Legislature(2007 - 2008)HOUSE FINANCE 519
05/11/2007 01:30 PM House FINANCE
| Audio | Topic |
|---|---|
| Start | |
| SB27 | |
| Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
| += | SB 27 | TELECONFERENCED | |
HOUSE FINANCE COMMITTEE
May 11, 2007
2:18 p.m.
CALL TO ORDER
Co-Chair Meyer called the House Finance Committee meeting to
order at 2:18:50 PM.
MEMBERS PRESENT
Representative Mike Chenault, Co-Chair
Representative Kevin Meyer, Co-Chair
Representative Bill Stoltze, Vice-Chair
Representative Harry Crawford
Representative Les Gara
Representative Mike Hawker
Representative Reggie Joule
Representative Mike Kelly
Representative Mary Nelson
Representative Bill Thomas, Jr.
MEMBERS ABSENT
Representative Richard Foster
ALSO PRESENT
Senator Bettye Davis; Thomas Obermeyer, Staff, Senator
Bettye Davis; Walter Majoros, Executive Director, Juneau
Youth Services; Janet Clarke, Assistant Commissioner,
Division of Finance and Management Services, Department of
Health and Social Services; Marie Darlin, AARP; Suzanne
Cunningham, Staff, Representative Meyer
PRESENT VIA TELECONFERENCE
None
SUMMARY
CSSB 27(FIN) am"An Act relating to eligibility requirements
for medical assistance for certain children, pregnant
women, disabled persons, and persons in medical or
intermediate care facilities; and providing for an
``effective date."
HCS CSSB 27 (FIN) was REPORTED out of Committee with a
"do pass" recommendation and with zero fiscal note #5
by the Department of Corrections, and fiscal notes #6,
#7, and #8 by the Department of Health and Social
Services.
2:18:57 PM
CS FOR SENATE BILL NO. 27(FIN) am
"An Act relating to eligibility requirements for
medical assistance for certain children, pregnant
women, disabled persons, and persons in medical or
intermediate care facilities; and providing for an
effective date."
SENATOR BETTYE DAVIS, sponsor, related that the bill had
been heard by the House Finance Committee previously. The
bill would provide an opportunity to keep some kids on
Denali Kid Care and brings other on the program. She urged
the committee to support the bill.
THOMAS OBERMEYER, STAFF, SENATOR BETTYE DAVIS, explained
that Denali Kid Care program is a part of the State Children
Health Insurance Program (SCHIP) program, which funds at a
rate of 70 percent federal money and 30 percent state money.
It supports children in all states. The Denali Kid Care
Program had about 7,600 children on the rolls as of the end
of 2006. Since the program was cut back in 2003, 3,000
children are no longer served. Another 1,000 children will
be dropped from the program if nothing is done.
The bill restores the Denali Kid Care program at 175 percent
of federal poverty level, the level that was set in 2003
after having been at 200 percent previously. Alaska is at
the lowest level of poverty percentage in the country, with
the exception of Montana and North Dakota. He requested
support for the bill.
Senator Davis added that the funding request is at 175
percent of poverty level. Co-Chair Meyer asked how that
percentage was decided. Senator Davis reported that the
original bill was at 200 percent and the amount was
decreased in Senate Finance. Co-Chair Meyer asked if
permanent funds were included when determining eligibility.
Senator Davis didn't know.
2:25:09 PM
Mr. Obermeyer mentioned that the 175 rate is a percentage of
the federal poverty guidelines. He emphasized that those
people are seriously financially strapped.
Representative Gara related that increasing from 150 percent
to 175 percent adds about 1,000 to 1,300 kids to the health
insurance rolls at a cost of about $600,000. 200 percent
would have added 2,000 - 2,500 kids to the rolls at a cost
of $1.2 million in state money because of the federal match.
The state's cost is $600 per child. Only two states insure
at a lower level than Alaska. He argued for 200 percent.
2:27:45 PM
WALTER MAJOROS, EXECUTIVE DIRECTOR, JUNEAU YOUTH SERVICES,
testified in strong support of SB 27. He related the impact
of Denali Kid Care on children's behavioral health services,
which funds the majority of these services. He discussed
the Bring the Kids Home Initiative. He spoke of the
problems with lessening support for health services due to
kids not qualifying for Denali Kid Care. Several states are
taking steps to expand health care coverage for kids. He
urged the committee to pass the amount at over 175 percent.
Representative Gara pointed out that if federal eligibility
is lost due to falling below 150 percent, it would cost the
state about $3 million.
2:32:03 PM
MARIE DARLIN, AARP, testified in support of SB 27. She
referred to a letter to the committee members (copy on
file.) She termed AARP the largest group of grandparents
in favor of Denali Kid Care. Her organization sees Denali
Kid Care as an important building block of the state's
health care program. She mentioned the number of kids who
are no longer qualifying for the program. She termed the
bill preventive health care that saves money later on.
Behavioral health needs also ought to be considered.
2:35:25 PM
Co-Chair Meyer turned attention to the fiscal notes.
JANET CLARKE, ASSISTANT COMMISSIONER, DIVISION OF FINANCE
AND MANAGEMENT SERVICES, DEPARTMENT OF HEALTH AND SOCIAL
SERVICES, drew attention to the three fiscal notes by the
department. She referred to a chart (copy on file) which
showed the total impact of the costs of Denali Kid Care at
175 percent, as well as the number of kids served. In 2008
the bill would add 1,277 kids and 218 pregnant women to the
program for an annual Medicaid program cost of $2,651.3
million and an annual administrative cost of $40.2 million.
The total cost would be $2,691.5 million, with the federal
share of $1,907.4 million, and the general fund share of
$783.5 thousand. Some of the children who were dropped
would be eligible for the program again.
Representative Gara asked if the general fund share would be
$783.5 thousand at 175 percent, and would be double that at
200 percent. Ms. Clarke said that is correct - it would
double.
Co-Chair Meyer asked if the dollar amount requested for
Denali Kid Care is available in the budget. Ms. Clarke
replied that these dollars are not in the budget and a
fiscal note would be needed.
Representative Gara pointed out the loss of federal monies
by not funding the program. It would be cheaper for the
state to go to 175 percent, than to do nothing.
2:40:18 PM
Representative Kelly asked how federal eligibility could be
maintained. He wondered if 150 percent is the goal amount.
Ms. Clarke said he was in the ball park.
Representative Gara announced that he and Senator
Wielechowski have a proposal that would provide universal
health care for children and let families buy into the
program if they are above 175 percent of the federal poverty
level. He asked if the fiscal note would only be about $3
million under such a proposal. Ms. Clarke said she does not
have that information with her.
2:41:41 PM
Co-Chair Meyer MOVED to ADOPT Amendment #1:
Page 1, lines 2-3:
Delete ", disabled persons, and persons in medical or
intermediate care facilities"
Insert "and disabled persons"
Co-Chair Chenault OBJECTED.
SUZANNE CUNNINGHAM, STAFF, REPRESENTATIVE MEYER, explained
that Amendment #1 was brought to the Co-chair's attention by
legislative legal services. An amendment was made in Senate
Finance that removed a section pertaining to the percentage
of federal poverty guidelines and individuals in medical or
intermediate care facilities. A title amendment was needed
because of that. It does not involve a title change
resolution because it is a technical change.
Representative Gara asked if the original bill extended care
to persons in medical or intermediate care facilities. Ms.
Cunningham said that was correct. Representative Gara asked
for more information.
Ms. Clarke reported that the original bill covered persons
who were eligible at 300 percent of poverty level. The cost
of adding 106 of them was $6.1 million. The Senate Finance
Committee changed that and kept it frozen in statute. She
explained that those individuals eventually qualify for
nursing homes.
Representative Gara asked if the levels would fall every
year. Ms. Clarke said they would.
Vice Chair Stoltze WITHDREW his objection. There being NO
OBJECTION, it was so ordered.
2:46:31 PM
Representative Gara MOVED to ADOPT Amendment #2:
Page 3, Line 26, following "poverty":
Delete: "line"
Insert: "guideline"
Page 4, Line 6, following "poverty":
Delete: "line"
Insert: "guideline"
Page 4, Line 29, following "poverty":
Delete: "line"
Insert: "guideline"
Line 25, following "poverty":
Delete: "line"
Insert: "guideline"
Representative Hawker OBJECTED.
Representative Gara MOVED to AMEND Amendment #2 by omitting
the Page 4, Line 6 change. There being NO OBJECTION, it was
so ordered.
Representative Gara explained that the Denali Kid Care is
based on a percentage of the federal poverty guideline. He
thought the wording "poverty line" was incorrect and should
be "poverty guidelines". Representative Hawker commented
that according to the federal Health and Human Services
Bulletin the correct wording is "poverty line" for Alaska.
He suggested conforming the bill to legislative drafting
suggestions. Vice Chair Stoltze concurred.
2:49:32 PM
Senator Davis related that legislative legal suggested
leaving "line" in the bill.
Representative Gara WITHDREW Amendment #2.
Representative Gara asked about the guideline for Alaska.
Ms. Clarke said it is an Alaska statute and it is a drafting
choice not to say "in Alaska".
Representative Gara asked about the federal schedule listing
for Alaska. Ms. Clarke deferred to legislative legal.
2:51:49 PM
Representative Kelly brought up that the state is
approaching a deficit. He voiced concern about adding to
this entitlement program. He spoke against having a third
of Alaskan kids in the program. He didn't think the program
was having a positive effect on social issues in the state.
He was opposed to handing out money from the government.
Representative Kelly MOVED to ADOPT Conceptual Amendment #3
- to set the federal rate of poverty at 150 percent for the
bill.
Representative Nelson OBJECTED.
Representative Hawker referred to a section of the bill on
page 5 regarding cost sharing, which would also have to be
changed if Conceptual Amendment #3 passes. Representative
Kelly thought whatever needed to be included to make the
bill conform to 150 percent could be done.
Co-Chair Meyer asked how easy it would be to make the
change. Ms. Clarke said that it would have a larger impact
than just reducing the percentage. It would change the
current Denali Kid Care program to 150 percent sooner than
was planned. A number of children would lose coverage
immediately. Representative Kelly said that was not his
intent. Co-Chair Meyer suggested the Representative Kelly
come up with an amendment by tomorrow.
Representative Gara suggested raising the percentage to 200
in a pending amendment.
Co-Chair Meyer suggested saving both amendments for the
floor. Representative Kelly agreed.
2:58:48 PM
Co-Chair Chenault asked if a family of four at 175 percent
poverty level makes about $47,000 a year. Ms. Clarke said
150 percent for a family of four would be $38,730; 200
percent would be $51,640. Co-Chair Chenault asked for
underlying factors why some families would need this
insurance support. He wondered if the numbers were too
high.
Ms. Clarke said SCHIP is a relatively new program, so many
of the changes have not been demonstrated yet. She brought
up the expense of health care in Alaska. There is a
provision in federal law prohibiting eligibility for Denali
Kid Care for a period of time. Co-Chair Chenault gave an
example of a family that would opt out of insurance to go on
Denali Kid Care. Ms. Clarke said if the insurance is
available by their employer, they do not qualify. Co-Chair
Chenault asked how many children in Alaska require state
assistance. Ms. Clarke thought about 50 percent.
3:04:00 PM
Mr. Obermeyer pointed out that the 2007 poverty guidelines
for Alaska show 175 percent of a family's income, not total
income. For a family of four, $41,300 is 200 percent of
their actual income. Ms. Clarke added that Denali Kid Care
does not cover the parents.
Representative Gara explained what is covered under the
kid's universal health care provision in his bill. He
shared statistics that half of employers in Alaska do not
provide insurance. He gave an example why this coverage is
needed. Half of the kids without insurance have parents who
work.
3:06:59 PM
Representative Kelly spoke of lack of faith in the system
regarding defined benefits. He spoke against adding more
into the welfare system - to entitlements.
Representative Kelly WITHDREW Conceptual Amendment #3.
Vice Chair Stoltze related a personal story supporting
families taking care of their own.
3:09:32 PM
Co-Chair Chenault MOVED to REPORT CSSB 27 (FIN) am, as
amended, from committee with individual recommendations and
the accompanying fiscal notes. There being NO OBJECTION, it
was so ordered.
HCS CSSB 27 (FIN) was REPORTED out of Committee with a "do
pass" recommendation and with zero fiscal note #5 by the
Department of Corrections, and fiscal notes #6, #7, and #8
by the Department of Health and Social Services.
ADJOURNMENT
The meeting was adjourned at 3:12 PM.
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