health screening examinations, and related                                                              
     services."                                                                                                                 
                                                                                                                                
Page 1, line 4:                                                                                                                 
     Delete "Section 1"                                                                                                       
     Insert "Sec. 2"                                                                                                          
                                                                                                                                
Page 3, following line 5:                                                                                                       
     Insert a new bill section to read:                                                                                         
   "* Sec. 3. The uncodified law of the State of Alaska is amended by                                                         
adding a new section to read:                                                                                                   
     WOMEN'S HEALTH PROGRAM UNDER STATE MEDICAID.                                                                               
The Department of Health and Social Services shall immediately                                                                  
prepare and submit to the United States Department of Health and                                                                
Human Services, for approval in accordance with the provisions of 42                                                            
U.S.C. 1396a (Title XIX, Social Security Act), an amendment to the                                                              
state plan consistent with AS 47.07.030, enacted by sec. 1 of this Act."                                                        
                                                                                                                                

2013-04-09                     Senate Journal                      Page 1073
Senator Gardner moved for the adoption of Amendment No. 1.                                                                      
Senator Coghill objected, then withdrew his objection. There being no                                                           
further objection, Amendment No. 1 was adopted.                                                                                 
                                                                                                                                
SPONSOR SUBSTITUTE FOR SENATE BILL NO. 49 am "An Act                                                                            
relating to women's health services and defining 'medically necessary                                                           
abortion' for purposes of making payments under the state Medicaid                                                              
program" was automatically in third reading.                                                                                    
                                                                                                                                
Senator Gardner  moved that the bill be returned to second reading for                                                          
the purpose of a specific amendment, that being Amendment No. 2.                                                                
Without objection, the bill was returned to second reading.                                                                     
                                                                                                                                
Senators Gardner, Ellis offered Amendment No. 2:                                                                                
                                                                                                                                
Page 1, line 1, following "Act":                                                                                              
     Insert "relating to Medicaid funding; and"                                                                               
                                                                                                                                
Page 3, following line 5:                                                                                                       
     Insert a new bill section to read:                                                                                         
"* Sec. 2. The uncodified law of the State of Alaska is amended by                                                            
adding a new section to read:                                                                                                   
     STATE MEDICAID FUNDING FOR FAMILY PLANNING                                                                                 
SERVICES. Notwithstanding any other provision of law, the                                                                       
Department of Health and Social Services shall pay, for additional                                                              
family planning services for eligible medical assistance recipients                                                             
under AS 47.07.020, an amount equal to the difference between the                                                               
amount paid from the general fund for abortion services covered under                                                           
AS 47.07.030 in the 12 months immediately preceding the first date on                                                           
which this Act is first implemented and the amount paid from the                                                                
general fund for abortion services under AS 47.07.030 in the 12                                                                 
months immediately following the first date on which this Act is first                                                          
implemented. The amount paid for family planning services under this                                                            
section may not supplant funds available from any other source for                                                              
family planning services for the same period."                                                                                  
                                                                                                                                
Senator Gardner moved for the adoption of Amendment No. 2.                                                                      
Senator Coghill objected.                                                                                                       
                                                                                                                                
                                                                                                                                

2013-04-09                     Senate Journal                      Page 1074
Senator Gardner moved and asked unanimous consent to withdraw                                                                   
Amendment No. 2. Without objection, Amendment No. 2 was                                                                         
withdrawn.                                                                                                                      
                                                                                                                                
SPONSOR SUBSTITUTE FOR SENATE BILL NO. 49 am was                                                                                
automatically in third reading.                                                                                                 
                                                                                                                                
Senator Wielechowski moved that the bill be returned to second                                                                  
reading for the purpose of a specific amendment, that being                                                                     
Amendment No. 3. Without objection, the bill was returned to second                                                             
reading.                                                                                                                        
                                                                                                                                
Senator Wielechowski offered Amendment No. 3:                                                                                   
                                                                                                                                
Page 1, line 1:                                                                                                                 
     Delete "defining 'medically necessary abortions' for purposes                                                            
of making payments"                                                                                                           
     Insert "establishing standards for payment for abortion                                                                  
services"                                                                                                                     
                                                                                                                                
Page 1, line 5, through page 3, line 5:                                                                                         
     Delete all material and insert:                                                                                            
          "Sec. 47.07.068. Payment for abortion services. (a) The                                                             
     department shall pay a provider for abortion services provided to a                                                        
     recipient of medical assistance under this chapter if the provider                                                         
     submits a completed form approved by the department that                                                                   
     certifies, based on all of the information available to the provider,                                                      
     that the abortion services were                                                                                            
              (1)  provided to a recipient whose pregnancy was the                                                              
     result of an act of rape or incest;                                                                                        
              (2)  necessary because of a physical disorder, physical                                                           
     injury, or physical illness, including a life-endangering physical                                                         
     condition caused by or arising from the pregnancy itself, that                                                             
     would have placed the woman in danger of death had the abortion                                                            
     not been performed; or                                                                                                     
              (3)  medically necessary for reasons other than the                                                               
     conditions in (a)(1) and (2) of this section.                                                                              
          (b)  The department shall seek federal funding available for                                                          
     abortion services provided for reasons specified in (a)(1) and (2)                                                         
     of this section."                                                                                                          
                                                                                                                                

2013-04-09                     Senate Journal                      Page 1075
Senator Wielechowski moved for the adoption of Amendment No. 3.                                                                 
Senator Coghill objected.                                                                                                       
                                                                                                                                
The question being: "Shall Amendment No. 3 be adopted?" The roll                                                                
was taken with the following result:                                                                                            
                                                                                                                                
SSSB 49 am                                                                                                                      
Second Reading                                                                                                                  
Amendment No. 3                                                                                                                 
                                                                                                                                
YEAS:  7   NAYS:  13   EXCUSED:  0   ABSENT:  0                                                                               
                                                                                                                                
Yeas:  Egan, Ellis, French, Gardner, Hoffman, Stedman,                                                                          
Wielechowski                                                                                                                    
                                                                                                                                
Nays:  Bishop, Coghill, Dunleavy, Dyson, Fairclough, Giessel,                                                                   
Huggins, Kelly, McGuire, Meyer, Micciche, Olson, Stevens                                                                        
                                                                                                                                
and so, Amendment No. 3 failed.                                                                                                 
                                                                                                                                
SPONSOR SUBSTITUTE FOR SENATE BILL NO. 49 am was                                                                                
automatically in third reading.                                                                                                 
                                                                                                                                
Senator Wielechowski moved that the bill be returned to second                                                                  
reading for the purpose of a specific amendment, that being                                                                     
Amendment No. 4. Without objection, the bill was returned to second                                                             
reading.                                                                                                                        
                                                                                                                                
Senators Wielechowski, Ellis, French, Gardner offered Amendment                                                                 
No. 4:                                                                                                                          
                                                                                                                                
Page 1, line 1, following "Act":                                                                                              
     Insert "relating to eligibility requirements for medical                                                                 
assistance for certain children and pregnant women;"                                                                          
                                                                                                                                
Page 1, line 3, following "program":                                                                                          
     Insert "; and providing for an effective date"                                                                           
                                                                                                                                
                                                                                                                                
                                                                                                                                
                                                                                                                                
                                                                                                                                

2013-04-09                     Senate Journal                      Page 1076
Page 1, following line 3:                                                                                                       
     Insert new bill sections to read:                                                                                          
"* Section 1. AS 47.07.020(b) is amended to read:                                                                             
          (b)  In addition to the persons specified in (a) of this section,                                                     
     the following optional groups of persons for whom the state may                                                            
     claim federal financial participation are eligible for medical                                                             
     assistance:                                                                                                                
              (1)  persons eligible for but not receiving assistance under                                                      
     any plan of the state approved under 42 U.S.C. 1381 - 1383c                                                                
     (Title XVI, Social Security Act, Supplemental Security Income)                                                             
     or a federal program designated as the successor to the aid to                                                             
     families with dependent children program;                                                                                  
              (2)  persons in a general hospital, skilled nursing facility,                                                     
     or intermediate care facility, who, if they left the facility, would be                                                    
     eligible for assistance under one of the federal programs specified                                                        
     in (1) of this subsection;                                                                                                 
              (3)  persons under 21 years of age who are under                                                                  
     supervision of the department, for whom maintenance is being                                                               
     paid in whole or in part from public funds, and who are in foster                                                          
     homes or private child-care institutions;                                                                                  
              (4)  aged, blind, or disabled persons, who, because they                                                          
     do not meet income and resources requirements, do not receive                                                              
     supplemental security income under 42 U.S.C. 1381 - 1383c (Title                                                           
     XVI, Social Security Act), and who do not receive a mandatory                                                              
     state supplement, but who are eligible, or would be eligible if they                                                       
     were not in a skilled nursing facility or intermediate care facility                                                       
     to receive an optional state supplementary payment;                                                                        
              (5)  persons under 21 years of age who are in an                                                                  
     institution designated as an intermediate care facility for the                                                            
     mentally retarded and who are financially eligible as determined                                                           
     by the standards of the federal program designated as the                                                                  
     successor to the aid to families with dependent children program;                                                          
              (6)  persons in a medical or intermediate care facility                                                           
     whose income while in the facility does not exceed 300 percent of                                                          
     the supplemental security income benefit rate under 42 U.S.C.                                                              
     1381 - 1383c (Title XVI, Social Security Act) but who would not                                                            
     be eligible for an optional state supplementary payment if they left                                                       
     the hospital or other facility;                                                                                            
                                                                                                                                
                                                                                                                                

2013-04-09                     Senate Journal                      Page 1077
              (7)  persons under 21 years of age who are receiving                                                              
     active treatment in a psychiatric hospital and who are financially                                                         
     eligible as determined by the standards of the federal program                                                             
     designated as the successor to the aid to families with dependent                                                          
     children program;                                                                                                          
              (8)  persons under 21 years of age and not covered under                                                          
     (a) of this section [,] who would be eligible for benefits under the                                                       
     federal program designated as the successor to the aid to families                                                         
     with dependent children program [,] except that they have the care                                                         
     and support of both their natural and adoptive parents;                                                                    
              (9)  pregnant women not covered under (a) of this section                                                         
     and who meet the income and resource requirements of the federal                                                           
     program designated as the successor to the aid to families with                                                            
     dependent children program;                                                                                                
              (10)  persons under 21 years of age not covered under (a)                                                         
     of this section who the department has determined cannot be                                                                
     placed for adoption without medical assistance because of a                                                                
     special need for medical or rehabilitative care and who the                                                                
     department has determined are hard-to-place children eligible for                                                          
     subsidy under AS 25.23.190 - 25.23.210;                                                                                    
              (11)  persons who can be considered under 42 U.S.C.                                                               
     1396a(e)(3) (Title XIX, Social Security Act, Medical Assistance)                                                           
     to be individuals with respect to whom a supplemental security                                                             
     income is being paid under 42 U.S.C. 1381 - 1383c (Title XVI,                                                              
     Social Security Act) because they meet all of the following                                                                
     criteria:                                                                                                                  
                   (A)  they are 18 years of age or younger and qualify                                                         
          as disabled individuals under 42 U.S.C. 1382c(a) (Title XVI,                                                          
          Social Security Act);                                                                                                 
                   (B)  the department has determined that                                                                      
                        (i)  they require a level of care provided in a                                                         
              hospital, nursing facility, or intermediate care facility for                                                     
              the mentally retarded;                                                                                            
                        (ii)  it is appropriate to provide their care outside                                                   
              of an institution; and                                                                                            
                        (iii)  the estimated amount that would be spent                                                         
              for medical assistance for their individual care outside an                                                       
              institution is not greater than the estimated amount that                                                         
              would otherwise be expended individually for medical                                                              
              assistance within an appropriate institution;                                                                     

2013-04-09                     Senate Journal                      Page 1078
                   (C)  if they were in a medical institution, they would                                                       
          be eligible for medical assistance under other provisions of                                                          
          this chapter; and                                                                                                     
                   (D)  home and community-based services under a                                                               
          waiver approved by the federal government are either not                                                              
          available to them under this chapter or would be inappropriate                                                        
          for them;                                                                                                             
              (12)  disabled persons, as described in 42 U.S.C.                                                                 
     1396a(a)(10)(A)(ii)(XIII), who are in families whose income, as                                                            
     determined under applicable federal regulations or guidelines, is                                                          
     less than 250 percent of the official poverty line applicable to a                                                         
     family of that size according to the United States Department of                                                           
     Health and Human Services, and who, but for earnings in excess                                                             
     of the limit established under 42 U.S.C. 1396d(q)(2)(B), would be                                                          
     considered to be individuals with respect to whom a supplemental                                                           
     security income is being paid under 42 U.S.C. 1381 - 1383c; a                                                              
     person eligible for assistance under this paragraph who is not                                                             
     eligible under another provision of this section shall pay a                                                               
     premium or other cost-sharing charges according to a sliding fee                                                           
     scale that is based on income as established by the department in                                                          
     regulations;                                                                                                               
              (13)  persons under 19 years of age who are not covered                                                           
     under (a) of this section and whose household income does not                                                              
     exceed 200 [175] percent of the federal poverty line as defined by                                                     
     the United States Department of Health and Human Services and                                                              
     revised under 42 U.S.C. 9902(2);                                                                                           
              (14)  pregnant women who are not covered under (a) of                                                             
     this section and whose household income does not exceed 200                                                            
     [175] percent of the federal poverty line as defined by the United                                                         
     States Department of Health and Human Services and revised                                                                 
     under 42 U.S.C. 9902(2);                                                                                                   
              (15)  persons who have been diagnosed with breast or                                                              
     cervical cancer and who are eligible for coverage under 42 U.S.C.                                                          
     1396a(a)(10)(A)(ii)(XVIII).                                                                                                
   * Sec. 2. AS 47.07.042(d) is amended to read:                                                                              
          (d)  In addition to the requirements established under (a) and                                                        
     (b) of this section, the department may require premiums or cost-                                                          
     sharing contributions from recipients who are eligible for benefits                                                        
     under AS 47.07.020(b)(13) and whose household income is                                                                    
     between 150 and 200 [175] percent of the federal poverty line. If                                                      

2013-04-09                     Senate Journal                      Page 1079
     the department requires premiums or cost-sharing contributions                                                             
     under this subsection, the department                                                                                      
              (1)  shall adopt in regulation a sliding scale for those                                                          
     premiums or contributions based on household income;                                                                       
              (2)  may not exceed the maximums allowed under federal                                                            
     law; and                                                                                                                   
              (3)  shall implement a system by which the department or                                                          
     its designee collects those premiums or contributions."                                                                    
                                                                                                                                
Page 1, line 4:                                                                                                                 
     Delete "Section 1"                                                                                                       
     Insert "Sec. 3"                                                                                                          
                                                                                                                                
Renumber the following bill section accordingly.                                                                                
                                                                                                                                
Page 3, following line 5:                                                                                                       
     Insert a new bill section to read:                                                                                         
"* Sec. 4. Sections 1 and 2 of this Act take effect immediately under                                                         
AS 01.10.070(c)."                                                                                                               
                                                                                                                                
Senator Wielechowski moved for the adoption of Amendment No. 4.                                                                 
Senator Coghill objected.                                                                                                       
                                                                                                                                
The question being: "Shall Amendment No. 4 be adopted?" The roll                                                                
was taken with the following result:                                                                                            
                                                                                                                                
SSSB 49 am                                                                                                                      
Second Reading                                                                                                                  
Amendment No. 4                                                                                                                 
                                                                                                                                
YEAS:  6   NAYS:  14   EXCUSED:  0   ABSENT:  0                                                                               
                                                                                                                                
Yeas:  Egan, Ellis, French, Gardner, Stedman, Wielechowski                                                                      
                                                                                                                                
Nays:  Bishop, Coghill, Dunleavy, Dyson, Fairclough, Giessel,                                                                   
Hoffman, Huggins, Kelly, McGuire, Meyer, Micciche, Olson, Stevens                                                               
                                                                                                                                
and so, Amendment No. 4 failed.                                                                                                 
                                                                                                                                
SPONSOR SUBSTITUTE FOR SENATE BILL NO. 49 am was                                                                                
automatically in third reading.                                                                                                 
                                                                                                                                

2013-04-09                     Senate Journal                      Page 1080
The question being: "Shall SPONSOR SUBSTITUTE FOR SENATE                                                                        
BILL NO. 49 am "An Act relating to women's health services and                                                                  
defining 'medically necessary abortion' for purposes of making                                                                  
payments under the state Medicaid program" pass the Senate?" The                                                                
roll was taken with the following result:                                                                                       
                                                                                                                                
SSSB 49 am                                                                                                                      
Third Reading - Final Passage                                                                                                   
                                                                                                                                
YEAS:  14   NAYS:  6   EXCUSED:  0   ABSENT:  0                                                                               
                                                                                                                                
Yeas:  Bishop, Coghill, Dunleavy, Dyson, Fairclough, Giessel,                                                                   
Hoffman, Huggins, Kelly, McGuire, Meyer, Micciche, Olson, Stevens                                                               
                                                                                                                                
Nays:  Egan, Ellis, French, Gardner, Stedman, Wielechowski                                                                      
                                                                                                                                
and so, SPONSOR SUBSTITUTE FOR SENATE BILL NO. 49 am                                                                            
passed the Senate.                                                                                                              
                                                                                                                                
Senator Coghill gave notice of reconsideration.