05/14/2015 01:00 PM House FINANCE

HOUSE BILL NO. 148                                                                                                            
                                                                                                                                
     "An  Act  relating  to  medical  assistance  reform                                                                        
     measures;  relating  to  eligibility  for   medical                                                                        
     assistance coverage; relating to medical assistance                                                                        
     cost containment measures by the Department of Health                                                                      
     and Social Services; and providing for an effective                                                                        
     date."                                                                                                                     
                                                                                                                                
1:11:03 PM                                                                                                                    
                                                                                                                                
Co-Chair Thompson provided prepared remarks:                                                                                    
                                                                                                                                
     First I  want to  thank the  governor for  bringing                                                                        
     Medicaid expansion before the  legislature in this                                                                         
     special session and  I want  to  thank Commissioner                                                                        
     Davidson and her staff for all the hard work that they                                                                     
     have done. The House majority shares the governor's                                                                        
     concerns with the health of Alaskans, especially the                                                                       
     most vulnerable Alaskans. However, hearings this week                                                                      
     have made it very  clear that Medicaid is a  bigger                                                                        
     problem than we knew; it is a highly complex system                                                                        
     facing significant challenges.                                                                                             
                                                                                                                                
     The legislation the governor has put before us does                                                                        
     not address a plan to move forward; only an acceptance                                                                     
     of twenty to forty thousand more people into a system                                                                      
     that has been acknowledged as broken. Currently the                                                                        
     administration has an RFP  out to  hire experts to                                                                         
     recommend Medicaid expansion and reform strategies for                                                                     
     Alaska. The final report is due  April 1, 2016. We                                                                         
     support the administration in this effort and agree                                                                        
     that it is  appropriate to allow time to  find its                                                                         
     consultant. The Legislative Budget and Audit Committee                                                                     
     is working on  an RFP to  hire its  own consultant.                                                                        
     Medicaid expansion without a plan could bankrupt this                                                                      
     state  within  six  years  when   promised  federal                                                                        
     participation expires.                                                                                                     
                                                                                                                                
     Currently, health and social services takes up about                                                                       
     30 percent of the state's unrestricted general funds                                                                       
     for agency operations in our annual operating budget.                                                                      
     At this  time the  House Finance  Committee is not                                                                         
     comfortable with advancing House Bill 148 since the                                                                        
     bill does not address which specific reforms Alaska                                                                        
     will pursue,  a  timeline for  carrying  out these                                                                         
     reforms, how the state will ensure cost savings for                                                                        
     Alaskans, or how the state will ensure quality care                                                                        
     and improved outcomes. Alaskans deserve specifics on                                                                       
  how Alaska's Medicaid program will be transformed.                                                                            
                                                                                                                                
     We have other issues. The MMIS system currently is not                                                                     
     certified. The  department  is  still  involved in                                                                         
     litigation concerning the functioning of  the MMIS                                                                         
     system with a stay until August. The system crashed                                                                        
     the first time when we loaded it with participants; it                                                                     
     was so faulty that the state had to sue Xerox. The                                                                         
     department assures us that most of the problems have                                                                       
     been corrected; however, now we are looking at adding                                                                      
     twenty to forty thousand new participants and seventy                                                                      
     thousand new NCCI  billing codes. Also,  Alaska is                                                                         
     identified as a  medical provider deficient  state.                                                                        
     Already in   the  Interior,  Medicare and   Tricare                                                                        
     recipients are having trouble finding providers. How                                                                       
     will twenty to forty thousand more people on Medicaid                                                                      
     effect provider availability?                                                                                              
                                                                                                                                
     Also, the King  v Burwell  decision by the  Supreme                                                                        
     Court, which is  expected in  July, could  severely                                                                        
     impact Alaskans  who  have  signed up   for  health                                                                        
     insurance through the federal exchange by costing them                                                                     
     their assistance. This committee believes that the                                                                         
     best time to negotiate with the federal government on                                                                      
     terms to expand Medicaid programs will be after we                                                                         
     have done our due diligence and have received reform                                                                       
     strategies from our consultants and not prior just                                                                         
     because federal funding is available.                                                                                      
                                                                                                                                
     With that we  conclude this current round of House                                                                         
     Finance Committee meetings and look forward to working                                                                     
     with the administration's consultants and ours on how                                                                      
     to best address  the healthcare needs of  Alaskans.                                                                        
     These are  just  a  few of  our  concerns on  this                                                                         
     committee.                                                                                                                 
                                                                                                                                
HB 148 was HEARD and HELD in committee for further                                                                              
consideration.