Legislature(2005 - 2006)BUTROVICH 205
02/23/2005 01:30 PM Senate HEALTH, EDUCATION & SOCIAL SERVICES
| Audio | Topic |
|---|---|
| Start | |
| SB70 | |
| SB78 | |
| Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
| *+ | SB 70 | TELECONFERENCED | |
| += | SB 78 | TELECONFERENCED | |
| + | TELECONFERENCED |
SB 78-SENIOR CARE PROGRAM
2:34:38 PM
CHAIR DYSON announced SB 78 to be up for consideration.
2:35:09 PM
COMMISSIONER JOEL GILBERTSON, Department of Health and Social
Services (DHSS), said SB 78 was submitted by the Governor as one
part of his senior care initiative concerning prescription drug
assistance and continuing cash assistance for some seniors. The
bill provides drug assistance for seniors with incomes below 300
percent of the poverty level and cash assistance for seniors
below 135 percent of the poverty level after the new Medicare
drug bill comes into effect.
COMMISSIONER GILBERTSON noted DHSS has provided a written
response to questions that the committee asked in last week's
meeting and he was present to answer additional questions from
the committee.
COMMISSIONER GILBERTSON said he could not find any information
on how other states propose to respond to the new Medicare
prescription drug benefit under Part B, but he found information
on current programs. He said most of the prescription drug
programs are in eastern states, but there are six programs west
of the Mississippi that provide direct drug assistance: Nevada,
Wyoming, Kansas, Minnesota, and Missouri. Of these states the
most generous is Nevada, which covers about 235 percent of the
federal poverty level with a benefit limit of about $5,000, with
$10 to $25 co-payments.
The next most generous is Missouri, which covers seniors to
about 185 percent of the poverty level with a 40 percent
copayment and a deductible based on income with a limit of
$5,000. Kansas covers up to about 135 percent and requires 30
percent in co-payments with a much smaller maximum benefit of
$1,200. Wyoming has the most austere program, which covers 100
percent of the poverty level and only provides three
prescriptions per month without age limit.
It is challenging to compare the current program with other
states because many have not yet responded to the new Medicare
prescription drug benefit that comes into effect next year and
will replace to some extent the various existing state programs.
He said Alaska's program was, on a dollar basis, fairly frugal
at $670 per beneficiary compared to $5,000 allowed under
Nevada's program.
CHAIR DYSON noted the cost of living varies throughout the state
and asked how the price of prescription drugs in Alaska compares
to that of other states.
COMMISSIONER GILBERTSON responded the retail cost of medication
is higher in rural Alaska, but the price of drugs in urban chain
stores is comparable to that of prices in the Lower 48.
CHAIR DYSON noted SB 78 does not allow for regional differences
in drug prices.
COMMISSIONER GILBERTSON responded the legislation would only
cover the premium and subsidy for the new Medicare drug benefit,
the price of which is consistent throughout the country.
2:42:05 PM
COMMISSIONER GILBERTSON stated the administration proposes an
entry threshold level of 300 percent of the poverty level.
Attachment 1 shows the number of individuals that would be
affected by different threshold levels. There was a question
concerning language that allows an absence from the state while
continuing to receive the benefits. Allowable absence language
from the Permanent Fund and the old Longevity Bonus Program was
provided in the report. The administration was not greatly
concerned about the language being broadened, but was greatly
concerned about excessively limiting the allowable exceptions.
2:44:46 PM
SENATOR ELTON asked how much the cost of the program would be
increased if the exceptions in the bill were like those allowed
in the Permanent Fund Program.
COMMISSIONER GILBERTSON responded he did not think it would
raise the cost of the program at all. The exception language
used in the bill was a good faith effort to show a commitment to
the state. Currently the state does not have any capacity to
enforce the exception rules.
SENATOR ELTON moved Amendment 1 to insert "and is for one of the
reasons listed in AS.43.23.008 which is the list of exceptions
for the Permanent Fund Dividend." He proposed the amendment in
light of the Commissioner's remark that adopting the Permanent
Fund exception language would not create a big cost impact. He
said this would make it easier for someone receiving both
Medicare benefits and a Permanent Fund check to follow one
recipe instead of two. Changes could be made to reflect the
interests of seniors such as eliminating the military exception
language. Seniors are often dealing with family issues and these
are reasonable absences.
2:47:08 PM
SENATOR GREEN objected saying she thought the language was
adequate as is.
CHAIR DYSON supported Senator Elton and noted many seniors
provide great support to their families during times of crisis
and should not have to face a penalty for such efforts.
CHAIR DYSON asked whether seniors would have to apply for a
waiver to receive an exception under the bill.
COMMISSIONER GILBERTSON responded if the absence is longer than
30 days and is not made for a medical reason, the individual
would have to get a waiver from the department. He reasserted
the department had no intention of establishing an enforcement
program.
2:50:39 PM
COMMISSIONER GILBERTSON noted it did not mean the department
expected everyone to be in compliance.
Roll call proved Amendment 1 passed. Senators Dyson, Elton,
Olson, and Wilken voted yea; Senator Green voted nay.
COMMISSIONER GILBERTSON said the report provided information
that answered Senator Olson's question about where senior
services were being provided. Figures in the report largely
concerned seniors living below the poverty line and do not allow
an accurate extrapolation to those living under 300 percent of
poverty level, which are probably increasingly concentrated
among urban populations. He noted DHSS was not able to determine
the number of seniors who would be eligible for both Indian
Health Services and premium benefits.
2:53:21 PM
JOHN SHERWOOD, Deputy Commissioner, DHSS, said in the event of
lacking appropriations, coverage for the Medicare part-B
deductible is first eliminated, followed by Medicare-B premiums,
and finally benefits for cash recipients.
CHAIR DYSON asked how much income the 300 percent threshold
allows a senior to have and still qualify.
COMMISSIONER GILBERTSON answered $36,400 for an individual and
$46,800 for a couple.
CHAIR DYSON asked how the 300 percent threshold was decided.
COMMISSIONER GILBERTSON responded the administration felt it was
the right level.
2:57:26 PM
CHAIR DYSON said he understands the Governor's letter to say 40
percent of Alaska seniors can't afford to live in the state and
need some sort of public welfare in order to maintain their
existence.
COMMISSIONER GILBERTSON said the administration would strongly
disagree with that statement. By an extension of that logic,
Medicare is a welfare program since the taxpayers subsidize it.
Medicare has provided a host of health care benefits to seniors
over the past 40 years and seniors have come to rely on it.
Prescription drugs are a new benefit available under Medicare
and the state is facing a legitimate risk that seniors below 300
percent of the poverty level may not be able to receive the
benefits of part-B. This does not mean that they are welfare
recipients and they cannot care of themselves.
CHAIR DYSON asked whether 40 percent of Alaska seniors would
qualify for the program.
COMMISSIONER GILBERTSON responded 40 percent would be covered
under current rates.
3:00:56 PM
BOB PETERS, Glennallen resident, said simplicity is a desirable
and important part of the Medicare system, which is already
pretty confusing for some seniors.
PAT LUBY, Advocacy Director, AARP, testified in support of SB
78. He said it addresses the AARP's concerns about seniors not
signing up for Medicare-B. He asserted prescription drugs play
an important preventative role in the health care of seniors.
3:03:23 PM
FRANK APPLE, member, Commission for the Aging, testified in
support for SB 78.
3:05:45 PM
SENATOR ELTON noted he accidentally eliminated exclusion for a
30-day excused absence for a business trip in his proposed
amendment. He proposed to amend Amendment 1 by inserting "for a
vacation or a business trip of 30 days or less and for one of
the following reasons listed in the AS.43.23.008", after the
word "temporary," on page 5, line 30.
3:07:28 PM
CHAIR DYSON moved to adopt the revised version of Amendment 2.
Hearing no objections, the motion carried.
3:12:52 PM
SENATOR ELTON moved CSSB 78(HES) Version G, out of committee
with individual recommendations and attached fiscal notes.
SENATOR WILKEN objected to express concerns about the $20
million fiscal note. He removed his objection.
Having no further objections, CSSB 78(HES) moved out of
committee.
| Document Name | Date/Time | Subjects |
|---|