Legislature(2007 - 2008)SENATE FINANCE 532
04/08/2008 09:00 AM Senate FINANCE
| Audio | Topic |
|---|---|
| Start | |
| HB 2 | |
| SB 8 | |
| SB 212 | |
| HB 147 | |
| HB 166 |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
| + | SB 212 | TELECONFERENCED | |
| += | SB 8 | TELECONFERENCED | |
| + | HB 2 | TELECONFERENCED | |
| + | HB 147 | TELECONFERENCED | |
| += | HB 166 | TELECONFERENCED | |
| + | HB 289 | TELECONFERENCED | |
| + | HB 307 | TELECONFERENCED | |
| + | HB 406 | TELECONFERENCED | |
| + | TELECONFERENCED |
SENATE BILL NO. 212
"An Act relating to eligibility requirements for medical
assistance for certain children and pregnant women; and
providing for an effective date."
9:49:16 AM
TOM OBERMEYER, STAFF, SENATOR DAVIS, presented an overview
of the bill by reading the Sponsor Statement:
SB 212 reinstates the qualifying income standards for
children and pregnant women receiving Medicaid benefits
under the Denali KidCare (DKC) program to poverty
guidelines used when the program was established in
1997 at 200% Federal Poverty Guideline (FPG) for
Alaska. Reduced and frozen at 175% FPG by the
Legislature in 2003, the equivalent income limits were
reduced in the following four years to 154% by the time
SB27 was implemented to reinstate current levels of the
FPG at 175% in 2007. Children and pregnant women with
household incomes between 176% and 200% FPG still have
not regained eligibility. SB212 also increases
allowable premiums or cost-sharing by families whose
incomes are between 150%-200% FPG.
The fiscal notes anticipate 2% enrollment growth after
2009 and an annual cost increase of 8.6%, allowing for
5% medical inflation in Alaska. The $249,600
appropriation required for 2009 does not reflect the
indirect savings by fewer emergency room visits and
many avoided long-term illnesses for SCHIP children.
The addition of one employee and office expense at
$73,800 provides for the anticipated increase in
enrollment of 218 pregnant women and 1277 children.
DHSS has requested additional support for Denali
KidCare in the Governor's FY09 budget.
Forty one-states allow participation by families at or
above 200% FPG with many over 300%. The reason for
higher SCHIP eligibility coverage in other states is
that the federal government reimburses SCHIP at an
enhanced rate, and higher SCHIP eligibility has proven
to be an efficient use of health care dollars. While
most patients enrolled in Medicaid are children,
children utilize only a fraction of the resources.
Early intervention and preventative care greatly reduce
visits to emergency rooms and costly long-term
illnesses. Hospitals regularly write-off the cost of
emergency room visits by non-emergency low-income,
indigent, or uninsured patients whom they must serve
when patients cannot pay. The costs of these non-
emergency visits to hospitals for SCHIP children and
other low-income and uninsured, who have no other way
of obtaining health care, are passed along in increased
costs to patients who do pay and/or are insured under
private or state health benefit plans. There is no
effect on eligibility for Denali KidCare if the SCHIP
allotment is fully expended. If costs exceed available
SCHIP funds, claims are simply reimbursed at the lower,
regular Medicaid rate, resulting in reduced federal
revenues.
9:52:16 AM
Senator Dyson asked what would be the financial difference
for a family of four.
Mr. Obermeyer explained that the amount is predicated on
income but he did not have the dollar amount. He referred to
a Medicaid expert online.
9:53:07 AM
STEVE HORN, EXECUTIVE DIRECTOR, ALASKA BEHAVIORAL HEALTH
ASSOCIATION testified via teleconference and spoke in
support of the bill. He reported that Alaska has the fourth
most stringent eligibility level for children's health
insurance in the country resulting in many children not
receiving needed basic health care. He believed Denali
KidCare will save Alaska money in the long run. Children
without health care receive less preventative care resulting
in higher health risks and greater use of expensive
emergency rooms.
9:54:38 AM
JERRY FULLER, MEDICARE DIRECTOR, DEPARTMENT OF HEALTH AND
SOCIAL SERVICES testified via teleconference and noted he
did not have the income chart with him to answer Senator
Dyson's question to describe the income level for a family
of four at the 200% level. He acknowledged that the Governor
has not taken a position on this bill.
9:55:37 AM
BRENDA MOORE, MEMBER, MEDICAL HEALTH BOARD AND COUNSELOR,
SUICIDE PREVENTION testified via teleconference in support
this bill and encouraged the bill being moved from
Committee.
9:56:55 AM
NAOMI TIGNER, ALASKA ASSOCIATION FOR HOMES FOR CHILDREN AND
PRESBYTERIAN HOSPITALITY HOUSE testified via teleconference
in support of this bill. She believed in the necessity of
raising the eligibility level to 200% to enable children to
receive basic needed health care.
AT EASE: 9:58:09 AM
RECONVENED: 9:58:50 AM
9:59:05 AM
ROD BETIT, PRESIDENT, ALASKA STATE HOSPITAL NURSING HOME
ASSOCIATION testified via teleconference and supported the
bill. As a member of the Governor's Health Care Strategy
Council, the Association listed this as one of their key
recommendations to bring coverage to the 200 percent level.
10:00:24 AM
LAWRENCE WEISS, EXECUTIVE DIRECTOR, ALASKA CENTER FOR PUBLIC
POLICY testified via teleconference in support of this bill.
He presented the economic issues for the 1,200 Alaska
children with no access to health care. For every thirty
cents the state spends, the federal governor would
contribute seventy cents. Children without health care are
at highest risk to use expensive emergency rooms where they
do not receive preventive health measures. This program will
save the state money in the future.
10:03:15 AM
ANGELA LISTAN spoke in support of the bill. She noted that
the cost of health care has risen faster than almost any
other living expense. She noted that forty-six states use
the 200 percent federal poverty level rate. She remarked
that the federal poverty level for a family of four is
$53,000 which is not enough to cover all expenses with the
additional expense for health insurance.
10:05:24 AM
GERAN TARR, ALLIANCE FOR REPRODUCTIVE JUSTICE testified via
teleconference in support of the bill. She agreed with the
previous comments from the others testifiers.
10:06:45 AM
GUS MARX, GRANTS MANAGER, JUNEAU YOUTH SERVICES supported
the bill. His family has used Denali KidCare in the past and
he applauded the state for helping families in need.
10:08:11 AM
JEFF JESSEE, CHIEF EXECUTIVE OFFICER, ALASKA MENTAL HEALTH
TRUST AUTHORITY spoke in support of the bill. He declared
that Medicaid is a crucial part of funding for children in
need and this bill will assist in financing future projects.
10:08:55 AM
Co-Chair Stedman reviewed the three Department of Health and
Social Services fiscal notes attached to this bill.
10:09:50 AM
Senator Thomas appreciated those who brought forth this
bill. He mentioned that other people were covered by this
bill, such as the aged, blind and mentally retarded.
10:10:42 AM
Co-Chair Hoffman MOVED to REPORT SB 212 out of Committee
with individual recommendations and the attached fiscal
notes.
Senator Dyson OBJECTED for discussion.
Senator Dyson warned of putting into Statute programs that
the Legislature may not be able to sustain in the long run.
He suggested the bill have a provision that in three or four
years the percentage reverts back to the 175 percent unless
the Legislature takes action. The state may run into a
deficient problem in the future. He reminded the Committee
of another state program that allows people with significant
health issues to get state financing.
Senator Dyson WITHDREW his OBJECTION.
Senator Elton OBJECTED for discussion.
Senator Elton reported his enthusiastic support for this
bill. He remarked that one of the biggest debates this year
was whether to provide energy assistance, across the board,
regardless of need or income level. In his opinion, the
beauty of SB 212 is the it provides medical assistance to
Alaskans in need and this is one of the preeminent concerns
and rights of all citizens. This program would receive $2
from the federal government for every $1 spent by the state.
Senator Elton WITHDREW his OBJECTION. There being NO
OBJECTION, it was so ordered.
SB 212 was REPORTED out of Committee with no recommendations
and three accompanying previously published fiscal notes
from the Department of Health and Social Services.
10:15:19 AM
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