Legislature(2009 - 2010)BUTROVICH 205
03/13/2009 01:30 PM Senate HEALTH & SOCIAL SERVICES
| Audio | Topic |
|---|---|
| Start | |
| SB61 | |
| SB70 | |
| Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
| *+ | SB 70 | TELECONFERENCED | |
| + | TELECONFERENCED | ||
| += | SB 61 | TELECONFERENCED | |
SB 61-MANDATORY UNIVERSAL HEALTH INSURANCE
CHAIR DAVIS announced the consideration of SB 61. The bill was
heard previously and there is a proposed committee substitute
(CS).
1:32:07 PM
ANDY MODEROW, staff to primary bill sponsor, Senator French,
said he and Ms. LeLake would recap what the subcommittee did and
then present the proposed CS.
AMORY LELAKE, staff to bill sponsor, Senator Ellis, reported
that during the March 10 subcommittee meeting a memo from
Senator French was distributed discussing three topics that were
raised during the first bill hearing. First was how the bill
affects 50-64 year old Alaskans. Second was how the
clearinghouse can be structured to reach all Alaskans. Third was
how employers and health benefit plans provided by employers
could be affected by the bill.
The sponsor suggested one change on the last topic. The
subcommittee supported the change conceptually and it is
incorporated in the proposed CS. The subcommittee also
considered the suggested change in language to mandate insurance
coverage for non-medical healthcare services provided by a
religious non-medical provider. The members present decided
against the proposed change citing that the bill has an opt-out
provision for Alaskans that don't want to participate for
religious reasons.
MR. MODEROW referenced page 4 of the memo that states, "Language
should be changed in Senate Bill 61 to say that a health care
insurance plan sold in the group market fulfills the individual
responsibility clause of the legislation." Mr. DeWitt of the
National Federation of Independent Business in Alaska brought
this to the sponsor's attention to ensure that employers won't
have to change existing employee plans to fulfill the
responsibility clause of the legislation.
The proposed CS, version E, replaces subsection (a)(4), starting
on page 5, line 30. It exempted employees who were receiving
benefits regulated under the Employee Retirement Income Security
Act (ERISA) that met or exceeded essential healthcare services
defined on page 7 and 8 of the bill. The new language covers
those plans and additional ones.
1:35:41 PM
MR. MODEROW explained the change in three parts. The first part
requires that a person be covered by a plan to fulfill the
individual responsibility clause. Merely offering a plan is not
adequate. The second part requires that the coverage be a health
benefit plan as defined in AS 21.54.500(15). This is a health
benefit plan that basically captures all employer based plans.
They could be regulated by ERISA or by the state insurance laws
within the group market. The third part requires that the plan
be offered through employment in the group market as defined in
AS 21.54.500(14).
The new subsection (a)(4) also strikes the element in the
original version that required that a plan meet the essential
healthcare services on pages 7 and 8 of the bill. This change
ensures that any existing employee health plan that currently
provides quality coverage to employees fulfills the individual
responsibility clause.
CHAIR DAVIS asked for a motion to adopt the committee substitute
(CS).
SENATOR PASKVAN moved to adopt the proposed CS for SB 61,
labeled 26-LS0312\E, as the working document. There being no
objection, version E was before the committee.
1:38:36 PM
AL TAMAGNI SR., Owner, Cancer Services International, Anchorage,
said his company administrates retirement plans and oversees
group health insurance plans for some employers. He does not
want to see SB 61 move forward. Nothing in the bill provides for
enhanced COBRA coverage under the federal stimulus. Under that
provision the federal government reimburses an employer 65
percent of the premium and the employee pays 35 percent. Also,
all of the large employers are again exempt from contributing to
the state plan. This is a problem for small employers who are
carrying the burden. We're seeing a "socialistic" movement in
this area, he said.
MR. TAMAGNI pointed out that SB 61 talks about "group markets"
but there is no reference to the individual market. Furthermore,
when he looks at the makeup of the task force, he only sees two
people that are paying the bills while the other 11 members are
the beneficiaries of those funds. There is not a balanced input
or fair representation of small businesses with less than 100
employees. In these uncertain economic conditions he would
suggest it's time to sit back and see what happens.
MR. TAMAGNI said he believes a smorgasbord of options could be
adopted so that the employer or the employee could choose
different elements of coverage including maternity care,
chiropractic care, or vision care. Those things need to be
addressed and SB 61 doesn't do that. The small business
community is again being asked to pay with very little
opportunity to participate.
1:44:16 PM
CHAIR DAVIS asked if he had a copy of the CS.
MR. TAMAGNI replied he didn't think so.
CHAIR DAVIS said there were few changes but she did want to be
sure he sees the new bill. She also asked what task force he
referenced.
MR. TAMAGNI directed attention to page 3, line 9, Sec. 21.54.210
Alaska Health Care Board and again suggested there needs to be
substantial changes to the membership of the proposed board.
SENATOR DYSON asked if he anticipates that health insurance
providers will increase rates because of this legislation.
MR.TAMAGNI replied he expects that would happen.
1:47:00 PM
SENATOR ELLIS asked if he as a small business person prefers a
national health care reform or a more Alaska specific approach
as proposed in SB 61.
MR. TAMAGNI said he'd prefer neither. The current system works
well for about 60-75 percent of the people and he doesn't agree
with changing the system for the remaining 25-40 percent. "We're
moving towards an imperialistic aspect as far as treatment of a
lot of elements in our society," he said.
CHAIR DAVIS closed testimony and said she would like to move the
bill.
1:49:23 PM
MR. MODEROW said he'd like to point out that page 10, Sec.
21.54.280 has provisions to get federal funding and other
sources of money into the healthcare fund to help implement the
program. He isn't familiar with the enhanced COBRA in the
stimulus, but they would like to capture dollars from all
available sources. In this bill they tried very hard to make
protections that are available in the small group market
available to individuals. He clarified that the CS seeks to not
change any of the mandated benefits in the small group.
CHAIR DAVIS said she thinks the committee has considered this
sufficiently. This is a good step and hopefully in the end it
will be agreeable to most people. The system is broken; there
are too many people out there without coverage.
SENATOR DYSON said he is impressed with the work that's been
done on the bill, but it starts with a premise he can't come to
grips with yet. "In our desire to make healthcare available to
everybody, we have decided that the way we've got to do that is
to make health insurance available to everybody." I can't come
to that conclusion, he said.
SENATOR DYSON commented that he realizes that the bill will
move, but he is going to object.
1:53:17 PM
SENATOR ELLIS said he is a co-sponsor and an enthusiast vote to
move the bill forward. The committee, subcommittee and staff in
particular have done good work. Senator French should be
commended for his efforts over the last three years. Senator
Ellis noted that he and former Senator Jim Duncan sponsored the
original universal healthcare task force 20 years ago. They
recommended a single payer system and the business community
called it socialized medicine, which it is not. Since then the
situation has gotten worse. Public opinion polling does not
agree with the figures provided by Mr. Tamagni.
Senator French has taken a market-based consumer driven
approach. It's not a single payer system and it's not socialized
medicine. It is socialized insurance through the private market
with government subsidy. We have to be respectful of the
concerns of small businesses, but large businesses can no longer
compete in the world market because this country hasn't solved
the healthcare issue, he said. Every other industrialized nation
has addressed healthcare and found resolution. This is a new
approach and a step forward. Private health insurers are
included and can make money.
CHAIR DAVIS commented that the COBRA enhancement in the stimulus
package could be incorporated in another committee.
1:57:12 PM
SENATOR PASKVAN moved to report committee substitute to SB 61
from committee with individual recommendations and accompanying
fiscal notes.
1:57:37 PM
SENATOR DYSON objected.
A roll call vote was taken. Senators Ellis, Thomas, Paskvan,
and Davis voted in favor of the motion. Senator Dyson voted
against it. Therefore, CSSB 61(HSS) was reported out of the
Senate Health and Social Services Standing Committee by a vote
of 4:1.
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