Legislature(2007 - 2008)CAPITOL 106
02/27/2007 03:00 PM House HEALTH, EDUCATION & SOCIAL SERVICES
| Audio | Topic |
|---|---|
| Start | |
| HCR3 | |
| HJR10 | |
| Overview: System of Early Education Development | |
| Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
| + | TELECONFERENCED | ||
| *+ | HCR 3 | TELECONFERENCED | |
| *+ | HJR 10 | TELECONFERENCED | |
| + | TELECONFERENCED |
HJR 10-MEDICAL ASSISTANCE FOR CHILDREN 3:29:43 PM CHAIR WILSON announced that the next order of business would be HOUSE JOINT RESOLUTION NO. 10, Relating to reauthorization of federal funding for children's health insurance; and encouraging the Governor to support additional funding for and access to children's health insurance. ROBERT MYERS, JR., Staff to Representative Peggy Wilson, Alaska State Legislature, presented HJR 10 on behalf of the House Health, Education and Social Services Standing Committee, sponsor on request, which is chaired by Representative Wilson, paraphrasing from a prepared statement, which read as follows [original punctuation provided]: Due in large part to the State Children's Health Insurance Program (SCHIP), the percentage of low- income children in the United States without health coverage has fallen by one-quarter since SCHIP was created in 1997, despite the erosion of private health coverage over this period. More than 4 million low- income children, most of whom would otherwise be uninsured, are enrolled in SCHIP. This remarkable success, however, is now threatened. Unlike Medicaid, an entitlement program whose federal funding increases automatically to compensate for increases in health-care costs (as well as increases in caseloads), SCHIP is a block grant with a fixed annual funding level. That block grant is due to run out in September, 2007. Denali KidCare, the form that SCHIP takes in Alaska, will be put in a very precarious position when that happens. Congress has allocated $5 billion for FY 2007 for all SCHIPs. Currently there are no further allocations. The number of children in the program has been declining since 2003 because of the frozen income guidelines. About half of the children that dropped out were picked up by Medicaid. 28 percent of Alaska's population is under 18. This compares to the US population, which is 25 percent. In 2003, Alaska spent almost $1,200 more per enrollee for Medicaid than the national average. We rank second highest in the nation for expenditures per child. Currently, we have 7,600 children enrolled in Denali KidCare. In FY 2006, we spent $25,894,400. Of that, $7,688,300 was state money. Federal money accounted for $18,206,000 of the funding. The state expends an average of $2,114 per child and $1,966 per pregnant woman enrolled in Denali KidCare. These are the cheapest expenditures per person of all Medicaid programs in the state. In the past, we have relied heavily on unallocated funds from the general SCHIP fund. For example, if Virginia has not used all of its allotted federal funds for its SCHIP, Alaska could get some of those funds. However, now that the programs across the nation have matured, there are no more unused funds. Alaska is one of 14 states expected to have a shortfall in SCHIP by May of 2007. The Federal Medical Assistance Percentage (FMAP) for 2007 is 57.58 percent regular and 70.31 percent enhanced. Medicaid is matched under the regular rate while Denali KidCare is matched at the enhanced rate. For 2008, we are anticipating roughly a 67-33 percent split for federal/state expenditures for Denali KidCare. The president's budget includes a provision to extend SCHIP by five years and increase the funding by $5 billion. DHSS estimates that Alaska will exhaust its dedicated federal funds somewhere in the second quarter of FY 2008. This will leave us with a $2.6 million shortfall that will have to be covered by the state general fund. We ask that this committee and the Legislature pass this resolution to urge Congress to renew its funding for SCHIP in general and Denali KidCare in particular so that we can continue to provide adequate coverage for the children of Alaska 3:35:34 PM REPRESENTATIVE GARDNER clarified the funding distribution, and asked if Alaska is spending above allocation, or whether the federal funding will no longer be available. MR. MYERS responded that SCHIP is a matching block grant, and restated how recipients may default to Medicare. 3:36:57 PM REPRESENTATIVE GARDNER stated concern for establishing a program dependent on receipt of tenuousness federal funding. She asked whether a situation might occur in which the state incurs expenditures and the matching funds are never received; a question for Congress perhaps. REPRESENTATIVE FAIRCLOUGH reported her experience of a federal block grant that was awarded, but ultimately reneged upon. CHAIR WILSON offered, "You don't spend it until you have it." MR. MYERS relayed that funds will begin to wane in May, 2007. Additional federal funding may be provided in September, 2007, but until then the state must address the four and one-half month funding gap. 3:39:28 PM REPRESENTATIVE NEUMAN directed attention to the terms "children of modest means," and "children who qualify," page 2, lines 5 and 19 respectively, and asked how this is determined. Further he asked what it equates to for a family of four. MR. MYERS answered that the qualifiers are stipulated in Alaska Statute. It is calculated at 160 percent of the federal poverty level, is based on family size, and is specifically listed up to a family of eight. He located the base poverty level figures, in the statutes, and read the first three parameters: Household of: 1 - $1,635 per month 2 - $2,208 per month 3 - $2,782 per month 3:43:06 PM KARLEEN JACKSON, Commissioner, Department of Health & Social Services (DHSS), stated support for HJR 10, and reported that the issue of children's health insurance funding is at the forefront, both at the governor's office and at the federal level. 3:43:57 PM REPRESENTATIVE FAIRCLOUGH asked how the state is planning to handle the shortfall of funds, beginning in May. COMMISSIONER JACKSON relayed the options, previously outlined, that would be used prior to defaulting to Medicare: reauthorization of the SHIP program; redistribution of excess funds, from other state's SCHIP authorizations; and a component to revise the formula used in redistribution of funds. REPRESENTATIVE NEUMAN asked if a resolution is a stable means to solicit federal funding, and whether there is a precedent for HJR 10. MR. MYERS offered that when congress authorized the original SCHIP block funding in 1997, the grant authorization totals were established for ten years; through 2007. 3:46:40 PM CHAIR WILSON closed public testimony. 3:46:53 PM REPRESENTATIVE SEATON moved Conceptual Amendment 1: Page 2, line 21 Following "sent", insert "both electronically and by postal service" There being no objection, Conceptual Amendment 1 was adopted. 3:47:34 PM REPRESENTATIVE FAIRCLOUGH moved to report HJR 10, as amended, out of committee with individual recommendations and the accompanying fiscal notes. There being no objection, CSHJR 10(HES) was reported from the House Health, Education and Social Services Standing Committee.
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