Legislature(2009 - 2010)CAPITOL 120
03/11/2010 01:00 PM House JUDICIARY
| Audio | Topic |
|---|---|
| Start | |
| HJR35 | |
| HB355 | |
| HB289 | |
| Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
| + | HB 287 | TELECONFERENCED | |
| + | HJR 35 | TELECONFERENCED | |
| + | HB 289 | TELECONFERENCED | |
| + | TELECONFERENCED | ||
| += | HB 355 | TELECONFERENCED | |
HJR 35 - CONST AM: HEALTH CARE
1:48:31 PM
CHAIR RAMRAS announced that the first order of business would be
HOUSE JOINT RESOLUTION NO. 35, Proposing amendments to the
Constitution of the State of Alaska prohibiting passage of laws
that interfere with direct payments for health care services and
the right to purchase health care insurance from a privately
owned company, and that compel a person to participate in a
health care system.
1:48:46 PM
REPRESENTATIVE MIKE KELLY, Alaska State Legislature, speaking as
one of the joint prime sponsors, indicated that HJR 35 - a
resolution proposing amendments to the Alaska State
Constitution - is in response to proposed federal healthcare-
reform legislation, which is meant to address the issues of
access, affordability, and quality. However, he remarked, many
people are unsure that the federal legislation is going to
adequately address those issues. [Should HJR 35 pass the
legislature and be adopted by the voters at the next general
elections, it would change the Alaska State Constitution such
that] it would preclude the passage of laws that prohibit or
penalize direct payment for healthcare services, or laws that
prohibit or penalize the purchasing of healthcare insurance, or
laws that compel one to participate in a healthcare system, or
laws that penalize one for refusing to participate in a
healthcare system. He acknowledged that passage of HJR 35 and
ratification by the voters of its provisions into the Alaska
State Constitution could create a conflict with the
aforementioned federal legislation should it pass as well. He
offered his understanding, though, that 35 other states are
considering legislation similar to HJR 35.
REPRESENTATIVE HOLMES relayed that one of the main concerns she
has with HJR 35 is that it could have severe, negative impacts
on any proposed changes to existing federal programs such as
Medicare, and those addressing Veterans Affairs (VA) benefits
and the issue of tribal health.
REPRESENTATIVE KELLY indicated that that might be the case, but
surmised that others could better address that issue. In
response to a question regarding the resolution's fiscal note,
he indicated that he would research its analysis further.
1:56:42 PM
PEGGYANN McCONNOCHIE relayed that she and her husband own three
small businesses, two of which have employees, and offered her
belief that the aforementioned federal legislation is going to
result in two of her businesses going out of business, and won't
necessarily resolve the problems it is meant to address. She
added that a system similar to that being proposed by the
federal government is already in place in New Zealand, where her
husband is from, and opined that it doesn't work there,
particularly with regard to pre-existing conditions. Alaskans
should come up with their own solution to the problems of access
to healthcare and its costs, she opined, and predicted that the
proposed federal legislation is going to impose unreasonable
burdens on Alaskans and their businesses, especially small
business like those she and her husband own. She said she is
excited about the possibility of getting a chance to vote on the
proposed changes to the Alaska State Constitution as embodied in
HJR 35. She surmised that the ratification of those changes
would protect small business from being taxed for not providing
healthcare insurance. In conclusion, she urged the committee to
pass HJR 35.
REPRESENTATIVE HOLMES asked Ms. McConnochie whether she would be
concerned if passage of HJR 35's proposed changes to the Alaska
State Constitution resulted in it becoming difficult to make
future changes to certain existing federal programs.
MS. McCONNOCHIE, citing her nescience regarding such programs,
declined to venture an opinion, but noted that small business
owners already face increasing taxes and costs.
2:00:29 PM
ANDREA DOLL, Director, Legislative Information Standing
Committee, Retired Public Employees of Alaska (RPEA), remarking
that the prospect of a national public health plan being imposed
on individuals has made people either very happy or very
fearful, explained that the RPEA feels that HJR 35 is an example
of an exaggerated response to the aforementioned proposed
federal healthcare-reform legislation. Because HJR 35 is
proposing to amend the Alaska State Constitution, it has raised
concern among many RPEA members that voter ratification of its
proposed changes would tie the hands of current and future
legislators and thereby preclude them from addressing Alaska's
healthcare issues, and from considering the full array of
options currently available. This is a shortsighted approach,
particularly given that no one yet knows what the proposed
federal legislation will ultimately entail.
MS. DOLL said that although keeping the federal government out
of the [business of] healthcare might be a political philosophy
that appeals to a significant sector of the population, to take
steps to amend the Alaska State Constitution is drastic and
potentially harmful. The RPEA, therefore, is asking the
committee to reconsider such an approach, and to defeat HJR 35
as currently written. In response to a question, she reiterated
that what's of concern to the RPEA is that voter ratification of
HJR 35's proposed changes to the Alaska State Constitution would
close off legislators' future options.
REPRESENTATIVE HOLMES, characterizing HJR 35 as a bit of a
kneejerk reaction to the proposed federal healthcare-reform
legislation, reiterated her concern that voter ratification of
HJR 35's proposed changes to the Alaska State Constitution could
have severe, negative impacts on any future changes to existing
federal programs, such as the Medicare system, which, as many
could agree, needs changing.
MS. DOLL concurred, reiterated some of her previous remarks,
predicted that passage of HJR 35 would engender litigation, and
pointed out that such litigation wouldn't solve anything.
2:09:30 PM
PATRICK LUBY, Advocacy Director, AARP Alaska, said that the AARP
Alaska is opposed to HJR 35, and feels that the Alaska State
Constitution shouldn't be amended except for very serious
reasons. The problems that HJR 35 purports to address don't
actually exist yet and may never exist, since no one knows what
Congress will do, and the AARP Alaska feels that Alaska should
keep its options open, especially with regard to an issue as
serious as healthcare. He added:
Although Alaska does not have managed care in the HMO
model using capitated cost, we do have new models that
do managed care. Healthcare now and in the future
will be all about networks and coordinated delivery of
services; pay for performance, paying physicians and
hospitals for more quality care, medical homes, not
paying providers for what's referred to as "never-
events" - which Medicare is already doing and is being
picked up as a model by Medicaid and private
insurers - ... will only increase in the future. Cost
containment is going to be the main focus of
healthcare debate in the future. In Alaska, we must
do something about the uninsured. Currently, 17
percent of Alaskans between the ages of 50 and 64 have
no insurance at all. When they need healthcare, they
often ended up in the emergency room - the most
expensive place to get it. They also usually cannot
pay their bill.
Those of us that do have insurance end up picking up
their tab. The average cost of the uninsured for
every Alaskan family is $1,900 annually. Employers,
including the State of Alaska, also pick of the cost
of those employers who do not provide coverage to
their employees. [The] AARP wants to make sure that
all of us participate in healthcare coverage so that
we can end this cost-shifting. [House Joint
Resolution 35] ... would allow people to opt out of
coverage. The rest of us would still be stuck with
their bills. We look to our legislators [to] provide
solutions to problems. Why close down this option
that might be very helpful to Alaska in the future?
We recommend a "nay" vote on HJR 35. Thank you.
MR. LUBY, in response to questions, relayed that the AARP Alaska
thinks that requiring some type of coverage - wherein everyone
participates and no one has to pick up someone else's bill - is
the sensible approach to take; that when something is done at
the national level, people would be able to either join some
type of [insurance] pool or enter into some type exchange; and
that if one doesn't pay for one's own health insurance - or
one's employer doesn't - there would be penalties, penalties
which would serve as an incentive to get people to actually
purchase the coverage, to make sure that everyone has some type
of basic coverage.
2:14:36 PM
DAVE ROLAND, Policy Analyst, Show-Me Institute, mentioned that
he's provided members' with his written testimony, and that he
has a background in constitutional law. With regard to the
question of whether legislation such as HJR 35 is premature, he
opined that now is the time to take action, and surmised that
passage of HJR 35 would give Alaskans the opportunity to decide
for themselves whether they think that their right to decide
whether or not to purchase healthcare insurance should be
constitutionally protected. He also offered his belief that
although under the Supremacy Clause of the U.S. Constitution,
federal law preempts state law, there is reason to believe that
with regard to the issue of mandated healthcare insurance, if
the voters ratify HJR 35's proposed constitutional changes and a
legal conflict then arises, the courts might instead rule that
the Alaska State Constitution preempts federal statute.
2:20:13 PM
CHRISTIE HERRERA, Director, Health and Human Services Task
Force, American Legislative Exchange Council (ALEC), relayed
that the ALEC applauds HJR 35 - which is modeled after "our own,
'freedom of choice in healthcare Act,' now in ... 38 states" -
because the ALEC believes that it will ensure continued access
to health services; that when government controls healthcare
dollars, it makes treatment decisions based on what's best for
government; and that patients, not bureaucrats, should decide
what's best for patients. The ALEC also applauds HJR 35 because
the ALEC believes that the resolution would stop mandates that
just don't work. She indicated that although the ALEC believes
it's important for people to have health insurance coverage, it
also believes that a government requirement to purchase it would
be ineffective, bureaucratic, and costly. For example, in
Massachusetts, which has mandated the purchase of health
insurance since 2006, such insurance cost 40 percent more than
in the rest of the country], a third of the population still
doesn't have coverage, it's harder for the newly-insured to see
a physician, emergency room usage has increased by 17 percent,
and legislators expect a $2 billion to $4 billion shortfall over
the next decade.
MS. HERRERA relayed that the ALEC also believes that HJR 35
would help Alaskans shield themselves from the proposed federal
healthcare-reform legislation, and from any attempt by the State
of Alaska to prohibit direct payment for medical care, and that
it would result in a federalism clash if Congress passes a law
that either forces people to purchase insurance or prohibits
direct payments. On the latter point, she offered her
understanding that the U.S. Supreme Court has already ruled in
favor of the states when they take steps to protect their
citizens' freedoms. She then offered her belief that the
problem of people seeking medical services but refusing to
purchase health insurance is going to exist anyway regardless of
whether HJR 35 passes and its proposed changes to the Alaska
State Constitution are then ratified by the voters; "even if ...
a mandate did solve the 'free-rider' problem, we would still be
forced to pay for the newly-insured with subsidies to purchase
the required insurance," she added, and offered her
understanding of what the provisions of the proposed federal
healthcare-reform legislation might entail and how they might
affect a low-income family of four.
MS. HERRERA offered her belief that HJR 35 won't affect federal
programs - such as Medicare and Medicaid - or that it would tie
the hands of legislators thereby preventing them from addressing
possible changes to such federal programs. Instead, she
ventured, HJR 35 would ensure that the cornerstone of any future
reforms is the preservation of patients' rights. She offered
her understanding that a study performed by the Cato Institute
estimates that the proposed federal healthcare-reform
legislation would require more than 100 million Americans to
drop their existing coverage and buy more expensive coverage
that they may not want or need. She concluded by reiterating
that the ALEC applauds HJR 35.
2:24:33 PM
CHAIR RAMRAS, after ascertaining that no one else wished to
testify, closed public testimony on HJR 35.
The committee took an at-ease from 2:24 p.m. to 2:26 p.m.
REPRESENTATIVE DAHLSTROM moved to report HJR 35 out of committee
with individual recommendations and the accompanying fiscal
notes. There being no objection, HJR 35 was reported from the
House Judiciary Standing Committee.