Legislature(2015 - 2016)HOUSE FINANCE 519
04/11/2015 01:00 PM House FINANCE
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| Audio | Topic |
|---|---|
| Start | |
| HB148 | |
| Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
| += | HB 148 | TELECONFERENCED | |
HOUSE FINANCE COMMITTEE
April 11, 2015
1:05 p.m.
1:05:22 PM
CALL TO ORDER
Co-Chair Thompson called the House Finance Committee
meeting to order at 1:05 p.m.
MEMBERS PRESENT
Representative Mark Neuman, Co-Chair
Representative Steve Thompson, Co-Chair
Representative Dan Saddler, Vice-Chair
Representative Bryce Edgmon
Representative Les Gara
Representative Lynn Gattis
Representative David Guttenberg
Representative Scott Kawasaki
Representative Lance Pruitt
Representative Tammie Wilson
MEMBERS ABSENT
Representative Cathy Munoz
ALSO PRESENT
Pamela Watts, Juneau Alliance for Mental Health, Inc.
(JAMHI), Juneau; Kate Burkhart, Southeast Alaska
Independent Living, Inc. (SAIL), Juneau; Colleen McKenzie,
Juneau Alliance for Mental Health, Inc., Juneau; Tony
Sholty, Juneau Alliance for Mental Health, Inc., Juneau;
Crystal Bourland, Self, Juneau; Lincoln Bean, Alaska Native
Health Board, Juneau; Joan O'Keefe, Southeast Alaska
Independent Living and Statewide Independent Living
Council, Juneau; Kimberlay Strong, Southeast Alaska
Regional Health Consortium, Klukwon; Crystal Dooley, Self,
Juneau; Walter Majoros, Executive Director, Juneau Youth
Services, Juneau; Ric Iannolino, Self, Juneau; Karla Hart,
Self, Juneau; Annika Ord, Self, Juneau; Jorden Nigro, Self,
Juneau; Representative Andy Josephson; Representative Dan
Ortiz.
PRESENT VIA TELECONFERENCE
Elizabeth Ripley, Executive Director, Mat-Su Health
Foundation, Mat-Su; Mike Coons, Self, Mat-Su; Annette
Alfonsi, Self, Anchorage; Marian Elliott, Self, Wasilla;
Mary Minor, Self, Homer; Margaret Soden, Self, Fairbanks;
Richard Cobden, Fairbanks Orthopedics, Fairbanks; Jim
Lynch, Chief Financial Officer, Fairbanks Memorial
Hospital, Fairbanks; Pat Branson, Executive Director,
Senior Citizens of Kodiak, Kodiak; Judy Eledge, Self,
Anchorage; Ric Nelson, Chair, Governor's Council on
Disabilities and Special Education, Anchorage; Kevin D.
McGee, National Association for the Advancement of Colored
People - Alaska, Anchorage; Randi Sweet, United Way of
Anchorage, Anchorage; Rosalie Nadeau, CEO, AKEELA,
Anchorage; Robin Smith, Self, Anchorage; Jessica Cler,
Alaska Public Affairs Manager, Planned Parenthood Votes
Northwest, Anchorage; Ernie Weiss, Self, Anchorage; Richard
Mandsager, Providence Medical Center, Anchorage; Dr. Ilona
Farr, Family Practice Anchorage, Anchorage; Dr. Mario
Lanza, Alyeska Family Medicine Inc., Anchorage; David
Morgan, Alaskan Center for Sustainable Healthcare
Expenditures and Policy, Anchorage; Dr. Brett Barringer,
Medical Practice Owner, Anchorage; Cam Carlson, Self,
Fairbanks; John Murphy, Self, Fairbanks; Patrick McCormick,
Self, Fairbanks; Andrew Reimherr, Self, Fairbanks; Robert
Clark, President, Bristol Bay Area Health Corporation,
Dillingham; Richard Smith, Self, Valdez/Ketchikan; Barbara
Bigelow, Self, Valdez; Ruthie Knight, Valdez Hospital
Board, Valdez; Daniel Hamm, Alaskan Republican Assembly,
Palmer; Dee McKee, Self, Palmer; George McKee, Self,
Palmer; Judge Michael Jeffery, Self, Barrow; Tom Chard,
Executive Director, Alaska Behavioral Health Association,
Juneau; Lizette Stiehr, Executive Director, Alaska
Association on Developmental Disabilities, Chugiak; Randy
Eledge, Self, Anchorage; Linda Stevens, Self, Anchor Point;
Patricia Fisher, Self, Meadow Lake; Mike Powers, CEO,
Fairbanks Memorial Hospital, Fairbanks; Christopher Jenson,
Physician and President, Interior Independent Practice
Association, Fairbanks; Cheryl Kilgore, Executive Director,
Interior Community Health Center; Eric Treider, Self,
Soldotna; Tanya Halliday, Manager, Cook Inlet Dental,
Soldotna; Trina Richardson, Self, Soldotna; Nelma Treider,
Self, Soldotna; Eleanor Murphy, Self, Eagle River; Jon
Zasad, Director, Marketing and Development, Anchorage
Neighborhood Health Center, Anchorage; Ben Firth, Self,
Anchor Point; Sherrell Holtshouser, Self, Anchorage;
Barnabas Firth, Self, Anchor Point; Dr. Colonel Cockrell
Cates, Alaska Osteopathic Medical Association, Anchorage;
Jeanne Gerhardt-Cyrus, Self, Kiana; Pat Stanley, Executive
Director, Council of Athebascan Tribal Government, Yukon
Flats; Robin Patrick, Self, Palmer; Ellen Adlam, Peninsula
Community Health Services, Soldotna; Heidi Frost, Self,
Anchorage; Nancy Burke, Self, Anchorage; Ryan McKee, Self,
Anchorage; Jeremy Price, Director, Americans for Prosperity
Alaska, Anchorage; Hans Roduik, Field Director, Americans
for Prosperity Alaska, Anchorage; Bob Reupke, Anchorage
Faith in Action Congregations Together, Anchorage; Dave
Branding, South Peninsula Behavioral Health Services,
Homer; Ken Landfield, Self, Homer; Jill Lush, Self, Homer;
Tyson Alteri, Self, Homer; Cassidy Lush, High School
Student, Homer; Monica Adams, CEO, Peninsula Community
Health Services, Kenai; Joshua Gilmore, Tanana Chiefs
Conference, Fairbanks; Jeanette Grasto, National Alliance
of Mental Illness (NAMI), Fairbanks; Daniel Nelson,
President, Alaska Pharmacists Association, Fairbanks; David
Boyle, Self, Anchorage; Andree McLeod, Self, Anchorage;
Jerry Jenkins, CEO, Anchorage Community Mental Health
Services, Anchorage; Michael Sobocinski, Anchorage
Community Mental Health Services, Anchorage; David Nees,
Self, Anchorage; Shelly Vendetti-Vuckovich, Self,
Anchorage; Katie Parrot, Director, Quality Assurance and
Program Development, Residential Youth Care, Ketchikan;
Mary Jane Toutonghi, Self, Soldotna; Pat Linton, Executive
Director, Seward Community Health Center, Seward; Jim Syke,
Self, Palmer; Bonnie Cameron, Self, Anchorage; Monica
Stoesser, Self, Anchorage; Tom Lakosh, Self, Anchorage;
Alex Gimarc, Self, Anchorage; Alex Prichard, Self,
Fairbanks; Lora Jorgenson, Self, Anchorage; Frank Box,
Self, Anchorage; Lee Coray-Ludden, Self, Clam-Gulch; John
Cullen, Family Physician, Valdez.
SUMMARY
HB 148 MEDICAL ASSISTANCE COVERAGE; REFORM
HB 148 was HEARD and HELD in committee for
further consideration.
1:05:44 PM
Co-Chair Thompson discussed the agenda for the day.
HOUSE BILL NO. 148
"An Act relating to medical assistance reform
measures; relating to eligibility for medical
assistance coverage; relating to medical assistance
cost containment measures by the Department of Health
and Social Services; and providing for an effective
date."
1:05:59 PM
PAMELA WATTS, JUNEAU ALLIANCE FOR MENTAL HEALTH, INC.
(JAMHI), JUNEAU, testified in support of Medicaid
expansion. She provided information about the organization;
its services helped keep many adults with mental illness
from needing more intensive and costly care. She detailed
that many of JAMHI's clients used Medicaid to receive
services. The organization also served a significant number
of people who were not currently eligible for Medicaid;
services for these clients were paid for with state general
funds and by scraping together other sources of funding.
She did not believe it was prudent to wait until people's
behavioral health problems became so severe that they
needed to apply for social security disability benefits to
become Medicaid eligible. She shared that early
intervention was more effective and saved the state money.
She urged the committee to support the expansion of
Medicaid in Alaska; it made good common and fiscal sense in
the short and long-term.
1:08:05 PM
KATE BURKHART, SOUTHEAST ALASKA INDEPENDENT LIVING, INC.
(SAIL), JUNEAU, testified in support of Medicaid expansion.
She communicated that the entity was not a Medicaid biller;
there was no financial incentive related to SAIL's support.
She shared that many of the disabled adults served by the
organization did not have healthcare. She detailed that
SAIL worked to help clients remain stable and active in the
community and to help them navigate the disability system
through the Social Security Administration (SSA). She
shared that one of the barriers to accessing Medicaid in
the state was the requirement that a person be determined
disabled by the SSA first, which could be very complex. The
bill ensured that Alaskans in need had access to healthcare
and that SAIL clients had a greater opportunity to be
productive and contributing in the community.
Co-Chair Thompson noted that Representative Edgmon and
Representative Kawasaki had joined the meeting.
1:09:54 PM
COLLEEN MCKENZIE, JUNEAU ALLIANCE FOR MENTAL HEALTH, INC.,
JUNEAU, testified in support of Medicaid expansion. She
stated that without Medicaid services many seriously
mentally ill adults would be unable to access necessary
care and would be faced with using the hospital as a
stopgap measure, or could in up homeless, or in jail.
Medicaid enabled individuals to receive therapy,
psychiatric services, case management, and support
services. She elaborated that many adults with mental
illness were not eligible for Medicaid and had little or no
means of support. She stressed that Medicaid funding was
critical for the organization to serve adults with mental
illness. She strongly encouraged Medicaid expansion.
1:11:28 PM
TONY SHOLTY, JUNEAU ALLIANCE FOR MENTAL HEALTH, INC.,
JUNEAU, stressed that Medicaid expansion was the right
thing to do and was the fiscally responsible and
conservative thing to do. He urged the committee to pass
the legislation, which would save the state money.
1:12:25 PM
CRYSTAL BOURLAND, SELF, JUNEAU, testified in support of
Medicaid expansion. She discussed her prior employment
where she had encountered many individuals who fell within
the Medicaid gap. She shared details about the individuals
that did not have healthcare coverage including college
students. She pointed to other individuals she had seen
without insurance including artists, seasonal and service
workers, self-employed persons, fishermen, and individuals
making minimum wage. She stressed that a lack in health
coverage could lead barriers to employment and to poor
health and quality of life.
1:14:34 PM
LINCOLN BEAN, ALASKA NATIVE HEALTH BOARD, JUNEAU, testified
in support of Medicaid expansion. He provided information
about his professional background. The board adamantly
believed that the present was the right time to expand
Medicaid. He spoke to the entity's track record as an
effective and innovative partner in the delivery of health
services and how Medicaid expansion was needed to improve
service delivery and cost savings. He referred to various
health programs offered by the entity; the system was
underfunded by 50 percent. He stressed that third-party
billing, which included Medicaid and other insurance, was
an essential component of the funding mix. He elaborated
that 100 percent Federal Medical Assistance Percentage
(FMAP) was another necessary element of the funding. He
shared that every time an Alaskan Native utilized an Alaska
Native Tribal Health Consortium (ANTHC) facility the costs
were reimbursed by 100 percent. Medicaid expansion was
critical to the reform of the tribal health system and to
achieve cost savings for the state.
Co-Chair Thompson noted that Representative Guttenberg
joined the committee; Representative Munoz was excused.
1:17:29 PM
JOAN O'KEEFE, SOUTHEAST ALASKA INDEPENDENT LIVING AND
STATEWIDE INDEPENDENT LIVING COUNCIL, JUNEAU, testified in
support of Medicaid expansion. She shared that both
organizations had passed resolutions in support of Medicaid
expansion and reform. She communicated that Alaskans with
behavioral health disorders, developmental disabilities,
Alzheimer's, dementia, and other were at a much higher risk
for being uninsured. She relayed that Medicaid expansion
would provide coverage for low income Alaskans with
disabilities who currently did not have health insurance.
She stated that the services available under Medicaid
expansion would offer more effective and less expensive
solutions. A person with healthcare was more likely to hold
down a job when their basic healthcare needs were met. She
urged the committee's support.
1:19:07 PM
KIMBERLAY STRONG, SOUTHEAST ALASKA REGIONAL HEALTH
CONSORTIUM, KLUKWON, testified in support of Medicaid
expansion and reform. She explained that an expansion in
Medicaid would enhance services available in rural
communities. She opined that people would not want to visit
villages that did not have access to services for heart
attack victims and other. She drew a distinction between
federal overreach versus viewing Medicaid expansion as a
helping hand. She believed a hand helping the state would
be beneficial.
1:21:27 PM
ELIZABETH RIPLEY, EXECUTIVE DIRECTOR, MAT-SU HEALTH
FOUNDATION, MAT-SU (via teleconference), testified in
support of Medicaid expansion. The entity believed health
reform was possible; the foundation had data and new
perspectives to help achieve the triple aim in Mat-Su,
which included better care for individuals, better health
for populations, and lower per capita costs. She strongly
urged the committee to pass HB 148 that worked to expand
and reform Medicaid. She discussed a recent report
published by the foundation that included a deep dive on
Mat-Su Regional Emergency Department utilization in 2013.
She provided patient visit statistics. She emphasized that
the care of high utilizers needed to be managed more
effectively. She relayed that reforms included in the
bill's Section 10 could accomplish the goal. She shared
that the Mat-Su population had almost doubled since 2000;
however, the community mental health center grants had
remained flat. She detailed that Medicaid expansion
prevented costly emergency department visits, helped reduce
cost shifting, and helped to lower healthcare costs system-
wide. She hoped the committee expedited passage of the
bill.
1:24:49 PM
Co-Chair Thompson noted that Representative Gara had joined
the committee.
MIKE COONS, SELF, MAT-SU (via teleconference), spoke in
opposition to Medicaid expansion. He supported reform only
if it helped reduce the number of Medicaid recipients and
fraud by users and to give help to those with a true need.
He believed the Department of Health and Social Services
had been untruthful about the impact of Medicaid expansion.
He was a former paramedic and stated that not one patient
he had treated or seen in the emergency room had earned the
right for free medical care. He spoke to people who had
earned money to pay for healthcare. He stressed that there
were people who only took and gave nothing back in return.
He urged the committee to not pass HB 148.
1:27:12 PM
ANNETTE ALFONSI, SELF, ANCHORAGE (via teleconference),
testified in support of Medicaid expansion. She shared her
personal story about how a traumatic brain injury had
impacted her life. She shared that prior to her accident
she had a job with great benefits and a college degree and
had never used any services. She looked forward to working
full-time again, but needed the right medical care to do
so. She strongly believed people should not be given
handouts; she was not asking for a handout. She asked for
help to pull herself up by her bootstraps to allow her the
ability to have time to get private insurance. She provided
other examples of how traumatic brain injuries impacted
individuals. She stated that Medicaid reform could be
further addressed the following legislative session. She
urged the committee to pass the legislation.
1:30:07 PM
MARIAN ELLIOTT, SELF, WASILLA (via teleconference),
testified in support of Medicaid expansion. She stressed
that Alaska's unemployment rate was one percent higher than
the national average. She discussed that coupled with
draconian cuts to the University that would cause students
to leave the state for their education. She emphasized that
Medicaid expansion would add jobs and pump revenue into the
economy. She did not understand the reasons for opposing
expansion. She stressed that the poor, sick, and elderly
did not cause the Medicaid problem and their exclusion from
healthcare would not fix the problem. She implored the
committee to pass the bill.
1:32:15 PM
MARY MINOR, SELF, HOMER (via teleconference), testified in
support of Medicaid expansion. She provided detail about
her personal experience with healthcare and private
insurance. She had a skiing accident had not been able to
afford health insurance beginning in 2010 due to its cost
of $800 per month with a $5,000 deductible. She had been
provided coverage under the Affordable Care Act, which had
been a blessing. She realized there was concern about abuse
of the healthcare system, but she believed it needed to be
dealt with separately. She underscored that the situation
was unsustainable. She stated that individuals should not
have to face bankruptcy to receive healthcare.
1:35:10 PM
MARGARET SODEN, SELF, FAIRBANKS (via teleconference),
testified in support of Medicaid expansion. She shared that
there were thousands of working people in the state who may
not receive health insurance or who work seasonal jobs and
may not qualify for an employer provided health plan during
the offseason. She pointed to large bills that people found
difficult to pay. She highlighted that the cost of
medication was often overwhelming; therefore, sometimes
individuals decided to not fill their prescriptions. Under
an expanded Medicaid program many of the individuals may
qualify for healthcare. She stressed that in the long run
it would cost everyone less money.
1:37:06 PM
RICHARD COBDEN, FAIRBANKS ORTHOPEDICS, FAIRBANKS (via
teleconference), testified in support of Medicaid
expansion. He shared that the orthopedic clinic currently
had 50 percent Medicare/Medicaid patients. He stated that
denied or unavailable medical care could often be called
deferred maintenance. He stressed that the long-term
results of an absence in medical care could be catastrophic
for individuals and the overall system. He spoke to
increasing costs and illness that could lead to decreased
health and death. He stated that payments from CMS Medicaid
were already very low. He cautioned about the tax in
Section 1 part 3 of the bill. He stated that the tax may
push more providers away and drop Medicaid participation.
The unintended consequence would be that there would be a
diminished level of care as more and more providers gave
up. He urged the committee to pass the bill.
1:39:12 PM
JIM LYNCH, CHIEF FINANCIAL OFFICER, FAIRBANKS MEMORIAL
HOSPITAL, FAIRBANKS (via teleconference), testified in
support of Medicaid expansion. He was not a fan of the
Affordable Care Act, but he believed Medicaid expansion was
the right thing to do. He underscored that it was
imperative to find a way to eliminate the dilemma of the
uninsured and currently Medicaid expansion was the best
vehicle to do so. He believed in the economic stimulus and
job growth effect of the expansion dollars. He reminded the
committee that currently the state provided approximately
$14 million annually in uncompensated care; the costs were
paid indirectly by the working people of Alaska and by
their employers. The expansion would have a positive ripple
effect. He stressed that saying no to expansion would not
save the federal dollars from being spent or redirect them
to deficit reduction. He believed other states would
eventually agree to expansion and that Alaska's economy
would be left behind.
1:41:05 PM
PAT BRANSON, EXECUTIVE DIRECTOR, SENIOR CITIZENS OF KODIAK,
KODIAK (via teleconference), testified in support of
Medicaid expansion. The group dealt with Medicaid on a
daily basis. She hoped the committee would seriously
consider the bill. She was fortunate to have health
insurance, but many people who had no insurance went to the
emergency room. She testified on Medicaid reform. She
stated that while the billing service had not been
completely fixed it had been greatly improved. She stressed
that reform was actively being done.
1:42:53 PM
JUDY ELEDGE, SELF, ANCHORAGE (via teleconference), spoke in
opposition to Medicaid expansion. She stated that the
current system was broken; she was tired of paying for
broken systems. She did not believe the system could be
expanded or reformed in 90 days. She believed that
expanding a broken system would increase the problem. As a
senior citizen, she could not find a doctor who took
Medicare. She told a story about a friend's son who had
been in and out of drug rehabilitation for years; he had
fathered six children all on Medicaid. The individual did
not work or support his children. She stressed that the
state was in a fiscal crisis. She stated that Alaska could
not afford to expand Medicaid because it did not know what
it would cost. She believed people should be taken care of,
but she did not think it should be expanded to able bodied
individuals whose lifestyle choices put them where they
were currently.
1:46:06 PM
RIC NELSON, CHAIR, GOVERNOR'S COUNCIL ON DISABILITIES AND
SPECIAL EDUCATION, ANCHORAGE (via teleconference),
testified in support of Medicaid expansion through an
interpreter. He spoke to a long list of reform actions the
council would like to see that it had provided to
legislators. He provided personal information. He was on
the Medicaid waiver; without the waiver he would not be
where he was currently. He shared that he was close to
graduating with a master's degree in public administration.
Without Medicaid expansion the state would not be able to
take care of many citizens who needed help to survive in
its communities. He urged support for the legislation.
1:49:03 PM
KEVIN D. MCGEE, NATIONAL ASSOCIATION FOR THE ADVANCEMENT OF
COLORED PEOPLE - ALASKA, ANCHORAGE (via teleconference),
testified in support of Medicaid expansion. The association
encouraged Alaskan politicians to stop their efforts to
defeat the much needed provisions of Medicaid expansion. He
detailed that expansion would provide basic medical care,
substance abuse treatment, mental health treatment, and
would reduce mortality rates. He highlighted that Medicaid
was an important safety net for many individuals. He spoke
to 4,000 new jobs the expansion would create. He stated
that 98.5 percent of Alaska veterans' spouses were not
covered under Veterans Affairs (VA) healthcare; many
spouses would gain healthcare under Medicaid expansion. The
state had the means to save lives by providing Medicaid
expansion. He asked the legislature to weigh the fiscal,
economic, and moral impacts of expansion.
1:51:26 PM
RANDI SWEET, UNITED WAY OF ANCHORAGE, ANCHORAGE (via
teleconference), testified in support of Medicaid expansion
and reform. She reasoned that expansion and reform were
healthy for Alaskans, the economy, state budget, and a
sustainable healthcare system. The organization offered its
partnership in helping to improve health and quality of
life outcomes for Alaskans. She spoke to joining forces to
leverage resources around the shared vision for Alaskans to
lead stable, healthy, and safe lives.
1:52:18 PM
ROSALIE NADEAU, CEO, AKEELA, ANCHORAGE (via
teleconference), testified in support of Medicaid
expansion. She shared that the majority of clients AKEELA
took care of did not qualify for Medicaid because they
generally did not have children or had not been declared
mentally ill by a doctor. She detailed that people treated
in the prison system at $158 per day who received no
aftercare ended up relapsing and potentially back in
prison. She shared that without medical care many clients
ended up in hospital emergency rooms with severe medical
problems related to addiction.
1:55:02 PM
ROBIN SMITH, SELF, ANCHORAGE (via teleconference),
testified in support of Medicaid expansion. She was very
concerned about the future of Alaska. She stressed that one
of the few bright spots on the horizon was Medicaid
expansion. She stated that between budget cuts and a loss
of business as a result of low oil prices, she believed the
state would go into recession. She stated that Medicaid
expansion would bring $1 billion to the Alaska economy over
the next five-year period and could potentially save $20
million to $35 million over the same period. She relayed
that fees from emergency room visits by the uninsured were
passed on to businesses and individuals in the state's
economy. She stated that expansion should reduce insurance
premiums. She was one year away from being a Medicare
patient. She emphasized that national healthcare reform was
necessary to ensure that all people had access to care.
1:57:30 PM
JESSICA CLER, ALASKA PUBLIC AFFAIRS MANAGER, PLANNED
PARENTHOOD VOTES NORTHWEST, ANCHORAGE (via teleconference),
testified in support of Medicaid expansion. She shared that
currently a childless adult without a disability who made
less than $20,000 had no affordable healthcare coverage
available. Individuals working multiple jobs to make ends
meet forego healthcare in order to pay utility bills, rent,
and to buy groceries. Many of the individuals ended up in
the emergency room when health problems persist; in the end
others ended up footing the bill for entirely preventable
health problems. She stressed that the increase in
healthcare usage would act as an economic driver creating
thousands of jobs. She furthered that expansion would
ensure coverage for working adults while they looked for
employment opportunities, started a business, or sought an
education. She stated that reform was also necessary to
ensure the most efficient system; however, expansion did
not need to wait for reform. She believed the state could
not afford to wait to expand Medicaid.
1:59:20 PM
ERNIE WEISS, SELF, ANCHORAGE (via teleconference),
testified in support of Medicaid expansion. He stated that
the legislature had an opportunity to save the state money
while helping some of its most needed residents. He
believed political opposition to the legislation was
misguided and incorrect. He urged the committee to pass the
legislation.
2:00:02 PM
RICHARD MANDSAGER, PROVIDENCE MEDICAL CENTER, ANCHORAGE
(via teleconference), testified in support of Medicaid
expansion. He spoke from the perspective of a hospital
leader. He shared that part of the mission at the hospital
was to take care of poor and vulnerable people. He stressed
that every person would become vulnerable at one point or
another and that care was needed. The hospital saw many
people who came to care late due to an absence in health
coverage. He saw Medicaid expansion as a way to fill one of
the gaps in the coverage system in America that would allow
people to receive care earlier and regularly. He
communicated that part of the deal under the Affordable
Care Act was that the hospital industry agreed that
Medicare payments to hospitals would slowly drop over a
decade. The idea had been that the hospital industry would
be kept whole with access to care paid for through Medicaid
expansion and the subsidized insurance through the
exchange. Whether or not Alaska chose to do Medicaid
expansion the reduction in the payments to the hospital had
been underway for five years and would continue for five
additional years. He stated that the organization was
committed to reform. He referred to conversation by some
about a broken system; his observation that the system was
steadily getting better and was not a reason to delay.
2:02:32 PM
Vice-Chair Saddler took over as chair.
DR. ILONA FARR, FAMILY PRACTICE ANCHORAGE, ANCHORAGE (via
teleconference), spoke in opposition to Medicaid expansion.
She communicated that a 6 percent tax in the bill was
discriminatory. She stated that it exempted large federal
funded institution and nonprofits and taxed small
businesses and providers. She stressed that the entity got
paid one-tenth of what large institutions received for the
same services. She stressed that the tax would drive
practitioners out of business. She was against paying for
more abortions. She highlighted that $6.2 billion was the
cost to the state by 2032 according to the Streur/Parnell
study. She stressed that 1,000 providers had been lost over
the past five years; if the number of providers continued
to decline there would not be sufficient providers to care
for Medicaid patients. She believed Medicaid fraud issues
needed to be addressed. She urged the committee to say no
to the bill.
2:05:29 PM
DR. MARIO LANZA, ALYESKA FAMILY MEDICINE INC., ANCHORAGE
(via teleconference), spoke in opposition to Medicaid
expansion. He stated that the legislation would have
devastating fiscal effects on the medical profession in
Alaska (primarily on private practice). He voiced concern
related to a provider tax that could cost medical providers
up to 6 percent of gross revenues. He stated that overhead
in primary care was about 60 percent; therefore, the impact
on net revenue would be approximately 15 percent. He
stressed that raising rates did not mean any additional
compensation from Medicaid or Medicare. He stated that
Medicaid paid 20 to 60 percent of the usual charges, which
was not enough to cover the associated overhead. He stated
that treating Medicaid patients was already a form of
charity. He continued that the bill would make Medicaid
available to more individuals but fewer would receive care.
He advised the legislature to come up with a system where
all citizens fairly paid for the cost of expanding
Medicaid.
2:08:09 PM
DAVID MORGAN, ALASKAN CENTER FOR SUSTAINABLE HEALTHCARE
EXPENDITURES AND POLICY, ANCHORAGE (via teleconference),
spoke in opposition to Medicaid expansion. He believed
reform meant driving down the cost for care, which was not
accomplished in the bill. He remarked that the state's
Department of Health and Social Services website showed
that the cost would be $317 per person per year. He stated
that there was a $20 million hole in the costs for the
five-year program. He stated that even with all reforms
that happen under the bill, it only addressed 1.5 percent
of the total Medicaid budget. He believed the state should
review emergency room uses. He suggested that the Alaska
State Hospital and Nursing Home Association (ASHNA) and the
Office of Management and Budget pull a sampling to
determine who was really using uncompensated care in
emergency rooms.
2:11:33 PM
DR. BRETT BARRINGER, MEDICAL PRACTICE OWNER, ANCHORAGE (via
teleconference), spoke in opposition to Medicaid expansion.
He pointed to an onerous provider tax in the legislation
that could be as much as 6 percent. He relayed that the
bill instructed DHSS to submit a plan for provider tax by
January 25, 2016. He added that it did not instruct the
department to determine if the tax was a good idea. He
treated Medicaid patients in his practice; he lost money on
the service, but he believed it was a beneficial service to
provide to the community. Additionally, he had serious
concerns related to an increase in the number of audits. He
questioned why he would risk his practice and future to
provide the service. He encouraged the committee to look at
other forms of providing coverage. He believed Medicaid
expansion was a lazy way to address a broken system.
2:14:48 PM
CAM CARLSON, SELF, FAIRBANKS (via teleconference), spoke in
opposition to Medicaid expansion. She remarked that the
country's medical and healthcare systems had very serious
needs and operational problems. She stressed that federal
dollars would not solve the problems. She associated
herself with the testimony of Judy Eledge.
2:16:01 PM
JOHN MURPHY, SELF, FAIRBANKS (via teleconference),
testified in support of Medicaid expansion. He discussed
that from 2016 to 2021 Alaska would pay less than 5 percent
of the Medicaid expansion costs and would receive
approximately $1.1 billion in coverage for Alaskans. He
shared that states that had expanded Medicaid had already
seen a 25 percent decrease in uncompensated care costs in
2014. He supported expansion because it would provide
health insurance for young Alaskans who were not insured by
their employers. He stressed that by accepting expansion
the state would provide coverage.
2:17:11 PM
PATRICK MCCORMICK, SELF, FAIRBANKS (via teleconference),
testified in support of Medicaid expansion. He provided
testimony as a teacher. He hoped to never use Medicaid;
however, without expansion he would not have a safety net.
He communicated that he paid for Medicaid with his federal
tax dollars and was glad to do so. He stressed that without
the safety net he could not invest himself completely into
making Alaska a better place.
2:18:51 PM
ANDREW REIMHERR, SELF, FAIRBANKS (via teleconference),
spoke in opposition to Medicaid expansion. He stated that
Medicaid was already the biggest spending program in the
state. He discussed cuts to education funding, which had
resulted in the loss of teachers but not administrators. He
stressed that the students ended up losing. He believed
patients would ultimately end up losing. He provided a
personal story about a family member who was not covered
under Medicare or Obamacare. He believed the expansion
constituted federal overreach, which would inhibit local
governments in determining how the money would be used.
2:20:40 PM
ROBERT CLARK, PRESIDENT, BRISTOL BAY AREA HEALTH
CORPORATION, DILLINGHAM (via teleconference), testified in
support of Medicaid expansion. He discussed that the
backlog had been taken care of. He was supportive of
Commissioner Davidson with the Department of Health and
Social Services. He stated that expansion would have
positive impacts on the society as a whole. He detailed
that expansion would take care of costly problems. He
believed the legislation was good for the state.
2:22:59 PM
RICHARD SMITH, SELF, VALDEZ/KETCHIKAN (via teleconference),
testified in strong support of Medicaid expansion.
2:23:34 PM
BARBARA BIGELOW, SELF, VALDEZ (via teleconference),
testified in support of Medicaid expansion. She provided a
story about a female taxi driver who was driving cab to
avoid homelessness and was uninsured. She stated that the
woman was not unique; there were thousands of individuals
who needed access to healthcare. She urged compassion and
doing the right thing for those in need of health benefits.
2:25:07 PM
RUTHIE KNIGHT, VALDEZ HOSPITAL BOARD, VALDEZ (via
teleconference), testified in support of Medicaid
expansion. She spoke to a recent unanimous resolution
passed by the health advisory council in support of
expansion. She believed more compassion was needed in the
state. She spoke to adults who were working two jobs and
still could not afford healthcare. She urged the committee
to pass the legislation to expand Medicaid.
2:27:05 PM
DANIEL HAMM, ALASKAN REPUBLICAN ASSEMBLY, PALMER (via
teleconference), spoke in opposition to Medicaid expansion.
He believed Medicaid expansion was welfare expansion. He
stressed that Medicaid was not free money. He stated that
taking more federal dollars would impose a tax on the other
49 states. He posed the question about socialism being good
or evil. He believed most socialism was evil. He claimed
Alaskans were already dependent enough. He agreed that
there was a moral obligation to take care of people who
could not care for themselves such as disabled and senior
citizens. He wondered if it was moral to add to the
national debt. He urged the committee to vote no on the
bill.
2:30:05 PM
DEE MCKEE, SELF, PALMER (via teleconference), spoke in
opposition to Medicaid expansion. She suggested that
because of the uncertainty of what the federal government
will do in the future she could not support Medicaid
expansion. She shared that her long-term doctor was moving
away from accepting Medicare because Medicaid
reimbursements were higher. She noted that Medicaid
reimbursements were greater for hospitals than for smaller
private practice. She concluded that 7 states that had
chosen Medicaid expansion had underestimated enrollment by
88 percent.
2:32:57 PM
GEORGE MCKEE, SELF, PALMER (via teleconference), spoke in
opposition to Medicaid expansion. He resented that his tax
dollars were taken and redistributed to Medicaid. He did
not believe the federal government would ever let the state
out of Medicaid expansion once it opted in. He stressed
that there was an unfunded liability for retirement and
healthcare that the state currently owed. He was adamantly
opposed to the bill.
2:34:39 PM
JUDGE MICHAEL JEFFERY, SELF, BARROW (via teleconference),
testified in support of Medicaid expansion. He spoke to
traumatic brain injuries and other disabilities that
individuals faced. He communicated that Medicaid expansion
would help to provide support in the community to enable
individuals to gain employment. He stressed that if support
for individuals would reduce recidivism.
2:36:38 PM
CRYSTAL DOOLEY, SELF, JUNEAU, testified in support of
Medicaid expansion. She provided information about herself;
she had served on active duty in the U.S. Coast Guard and
had a master's degree. She shared that she suffered from
bipolar disorder and had thought about suicide many times
in the past. She shared that she was not alone in her
illness. She was lucky her employer provided insurance; if
she had to choose between medication and groceries she
believed she would not be here. She stressed that Medicaid
expansion would be positive. She provided further
information about herself. She asked the committee to think
hard about expansion.
2:40:25 PM
WALTER MAJOROS, EXECUTIVE DIRECTOR, JUNEAU YOUTH SERVICES,
JUNEAU, testified in support of Medicaid expansion. The
agency believed that the legislation was a win-win and was
good for uninsured individuals. He shared that once youths
turned 18 they often lost insurance coverage. He detailed
that insurance would improve access to mental health and
substance abuse treatment and preventative and primary
care. The legislation was also good for the state budget;
the federal government would reimburse at least 90 percent
of the cost. Additional savings would be generated through
refinancing general fund services such as inmate care. The
legislation would be good for the state economy and would
add over 4,000 new jobs. He believed the bill would be a
catalyst for reform. He asked the committee to support the
bill.
2:42:36 PM
TOM CHARD, EXECUTIVE DIRECTOR, ALASKA BEHAVIORAL HEALTH
ASSOCIATION, JUNEAU (via teleconference), testified in
support of Medicaid expansion. He addressed the likely
effect Medicaid expansion would have on members. He
discussed helping to create a sustainable Medicaid and
overall budget for the state. The organization had
participated in ways to address reform such as the Medicaid
Task Force and the Medicaid Reform Advisory Group. He urged
support for the legislation.
2:44:52 PM
RIC IANNOLINO, SELF, JUNEAU, testified in support of
Medicaid expansion. He had worked at the Fetal Alcohol
Spectrum Disorder diagnostic clinic and shared that most of
his clients required some form of Medicaid; many of the
people without access to healthcare ended up homeless or in
jail. He believed expansion was a win-win for the state. He
detailed that if one member in a family lost their health
it dramatically impacted the entire family. He urged
support for the bill.
2:46:37 PM
Co-Chair Thompson noted that the committee would take a 15
minute break at 3:00 p.m.
KARLA HART, SELF, JUNEAU, testified in support of Medicaid
expansion. She believed expansion was morally and
economically the correct action for Alaska. She referred to
testimony that Alaska was in a time of upheaval and budget
cuts that would ripple far and wide; people currently
employed and insured would find themselves without jobs.
She stressed that the current crisis could create
opportunity as talented people create jobs through self-
employment. She reasoned that knowing healthcare was
available to get through hard times would help people get
through. She discussed that the bill directed the
administration to conduct a study and to determine
recommendations for future legislation regarding a provider
tax. She clarified that there would be a separate public
process addressing any tax on providers. She asked the
committee to support the legislation.
2:48:11 PM
ANNIKA ORD, SELF, JUNEAU, testified in support of Medicaid
expansion. She was currently paying significant money for
private health insurance that had a large deductible. She
fell into the donut hole of no coverage. She observed that
it made no sense that someone earning under a threshold
received no subsidy. She asked the committee to expand
Medicaid to help young college graduates to get their feet
on the ground.
2:49:22 PM
LIZETTE STIEHR, EXECUTIVE DIRECTOR, ALASKA ASSOCIATION ON
DEVELOPMENTAL DISABILITIES, CHUGIAK (via teleconference),
testified in strong support of Medicaid expansion. She
stated that the bill would increase jobs and insurance. She
addressed concerns about the Medicaid system being broken.
She read from a letter from the association:
To Whom It May Concern,
The Alaska Association on Developmental Disabilities
has consistently voiced concerns regarding the
inadequate reimbursement levels experienced by
providers of developmental disability services since
the MMIS conversion to the Enterprise System was
inaugurated by Xerox in October of 2013. Over the past
19 months, Margaret Brodie the Director of the
Division of Health Care Services has worked diligently
and tirelessly to seek remedy from Xerox for the new
system flaws. AADD is appreciative of her success in
leveraging the Xerox corrective action plan to bring
improved stabilization to new claims processing during
the first quarter of 2015. Ms. Brodie has been present
in communicating her awareness of system issues and
projected timelines for correction. AADD has
confidence in Margaret Brodie's ability to hold Xerox
to its post corrective action plan to address the
backlog of unpaid claims on behalf of providers.
Margaret is also aware of system issues regarding
Medicaid eligibility and is committed to quick
resolution. These improvements are significant to
providers and indicate the correctional trends
essential to the Department of Health and Social
Services.
2:52:32 PM
RANDY ELEDGE, SELF, ANCHORAGE (via teleconference), spoke
in opposition to Medicaid expansion. He was concerned that
some legislators were listening to special interest groups.
He was appalled that his wife paid monthly for Medicare
after paying into the system during her professional
career. He believed the lack of doctors accepting Medicare
in Alaska was at a crisis level. He did not believe
Medicaid expansion was in the best long-term interest of
the state. He wondered how increasing eligible recipients
by up to 50,000 would create a better situation. He stated
that Medicaid paid more than Medicare and Tricare; he
believed the system was broken. He asked how the
legislature could read reports from genuine organizations
versus what special interest groups asserted. He encouraged
the committee to do its own research. He did not want to
sacrifice what veterans or senior citizens had done for the
state.
2:55:18 PM
LINDA STEVENS, SELF, ANCHOR POINT (via teleconference),
testified in support of Medicaid expansion. She was part of
the working poor who did not have healthcare coverage. She
made $775 per month and had been told that the cheapest
healthcare she could get was $780 per month. She stressed
that passing the bill would save many lives. She emphasized
that 43,000 people was not a minority group in Alaska.
2:56:37 PM
PATRICIA FISHER, SELF, MEADOW LAKE (via teleconference),
testified in support of Medicaid expansion. She relayed
that the Mat-Su Borough Assembly had recently voted in
favor of a letter to the governor supporting Medicaid
expansion. She believed expansion was right for the entire
state. She reasoned that the issue was a moral one and not
a conservative or liberal issue. She opined that there was
no more tragic situation than people being unable to afford
Medicare. She stressed that families could be devastated.
She stated that the legislature was smart enough to make
necessary corrections on the bill. She stressed that
overall the expansion was critical to the state.
2:58:30 PM
AT EASE
3:15:39 PM
RECONVENED
MIKE POWERS, CEO, FAIRBANKS MEMORIAL HOSPITAL, FAIRBANKS
(via teleconference), testified in support of Medicaid
expansion. He highlighted a recent study by Manatt Health
Solutions and the Robert Wood Johnson Foundation indicating
the budget impact of Medicaid. The study used a sample of
eight states and determined that revenues were expected to
exceed $1.8 billion by the end of 2015; the findings
indicated that every expansion state should expect to
reduce state spending on programs for the uninsured. He
would forward the study to committee members.
3:17:46 PM
CHRISTOPHER JENSON, PHYSICIAN AND PRESIDENT, INTERIOR
INDEPENDENT PRACTICE ASSOCIATION, FAIRBANKS (via
teleconference), was not opposed to caring for people in
need, but was completely opposed to provider tax that would
penalize members of the medical profession who were
providing care at a loss. He relayed that the association
was well aware of the continuing problem of a large number
of people without health insurance despite the
implementation of the Affordable Care Act; it also agreed
that people needed access to care. He cared for people with
Medicare, Medicaid, and no insurance because it was the
right thing to do. He asked the committee to keep in mind
that the provider tax would likely be very damaging to
physicians providing direct care to Medicaid patients,
which may affect the overall access to care.
3:19:41 PM
CHERYL KILGORE, EXECUTIVE DIRECTOR, INTERIOR COMMUNITY
HEALTH CENTER (via teleconference), testified in support of
Medicaid expansion. She communicated that the center took
care of all people including the poor, near-poor, insured,
and uninsured. The center believed everyone deserved
primary care regardless of the ability to pay. She stressed
that primary care helped to keep people out of the
hospital. She detailed that health centers had the capacity
to see an expanded population and would continue to see
Medicaid and Medicare populations. She shared that in 2014
the center had $6,000 in bad debt and its charity care was
$786,000. She relayed that there were people working in
small business in the community who contributed to society,
but were uninsured. She believed Medicaid expansion would
address the population. Additionally, there were
individuals in the community who were unable to work.
However, she believed that disparity between citizens was
inherently poor public policy and was bad for businesses
and the community.
3:22:02 PM
ERIC TREIDER, SELF, SOLDOTNA (via teleconference),
testified in support of Medicaid expansion. He relayed a
story about a man who had shot himself and had been taken
to the emergency room. He had been told by a family member
of the man that he had worked hard as a contractor to
support his family; like many Alaskan workers he did not
qualify for Medicaid, but could not afford private
insurance. He had developed serious health problems and the
mountain of unpaid medical bills weighed so heavily upon
him that he felt the only thing he could do to protect his
family from financial ruin was to commit suicide. Mr.
Treider was disturbed and disgusted to see how the debate
over Medicaid expansion had veered away from a debate about
human values and had shifted into a political spectacle. He
reminded the committee that residents had elected members
of the legislature to serve the interests of Alaskans. He
underscored that the legislation would save peoples' lives.
3:24:23 PM
TANYA HALLIDAY, MANAGER, COOK INLET DENTAL, SOLDOTNA (via
teleconference), testified in support of Medicaid
expansion. She reasoned that in order to solve a problem it
was necessary to understand it first. She spoke to some
reasons why providers chose to not accept Medicaid
including high no-show rates, increased paperwork burden,
no-pay or slow-pay, and an unwillingness to see "those
people." She relayed that Medicaid did pay eventually. She
stated that if it was required like insurance to pay within
30 days it may entice more providers to participate. She
stated that most of the individuals worked hard, but fell
between the cracks. She detailed that Medicaid paid
reasonable fees with the exception of dentures. She agreed
that ACS Xerox had broken the path, but the state was
proactively working to fix the problem. She stated that the
payment system was working, albeit not perfectly. She
encouraged the legislature to work on Medicaid reform if it
so desired, but to discontinue stonewalling expansion.
3:26:21 PM
TRINA RICHARDSON, SELF, SOLDOTNA (via teleconference),
testified in support of Medicaid expansion. She spoke about
the hardworking people who were falling into the Medicare
gap. She was offended by comments that the individuals were
lazy and not doing their part for society. She disputed the
statements and emphasized that the majority of the time it
was not true. She believed that investing in the healthcare
of a large number of Alaskans was investing in the state's
future and its economy. She reasoned that the additional
money coming into the state would help to pay for health
services and were likely to be put back into the state's
economy. She stated that expansion would help lower the
number of emergency department visits. She relayed that the
hospital had seen people with no health coverage that ended
up costing the hospital more than $1 million; Medicaid
would not cover the entire portion, but it would help. She
asked that the committee support the bill.
3:28:39 PM
NELMA TREIDER, SELF, SOLDOTNA (via teleconference),
testified in support of Medicaid expansion. She believed
the money being decided via the state budget process was
not being used to correctly represent or care for Alaskan
citizens. She remarked that huge cuts were being made to
almost every service that promoted and protected the health
and wellbeing of the citizens. She referred to reports
about how economically bad it would be in the upcoming
years. She found it hurtful that millions of dollars were
given to any oil related company. She observed that based
on testimony during the meeting there was fear surrounding
how Medicaid expansion would impact Alaskans. She believed
there was a need for truthful communication and
understanding. She asked the committee to make its
decisions based on what was right for the citizens of
Alaska.
3:30:30 PM
JORDEN NIGRO, SELF, JUNEAU, testified in support of
Medicaid expansion. She shared that she had worked in
social services for 16 years. She told a personal story
about her appreciation for her home and observed that many
individuals were not lucky enough to own a house due to
medical costs. She communicated that her father was a
fishermen and raised her as a single dad; when she was
young there was no health insurance in her household. She
felt that it was the obligation of the state to provide
Medicaid expansion for its people.
3:32:39 PM
ELEANOR MURPHY, SELF, EAGLE RIVER (via teleconference),
testified in support of Medicaid expansion. She wanted to
see all Alaskans have access to quality healthcare. She
supported reforms that increased efficiencies in the
system. Additionally, she supported Alaska's incentive
program to encourage providers to come to Alaska to work
for its underserved population. She was more than willing
to pay her fair share of state taxes if it was needed to
build a strong, safe state. She strongly supported Medicaid
expansion.
3:33:48 PM
JON ZASAD, DIRECTOR, MARKETING AND DEVELOPMENT, ANCHORAGE
NEIGHBORHOOD HEALTH CENTER, ANCHORAGE (via teleconference),
testified in support of Medicaid expansion and reform. He
spoke to part of the center's mission to advocate for
comprehensive coverage for all of its patients. The center
believed expansion and reform would improve care it could
provide patients, help it to continue to address health
outcomes of its patients (especially related to costly
chronic conditions such as diabetes and hypertension), and
it would begin to address the ever increasing cost of
Medicaid in Alaska. He communicated that in 2014 the center
had provided $7.5 million of charity care and for almost
$600,000 in bad debt primarily from patients without
insurance. He detailed that over 4,000 of its patients
would be eligible for expanded Medicaid coverage. He spoke
to the uncomfortable situation where providers and patients
self-rationed needed care due to the cost of referrals,
prescriptions, and treatments. He shared that the center
was already implementing many of the nationally suggested
reforms that would reduce the cost of care in its system.
He provided additional detail about the center and its work
to be part of the solution. He looked forward to seeing
more patients receiving the medical care they deserved. He
strongly encouraged the committee to support Medicaid
expansion and reform.
3:36:45 PM
BEN FIRTH, SELF, ANCHOR POINT (via teleconference), spoke
in opposition to Medicaid expansion. He relayed that he was
an artist supporting eight children. His family had not had
health insurance in over 30 years, but they had never been
without healthcare. He relayed that because Alaska had not
expanded Medicaid his family had avoided paying a federal
penalty for not having health insurance. He communicated
that his healthcare provider did not accept Medicaid. He
had no problem accepting help from people who offer it, but
he did not want his bills being paid with money forcibly
taken from other Americans. He believed that federal money
was not free money. He opined that there were many reasons
not to expand Medicaid. He believed it would do more harm
than good.
3:38:55 PM
SHERRELL HOLTSHOUSER, SELF, ANCHORAGE (via teleconference),
testified in support of Medicaid expansion. She relayed
that she had been a public health nurse for forty years.
She was currently covered by private medical insurance; she
understood that the premium she paid helped subsidize those
without coverage. She noted that currently people receiving
Medicaid expansion coverage in other states were
benefitting from her federal tax dollars. She would like to
see Alaskans benefitting from them as well. She believed
that the Alaska Medicaid program needed reforming. She
opined that the former administration had failed the
citizens of Alaska when they failed to seek out appropriate
expertise to work on reform. She emphasized that Medicare
also needed reform. She believed it was not logical to
argue that because Medicare was not working well that
Medicaid should not be reformed and expanded. She stated
that pitting one group against another was an illogical
approach for successful reform. She asked the committee to
pass the legislation.
3:42:07 PM
BARNABAS FIRTH, SELF, ANCHOR POINT (via teleconference),
spoke in opposition to Medicaid expansion. He believed that
every few years Alaskans were pushed and shamed into
expanding social programs such as Medicaid. He acknowledged
that there would always be people who need help. He
suggested that people take responsibility for themselves
and their communities. He believed the right thing was to
say no to Medicaid expansion. He stressed that the federal
deficit was astronomical and the federal government would
have to make cuts in the future. He furthered that the
federal government could revoke its funding for the program
at any time. He asked that legislators have the courage say
no to Medicaid expansion.
3:44:32 PM
DR. COLONEL COCKRELL CATES, ALASKA OSTEOPATHIC MEDICAL
ASSOCIATION, ANCHORAGE (via teleconference), agreed that
medical coverage was important and that all physicians had
a responsibility to provide care. He stated that during the
Clinton Administration there had been a dramatic change in
medical reimbursement for Medicaid and Medicare into a two
or three-tiered system. He detailed that there was a
dramatic escalation of reimbursement to federal clinics and
other community health centers nationwide. Additionally,
military hospitals and VA hospitals also received an
increase in reimbursement for Medicaid. He addressed that
at the same time private physicians who pay taxes in
communities saw a dramatic decrease in reimbursement;
therefore, Medicaid and Medicare patients had been limited.
He recommended a review of payment differentials between
the entities. He spoke to a dramatic decrease in payments
to providers in rural communities, which had run private
physicians out of business. He addressed that community
health clinics paid no taxes and had other advantages. He
recommended a review of reimbursement schedules prior to
making a decision.
3:47:42 PM
JEANNE GERHARDT-CYRUS, SELF, KIANA (via teleconference),
testified in support of Medicaid expansion. She shared that
Medicaid expansion would help over 1,000 people receive
services in the Kiana region alone. She stated that
currently many people fell through the cracks and accessed
crisis services because they did not have access to regular
care. The reality impacted families and individuals with
behavioral health issues who were currently over populating
prisons and treatment center due to chronic failure, which
was exacerbated by the lack of services and support. She
detailed that some providers would not provide services
without a guarantee of Medicaid funds. She spoke to the
challenges families had when faced with missing work when
caring for a family member. She stressed that without
needed services too many people who experience disabilities
lack access and supports. She stated that Medicaid
expansion would allow for reform to make services
available. She emphasized that the way to help people
become independent was by providing needed support.
3:50:12 PM
PAT STANLEY, EXECUTIVE DIRECTOR, COUNCIL OF ATHEBASCAN
TRIBAL GOVERNMENT, YUKON FLATS (via teleconference),
testified in support of Medicaid expansion. She explained
that the council villages were remote and without road
access to Fairbanks. Many residents worked in seasonal
employment to support their subsistence way of life and did
not have health insurance. She communicated that the health
system in the Yukon Flats was dependent on funding from
multiple sources; Indian Health Services provided
approximately half the support needed for adequate
healthcare and supplemental grants and third-party billing
provided additional funding. The council had been working
with the state on Medicaid billing issues and expected to
see the issues resolved in the next month or two. She
relayed additional statistics concerning the council. She
expounded that expanded Medicaid would enable the council
to increase billing to expand needed services, especially
in early detection, prevention, and behavioral health.
3:53:21 PM
ROBIN PATRICK, SELF, PALMER (via teleconference), spoke in
opposition to Medicaid expansion. He believed no one was
entitled health insurance or healthcare. He had been taught
to provide for himself. He believed that it was not the
responsibility of the government to provide healthcare to
the people of the state.
3:54:34 PM
ELLEN ADLAM, PENINSULA COMMUNITY HEALTH SERVICES, SOLDOTNA
(via teleconference), testified in support of Medicaid
expansion. She recognized that there was work to do, but
she stressed that the community health center had been
providing service for 50 years nationwide. The mission was
to have a place where people could receive good care. She
shared that the organization was creating medical homes
where people would receive preventative care. She believed
that community health centers should be included in the
discussion. She reiterated her strong support for the
legislation.
3:56:11 PM
HEIDI FROST, SELF, ANCHORAGE (via teleconference),
testified in support of Medicaid expansion. She and her
husband were both military veterans. She spoke about an
accident that had caused a traumatic brain injury. She
stressed that the injuries would have been unbearable if it
had not been for the medical assistance she had received
under her health insurance. However, she knew many others
who had not been so lucky to have good insurance. She
emphasized that the bill would benefit Alaska and Alaskans.
She detailed that the bill would create jobs and would
increase the number of insured Alaskans. She stated that
people would be healthier with Medicaid reform; many people
feel the need to wait until they were really sick before
going to the doctor. She asked the committee to support HB
148.
3:57:51 PM
NANCY BURKE, SELF, ANCHORAGE (via teleconference),
testified in support of Medicaid expansion. She had heard
much discussion about not providing access to medical care
because other sectors such as churches would take care of
it. She shared that she was part of a large church in
Anchorage and there were a large number of people who
sought assistance from the church. She was concerned about
some rhetoric about churches and their assistance to
members because under an economic decline church resources
would decrease. She discussed the financial challenges of
congregational members related to health bills. She
discussed that in states that had accepted expansion the
ability to help provide services to people was beneficial;
several states had reported net gains in revenue resulting
from decreases in the use of general funds. She
communicated that 72 percent of people in expansion states
are part of families with working family members. She asked
the committee to support expansion.
4:01:37 PM
RYAN MCKEE, SELF, ANCHORAGE (via teleconference), spoke in
opposition to Medicaid expansion. He was surprised by the
number of questions that had not been answered related to
the cost of Medicaid expansion. He questioned the accuracy
of the numbers provided by the administration in
legislative committee hearings in relation to the number of
jobs that would be created. He wondered how many other
states had underestimated their numbers. He stated that
some other states had gone broke or had canceled Medicaid
expansion. He was wondering about why more questions were
not being answered. He reiterated that he did not support
Medicaid expansion.
4:04:15 PM
JEREMY PRICE, DIRECTOR, AMERICANS FOR PROSPERITY ALASKA,
ANCHORAGE (via teleconference), spoke in opposition to
Medicaid expansion. He relayed that he grew up in a family
that only had catastrophic insurance. He understood what it
was like to have to pay for procedures out-of-pocket;
however, he was opposed to Medicaid expansion. He stated
that many people in support of expansion supported the
Affordable Care Act (ACA). He was not surprised that
hospitals and health centers supported Medicaid expansion
and the ACA. He stated that private physicians were opposed
to expansion. He encouraged the legislature to vote in
opposition to Medicaid Expansion.
4:06:47 PM
HANS RODUIK, FIELD DIRECTOR, AMERICANS FOR PROSPERITY
ALASKA, ANCHORAGE (via teleconference), spoke in opposition
to Medicaid expansion. He believed that with the current
budget deficit expansion was irresponsible. He urged the
committee to oppose expansion because Medicaid
reimbursement rates in Alaska were far greater than
Medicare's. He stated that by adding 40,000 new patients,
medical providers would be financially incentivized to see
Medicaid patients ahead of seniors on Medicare. He wondered
if pregnant women and children would have access to a
provider in a state that lacked providers. He stated that
the Medicaid system was failing tax payers, current
recipients, and Alaskan providers. He relayed that by 2030,
without expansion, Medicaid cost was expected to reach $4.5
billion. He spoke to other projected costs in Alaska and
other states.
4:09:52 PM
BOB REUPKE, ANCHORAGE FAITH IN ACTION CONGREGATIONS
TOGETHER, ANCHORAGE (via teleconference), testified in
support of Medicaid expansion. He personally had medical
insurance, but believed that Medicaid expansion was the
right thing to do. He also believed that the there was a
moral obligation to provide medical insurance for Alaskans
who could not afford it. He detailed that the individuals
were mostly low-income, single men and women who had fallen
through the cracks. He elaborated that medical bills were
the number one cause of bankruptcy in the U.S. He reasoned
that a lack of insurance caused people to put off medical
care, which meant that medical conditions could become
worse. He opined that expansion was a win-win situation for
the state. He believed it was the perfect time for
expansion given the fiscal condition of the state due to
low oil prices.
4:11:35 PM
DAVE BRANDING, SOUTH PENINSULA BEHAVIORAL HEALTH SERVICES,
HOMER (via teleconference), testified in strong support of
Medicaid expansion and reform. He shared that the
organization stood with the majority of Alaskans who voted
to elect Governor Walker, understanding that Medicaid
expansion was a primary component of his campaign. The
organization provided quality services regardless of
people's ability to pay; in recent years its uncompensated
care costs had increased three-fold. He believed that
expansion would help financially stabilize local services.
The organization also supported reform. He acknowledged
that the system was inherently flawed, but far from broken.
4:13:51 PM
KEN LANDFIELD, SELF, HOMER (via teleconference), testified
in support of Medicaid expansion. He believed that
government had fundamental obligations including providing
healthcare and education. He urged the committee to support
the legislation and Medicaid expansion. He referred to the
Alaska Constitution and read that the legislature "shall
provide for the promotion and protection of public health"
and the legislature "shall provide for public welfare."
4:15:08 PM
JILL LUSH, SELF, HOMER (via teleconference), testified in
support of Medicaid expansion. She believed that it was an
economic and moral issue. She strongly believed in taking
care of one another, especially in Alaska where there were
many isolated families. She appreciated the opportunity to
testify. She hoped the legislature heard the will of the
people that many citizens supported Medicaid expansion.
4:16:06 PM
TYSON ALTERI, SELF, HOMER (via teleconference), testified
in support of Medicaid expansion. He was injured as a
fisherman that had caused serious health implications. He
reiterated his support for Medicaid expansion.
4:16:46 PM
CASSIDY LUSH, HIGH SCHOOL STUDENT, HOMER (via
teleconference), testified in support of Medicaid
expansion. He had personally required the use of healthcare
multiple times and felt that it was necessary for all
people to have access to healthcare when they need it most.
4:17:37 PM
MONICA ADAMS, CEO, PENINSULA COMMUNITY HEALTH SERVICES,
KENAI (via teleconference), testified in support of
Medicaid expansion. She read a series of written
testimonies from clients all in support of Medicaid
Expansion. She relayed that annually the organization
provided between $2 million and $3 million in uncompensated
care. She remarked that it was unsustainable for the state
to rely on community health centers and behavioral health
agencies to provide all of the care; there were
insufficient grants to cover everyone who needed services
in the state. She strongly supported HB 148.
4:19:27 PM
JOSHUA GILMORE, TANANA CHIEFS CONFERENCE, FAIRBANKS (via
teleconference), testified in support of Medicaid
expansion. He observed that given that the state's current
financial situation was lacking, Medicaid expansion offered
a unique opportunity; it was one of the few opportunities
that would increase the state's revenues by up to $1
billion over the upcoming five years. He relayed that
expansion would improve access, care, and outcomes for a
vulnerable population (specifically the working poor. He
opined that medical care was an individual's right. He
believed the state had an obligation to ensure that people
were able to seek needed treatment in a timely way to
prevent worsening outcomes. He reasoned that healthy
individuals were able to contribute much more than
individuals who were unemployed due to illness or injury.
He thanked the committee for its time and urged its support
for HB 148.
4:21:46 PM
JEANETTE GRASTO, NATIONAL ALLIANCE OF MENTAL ILLNESS
(NAMI), FAIRBANKS (via teleconference), testified in
support of Medicaid expansion. She shared that NAMI
believed Medicaid expansion was the right thing to do
morally, ethically, financially, and on a human level. She
cited specific examples of difficulties of receiving care.
She stressed that it was difficult to get help even through
community mental health centers because grants did not
provide for everyone who had no method to pay. She
emphasized that the inability to pay for medical care did
not eliminate healthcare needs, but eventually moved into
more expensive institutional care such as emergency rooms,
mental health units, and correctional facilities. She
relayed that treatment for mental illness enabled many
people to return to work.
4:23:38 PM
DANIEL NELSON, PRESIDENT, ALASKA PHARMACISTS ASSOCIATION,
FAIRBANKS (via teleconference), testified in support of
Medicaid expansion. He noted that there had been several
large financial analyses of the issue; the majority had
shown significant positive financial impact for the private
sector and government. He stated that projections showed an
increase of 4,000 new jobs, $2.5 billion in economic
activity, and $1.2 billion in salaries and wages. He
detailed that the increase in Medicaid expenditures in the
state had been projected at only 1.4 percent. He
communicated that many religious, social advocacy, medical,
and other groups (both liberal and conservative) had
advocated for Medicaid expansion. He shared that Medicaid
expansion would provide a venue to increase medication
access to those in need, while simultaneously improving the
state's economy. He encouraged members to vote in favor of
HB 148.
4:25:53 PM
DAVID BOYLE, SELF, ANCHORAGE (via teleconference),
testified in opposition to Medicaid expansion. He was a
senior and military veteran. He stressed that the issue was
about fairness. He opposed Medicaid expansion because of
the serious impact it would have on seniors on Medicare and
veterans enrolled in Tricare. He communicated that Medicaid
reimbursed primary care physicians about 30 percent more
than Medicare or Tricare. He stressed that seniors had paid
into the Medicare system every working day of their lives;
however, Medicaid patients paid nothing into the system. He
stated that veterans' families would take a backseat to
people enrolled in Medicaid. He understood that much of the
Medicaid funds would be used by patients for transportation
from rural Alaska to see providers in Anchorage; however,
Medicare and Tricare did not pay seniors or veterans'
families to travel. He questioned the likelihood that 4,000
jobs would be created under Medicaid expansion. He reminded
the committee that its members would someday be Medicare
recipients.
4:29:06 PM
ANDREE MCLEOD, SELF, ANCHORAGE (via teleconference), she is
a registered Republican in support of Medicaid expansion.
She stated that the intent was to provide health services
to Alaskans in dire need of the services. She stated that
the issue was complicated. She stated that Congress had
already vetted Medicaid expansion. She noted that there was
federal funding available to enable a system that would
streamline services and simplify the process of providing
health related services to vulnerable adults. She stated
that 1,200 to 1,500 additional people would have access to
mental health services in Anchorage and Fairbanks alone.
She stated that without the services most of the
individuals ended up in jail, in the emergency room, and
living on the streets. She stated that the individuals were
ill through no fault of their own.
4:30:55 PM
JERRY JENKINS, CEO, ANCHORAGE COMMUNITY MENTAL HEALTH
SERVICES, ANCHORAGE (via teleconference), testified in
support of Medicaid expansion and reform. He relayed that
expansion would allow an increased capacity to see more
individuals and would take some of the pressure off of the
Alaska Psychiatric Institute and potentially the Department
of Corrections. He shared that expansion would enable the
organization to see people sooner and would hopefully help
offer lower cost services.
4:31:46 PM
MICHAEL SOBOCINSKI, ANCHORAGE COMMUNITY MENTAL HEALTH
SERVICES, ANCHORAGE (via teleconference), testified in
support of Medicaid expansion. He emphasized the importance
of the state moving toward integrative care to address
behavioral and physical health issues early on in order to
improve the overall quality of healthcare. He believed
Medicaid expansion would be a key component of moving
towards integrative care. He believed the bill was an
important step in the right direction. He stated that that
mental health and substance abuse were linked to physical
health. He thanked the committee for hearing his testimony.
4:33:14 PM
~Michael Chambers, Chair, Alaska Libertarian Party,
Anchorage{ spoke in opposition to Medicaid expansion. He
communicated that Libertarians overall believe in less
government dependency and more individual responsibility.
He stated that currently the federal Indian Health Service
was only funded at 54 percent. He wondered if any
representatives had requested that federal representatives
demand full funding. He stated that some of Medicaid
funding under expansion would be used to augment medical
travel into Anchorage. He spoke to the high rate of no-
shows for medical appointments even when travel costs were
covered. He questioned if it was a legitimate investment to
use Medicaid for travel purposes other than medical care.
He stressed that currently Medicaid was fraught with
questionable reimbursements. He wondered if the committee
knew what the liability would be to Alaska if it had to opt
out because it could not sustain the financial burden. He
opined that Medicaid was clearly an expansion of Obamacare.
He stated that Medicaid expansion would encourage couples
"shacking up" for government benefits.
4:36:10 PM
DAVID NEES, SELF, ANCHORAGE (via teleconference), spoke in
opposition to Medicaid expansion. He stated that his in-
laws had worked for 50 years in Alaska and had earned the
right to Medicare. He stressed that they would be last in
line for medical care if the bill passed. He stressed that
Medicaid was an entitlement and was not earned. He
acknowledged that there were needs existing, he did not
feel it was right to displace people who had earned
healthcare. He questioned the feasibility of adding 40,000
recipients to Medicaid.
4:37:51 PM
SHELLY VENDETTI-VUCKOVICH, SELF, ANCHORAGE (via
teleconference), testified in support of Medicaid
expansion. She shared that she had emailed every member of
the legislature; she had also called legislators and had
testified in the past. She relayed her personal experience
with medical bills. She had not qualified for Medicaid as a
young parent and when her son had been hospitalized for 3.5
weeks the bills had been in the hundreds of thousands of
dollars; for 12 years she had been paying a monthly payment
that would continue for another 10 years. She reiterated
other testimony that the number of young adults suffering
from mental health issues would benefit from Medicaid
expansion. Without treatment many of the individuals self-
medicated, which would create an entire group that would
end up costing the state money in the legal and
correctional systems. She did not understand how Alaska
could say no to Medicaid Expansion. She encouraged support
of HB 148.
4:41:14 PM
KATIE PARROT, DIRECTOR, QUALITY ASSURANCE AND PROGRAM
DEVELOPMENT, RESIDENTIAL YOUTH CARE, KETCHIKAN (via
teleconference), testified in support of Medicaid
expansion. She stated that the organization and its current
patients would not benefit directly from Medicaid
expansion. However, the organization was taking a longer-
term perspective for the youths it served; some of the
youths would need behavioral health support services well
into adulthood. As a provider, the organization was very
familiar with the challenges related to the payment and
eligibility systems. She shared that they had trouble with
receiving timely payments and had been owed a significant
amount of money; however, in spite of the challenges the
organization supported Medicaid expansion. They did not
believe that a broken system was justification for allowing
a broken citizenry. She spoke to the daily challenges
facing clients that could not be overcome without help; too
often individuals could not access the care they needed
without insurance. She acknowledged that the organization
was nervous about the measures that could weaken the
already weakened and stressed system of care; however, they
believed that reform was possible through expansion. The
organization took DHSS at its word that the staff were
working diligently to repair the systems; the hard work was
beginning to show results.
4:44:01 PM
MARY JANE TOUTONGHI, SELF, SOLDOTNA (via teleconference),
testified in support of Medicaid expansion. She was very
concerned about Alaskans without health insurance. She
believed Medicaid expansion would offset the state's
economic woes. She disputed the argument that the state
would be stuck when the federal government no longer
provided funding. She reasoned that the state could help
people avoid pain and suffering and to become more
productive citizens while it had Medicaid. She stressed
that Alaskans deserved to have healthcare much more than
highly profitable companies deserved to receive major draws
from the state's assets with no responsibilities in
exchange. She reiterated her support for Medicaid
expansion.
4:46:05 PM
PAT LINTON, EXECUTIVE DIRECTOR, SEWARD COMMUNITY HEALTH
CENTER, SEWARD (via teleconference), testified in support
of Medicaid expansion. He stated that at they saw the
challenges and frustrations facing many patients and fellow
citizens on a daily basis who fell between the eligibility
cracks. He communicated that Medicaid expansion would
enhance the sustainability community health center. He
stressed that community members needed and wanted
sustainable primary care. He supported reforming Medicaid
to control costs, better coordinate care, and improve
patient outcomes. He believed primary care would naturally
assume an even greater role within the reformed Medicaid
program. The center was ready to do its part. He asked the
committee to hold community health centers accountable to
do their part to achieve the goals.
4:48:34 PM
JIM SYKE, SELF, PALMER (via teleconference), testified in
support of Medicaid expansion. He noted that the Mat-Su
Borough Assembly had sent a letter supporting Medicaid
expansion. He shared that his wife and daughter were both
registered nurses; he had been involved with the healthcare
issue in Alaska for 25 years and had been generally unhappy
with healthcare reforms in Washington D.C. However, there
were many people who currently needed treatment and many
new people who needed health information and early
intervention of treatment in order to avoid the need for
serious treatment. He believed it was important to get
ahead of the curve to meet people's immediate and critical
needs and to take steps that would lead to a healthier
population. He asked the committee to act on providing
healthcare coverage for people at present instead of
putting it off for another generation. He noted the
legislation had broad support across a spectrum of people
and groups. He believed the best opportunity the state had
to control and lower costs, attract more jobs, and to
promote better community health.
4:50:36 PM
BONNIE CAMERON, SELF, ANCHORAGE (via teleconference), spoke
in opposition to Medicaid expansion. She felt that the
Governor was shaming the people of the state into expanding
Medicaid. She was counting on the legislature to protect
its constituents and their paychecks. She stressed that it
was not the role or responsibility to pay for things that
citizens should be responsible for paying for themselves.
She wondered how fathers and husbands were supposed to lead
and provide for their families if the government was acting
as a parent in all aspects of people's lives. She believed
healthcare costs would continue to escalate as long as
people using the service were not paying for it. She stated
that her family had been without health insurance for
several years; she found that providers had been helpful
and willing to work with them on payment plans. She opined
that the state already had a state income tax and would
raid the Permanent Fund in the future. She stated that
Anchorage was already not affordable to live in. She
wondered where the welfare would stop.
4:53:01 PM
MONICA STOESSER, SELF, ANCHORAGE (via teleconference),
spoke in strong support of the legislation. She worked in
the homeless division of Anchorage Community Mental Health.
The agency was one of the only organizations that provided
free healthcare for uninsured adults with mental illness.
She stressed that it was extremely difficult for patients
to get into see someone at the organization; there were
many people who were screened and denied, but who had
mental health issues. She had heard the argument many times
that people who were in the shelters and did not qualify
for the Affordable Care Act (ACA) should get on social
security for Medicaid or they should become employed to
gain eligibility for the ACA. However, to get gain access
to either it was necessary to have doctor's reports. She
emphasized that the individuals could not qualify for a
disability without seeing a physician, but could not see a
physician without health coverage. She pointed to high
numbers of incarcerated individuals with mental illness in
Alaska. She underscored that the state was already paying
for the individuals, but not in a way that helped them get
the needed care. She strongly urged the committee to go
forward with Medicaid expansion.
4:55:14 PM
TOM LAKOSH, SELF, ANCHORAGE (via teleconference), testified
in support of Medicaid expansion. He believed that most of
the committee members who were concerned about the passage
of the bill were concerned that it may harm the state's
economy. He suggested that the bill would do just the
opposite. He stated Medicaid expansion would mean that
businesses would not have to pay for or subsidize the
healthcare of 40,000 workers who would qualify for
healthcare. He surmised that it would allow for higher
profits in the industries. He believed it would be
necessary in the near future to implement a personal income
tax in order to balance the state's budget. He opined that
the added healthcare workers would help support the
government coffers. He believed that in order for
businesses to be competitive it was necessary to have
healthy workers. He mentioned compassion for the state's
citizens. He urged the committee members to support HB 148.
4:57:51 PM
ALEX GIMARC, SELF, ANCHORAGE (via teleconference), spoke in
opposition to Medicaid expansion. He was a parent of a
disabled 29-year. He was not convinced that Medicaid
expansion would serve anyone any better. He was concerned
that spreading scarce resources amongst a larger number of
people would hurt individuals with disabilities currently
in the system. He stated that Medicaid expansion would not
solve any of the systems current problems such as long wait
times for approvals, multiple pre-approval requirements, a
lack of providers, or the lack of treatment funded by
Medicaid. He opined that if the number of Medicaid
recipients increased from 60,000 to over 80,000 the
problems would worsen for all recipients. He reasoned it
did not make sense to dig a financial hole deeper. He
believed expansion would hurt recipients.
5:00:22 PM
ALEX PRICHARD, SELF, FAIRBANKS (via teleconference),
testified in support of Medicaid expansion. He would
provide written testimony due to the poor phone connection.
5:01:30 PM
LORA JORGENSON, SELF, ANCHORAGE (via teleconference),
testified in support of Medicaid expansion. She believed
everyone should have access to affordable healthcare. She
stressed that Medicaid expansion would provide healthcare
for 42,000 residents, create approximately 4,000 new jobs,
generate $1.2 billion in wages to Alaskans, and $1.1
billion in new federal revenue to the state. She believed
it was the role of government to provide for the health,
welfare, and safety of its residents. She remarked that the
state was already paying the cost, which she believed costs
to the state would be reduced. She opined that the state
should not turn its back on its residents during a time of
need. She encouraged committee members to support HB 148.
5:03:12 PM
FRANK BOX, SELF, ANCHORAGE (via teleconference), spoke in
support of Medicaid expansion. He communicated that he
worked for an independent living center in Anchorage and
facilitated a head injury support group. He worked with
many people who fell through the cracks and who would
benefit from Medicaid expansion. He shared that his family
would benefit as well. He had a granddaughter with cancer
and his family could not make any more money or they would
lose their benefits. He was also a cancer survivor and
spoke about the financial challenges he experienced. He
discussed that it was very challenging to pay for COBRA
insurance when a person had lost their income due to
illness or an accident. He stated that Medicaid expansion
would provide preemptive care and would keep many people
from having to go to the emergency room. He disputed the
belief that people would rather be on welfare than have a
job. He was strongly in support of HB 148.
5:05:51 PM
LEE CORAY-LUDDEN, SELF, CLAM-GULCH (via teleconference),
testified in support of Medicaid expansion. She had over
forty years of experience working in the human services
field with a broad range of people. She thanked the
committee.
5:06:25 PM
JOHN CULLEN, FAMILY PHYSICIAN, VALDEZ (via teleconference),
testified in strong support of Medicaid expansion. He
worked in private practice and relayed that his office
ended up writing off a significant portion of its charges
due to people's inability to pay. He stated that everyone
paid for the care of the uninsured; the costs were shifted
to those with insurance coverage. Many of the people that
would benefit from expansion were working poor people who
could not afford insurance. He communicated that under the
federal plan Medicaid expansion was supposed to take up the
slack for not offering hospitals funding for uncompensated
care; therefore, without expansion, hospitals were
suffering a significant loss. He thanked the committee for
its time.
5:08:42 PM
Co-Chair Thompson CLOSED public testimony.
Co-Chair Thompson thanked all of the people who testified.
He reviewed the agenda for the following finance committee
hearing scheduled for Monday, April 13, 2015.
ADJOURNMENT
5:10:28 PM
The meeting was adjourned at 5:10 p.m.
| Document Name | Date/Time | Subjects |
|---|---|---|
| HB 148 Emailed Public Testimony.pdf |
HFIN 4/11/2015 1:00:00 PM |
HB 148 |
| H Fin question provider tax 041115.pdf |
HFIN 4/11/2015 1:00:00 PM |
HB 148 |
| HB 148 Public Testimony Faxed.pdf |
HFIN 4/11/2015 1:00:00 PM |
HB 148 |
| HB 148 Additional Public Testimony.pdf |
HFIN 4/11/2015 1:00:00 PM |
HB 148 |