Legislature(2011 - 2012)CAPITOL 106
03/08/2011 03:00 PM House HEALTH & SOCIAL SERVICES
| Audio | Topic |
|---|---|
| Start | |
| HB1 | |
| HB78 | |
| Presentation: Alaska Healthcare Workforce Plan | |
| Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
| *+ | HB 1 | TELECONFERENCED | |
| *+ | HB 78 | TELECONFERENCED | |
| + | TELECONFERENCED | ||
| + | TELECONFERENCED |
HB 1-POLICY FOR SECURING HEALTH CARE SERVICES
3:03:20 PM
CHAIR KELLER announced that the first order of business would be
HOUSE BILL NO. 1, "An Act stating a public policy that allows a
person to choose or decline any mode of securing health care
services."
3:05:44 PM
KAREN SAWYER, Staff, Representative Carl Gatto, Alaska State
Legislature, presented HB 1 and stated:
This bill is not really about health insurance or
health care services, but it's rather about state
rights. We allege that the new federal law passed
last year, "Patient Protection and Affordable Care
Act," otherwise also known as Obamacare, infringes
upon the constitutional rights of U.S. individuals by
mandating all citizens and legal residents have
qualifying health care coverage or pay a tax penalty.
By imposing such a mandate, this law exceeds the
powers of the United States under the Constitution.
We're not challenging the authority of the federal
government, they've actually challenged our authority,
and it's up to us to defend ourselves. If we don't,
this is just the beginning of more federal take-over.
Therefore, this bill will codify as state policy that
every person in the State of Alaska is and shall
continue to be free from federal government force in
the selection of health insurance options, and that
such liberty is protected by the constitutions of the
United States and the State of Alaska. This bill also
removes the authority of any state official or
employee from enforcing any penalty which violates the
policy.
3:07:07 PM
MS. SAWYER referred to the handout, titled "HB 1-Explanation
of:" [Included in members' packets]. She stated that the
sponsor was agreeable to having this explanation included in the
bill.
CHAIR KELLER clarified that HB 1, Version A, was in front of the
committee.
MS. SAWYER, referring to the "Patient Protection and Affordable
Care Act," reported that nationwide, 40 state legislators had
"introduced legislation to limit, alter, or oppose selected
federal actions regarding this bill, including single care
provisions and mandates that would require purchase of
insurance." She asked that Alaska join the seven other states
which enacted legislation "to establish the individual's right
in their state to be free of federal government force to make
their own choice about health care." She quoted a statement by
former Supreme Court Justice Sandra Day O'Connor regarding the
federal regulation of states.
3:08:58 PM
REPRESENTATIVE SEATON offered his belief that HB 1 limited state
action, not federal action. As he did not see any naming of the
federal government, he opined that the requirement was for the
state or within the state.
MS. SAWYER replied that HB 1 would put into policy that Alaska
guaranteed for individuals to have the right to choose.
3:10:39 PM
REPRESENTATIVE SEATON, referring to an initiative for managed
care on the Kenai Peninsula, asked if HB 1 would prevent health
care by a subdivision of the state.
MS. SAWYER offered her belief that HB 1 prevented a mandate for
Alaskans to buy health care, except for those provisions listed
on page 1, line 12.
3:11:58 PM
REPRESENTATIVE MILLER asked to clarify that the bill sponsors
deemed the "Patient Protection and Affordable Care Act" as
unconstitutional. He stated that of the five court cases
regarding this, three had ruled for its constitutionality. He
pointed to the recent court ruling in Florida which directed
that portions of the federal health care act should be
implemented. He asked if HB 1 was a bit premature.
MS. SAWYER offered her understanding that the recent Florida
ruling was a 7 day stay for appeal. She declared that the
sponsors still desired that HB 1 become a state policy "that
will protect us."
3:13:55 PM
REPRESENTATIVE MILLER asked to clarify that HB 1 stated that
Alaskans are free to choose or decline any mode of obtaining
health care, but that HB 1 does not apply to health care
services that might be required by the State of Alaska.
MS. SAWYER concurred, and she directed attention to the handout,
"HB 1-Explanation of:"
REPRESENTATIVE MILLER opined that HB 1 stated that "the federal
government can't mandate anything, but the state still retains
its ability to do so."
MS. SAWYER concurred.
3:14:50 PM
REPRESENTATIVE HERRON asked how HB 1 addressed the problem of
uninsured people going to hospital emergency rooms.
MS. SAWYER replied that HB 1 did not address any provisions for
health care service. She offered her belief that HB 1 was
"about just the federal government telling the states, the
individuals of our state, that they have to do something, or be
taxed." She stated that her limited understanding of the
"Patient Protection and Affordable Care Act" was that there
would "still be a significant number of individuals who will
still not have health care." She opined that many more people
would be added to Medicaid.
3:16:23 PM
REPRESENTATIVE HERRON, reading from HB 1, summarized that Alaska
was creating "a policy of the State of Alaska that [a person
has] the right to choose or decline any mode of obtaining health
care services without penalty or threat of penalty." Offering
an assumption for the passage of HB 1, he inquired to the
efficacy for the passage of a policy to stop any chosen federal
law or mandate to which some people disagree.
MS. SAWYER replied that HB 1 could set an important precedent
for future federal mandates. She declared that Alaska was an
important state to the federal government.
3:17:43 PM
REPRESENTATIVE MILLETT asked how many states had passed similar
legislation.
MS. SAWYER replied that seven states had similar legislation.
REPRESENTATIVE MILLETT asked about any anticipated federal
response.
MS. SAWYER offered her belief that the federal government "was
just waiting to see what's going to happen." She opined that
even with passage of the Patient Protection and Affordable Care
Act, there was no enforcement to non-compliance. She declared
that President Obama had relaxed some of his provisions,
allowing states to offer alternative choices.
3:19:54 PM
REPRESENTATIVE MILLETT asked to clarify that greater opposition
to the federal health care act would lead to removal of the more
stringent requirements.
MS. SAWYER offered her belief that a majority of the country was
opposed to the mandate, and that would make a difference.
3:21:02 PM
REPRESENTATIVE MILLER asked whether there was a state
requirement for vaccines to children attending public school.
MS. SAWYER offered her belief that it was a requirement, and, in
response to Representative Miller, she relayed that the vaccines
would still be required. She emphasized the importance of the
list on the handout.
3:21:45 PM
REPRESENTATIVE MILLER, referencing the vaccines, asked if there
were any health mandates that came from federal legislation.
MS. SAWYER replied that she would look into it.
3:22:24 PM
REPRESENTATIVE MILLER, referring to the mandatory vaccine for
smallpox in 1969, opined that HB 1 would allow him to now
decline anything similar.
MS. SAWYER, referring to (9) of the handout, said that the
committee could include something to cover this.
3:23:30 PM
REPRESENTATIVE MILLER offered his belief that vaccines for any
naturally occurring diseases, listing HIV, tuberculosis, polio,
malaria, or dengue fever, would not be mandatory under HB 1.
MS. SAWYER opined that vaccinations were not mandatory for
Alaskans.
REPRESENTATIVE MILLER agreed, stating that HB 1 would enforce
that, no matter whether public health was threatened.
3:24:37 PM
MS. SAWYER declared that even knowingly having a disease still
did not mandate a vaccination.
REPRESENTATIVE MILLER, directing attention to page 2, line 3,
suggested the addition of prevention.
3:25:14 PM
CHAIR KELLER opened public testimony.
3:26:17 PM
PAT LUBY, Advocacy Director, AARP, declared that "many well
meaning people have completely opposite positions on the federal
health care reform bill, especially the individual mandate." He
pointed out that people had declined health insurance for many
years. He noted that many others, including older people,
wanted health insurance but could not secure it. He stated that
19 percent of Alaskans between 50 and 64 were uninsured. He
reported that the uninsured ended up in the emergency room,
which was paid for by those who had insurance. He estimated
that every Alaskan family spent $1900 annually toward people
without insurance. He emphasized that the State of Alaska, and
private employers who provided insurance, among others, paid for
the uninsured, as the costs were shifted to those with coverage.
He pointed out that proposed HB 1 would continue the practice of
cost shifting.
3:28:33 PM
MR. LUBY relayed the story of an accident to a 54 year old with
no health insurance. He defined cost shifting as the payment
for these incidences by those who did have health insurance. He
declared that HB 1 had nothing to do with freedom of choice, it
had to do with cost shifting. He established that the Patient
Protection and Affordable Care Act would subsidize those who
could not afford health insurance. He affirmed that HB 1 would
continue cost shifting to those who did have insurance.
3:30:06 PM
CHAIR KELLER asked which was more important, choice or paying
your own way. He offered his belief that it was unprecedented
for any government to declare that it was mandatory to buy a
commodity or a service.
MR. LUBY compared the federal health care act to social
security, and stated that it provided for retirement or
disability. He noted that it was mandatory, and it ensured that
the public would not have to provide for an individual. He
indicated that this was the basis for the Patient Protection and
Affordable Care Act.
3:31:56 PM
REPRESENTATIVE SEATON asked to clarify that if an individual
declined health insurance, they would be responsible for any
costs incurred.
MR. LUBY replied that the Supreme Court had ruled that an
individual had to be treated; however, the cost would be paid by
those with insurance.
3:33:13 PM
REPRESENTATIVE SEATON, pointing to line 10, referred to "without
penalty or threat of penalty," and asked if this could include
personal liability as an individual consequence.
MR. LUBY determined that the only exclusion within the Patient
Protection and Affordable Care Act was to decline the purchase
of insurance for religious reasons. He explained the sliding
scale for payment of basic health coverage, and confirmed that
there was a tax penalty for failure to purchase health
insurance. He declared that even the payment of a tax penalty
would still require hospital payment by someone else.
3:35:27 PM
REPRESENTATIVE SEATON declared that proposed HB 1 concerned
itself with a policy of the state, and not with the Patient
Protection and Affordable Care Act. He questioned whether HB 1
removed personal liability for an individual who refused health
insurance. He asked Mr. Luby if inclusion of personal liability
would address some of the AARP concerns.
MR. LUBY opined that the health exchange would offer many
choices, and that some individuals would choose to pay the
penalty and pay for their own health care costs.
3:38:09 PM
REPRESENTATIVE HERRON asked if proposed HB 1 would affect
federal law. He questioned whether a lawsuit would be a
substitute for the bill.
3:38:39 PM
SIGNE ANDERSON, Chief Assistant Attorney General - Statewide
Section Supervisor, Commercial/Fair Business Section, Civil
Division (Anchorage), Department of Law (DOL), replied that the
state was already a party to a lawsuit challenging the Patient
Protection and Affordable Care Act. She offered her belief that
proposed HB 1 was a policy statement in support of the lawsuit.
3:39:00 PM
REPRESENTATIVE SEATON, referring to page 1, line 9, asked if
"decline any mode of obtaining health care services without
penalty or threat of penalty" could be amended to ensure
personal liability for the costs associated with health care
service.
MS. ANDERSON replied that HB 1 could be amended. She stated
that the definition of "penalty" only included a fine, tax,
surcharge fee, or similar. She declared that all ambiguity
could be removed with an amendment.
3:40:25 PM
CHAIR KELLER closed public testimony.
3:40:49 PM
CHAIR KELLER commented that HB 1 "is so easy to understand" if
individuals take responsibility for paying for their own health
care.
[HB 1 was held over.]