Legislature(2007 - 2008)BELTZ 211
03/11/2008 01:30 PM LABOR & COMMERCE
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SB 160-MANDATORY UNIVERSAL HEALTH CARE 2:34:14 PM CHAIR ELLIS announced SB 160 to be up for consideration. The committee had CSSB 160(L&C), 25-LS0728\T to consider. SENATOR FRENCH, sponsor of SB 160, said he would comment on CSSB 160(L&C), 25-LS0728\T. He said it makes six changes, some small and some fairly significant. The first change is on page 3, lines 15-17, that broadens the view points that are represented on the Health Care Board. Concerns were heard from insurers that the definition of entities that would make up the insurance representatives on the board was too narrow. So now the two representatives are one large scale wholesaler and small scale retailer. He explained the retailer is called an "insurance producer," an industry term that refers to the customer oriented on-the-ground insurance retailer. 2:36:20 PM The second change is on page 5, lines 6-8, and clearly gives the duty to the board of making a plan that can effectively protect an individual from severe financial hardship in times of medical need - taking into account a household's income and other relevant financial criteria. He said, "It will make certain that insurance is meaningful for each Alaskan since a $10,000 deductible health care plan isn't much use to a household that earns $15,000 a year." 2:36:50 PM SENATOR FRENCH said the third change came in response to a concern of Senator Stevens. It removes a few words from what was subsection 7 on page 6. It used to say that Indian Health Service (IHS) benefits had to meet or exceed the benefits for essential health care services as defined in the legislation. That has been removed to make it clear that individuals who are satisfied with the care they receive through IHS facilities won't be subject to the requirement to have additional coverage - even if the IHS benefits don't line up exactly with essential health care services. To a large extent, this alleviates the fine decisions the board would have to make as to each IHS recipient and whether the benefits they receive met or exceeded those adopted by the plan. He said he worked with tribal representatives, and the important facts to keep in mind when looking at the interplay between SB 160 and the IHS system are first, that any third party payer will be first in line if an IHS beneficiary with third-party insurance walks into a clinic anywhere if they have third party insurance. The second thing to remember is that the amount of money dedicated by the federal government to IHS beneficiaries is fixed every year; it is distributed at the beginning of the year and that's the end of it. It is not limitless. They have enough money for day-to-day clinic visits and check ups, but when it comes to bone marrow transplants or a knee replacement or heart surgery, they may be "rationed out," because the amount of money allocated that year has been used up. So in essence SB 160 helps add to the care of any IHS beneficiary in the state. SENATOR FRENCH said IHS beneficiaries receive on average about $2,000 per individual spread across the entire population whereas someone outside the IHS receives about $4,000 to $5,000. SB 160 allows any IHS beneficiary to join the plan if they choose or not depending on how satisfied they are with their own personal situation. Senator French said, "SB 160 will not back out a single federal dollar that is currently being received in Alaska for the benefit of IHS beneficiaries." He said this was the most complex change even though it was just the reduction of a few words. The fourth change was on page 6, lines 11-14, that has to do with concerns on behalf of the Christian Science Religion who eschew modern medical practices. So SB 160 has allowed an exemption for those individuals. If they can demonstrate to the board that their deeply held religious beliefs are contrary to this program, they don't have to participate. Exemptions will be rigorously granted. SENATOR FRENCH said the next change is how "employees" and the "employer levy" are defined. There was concern that "employee" was defined too broadly. Imagine a business that employed nothing but military spouses or spouses of state or federal employees - all covered by health insurance. There is absolutely no need to apply an employer levy against that employer, because not a single one of those individuals needs health insurance. So an "employee" is defined as someone who is required to participate in the Alaska Health Care Plan on page 8, lines 11- 20 and that means they don't have coverage anywhere else. 2:42:06 PM He said the second change is with counting the number of employees, because you get into problems of defining how many hours a week that is. So, they went with the payroll number, which is roughly equal to what one would imagine 10 full-time employee equivalents is - the $500,000 figure. He explained if your total payroll of employees that don't have coverage anywhere else is $500,000 or less, no levy whatsoever. If it's between $500,000 and $1,000,000 it's 1 percent; if it's over $1,000,000 it's 2 percent. This is more business friendly and easier to understand. Finally, he said language on page 12, line 18, changes the effective dates to comport with concerns Legislative Legal had regarding adoption of regulations. 2:43:48 PM MARY RAYMOND, representing herself from Homer, said after listening to task forces and various bills to get affordable insurance for the last 20 years this is very exciting. Her concern that it was promoted as compulsory had been addressed. 2:45:09 PM PATRICK DALTON, Delta Junction, representing himself, agreed with the public oversight provision. He also suggested having two alternative health professionals on the Health Care Board - naturopath or herbologist. However, he asserted the legislature has no constitutional authority to require a citizen to contract into any health care plan whatsoever. Second, Mr. Dalton said, an element of hypocrisy exists because SB 160 requires everyone to have a health care card and then it turns around and denies coverage to any Alaskan who does not have one. He said the "preamble" of the bill clearly states that all Alaskans are eligible for this and he suggested just expanding health care coverage to any Alaskan who can prove they are a citizen or a resident. That way compliance doesn't have to be forced. Furthermore, he asked what criminal penalties there are for not partaking in the system. Finally, he said if they have to require health care coverage, even though he doesn't think they have the right to do that, he suggested having an opt-out system. He also asked how someone can demonstrate they have a firmly held religious belief that being a subjective matter. CHAIR ELLIS thanked everyone for sharing their thoughts and said he would hold SB 160 for further work. There being no further business to come before the committee, he adjourned the meeting at 2:49:27 PM.