Legislature(2003 - 2004)
05/15/2003 07:53 AM Senate L&C
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* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
CSHB 195(L&C)am-STATE HEALTH INSURANCE PLAN
SENATOR SEEKINS announced CSHB 195(L&C)am to be up for
consideration.
MS. HEATHER NOBREGA, staff to Representative Rokeberg, explained
that CSHB 195(L&C)am deals with two distinct areas. Section 1
attempts to give individual health care insurance seekers the
option of providing a bare bones insurance policy that doesn't
include the state mandates listed in statute. This is intended
to be in addition to the normal individual plan that would
include all the mandates that are required. The proposed CS
includes clarifying language on this issue on page 2, lines 2 -
4, that the bare bones coverage is "in addition to" the
mandatory coverages listed in statute.
The Division of Insurance requested the second portion of the
bill. The federal government has adopted the Trade Adjustment
Assistance Act, which provides a 65% health care tax credit on
an insurance premium for people, like timber and oil workers,
who have lost their jobs due to the effects of international
trade acts.
Sections 2 through 9 make conforming amendments to the Alaska
Comprehensive Health Insurance Association (ACHIA) statutes so
that those individuals who do qualify under the Federal Trade
Adjustment Assistance Act can actually get 65% of their ACHIA
premiums paid by the federal government.
SENATOR DAVIS arrived at 3:22 p.m.
SENATOR SEEKINS moved to adopt SCS CSHB 195(L&C), version U, as
the working document. There were no objections and it was so
ordered.
SENATOR SEEKINS asked Ms. Nobrega to explain the numbers on the
handout, which she did briefly.
SENATOR SEEKINS asked what the impetus was to provide this kind
of policy.
MS. NOBREGA replied that this was Representative Rokeberg's
idea. He wanted to help provide cheaper health care insurance
for people who don't want all the coverage but would like some
form of health care insurance.
MS. MICHELLE CASSANO, Executive Director, American Diabetes
Association, wanted to clarify the mandate in AS 06.42.390 is
for coverage of diabetes treatment including medication,
equipment and education. She indicated:
HB 195 will eliminate the requirement that state
regulated individual health insurance plans cover
diabetes supplies, equipment and self-management
education. It will eliminate a similar requirement to
many other health benefits. The business community
claims mandates-free policies provide affordable
health insurance through [indisc.] consumer choice,
but, in fact, they only provide employers and
consumers with the choice of a health insurance plan
that does not cover basic, necessary services.
HB 195 will allow diabetes coverage to be offered
rather than required in individual health insurance
plans. [Indisc.] option coverage, but it doesn't
work...
She said that they wouldn't support HB 195 unless section 1 was
eliminated. Approximately 39,000 Alaskans are affected by
diabetes.
SENATOR STEVENS asked if the changes in the bill would remove
the mandate that insurance policies cover preventative treatment
of diabetes and whether that would let the insurance companies
off the hook for all of the debilitating aspects of diabetes as
it progresses.
MS. CASSANO replied that it is scientific fact that preventative
care and good control of diabetes can limit complications in the
aggregate by 68% in both Type 1 and Type 2 diabetes.
MS. LOIS HILDEBRAND, Volunteer, American Cancer Society, said:
This bill sets up a dangerous precedent for Alaskans
for not getting life-saving cancer screening tests.
Furthermore, it contains inconsistencies that
undermine the stated intent of the legislation. Over
the last decade, state legislatures have increasingly
become aware of the importance of requiring insurance
coverage for cancer screening. Early detection of
cancer is the key to survival....
She said that all attempts made to reduce required insurance
coverage in Washington State failed.
MR. BILL MOORE, Manager, Legislative Policy, [indisc.], said his
group likes legislation that responds to consumer concerns about
rising costs of health insurance premiums and offers a choice in
the health insurance marketplace. He stated, "We think HB 195
advances all of these principles."
MS. JANEL WRIGHT, Anchorage resident, said she has had diabetes
for over 27 years and urged the committee to not pass HB 195 or
at least to eliminate section 1. She pointed out, "Access to and
reimbursement providing supplies and equipment and self
management education is cost effective." She said managing
diabetes is expensive, but the cost to treat the complications
of unmanaged diabetes is even more expensive.
MS. LINDA HALL, Director of the Division of Insurance, said she
thought there was a misunderstanding about this particular bill
and the adopted CS.
There is no intention on the part of the sponsor of
the bill, which has the support of the division, to
remove mandates for coverage. This was an attempt to
make an option available should anyone choose to do
so, requires a very clear disclosure of the lesser
coverage provided by this particular option so that it
might make a small dent in the number of uninsured
people. We have a problem with health insurance costs;
we have a problem with health care costs....
MS. HALL said the CS specifically maintains those mandates for
individuals who choose to buy individual health care policies.
This does not affect group policies or employer provided
policies at all. She explained:
The Division of Insurance did ask for the balance of
this bill to be added. There will be federal money
available in August for individuals whose jobs are
replaced through various international trade assistant
acts. This money is coming from the federal government
and will be administered by the Department of Labor.
Again, this is a small step in helping alleviate our
uninsured population. The estimate right now is that
there probably would have been 200 people this year
affected by this. The estimates we were given by the
Alaska Department of Labor indicated up to as many as
2,000 could have been affected in some prior years.
We're very much encouraging you to pass this bill so
that our citizens will be eligible for this care in
August when the money is available.
CHAIR BUNDE thanked her and said they would hear the bill again
and Ms. Hall would be available, but he wanted to take public
testimony with the remaining time.
MS. BETSY TURNER-BOGGREN, Ester resident, asked the committee to
not support HB 195 as it is written. Three years ago, she and
her son, Max, traveled to Juneau and testified in front of this
committee in support of HB 298 and SB 276, which required
insurers in our state to reimburse for costs related to diabetes
management. It became law and had overwhelming support. She told
members, "HB 195 would not create a new type of health insurance
policy. Instead, it would recreate the old type of policies that
did not work well for the people of Alaska."
CHAIR BUNDE responded that testimony from the Division of
Insurance said that this bill does not remove any requirement
for coverage.
MS. BOGGREN replied that she didn't think that the language
stated that very clearly, especially in section 1, which says:
A health care insurer may offer a health care
insurance plan issued to the individual market that
does not include health coverage required under...
CHAIR BUNDE said he would get further clarification of that
section.
MS. KARIN BRAUN, Nurse Midwife, opposed HB 195, especially
section 1. She was concerned that if the legislature creates
this precedent for individuals, group insurance will follow.
MS. CARLA WILLIAMS, Alaska Breast Cancer Advocacy Partners,
opposed HB 195 and said that she had submitted written
testimony.
MS. CAMILLE SOLEIL, Alaska Nurses Association (ANA), said the
ANA opposes section 1 of HB 195. The ANA's concern is that this
type of insurance would discriminate against midwives.
CHAIR BUNDE apologized for rushing the testimony, but members
were late for another meeting. He said he would hold the bill
for further work and testimony.
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