Legislature(2009 - 2010)BUTROVICH 205

03/11/2009 01:30 PM HEALTH & SOCIAL SERVICES

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Heard & Held
Heard & Held
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          SB  11-DEPENDENT HEALTH INSURANCE; AGE LIMIT                                                                      
CHAIR DAVIS announced consideration of SB 11.                                                                                   
1:33:34 PM                                                                                                                    
TOM OBERMEYER, staff to Senator Davis, read the sponsor                                                                         
statement for SB 11 as follows:                                                                                                 
1:34:00 PM                                                                                                                    
     SB  11 requires  an  insurer to  enroll, and  prohibits                                                                    
     taking  off  the  rolls   or  eliminating  health  care                                                                    
     insurance coverage without the  consent of the insured,                                                                    
     for a person  less than 26 years old who  is related to                                                                    
     the  insured, unmarried,  financially dependent  on the                                                                    
     insured,  does  not  have dependents,  enrolled  in  an                                                                    
     institution of higher education,  and not insured under                                                                    
     another policy. SB 11 changes  the age that a person is                                                                    
     considered  a child  from 23  years  of age  to 26  for                                                                    
     purposes of  determining who may  be insured  under the                                                                    
     same policy of health insurance.                                                                                           
     Young  adults,  ages  19-29, are  one  of  the  largest                                                                    
     growing segments of the  U.S. population without health                                                                    
     insurance.  In  2004  almost 14  million  young  adults                                                                    
     lacked  coverage,  an  increase of  2.5  million  since                                                                    
     2000. This rapid change is  due in part to their losing                                                                    
     coverage  under  their  parents'  policies  at  19,  or                                                                    
     Medicaid,   or   State  Children's   Health   Insurance                                                                    
     Program,  or graduation  from high  school or  college.                                                                    
     Almost  half  of  college  graduates  and  high  school                                                                    
     graduates  will be  uninsured  for  a substantial  time                                                                    
     after graduation.                                                                                                          
     Age 19 is a crucial  year in health insurance coverage.                                                                    
     Both public and private  insurance plans treat this age                                                                    
     as  a turning  point  for insurance  coverage. Even  if                                                                    
     youth go on to college,  parents' insurance plans often                                                                    
     stop    before   graduation.    Almost   all    private                                                                    
     universities   and   about   one   fourth   of   public                                                                    
     universities  require health  insurance as  a condition                                                                    
     of enrollment. Forty percent  of part-time students and                                                                    
     non-students,  and  20  percent of  full-time  students                                                                    
     ages 19-23 are uninsured.                                                                                                  
     Insurance  coverage  is  important for  this  generally                                                                    
     healthy group of young adults  who should be encouraged                                                                    
     to  start taking  responsibility for  their own  health                                                                    
     care. It has  been found that 14 percent  of adults 18-                                                                    
     29 are obese,  an increase of 70 percent  in the 1990s,                                                                    
     the fastest  rate of increase  among all  adults. There                                                                    
     are  3.5 million  pregnancies each  year  among the  21                                                                    
     million women  ages 19-29.  One-third of  all diagnoses                                                                    
     of  HIV are  made  among young  adults. Emergency  room                                                                    
     visits  are far  more  common among  young adults  than                                                                    
     children  or older  adults. Most  young adults  have no                                                                    
     regular doctor, no link to  the health care system, and                                                                    
     more  than one-third  of those  who do  require medical                                                                    
     attention are  often saddled  with debt  and collection                                                                    
     States are taking action to  mandate coverage for young                                                                    
     adults,  often allowing  for  targeted policy  options.                                                                    
     For  example, in  2006 New  Jersey required  most group                                                                    
     health  plans to  cover single  adult dependents  up to                                                                    
     age 30.  Massachusetts as part  of its  expanded health                                                                    
     insurance  law   in  2006  considered   dependents  for                                                                    
     insurance purposes up to age  25 or for two years after                                                                    
     they  are  no  longer  claimed on  their  parents'  tax                                                                    
     returns. Since 1994 Utah  has required coverage through                                                                    
     age 26, and New  Mexico provides coverage for unmarried                                                                    
     dependents  up   to  age   25,  regardless   of  school                                                                    
     enrollment.  Texas in  2003 allowed  full-time students                                                                    
     up to be  covered by their parents'  insurance plans to                                                                    
     age   25.  It   is  not   uncommon,  or   unreasonable,                                                                    
     therefore,  that  Senate   Bill  11  requires  offering                                                                    
     family health insurance  coverage to dependent children                                                                    
     up to age 26.                                                                                                              
1:38:12 PM                                                                                                                    
SENATOR  DYSON  said he  had  hoped  someone from  the  insurance                                                               
industry would testify  and said he is glad that  it is not Chair                                                               
Davis's intention to move the bill today.                                                                                       
CHAIR DAVIS  said this bill has  been heard before and  thinks it                                                               
would be  quite helpful to  the young  people of this  state; she                                                               
intended to hold it to give  people more opportunity to speak for                                                               
or against it.                                                                                                                  
SENATOR DYSON  asked if the  term "enrolled" in  higher education                                                               
has been defined for the purposes of this bill.                                                                                 
CHAIR  DAVIS  replied that  she  believes  a  student has  to  be                                                               
enrolled full  time, which  would mean at  least 12  credits, but                                                               
she will verify that.                                                                                                           
MR. OBERMEYER  said that language  on page 2,  AS 21.42.345(e)(5)                                                               
says the  person must be enrolled  "as a full-time student  at an                                                               
institution  of higher  education accredited  by the  regional or                                                               
national  accrediting  agencies  recognized by  the  Council  for                                                               
Higher  Education  Accreditation  or  the  U.  S.  Department  of                                                               
Education."  The fiscal  note indicates  that  the University  of                                                               
Alaska currently  has 200 non-active dependents  between the ages                                                               
of  24  and 26  who  would  become  re-eligible for  health  care                                                               
insurance  if  this  bill  were  to  pass;  the  expected  annual                                                               
increase in cost to UA would be approximately $1.2 million.                                                                     
SENATOR DYSON admitted  that he had not read that  portion of the                                                               
bill carefully.  He wondered whether,  if a kid enrolls  and gets                                                               
coverage and then quits school or  flunks out, if a process is in                                                               
place to let the insurer know the student is no longer eligible.                                                                
1:42:12 PM                                                                                                                    
SENATOR THOMAS joined the meeting.                                                                                              
CHAIR DAVIS  responded that  it depends on  who your  coverage is                                                               
with; but  in her experience  the insurer will carry  the student                                                               
to the  end of that school  year, but will not  renew coverage if                                                               
the student does not enroll for the following school year.                                                                      
SENATOR DYSON  said that  he probably  knows far  more scoundrels                                                               
than Senator  Davis does, who are  looking for a way  to scam the                                                               
MR.  OBERMEYER remarked  that the  increased  cost to  continuing                                                               
coverage  for these  children  has  not been  very  high. It  was                                                               
anticipated that if the parents want  to keep their children on a                                                               
health  care plan,  they could  do  so until  age 26;  this is  a                                                               
relatively  healthy  population  group,   so  it  hasn't  greatly                                                               
increased the cost  to private insurers. He said he  would try to                                                               
get some figures from other states.                                                                                             
SENATOR PASKVAN  observed that  this would help  a person  who is                                                               
18, joins the  military for a few years, gets  out and then wants                                                               
to go back to school full time.                                                                                                 
1:44:32 PM                                                                                                                    
SENATOR DYSON  added that will be  true only if the  person meets                                                               
the criteria of being a dependent child.                                                                                        
MR.  OBERMEYER  pointed  to  the  second  page  of  the  National                                                               
Conference of State Legislatures  (NCSL) Legislative Brief in the                                                               
members' packets. Under State Action, it says:                                                                                  
     Expanded coverage  for young  adults may  be structured                                                                    
     as  an  insurance  policy  rider  with  supplements  et                                                                    
     cetera... More  commonly, coverage  is extended  to all                                                                    
     policies and the  young adult is simply  covered by the                                                                    
     family premium.  Some experts  predict that  the latter                                                                    
     strategy  may increase  employer  premiums  by about  5                                                                    
     percent to 9 percent.                                                                                                      
That may  not be significant, he  said, but it depends  upon what                                                               
population  sample  one is  looking  at,  and other  options  are                                                               
available  like   keeping  students  on  the   plan  but  perhaps                                                               
requiring  a  small  rider.  He   mentioned  this  because  those                                                               
students who  are forced to  accept college plans  sometimes find                                                               
they are paying $1800 or more  per year for coverage; if they can                                                               
stay  on their  parents'  plan, it's  far  cheaper than  anything                                                               

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