Legislature(2017 - 2018)CAPITOL 106

03/09/2017 03:00 PM HEALTH & SOCIAL SERVICES

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* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+= HB 25 INSURANCE COVERAGE FOR CONTRACEPTIVES TELECONFERENCED
Heard & Held
-- Public Testimony --
+= HB 123 DISCLOSURE OF HEALTH CARE COSTS TELECONFERENCED
Moved CSHB 123(HSS) Out of Committee
-- Public Testimony --
*+ HCR 3 APRIL 2017: CHILD ABUSE PREVENTION MONTH TELECONFERENCED
Heard & Held
-- Testimony <Invited/Public> --
+ Bills Previously Heard/Scheduled TELECONFERENCED
                    ALASKA STATE LEGISLATURE                                                                                  
      HOUSE HEALTH AND SOCIAL SERVICES STANDING COMMITTEE                                                                     
                         March 9, 2017                                                                                          
                           3:01 p.m.                                                                                            
                                                                                                                                
MEMBERS PRESENT                                                                                                               
                                                                                                                                
Representative Ivy Spohnholz, Chair                                                                                             
Representative Bryce Edgmon, Vice Chair                                                                                         
Representative Sam Kito                                                                                                         
Representative Geran Tarr                                                                                                       
Representative David Eastman                                                                                                    
Representative Jennifer Johnston                                                                                                
Representative Colleen Sullivan-Leonard                                                                                         
                                                                                                                                
MEMBERS ABSENT                                                                                                                
                                                                                                                                
Representative Matt Claman (alternate)                                                                                          
Representative Dan Saddler (alternate)                                                                                          
                                                                                                                                
COMMITTEE CALENDAR                                                                                                            
                                                                                                                                
HOUSE BILL NO. 25                                                                                                               
"An  Act relating  to insurance  coverage for  contraceptives and                                                               
related  services; relating  to medical  assistance coverage  for                                                               
contraceptives  and  related  services;   and  providing  for  an                                                               
effective date."                                                                                                                
                                                                                                                                
     - HEARD & HELD                                                                                                             
                                                                                                                                
HOUSE BILL NO. 123                                                                                                              
"An Act relating to disclosure of health care services and price                                                                
information; and providing for an effective date."                                                                              
                                                                                                                                
     - MOVED CSHB 123(HSS) OUT OF COMMITTEE                                                                                     
                                                                                                                                
HOUSE CONCURRENT RESOLUTION NO. 3                                                                                               
Proclaiming April 2017 as Child Abuse Prevention Month; and                                                                     
proclaiming April 7, 2017, as Go Blue Friday.                                                                                   
                                                                                                                                
     - HEARD & HELD                                                                                                             
                                                                                                                                
PREVIOUS COMMITTEE ACTION                                                                                                     
                                                                                                                                
BILL: HB 25                                                                                                                   
SHORT TITLE: INSURANCE COVERAGE FOR CONTRACEPTIVES                                                                              
SPONSOR(s): REPRESENTATIVE(s) CLAMAN                                                                                            
                                                                                                                                
01/18/17       (H)       PREFILE RELEASED 1/9/17                                                                                
01/18/17       (H)       READ THE FIRST TIME - REFERRALS                                                                        
01/18/17       (H)       HSS, FIN                                                                                               
02/28/17       (H)       HSS AT 3:00 PM CAPITOL 106                                                                             
02/28/17       (H)       Heard & Held                                                                                           
02/28/17       (H)       MINUTE(HSS)                                                                                            
03/09/17       (H)       HSS AT 3:00 PM CAPITOL 106                                                                             
                                                                                                                                
BILL: HB 123                                                                                                                  
SHORT TITLE: DISCLOSURE OF HEALTH CARE COSTS                                                                                    
SPONSOR(s): REPRESENTATIVE(s) SPOHNHOLZ                                                                                         
                                                                                                                                
02/13/17       (H)       READ THE FIRST TIME - REFERRALS                                                                        
02/13/17       (H)       HSS, JUD                                                                                               
03/02/17       (H)       HSS AT 3:00 PM CAPITOL 106                                                                             
03/02/17       (H)       Heard & Held                                                                                           
03/02/17       (H)       MINUTE(HSS)                                                                                            
03/09/17       (H)       HSS AT 3:00 PM CAPITOL 106                                                                             
                                                                                                                                
BILL: HCR 3                                                                                                                   
SHORT TITLE: APRIL 2017: CHILD ABUSE PREVENTION MONTH                                                                           
SPONSOR(s): REPRESENTATIVE(s) TARR                                                                                              
                                                                                                                                
01/23/17       (H)       READ THE FIRST TIME - REFERRALS                                                                        
01/23/17       (H)       HSS, FIN                                                                                               
03/09/17       (H)       HSS AT 3:00 PM CAPITOL 106                                                                             
                                                                                                                                
WITNESS REGISTER                                                                                                              
                                                                                                                                
LIZZIE KUBITZ, Staff                                                                                                            
Representative Matt Claman                                                                                                      
Alaska State Legislature                                                                                                        
Juneau, Alaska                                                                                                                  
POSITION STATEMENT:  Presented HB 25 on behalf of the bill                                                                    
sponsor, Representative Claman.                                                                                                 
                                                                                                                                
JUDY ANDREE                                                                                                                     
League of Women Voters                                                                                                          
Juneau, Alaska                                                                                                                  
POSITION STATEMENT:  Testified in support of HB 25.                                                                           
                                                                                                                                
CARMEN LOWRY, Executive Director                                                                                                
Alaska Network on Domestic Violence and Sexual Assault                                                                          
Juneau, Alaska                                                                                                                  
POSITION STATEMENT:  Testified in support of HB 25.                                                                           
                                                                                                                                
ALYSON CURREY                                                                                                                   
Planned Parenthood Votes Northwest and Hawaii                                                                                   
Juneau, Alaska                                                                                                                  
POSITION STATEMENT:  Testified in support of HB 25.                                                                           
                                                                                                                                
ELIZABETH FIGUS, PhD Student                                                                                                    
University of Alaska Fairbanks                                                                                                  
Juneau, Alaska                                                                                                                  
POSITION STATEMENT:  Testified in support of HB 25.                                                                           
                                                                                                                                
MICHAEL PAULEY                                                                                                                  
Alaska Family Council                                                                                                           
Anchorage, Alaska                                                                                                               
POSITION STATEMENT:  Testified against HB 25.                                                                                 
                                                                                                                                
ARLENE BRISCOE, Vice President                                                                                                  
Legislative Chair                                                                                                               
Alaska Nurses Association                                                                                                       
Anchorage, Alaska                                                                                                               
POSITION STATEMENT:  Testified in support of HB 25.                                                                           
                                                                                                                                
RUDY POGLITSH                                                                                                                   
Wasilla, Alaska                                                                                                                 
POSITION STATEMENT:  Testified against HB 25.                                                                                 
                                                                                                                                
KATIE BRUGGEMAN                                                                                                                 
Anchorage, Alaska                                                                                                               
POSITION STATEMENT:  Testified in support of HB 25.                                                                           
                                                                                                                                
JEANNETTE OKINCZYC                                                                                                              
Fairbanks, Alaska                                                                                                               
POSITION STATEMENT:  Testified in support of HB 25.                                                                           
                                                                                                                                
ANNA LATHAM, Deputy Director                                                                                                    
Juneau Office                                                                                                                   
Division of Insurance                                                                                                           
Department of Commerce, Community & Economic Development                                                                        
Juneau, Alaska                                                                                                                  
POSITION STATEMENT:  Answered questions during discussion of HB                                                               
25.                                                                                                                             
                                                                                                                                
REPRESENTATIVE MATT CLAMAN                                                                                                      
Alaska State Legislature                                                                                                        
Juneau, Alaska                                                                                                                  
POSITION STATEMENT:  Answered questions during discussion of HB                                                               
25, as the sponsor of the bill.                                                                                                 
                                                                                                                                
BERNICE NISBETT, Staff                                                                                                          
Representative Ivy Spohnholz                                                                                                    
Alaska State Legislature                                                                                                        
Juneau, Alaska                                                                                                                  
POSITION STATEMENT:  Presented the committee substitute for HB                                                                
123, on behalf of the bill sponsor, Representative Spohnholz.                                                                   
                                                                                                                                
JENNIFER MEYHOFF, Senior Vice President                                                                                         
Marsh and McLennan Agency                                                                                                       
Anchorage, Alaska                                                                                                               
POSITION STATEMENT:  Testified in support of HB 123.                                                                          
                                                                                                                                
JOSH BIEGEL                                                                                                                     
Anchorage, Alaska                                                                                                               
POSITION STATEMENT:  Testified during discussion of HB 123.                                                                   
                                                                                                                                
TERRY ALLARD, Senior Benefits Advisor                                                                                           
Wilson Agency                                                                                                                   
Anchorage, Alaska                                                                                                               
POSITION STATEMENT:  Testified in support of HB 123.                                                                          
                                                                                                                                
BECKY HULTBERG, President/CEO                                                                                                   
Alaska State Hospital and Nursing Home Association                                                                              
Juneau, Alaska                                                                                                                  
POSITION STATEMENT:  Testified and answered questions during the                                                              
presentation of HB 123.                                                                                                         
                                                                                                                                
GINA BOSNAKIS                                                                                                                   
Small Business Owner                                                                                                            
Anchorage, Alaska                                                                                                               
POSITION STATEMENT:  Testified in support of HB 123.                                                                          
                                                                                                                                
T.J. ALINEN, Assistant Vice President                                                                                           
Human Resources                                                                                                                 
Denali Federal Credit Union                                                                                                     
Anchorage, Alaska                                                                                                               
POSITION STATEMENT:  Testified in support of HB 123.                                                                          
                                                                                                                                
KYLE MIRKA                                                                                                                      
Business Owner                                                                                                                  
Anchorage, Alaska                                                                                                               
POSITION STATEMENT:  Testified in support of HB 123.                                                                          
                                                                                                                                
RHONDA KITTER, Chief Financial Officer                                                                                          
Public Education Health Trust                                                                                                   
Anchorage, Alaska                                                                                                               
POSITION STATEMENT:  Testified in support of HB 123.                                                                          
                                                                                                                                
SHAWN PURVIANCE, Owner                                                                                                          
Valley Block and Concrete                                                                                                       
Wasilla, Alaska                                                                                                                 
POSITION STATEMENT:  Testified in support of HB 123.                                                                          
                                                                                                                                
DENISE DANIELLO, Executive Director                                                                                             
Alaska Commission on Aging                                                                                                      
Division of Senior and Disabilities Services                                                                                    
Department of Health and Social Services (DHSS)                                                                                 
Juneau, Alaska                                                                                                                  
POSITION STATEMENT:  Testified in support of HB 123.                                                                          
                                                                                                                                
MAGDALENA OLIVEROS, Staff                                                                                                       
Representative Geran Tarr                                                                                                       
Alaska State Legislature                                                                                                        
Juneau, Alaska                                                                                                                  
POSITION  STATEMENT:   Introduced HCR  3  on behalf  of the  bill                                                             
sponsor, Representative Tarr.                                                                                                   
                                                                                                                                
REPRESENTATIVE GERAN TARR                                                                                                       
Alaska State Legislature                                                                                                        
Juneau, Alaska                                                                                                                  
POSITION  STATEMENT:   Introduced HCR  3  as the  sponsor of  the                                                             
resolution.                                                                                                                     
                                                                                                                                
PATRICK ANDERSON                                                                                                                
Anchorage, Alaska                                                                                                               
POSITION STATEMENT:  Testified in support of HCR 3.                                                                           
                                                                                                                                
ACTION NARRATIVE                                                                                                              
                                                                                                                                
3:01:37 PM                                                                                                                    
                                                                                                                                
CHAIR IVY SPOHNHOLZ  called the House Health  and Social Services                                                             
Standing   Committee    meeting   to    order   at    3:01   p.m.                                                               
Representatives  Spohnholz, Sullivan-Leonard,  Johnston, Eastman,                                                               
and Edgmon  were present at  the call to order.   Representatives                                                               
Tarr and Kito arrived as the meeting was in progress.                                                                           
                                                                                                                                
          HB 25-INSURANCE COVERAGE FOR CONTRACEPTIVES                                                                       
                                                                                                                                
3:02:16 PM                                                                                                                    
                                                                                                                                
CHAIR SPOHNHOLZ announced that the  first order of business would                                                               
be HOUSE BILL NO. 25, "An  Act relating to insurance coverage for                                                               
contraceptives   and  related   services;  relating   to  medical                                                               
assistance coverage for contraceptives  and related services; and                                                               
providing for an effective date."                                                                                               
                                                                                                                                
3:03:12 PM                                                                                                                    
                                                                                                                                
LIZZIE KUBITZ,  Staff, Representative  Matt Claman,  Alaska State                                                               
Legislature,  stated that  proposed  HB 25  mandated that  health                                                               
care  insurers   provide  coverage  for  a   12-month  supply  of                                                               
contraceptives at one  time.  She reported  that currently, women                                                               
who  used prescriptive  contraceptives  needed to  return to  the                                                               
pharmacy   every   one   to  three   months   to   refill   their                                                               
prescriptions.   She pointed  to the  difficulties for  women who                                                               
did not have  access to transportation, worked  multiple jobs, or                                                               
lived in  rural areas of the  state of getting refills  so often.                                                               
She shared  that the Centers  for Disease Control  and Prevention                                                               
(CDC) recommended  dispensing a  year's supply  of contraception,                                                               
as  missing  pills was  a  major  reason for  oral  contraceptive                                                               
failure leading  to unintended pregnancies.   Greater  access and                                                               
availability  to contraceptives  reduced unintended  pregnancies,                                                               
with  a  direct cost  savings  to  the  state.   She  noted  that                                                               
hormonal contraceptives  were used  for reproductive  health care                                                               
and  other   medical  reasons,   including  menstrual   pain  and                                                               
migraines.   She declared that  the proposed bill sought  to make                                                               
prescriptive  contraceptives more  easily  available, which  made                                                               
sense for Alaskan women and families.                                                                                           
                                                                                                                                
REPRESENTATIVE SULLIVAN-LEONARD asked  about testimony from those                                                               
who were seeking contraceptives for a full year.                                                                                
                                                                                                                                
MS. KUBITZ replied that there were individuals ready to testify.                                                                
                                                                                                                                
3:06:07 PM                                                                                                                    
                                                                                                                                
CHAIR SPOHNHOLZ opened public testimony.                                                                                        
                                                                                                                                
3:06:40 PM                                                                                                                    
                                                                                                                                
JUDY ANDREE,  League of Women  Voters, stated that the  League of                                                               
Women  Voters  fully  supported comprehensive  affordable  health                                                               
care for all people, including  reproductive health care, and the                                                               
availability of  birth control.   She stated that the  ability to                                                               
avoid  unintended  pregnancies was  of  primary  importance to  a                                                               
woman's health  and her  ability to  chart her  own future.   She                                                               
relayed that planning a pregnancy  with the help of birth control                                                               
could increase a  woman's economic opportunities.   She said that                                                               
this could  also lead to savings  to the state, as  64 percent of                                                               
pregnancies required public  financing.  She pointed  to a letter                                                               
of support [Included  in members' packets].  She  added that this                                                               
was the time  to accept birth control as an  important and normal                                                               
part of women's health care, and  that it should be as affordable                                                               
and  accessible, as  possible.   She  reiterated  support of  the                                                               
proposed bill.                                                                                                                  
                                                                                                                                
3:08:55 PM                                                                                                                    
                                                                                                                                
CARMEN  LOWRY, Executive  Director,  Alaska  Network on  Domestic                                                               
Violence  and  Sexual Assault,  offered  some  background on  the                                                               
network,  that  it was  comprised  of  19 member  programs  which                                                               
provided services  to victims and survivors  of domestic violence                                                               
and sexual assault  across Alaska, about 7,000  people during the                                                               
previous year.   She said  that access  for a 12-month  supply of                                                               
contraceptives allowed protection and  a reduced risk of coercion                                                               
from an abuser.   She stated that  it was a common  tactic for an                                                               
abuser  to attempt  to  control  access to  birth  control.   She                                                               
shared research which  had shown that women  were more vulnerable                                                               
during pregnancies, hence  their range of choices  for leaving an                                                               
abusive relationship became more limited.   She stated that a 12-                                                               
month supply offered a wider range  of choices.  She declared, as                                                               
there  was  a  disproportionate   number  of  women  experiencing                                                               
domestic  violence in  rural areas,  it was  important to  ensure                                                               
full range access to contraceptives.   She stated support for the                                                               
proposed bill.                                                                                                                  
                                                                                                                                
3:12:21 PM                                                                                                                    
                                                                                                                                
ALYSON  CURREY, Planned  Parenthood Votes  Northwest and  Hawaii,                                                               
stated support  for the proposed  bill.  She declared  that every                                                               
woman should  have full access  to the birth control  method that                                                               
worked  best   for  her,   without  any   barriers  to   cost  or                                                               
availability,  regardless of  insurance  plan.   She stated  that                                                               
proposed  HB  25 would  remove  any  barriers, allow  women  more                                                               
career   and   education   opportunities,   encourage   healthier                                                               
pregnancies,  and   make  them   less  dependent   on  government                                                               
programs.  She reported that  consistent use of birth control was                                                               
the best  way to prevent  unintended pregnancy, although,  one in                                                               
four women  stated they  had missed  pills because  of a  lack of                                                               
availability.    A  full year  supply  improved  consistent  use,                                                               
reduced the  odds of  an unintended pregnancy  by 30  percent and                                                               
was associated  with a 46 percent  drop in the chance  of needing                                                               
an abortion.  She declared that  this was cost effective for both                                                               
public and private  insurance plans, as it lowered  the costs for                                                               
follow  up  visits, pregnancy  tests,  and  the long  term  costs                                                               
associated  with unintended  pregnancy.   She declared  that this                                                               
was a solution  that would work for women and  she stated support                                                               
of HB 25.                                                                                                                       
                                                                                                                                
3:14:24 PM                                                                                                                    
                                                                                                                                
ELIZABETH FIGUS,  PhD. Student,  University of  Alaska Fairbanks,                                                               
shared that she  was a fisherperson during the  summers which did                                                               
not allow much  time to get to doctors, and  she urged support of                                                               
the proposed bill.   She declared that it was  frustrating and an                                                               
unnecessary  expense  to  alter   schedules  for  a  pre-approved                                                               
prescription pick-up.  She offered  her belief that this bill was                                                               
about  streamlining   prescription  medication  pick-ups.     She                                                               
pointed out  the need  for economic efficiency.   She  stated her                                                               
support for HB 25.                                                                                                              
                                                                                                                                
3:16:13 PM                                                                                                                    
                                                                                                                                
MICHAEL PAULEY,  Alaska Family Council,  stated that  the council                                                               
was opposed  to the proposed  legislation, as it  was essentially                                                               
taking a health care mandate and  grafting it into state law.  He                                                               
directed  attention to  written testimony  [Included in  members'                                                               
packets].  He expanded on a  few of those points, noting that the                                                               
primary objection  was for a  sweeping one size fits  all mandate                                                               
which  would require  every insurance  plan issued  in Alaska  to                                                               
provide coverage  for certain  drugs and  devices that  "have the                                                               
effect  of  causing  very  early   abortions."    He  stated  his                                                               
organization's objections toward  helping subsidize or facilitate                                                               
this.   He  opined that  the proposed  bill defined  prescription                                                               
contraceptive as a  drug or device as something  which required a                                                               
prescription  and  was  approved  by   the  U.S.  Food  and  Drug                                                               
Administration  for  the purpose  of  preventing  pregnancy.   He                                                               
offered  definitions  for  conception  and  pregnancy,  which  he                                                               
opined were similar  to those by numerous  religious groups which                                                               
had  filed  lawsuits  objecting to  the  Patient  Protection  and                                                               
Affordable Care  Act (PPACA).   He reiterated that  the religious                                                               
exemptions offered  in the proposed bill  "ranged from inadequate                                                               
to non-existent."   He offered the  belief that it was  a mistake                                                               
to  "peg  the  religious  exemptions   to  federal  statutes  and                                                               
regulations   associated  with   [PPACA]"   and  that   religious                                                               
exemptions  "should  be  spelled  out  in  plain  English."    He                                                               
suggested  that the  House Health  and  Social Services  Standing                                                               
Committee seek legal advice for  interaction of the proposed bill                                                               
with the  existing statute, AS  25.20.025.   He asked if  a young                                                               
woman could  receive contraception  and have her  parent's health                                                               
insurance pay for  this.  He asked that the  committee review the                                                               
broader   economic   impact    of   the   proposed   legislation,                                                               
specifically  on  the  effect  of  fertility  on  the  long  term                                                               
economic  well-being.    He  referenced  the  "replacement  level                                                               
fertility rate"  which addressed  the average number  of children                                                               
born to  each woman in a  society in order for  the population to                                                               
sustain  itself.   He spoke  about an  international "demographic                                                               
crisis" in developed countries.                                                                                                 
                                                                                                                                
3:25:43 PM                                                                                                                    
                                                                                                                                
ARLENE BRISCOE, Vice President,  Legislative Chair, Alaska Nurses                                                               
Association, stated  support for the proposed  bill, and directed                                                               
attention to a  letter of support [Included  in members' packets]                                                               
stating the strong belief that  Alaskan women and families should                                                               
have  an opportunity  to have  available, adequate  birth control                                                               
supplies for 12-months  at a time.  She declared  that this would                                                               
prevent unintended  pregnancies which cost the  state millions of                                                               
dollars annually.                                                                                                               
                                                                                                                                
3:27:15 PM                                                                                                                    
                                                                                                                                
RUDY POGLITSH  said that the  proposed bill allowed  abortion and                                                               
not  contraception, which  he deemed  was "the  gravest of  moral                                                               
issues."   He stated  that lawmakers  should not  force someone's                                                               
morality on someone else.  He declared his opposition to HB 25.                                                                 
                                                                                                                                
3:28:15 PM                                                                                                                    
                                                                                                                                
KATIE  BRUGGEMAN  declared  that   the  U.S  Supreme  Court,  not                                                               
advocacy  groups,  had  decided   that  women  could  decide  for                                                               
themselves whether they  wanted to bear and raise  children.  She                                                               
shared that one reason to support  the bill was that lower income                                                               
women working  several jobs and relying  on public transportation                                                               
would benefit from fewer trips to  the pharmacy.  She opined that                                                               
there were also fewer administrative  costs.  She stated that the                                                               
proposed bill  made sense  for women in  the tourism  and fishing                                                               
industries  who   did  not  have  access   readily  available  to                                                               
pharmacies.  She  declared that family planning  was an essential                                                               
component   of  economic   opportunity   for   women,  and   that                                                               
reproductive  choice allowed  for great  access to  education and                                                               
career advancement.                                                                                                             
                                                                                                                                
3:29:24 PM                                                                                                                    
                                                                                                                                
JEANNETTE OKINCZYC  stated her support  of the proposed  bill and                                                               
said that birth control was  a responsible action and that family                                                               
planning should  be a right.   She stated that the  proposed bill                                                               
offered families the power to make responsible decisions.                                                                       
                                                                                                                                
3:31:12 PM                                                                                                                    
                                                                                                                                
CHAIR SPOHNHOLZ closed public testimony.                                                                                        
                                                                                                                                
REPRESENTATIVE EASTMAN asked for the division's perspective.                                                                    
                                                                                                                                
3:31:46 PM                                                                                                                    
                                                                                                                                
ANNA  LATHAM,   Deputy  Director,  Juneau  Office,   Division  of                                                               
Insurance,   Department  of   Commerce,   Community  &   Economic                                                               
Development, replied that the Division  of Insurance had prepared                                                               
a  zero-fiscal  note   for  the  proposed  bill,   and  that  the                                                               
administration's  stance was  officially  neutral.   She  relayed                                                               
that  this  legislation would  be  processed  to ensure  that  it                                                               
adhered to Alaska statute before approval by the division.                                                                      
                                                                                                                                
MS.  LATHAM, in  response  to Representative  Eastman, said  that                                                               
self-funded  plans   under  ERISA  [Employee   Retirement  Income                                                               
Security Act of 1974] could take  this into account and any group                                                               
health  or  individual  market plans  would  require  legislative                                                               
action prior to the change.                                                                                                     
                                                                                                                                
REPRESENTATIVE EASTMAN asked  what changes would need  to be made                                                               
for this to be done voluntarily.                                                                                                
                                                                                                                                
MS. LATHAM  replied that it would  need to be driven  by a change                                                               
in Alaska statute.                                                                                                              
                                                                                                                                
REPRESENTATIVE EASTMAN  asked what,  in statute, would  keep this                                                               
from being changed if it was desired.                                                                                           
                                                                                                                                
MS.  LATHAM offered  her  belief that  nothing  in statute  would                                                               
prevent this  from an insurance standpoint,  although there could                                                               
be another prescribing requirement or other issues.                                                                             
                                                                                                                                
CHAIR  SPOHNHOLZ  suggested that  the  bill  sponsor could  offer                                                               
additional information.                                                                                                         
                                                                                                                                
MS. KUBITZ in  response to Representative Eastman,  said that the                                                               
proposed bill was  not a mandate to  insurance companies, however                                                               
it allowed  for an option  to the  consumers.  The  proposed bill                                                               
would be a mandate to make  it available, as it was currently the                                                               
"culture of the insurers" to only offer shorter supplies.                                                                       
                                                                                                                                
REPRESENTATIVE  EASTMAN  questioned  the  financially  beneficial                                                               
aspect  as insurance  companies were  not currently  offering it,                                                               
when they usually acted in their own economic best interest.                                                                    
                                                                                                                                
REPRESENTATIVE  MATT CLAMAN,  Alaska  State Legislature,  offered                                                               
his  belief that  it  would  be necessary  to  ask the  insurance                                                               
companies.                                                                                                                      
                                                                                                                                
MS. KUBITZ  cited a  letter in opposition,  and added  that there                                                               
was a general "push back" to any mandates to insurers.                                                                          
                                                                                                                                
REPRESENTATIVE  EASTMAN  asked  if any  insurance  companies  had                                                               
taken this step.                                                                                                                
                                                                                                                                
MS. KUBITZ said that although  a number of states had implemented                                                               
this  mandate,  she was  not  aware  of any  insurance  companies                                                               
offering this on their own.                                                                                                     
                                                                                                                                
REPRESENTATIVE  EASTMAN asked  about a  response to  the concerns                                                               
for claims that this was a mandate for early abortions.                                                                         
                                                                                                                                
MS.  KUBITZ  replied  that  emergency  contraceptive  pills  were                                                               
covered  under contraceptives,  and  that the  proposed bill  was                                                               
offering  a safe  and effective  means  of preventing  pregnancy.                                                               
She  declared   that  emergency   contraceptive  pills   did  not                                                               
terminate or  interrupt an established pregnancy,  hence they did                                                               
not cause an abortion.  She  declared that the only connection to                                                               
abortion was the potential to prevent the need.                                                                                 
                                                                                                                                
REPRESENTATIVE EASTMAN asked for her definition to pregnancy.                                                                   
                                                                                                                                
MS.   KUBITZ    offered   her   understanding    that   emergency                                                               
contraceptive pills prevented ovulation,  and not the termination                                                               
of an established pregnancy.                                                                                                    
                                                                                                                                
CHAIR SPOHNHOLZ pointed out that  these were already available on                                                               
the  market  and that  the  proposed  bill did  not  specifically                                                               
address them.   She stated that  this was a different  issue, the                                                               
proposed  bill  was  for  an extension  to  the  availability  of                                                               
contraception.                                                                                                                  
                                                                                                                                
REPRESENTATIVE JOHNSTON  asked why  this 12-month supply  was not                                                               
being offered for other prescription  drugs with similar benefits                                                               
to the patient.                                                                                                                 
                                                                                                                                
MS.  KUBITZ  replied that  there  were  a number  of  maintenance                                                               
medications  available,  including   birth  control,  high  blood                                                               
pressure,  and   heart  disease,  and  prescribers   could  write                                                               
prescriptions  for a  90  day  supply with  three  refills.   She                                                               
opined  that control  of the  dispensation  was a  choice of  the                                                               
insurance companies, which was  different for different insurance                                                               
companies.                                                                                                                      
                                                                                                                                
REPRESENTATIVE JOHNSTON asked about  an extension of this mandate                                                               
to include other drugs, citing that  "it's not broad enough" as a                                                               
possible problem with the legislation.                                                                                          
                                                                                                                                
REPRESENTATIVE CLAMAN reminded that  there had been discussion in                                                               
a  previous  meeting  for  "a  number  of  medications  that  are                                                               
prescribed up to 12-month supply."   He offered his understanding                                                               
that  there were  other medications  dispensed for  more than  90                                                               
days, citing some of the  mail-in prescription programs, although                                                               
he was unsure of the details for specific medications.                                                                          
                                                                                                                                
REPRESENTATIVE   EASTMAN   asked   if  anything   prevented   the                                                               
dispensation of contraception medication through the mail.                                                                      
                                                                                                                                
MS. KUBITZ  replied that there  were mail order  programs through                                                               
some insurers  for a  90-day supply.   She  pointed out  that the                                                               
proposed bill  allowed for all  of the prescription to  be mailed                                                               
in bulk  at one time.   She offered  her belief that  women would                                                               
like access to more than what was currently available.                                                                          
                                                                                                                                
REPRESENTATIVE EASTMAN  opined that a  year was a long  period of                                                               
time, and that  it was possible for  some loss of the  pills.  He                                                               
asked about any associated cost and impact on the insurers.                                                                     
                                                                                                                                
REPRESENTATIVE CLAMAN offered his belief  that the risk of losing                                                               
prescriptions did  not depend  on the length  of the  supply, and                                                               
that there was not a significant impact to the actuarial world.                                                                 
                                                                                                                                
MS. KUBITZ added  that the fiscal note labeled  OMB 2077 provided                                                               
by  the Department  of Health  and Social  Services [Included  in                                                               
members' packets]  did take  into account  the potential  loss of                                                               
supply.                                                                                                                         
                                                                                                                                
3:46:01 PM                                                                                                                    
                                                                                                                                
CHAIR SPOHNHOLZ stated that the bill would be held over.                                                                        
                                                                                                                                
             HB 123-DISCLOSURE OF HEALTH CARE COSTS                                                                         
                                                                                                                                
3:46:26 PM                                                                                                                    
                                                                                                                                
CHAIR SPOHNHOLZ announced  that the next order  of business would                                                               
be HOUSE BILL  NO. 123, "An Act relating to  disclosure of health                                                               
care services and price information; and providing for an                                                                       
effective date."                                                                                                                
                                                                                                                                
3:46:48 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE EDGMON moved to adopt the proposed committee                                                                     
substitute (CS) for HB 123, labeled 30-LS0380\T, Glover, 3/9/17,                                                                
as the working draft.                                                                                                           
                                                                                                                                
CHAIR SPOHNHOLZ objected for discussion.                                                                                        
                                                                                                                                
BERNICE  NISBETT,  Staff,  Representative Ivy  Spohnholz,  Alaska                                                               
State  Legislature,  paraphrased  the  changes  in  the  proposed                                                               
committee substitute [Included in members' packets], which read:                                                                
                                                                                                                                
     Section 2,  subsections (a) and (b)  states that health                                                                    
     care facilities  and providers will  compile a  list by                                                                    
     procedure code.                                                                                                            
                                                                                                                                
     We've  also  changed  "including  a  brief  and  easily                                                                    
     understandable  description,"  to  "in  plain  language                                                                    
     that  an  individual  with   no  medical  training  can                                                                    
     understand."                                                                                                               
                                                                                                                                
     Line 23 we added "and" after "performed;"                                                                                  
                                                                                                                                
     Subsection (d) states that the  health care provider or                                                                    
     facility may add a disclaimer  explaining that what the                                                                    
     consumer pays  may be higher  or lower than  the amount                                                                    
     listed.                                                                                                                    
                                                                                                                                
     Subsection (g)  states that if the  individual is fined                                                                    
     and wants  to appeal, the  individual is entitled  to a                                                                    
     hearing  conducted  by  the  office  of  administrative                                                                    
     hearings.                                                                                                                  
                                                                                                                                
     In  Subsection  (h),  the  definition  of  health  care                                                                    
     facility  does not  include federal  health a  facility                                                                    
     operated by  an Alaska tribal health  organization or a                                                                    
     hospital operated  by the  United States  Department of                                                                    
     Veterans  Affairs or  the United  States Department  of                                                                    
     Defense, or  any other  federally operated  hospital or                                                                    
     facility.                                                                                                                  
                                                                                                                                
     Subsection  (h), number  (7)     undiscounted price  is                                                                    
     defined.                                                                                                                   
                                                                                                                                
3:49:22 PM                                                                                                                    
                                                                                                                                
CHAIR SPOHNHOLZ opened public testimony.                                                                                        
                                                                                                                                
3:49:43 PM                                                                                                                    
                                                                                                                                
JENNIFER  MEYHOFF,  Senior  Vice President,  Marsh  and  McLennan                                                               
Agency,  stated that  the agency  was a  global consulting  firm.                                                               
She  added that  she was  the  Legislative Chair  for the  Alaska                                                               
Association of Health Underwriters, and  that she had 25 years of                                                               
employee  benefits  consulting  experience and  she  worked  with                                                               
employers  statewide for  selection of  products to  the employee                                                               
benefit packages.   She offered a comparison for  the purchase of                                                               
health care to the determinations for  buying coffee or gas or an                                                               
airline  ticket,  and  declared  that   a  consumer  can  make  a                                                               
reasonable decision.   She declared her support  for the proposed                                                               
bill,  as  it was  time  to  offer  this information  to  patient                                                               
consumers, in order  to allow decisions prior  to receiving care.                                                               
She  suggested that  this could  contain  or reduce  the cost  of                                                               
health care.                                                                                                                    
                                                                                                                                
3:53:12 PM                                                                                                                    
                                                                                                                                
CHAIR SPOHNHOLZ  removed her objection.   There being  no further                                                               
objection, Version T was adopted as the working draft.                                                                          
                                                                                                                                
REPRESENTATIVE  JOHNSTON  stated  that  full  disclosure  offered                                                               
choice and the  knowledge of cost.  She asked  for the reason for                                                               
the  exemptions to  publicly funded  organizations  named in  the                                                               
proposed bill.                                                                                                                  
                                                                                                                                
MS. MEYHOFF  expressed her  agreement that  the charges  at those                                                               
organizations would not affect her  clients, although she offered                                                               
her belief that it was "a  very valid question of the information                                                               
being available could be useful to the overall market."                                                                         
                                                                                                                                
3:55:13 PM                                                                                                                    
                                                                                                                                
JOSH BIEGEL shared a saga of  the medical costs after an accident                                                               
in which his wife broke her arm when she fell on the ice.                                                                       
                                                                                                                                
3:57:29 PM                                                                                                                    
                                                                                                                                
TERRY ALLARD,  Senior Benefits Advisor, Wilson  Agency, said that                                                               
she  was also  a  charter  member of  the  Alaska Association  of                                                               
Health Underwriters  and a member  of the  Legislative committee.                                                               
She urged  passage of the proposed  bill.  She reported  that she                                                               
had been in the insurance  and employee benefits field all across                                                               
Alaska for  more than 30  years.  She  reported that she  spent a                                                               
significant  amount  of  time  educating  employees  about  their                                                               
benefits and how  to best use them,  which included conversations                                                               
for  being a  responsible consumer.    She declared  that it  was                                                               
difficult  for an  individual  to be  a  responsible consumer  of                                                               
health care services in Alaska, as  it was not always possible to                                                               
get the information necessary to  make an informed decision.  She                                                               
said that it was easier  to determine the procedural options than                                                               
making an informed  decision for the cost and the  provider.  She                                                               
stated that consumers could make  informed decisions about almost                                                               
everything  except  medical  services.    She  relayed  that  the                                                               
Municipality  of  Anchorage  had  recently  passed  an  ordinance                                                               
requiring  transparency  from providers  within  the  city.   She                                                               
stated that this needed to be  available all over the state.  She                                                               
cited that almost  30 other states had  passed transparency bills                                                               
similar  to the  proposed  bill.   She  offered  her belief  that                                                               
health  care needed  to  evolve and  provide  information to  the                                                               
consumers in  a more  relevant and  timely way.   She  stated her                                                               
support of HB 123.                                                                                                              
                                                                                                                                
REPRESENTATIVE SULLIVAN-LEONARD  asked if  her agency had  a data                                                               
base  available  to   the  consumer  for  the   cost  of  various                                                               
procedures.                                                                                                                     
                                                                                                                                
MS.  ALLARD  said  that  her firm  was  an  independent  employee                                                               
benefits advisory company and did not have access to that data.                                                                 
                                                                                                                                
REPRESENTATIVE SULLIVAN-LEONARD asked if  the proposed bill would                                                               
have  helped  Mr.  Biegel  with   the  challenges  posed  by  his                                                               
insurance company.                                                                                                              
                                                                                                                                
MS.  ALLARD opined  that the  proposed  bill would  help in  some                                                               
ways,  although  the  issue  for  in-network  providers  and  the                                                               
charges was  a separate issue.   She said that the  proposed bill                                                               
does get  to the heart  of the  matter, as full  understanding of                                                               
the insurance coverage  would have allowed him to  seek care from                                                               
another provider.                                                                                                               
                                                                                                                                
REPRESENTATIVE  SULLIVAN-LEONARD  offered  her  belief  that  the                                                               
variables could make it a different price for each patient.                                                                     
                                                                                                                                
MS. ALLARD acknowledged  that the price could be  different.  She                                                               
offered her  understanding that the  proposed bill would  ask the                                                               
providers  to post  the rack  rate, and  then the  responsibility                                                               
would be for the consumer to  speak with the insurance company to                                                               
understand the charges and how they would be covered.                                                                           
                                                                                                                                
REPRESENTATIVE JOHNSTON  shared that this was  an opportunity for                                                               
collusion by the insurance companies when publishing rack rates.                                                                
                                                                                                                                
MS. ALLARD  said that this  would put  prices on the  open market                                                               
and allow the consumer to shop.   She pointed out that there were                                                               
laws against collusion among medical providers.                                                                                 
                                                                                                                                
REPRESENTATIVE  JOHNSTON  asked  if  a public  clinic  should  be                                                               
excluded.                                                                                                                       
                                                                                                                                
MS. ALLARD said  that she did not know enough  about the proposal                                                               
for public  clinics, although in  a setting for health  care that                                                               
was  being reimbursed,  it would  be  logical to  have that  cost                                                               
information disclosed to the consumer.                                                                                          
                                                                                                                                
CHAIR SPOHNHOLZ  pointed out  that the  aforementioned disclaimer                                                               
information was  included in Version  T of the proposed  bill, so                                                               
that  consumers were  not intimidated  by pricing.   A  community                                                               
health center could  mention its sliding fee schedule  as well as                                                               
the  providers insurance  accepted,  and a  private office  could                                                               
mention it was a preferred provider for certain organizations.                                                                  
                                                                                                                                
REPRESENTATIVE  JOHNSTON  asked  if  there was  any  use  for  an                                                               
additional disclaimer stating that rates were negotiable.                                                                       
                                                                                                                                
CHAIR SPOHNHOLZ  acknowledged that it  could be written  into the                                                               
disclaimer  as the  language had  intentionally been  left fairly                                                               
broad.                                                                                                                          
                                                                                                                                
REPRESENTATIVE  EASTMAN  asked  if  insurance  providers  usually                                                               
considered competition pricing.                                                                                                 
                                                                                                                                
MS.  ALLARD said  that frequently  the  insurance providers  were                                                               
aware  of other  charges,  although  she did  not  know how  that                                                               
knowledge was attained.                                                                                                         
                                                                                                                                
4:07:23 PM                                                                                                                    
                                                                                                                                
BECKY HULTBERG, President/CEO, Alaska  State Hospital and Nursing                                                               
Home  Association,  said that  ASHNHA  supported  the concept  of                                                               
price  transparency  and  consumer   engagement  in  health  care                                                               
decision making.  She stated that  the third party payment to the                                                               
insurance  mechanism   made  health  care  decisions   much  more                                                               
complicated.    She reported  that  there  were many  differences                                                               
between typical  commodities and complex health  care payment and                                                               
delivery systems.   She  stated that, although  there was  not an                                                               
easy solution  to the problem without  dismantling and rebuilding                                                               
the health care  system, the proposed bill was a  good first step                                                               
toward more transparent pricing.   She said that providers to the                                                               
state should aspire to transparent pricing  in a way that did not                                                               
add additional  cost to the  system.   She declared that  cost in                                                               
the form of compliance should  not outweigh the benefits, and the                                                               
proposed  bill   would  not  impose   significant  administrative                                                               
burdens  that  would  be  transferred  as  higher  costs  to  the                                                               
consumer.     She   reported  that   ASHNHA  hospitals   provided                                                               
estimates,  and she  expressed her  desire  that consumers  would                                                               
call and  ask for price estimates,  to either the insurer  or the                                                               
hospital.   She stated that the  insurers had the best  access to                                                               
the best data, and that insurers  should be required to also make                                                               
transparency  tools available  to consumers.   She  declared that                                                               
health care price transparency was a complex topic.                                                                             
                                                                                                                                
REPRESENTATIVE  TARR asked  if the  insurer was  also making  the                                                               
transparency tool  available to  allow the consumer  to determine                                                               
what they would owe.                                                                                                            
                                                                                                                                
MS.  HULTBERG explained  that she  was not  recommending anything                                                               
directly related  to the proposed  bill but simply  an additional                                                               
way for  the consumer to gain  access to price information.   She                                                               
stated  that many  insurers and  many self-insured  employers had                                                               
price transparency  tools.   She shared that  it was  possible to                                                               
share information  on the employee  deductible and out  of pocket                                                               
cost.  She  suggested that the proposed bill  focused on patients                                                               
without insurance  who would be  paying a rate comparable  to the                                                               
rack rate.   She declared  that improvement for the  provision of                                                               
price information  was a shared  responsibility of  providers and                                                               
insurers.                                                                                                                       
                                                                                                                                
4:12:50 PM                                                                                                                    
                                                                                                                                
GINA BOSNAKIS, Small  Business Owner, stated that  she had worked                                                               
in the insurance industry for about  30 years.  She reported that                                                               
she worked daily with employees  and families, in addition to her                                                               
employer  clients, to  find the  best fit  for health  insurance.                                                               
She  testified in  support of  the proposed  bill.   She reported                                                               
that,  although  coding issues  or  incorrect  payments could  be                                                               
quickly fixed, the  most common reason for patient  calls was for                                                               
procedures  performed by  a  provider  deemed as  out-of-network.                                                               
She explained  that acceptance  of insurance  by a  provider, and                                                               
being  an  in-network  and  preferred   provider  were  two  very                                                               
different things and  resulted in a very different  charge to the                                                               
patient.   She  said  this legislation  would  give patients  the                                                               
power  to  better understand  what  to  ask, prior  to  incurring                                                               
unexpected expenses.   She offered  her belief that  the proposed                                                               
bill had  the potential to  affect the increasing cost  of health                                                               
care in Alaska.                                                                                                                 
                                                                                                                                
4:16:08 PM                                                                                                                    
                                                                                                                                
T.J. ALINEN,  Assistant Vice  President, Human  Resources, Denali                                                               
Federal Credit  Union, reported that Denali  Federal Credit Union                                                               
was the  third largest  credit union  in the  state, and  had 325                                                               
employees residing  in Alaska.   He declared that  Denali Federal                                                               
Credit Union  supported the  proposed bill.   He stated  that the                                                               
escalation  in  cost of  health  care  was  one of  the  greatest                                                               
challenges faced  by many  organizations in the  state.   He said                                                               
that,  in   a  free  market,   buyers  and  sellers   engaged  in                                                               
communication in determining pricing  for services and goods, yet                                                               
this did  not occur in the  health care industry.   He emphasized                                                               
that  market transparency  and  the  availability of  information                                                               
would  assist   all  Alaskans  for   being  better   health  care                                                               
consumers.                                                                                                                      
                                                                                                                                
4:19:01 PM                                                                                                                    
                                                                                                                                
KYLE MIRKA,  Business Owner, reported that  his business employed                                                               
50 people  and provided an  employer sponsored health  care plan.                                                               
He pointed out that, as premiums  had risen almost 40 percent, it                                                               
would have  been cheaper to  discontinue the plan and  simply pay                                                               
the PPACA fine.   However, his business wanted  to provide health                                                               
care  benefits  to  its  employees,   even  though  the  business                                                               
"shouldered the  remainder of the  burden."  He pointed  out that                                                               
any  additional increases  would make  it not  affordable for  an                                                               
employer sponsored plan.   He declared that health  care costs in                                                               
Alaska "are  simply out of control."   He opined that  it was the                                                               
only industry  where the costs  for services were  unknown before                                                               
the service was rendered.  He  shared that a standard answer from                                                               
health care  professionals for  the high cost  of health  care in                                                               
Alaska was  that "it's expensive to  practice in the state."   He                                                               
reported that  most of his  business products could  be purchased                                                               
in  Anchorage for  the same  price as  in Seattle,  Pocatello, or                                                               
Portland.    He  acknowledged  that, although  there  were  added                                                               
freight costs  to Alaska, as well  as higher labor costs,  it was                                                               
generally  agreed   that  health   care  costs  in   Alaska  were                                                               
disproportionately higher  than anywhere else  in the world.   He                                                               
offered his  belief that  price transparency  was the  first step                                                               
toward solving the  health care problems in Alaska.   He declared                                                               
his support for the proposed bill.                                                                                              
                                                                                                                                
4:21:17 PM                                                                                                                    
                                                                                                                                
RHONDA KITTER,  Chief Financial Officer, Public  Education Health                                                               
Trust, reported that the Public  Education Health Trust was a not                                                               
for  profit  health  insurance   provider  for  public  education                                                               
employees  in  Alaska.    She  relayed  that  there  were  17,000                                                               
Alaskans  with health  insurance through  the trust.   She  added                                                               
that she  was also the  Co-Chair of the Alaskans  for Sustainable                                                               
Health Costs,  a group of  employers working together  to address                                                               
the rising  costs of  health insurance premiums  in Alaska.   She                                                               
pointed out  that the question  of how much  does it cost  was so                                                               
integrated into the act of buying  that consumers did not have to                                                               
ask,  as  prices   were  printed,  stamped,  and   posted.    She                                                               
acknowledged that there  were some practices, such  as car repair                                                               
and  home  improvement, which  did  not  usually publish  prices,                                                               
although  most  professions  could  not feign  a  "hard  to  say"                                                               
attitude when questioned  about costs.  She  declared support for                                                               
the proposed bill.  She  stated that the bill "correctly requires                                                               
the  disclosure of  fees at  the provider  and facility  offices,                                                               
placing the requirement for public  disclosure ... in the offices                                                               
of those organizations."   She conceded that,  while the proposed                                                               
bill was  not the silver  bullet solution for  sustainability, it                                                               
was "one silver BB that is needed to address the rising cost."                                                                  
                                                                                                                                
4:23:47 PM                                                                                                                    
                                                                                                                                
SHAWN PURVIANCE,  Valley Block and  Concrete, offered  his belief                                                               
that health  care costs had  driven health insurance  premiums so                                                               
high that it  was difficult for his business to  take care of its                                                               
40  employees.    He  opined  that  the  free  enterprise  system                                                               
required competition,  which could  not exist unless  people knew                                                               
the  cost of  goods,  and  that the  health  care  needed "to  be                                                               
brought  into the  fold of  the  free enterprise  system, so  the                                                               
consumer  can  decide what  gets  them  the  best value  for  the                                                               
services they require."  He declared  that he was not a "huge fan                                                               
of government  regulation of  any industries,"  but he  felt this                                                               
was an important  first step for something which  would happen of                                                               
its own  accord.  He offered  his belief that the  cost of health                                                               
care  was out  of proportion  in Alaska,  although the  insurance                                                               
companies did have  some culpability.  He offered  an analogy for                                                               
the increased  cost of health  insurance compared to the  cost of                                                               
concrete during the  past 9 years, pointing out that  that it was                                                               
not possible to raise concrete prices  to stay in step.  He asked                                                               
why health  care was so expensive  in Alaska, as it  did not cost                                                               
that  much more  to do  business in  Alaska.   He noted  that his                                                               
business  proudly  posted  its  prices on  handouts  and  on  its                                                               
website.   He offered his  belief that  the proposed bill  was an                                                               
important  first  step  to  provide  affordable  health  care  in                                                               
Alaska.  He declared his support for the proposed bill.                                                                         
                                                                                                                                
4:29:22 PM                                                                                                                    
                                                                                                                                
DENISE DANIELLO, Executive Director,  Alaska Commission on Aging,                                                               
Division  of  Senior  and Disabilities  Services,  Department  of                                                               
Health  and  Social Services  (DHSS),  expressed  support by  the                                                               
commission for the  proposed bill.  She offered  a brief overview                                                               
of the commission.   She referenced an  earlier statewide meeting                                                               
with seniors discussing  the proposed bill, and  added that there                                                               
was an overwhelming  positive response for the bill.   She shared                                                               
that a  priority strategy  was to  disclose health  care pricing.                                                               
She acknowledged  that this  was a first  step toward  a solution                                                               
for a  very complicated situation.   She declared support  for HB                                                               
123.                                                                                                                            
                                                                                                                                
4:32:20 PM                                                                                                                    
                                                                                                                                
CHAIR SPOHNHOLZ closed public testimony.                                                                                        
                                                                                                                                
REPRESENTATIVE  EASTMAN  asked  if   a  cost  comparison  with  a                                                               
competitor had  been considered  as a  means to  accomplish price                                                               
transparency.                                                                                                                   
                                                                                                                                
CHAIR  SPOHNHOLZ, as  the sponsor  of  the bill,  said that  this                                                               
comparison was  usually required of insurance  providers, and she                                                               
acknowledged that  this was  a potential option.   She  said that                                                               
the changes  to health care costs  and reform of the  health care                                                               
system was a  marathon and that the proposed bill  was only a few                                                               
hundred  yards  into the  first  mile,  although  it was  a  very                                                               
important first  step.  She offered  her belief that it  was very                                                               
important  for consumers  to have  the  necessary information  to                                                               
make an  informed decision at  the time  of service.   She opined                                                               
that this was a simple first movement.                                                                                          
                                                                                                                                
REPRESENTATIVE   EASTMAN  said   that  he   was  in   support  of                                                               
transparency  and that  the proposed  bill offered  modest gains.                                                               
He opined that this information  did not necessarily translate to                                                               
the transparency he would hope  to achieve.  He acknowledged that                                                               
he did  not have an  answer, but  that he was  not overoptimistic                                                               
for success.                                                                                                                    
                                                                                                                                
CHAIR SPOHNHOLZ  stated that  the feedback  was valid,  and there                                                               
were  more  comprehensive  ways  to   address  the  issue.    She                                                               
suggested that  an all  payer claims database  could be  the gold                                                               
standard, as it would allow people  to look at much more detailed                                                               
information  which   incorporated  each   individual's  insurance                                                               
situation.   She added that  it would also require  a significant                                                               
fiscal  note, which  was not  feasible in  the current  financial                                                               
situation.                                                                                                                      
                                                                                                                                
4:37:03 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  EDGMON  moved to  report  CSHB  123, Version  30-                                                               
LS0380\T,  Glover,  3/9/17,  out  of  committee  with  individual                                                               
recommendations and  the forthcoming  fiscal notes.   There being                                                               
no objection, CSHB 123 (HSS) was  moved from the House Health and                                                               
Social Services Standing Committee.                                                                                             
                                                                                                                                
4:37:35 PM                                                                                                                    
                                                                                                                                
The committee took an at-ease from 4:37 p.m. to 4:41 p.m.                                                                       
                                                                                                                                
         HCR 3-APRIL 2017: CHILD ABUSE PREVENTION MONTH                                                                     
                                                                                                                                
4:41:40 PM                                                                                                                    
                                                                                                                                
CHAIR SPOHNHOLZ announced that the  final order of business would                                                               
be HOUSE CONCURRENT  RESOLUTION NO. 3, Proclaiming  April 2017 as                                                               
Child Abuse Prevention  Month; and proclaiming April  7, 2017, as                                                               
Go Blue Friday.                                                                                                                 
                                                                                                                                
4:41:57 PM                                                                                                                    
                                                                                                                                
MAGDALENA  OLIVEROS,  Staff,  Representative Geran  Tarr,  Alaska                                                               
State Legislature, stated that  the proposed resolution nominated                                                               
the month  of April to  be named  and recognized as  "Child Abuse                                                               
Prevention Month" and proclaimed April  7, 2017, to be recognized                                                               
as "Go Blue  Friday."  She explained that "Go  Blue Friday" would                                                               
allow Alaskans statewide to wear  blue as a symbolic gesture that                                                               
child abuse  would not be  tolerated in  Alaska.  By  speaking up                                                               
and raising  awareness, Alaskans could  stand together to  put an                                                               
end  to  the  violence,  and  be a  part  of  the  effort  toward                                                               
prevention.   She offered a  history of the national  child abuse                                                               
prevention  month,   and  pointed   out  that  it   recognized  a                                                               
commitment  and   dedication  to  implementing   and  identifying                                                               
solutions to  ending child  abuse.  She  stated that  every year,                                                               
many  states recognized  the month  of April  to stand  strong in                                                               
support of  children.  She  reported that  Alaska had one  of the                                                               
highest rates  of child abuse  in the country  - 42 out  of 1,000                                                               
children were victims of abuse -  and that in 2014, the Office of                                                               
Children's Services had received  more than 40,000 allegations of                                                               
harm.   She noted that  children who  were subject to  abuse were                                                               
more likely  to become abusers  and engage in  criminal activity,                                                               
as  well as  have  more psychological  and physiological  issues.                                                               
She  declared  that every  child  deserved  a  safe home  and  an                                                               
opportunity to  grow into a  responsible member of society.   She                                                               
emphasized that everyone  needed to work together  to support the                                                               
children in the state.                                                                                                          
                                                                                                                                
4:44:29 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  GERAN TARR,  Alaska  State Legislature,  directed                                                               
attention to the "Alaska OCS  Protective Service Reports Received                                                               
During  2016"  [Included in  members'  packets]  and shared  that                                                               
these reports  were produced  monthly.   She offered  her opinion                                                               
that  these reports  should be  monitored  closely, pointing  out                                                               
that the  total number  of alleged victims  of physical  abuse in                                                               
this report was equal to the  total number of students at Wasilla                                                               
High  School, at  East  High  School, and  half  the students  at                                                               
Juneau-Douglas High School.   She declared that  the numbers were                                                               
staggering, reporting  that rates of  child abuse in  Alaska were                                                               
six  times the  national average.   She  opined that  this was  a                                                               
public health  crisis, as well as  a moral crisis.   She directed                                                               
attention   to  the   handout  about   ACEs  (Adverse   Childhood                                                               
Experiences) [Included  in members'  packets] and  explained that                                                               
the challenge  presented by the current  fiscal situation offered                                                               
an opportunity to better understand  the cost to society from the                                                               
impact of child abuse, estimated to  be in excess of $700 million                                                               
annually.  She reported that  these Adverse Childhood Experiences                                                               
had impacts on  relationships, the ability to keep  jobs, and the                                                               
engagement in risky  behaviors.  She added that there  was also a                                                               
physiological impact,  which included obesity and  diabetes.  She                                                               
declared that,  not only was there  a cost benefit to  the health                                                               
care  system,  but  there  was an  added  benefit  for  healthier                                                               
communities, stronger  individuals, and a healthier  Alaska.  She                                                               
offered her  belief that the state  did not have "a  handle on it                                                               
enough"  to not  have  this resolution  presented for  discussion                                                               
each year.   She stated that  it was necessary to  be reminded of                                                               
the  violence   in  our  communities,  the   families  that  were                                                               
struggling, the  children that were  impacted, and the  ways that                                                               
could be  offered for a  solution.   She explained that  "Go Blue                                                               
Friday" provided  a day for everyone  to be a participant  in the                                                               
process,  as everyone  could wear  blue  or have  a blue  button,                                                               
which  could spark  conversation.   She expressed  a strong  hope                                                               
that  more  people  than ever  would  participate  and  encourage                                                               
others to seek out help, which could help prevent child abuse.                                                                  
                                                                                                                                
REPRESENTATIVE  SULLIVAN-LEONARD asked  why she  chose the  color                                                               
blue.                                                                                                                           
                                                                                                                                
REPRESENTATIVE TARR  explained that  blue was the  national color                                                               
for child abuse prevention.   She suggested that the House Health                                                               
and Social Services Standing Committee all wear blue.                                                                           
                                                                                                                                
4:51:33 PM                                                                                                                    
                                                                                                                                
PATRICK ANDERSON  stated that he  had sent in  written testimony.                                                               
He shared  that, in 2003,  he had left  law practice in  order to                                                               
pursue  "a very  nebulous vision  of healing."   He  referenced a                                                               
paper he had written in 2009  in which he stated that health care                                                               
costs  could be  reduced  by  50 percent  by  addressing a  "lean                                                               
health  care" management  system,  which  would include  programs                                                               
that  addressed child  abuse and  neglect.   He pointed  out that                                                               
there was  a "huge cost  to childhood acquired trauma,"  an issue                                                               
for which  criminal penalties could  not be legislated.   He said                                                               
that the original Adverse Childhood  Experiences study found that                                                               
22 percent of a  predominantly white, middle class, well-educated                                                               
population  had  identified sexual  abuse  in  their lives.    He                                                               
stated  that the  legal definition  of child  abuse did  not take                                                               
into   account   all   the  iterations   of   adverse   childhood                                                               
experiences,  and did  not adequately  reflect these  costs.   He                                                               
suggested that policy  dialogues needed to go  further to include                                                               
the programs which supported the  elimination of child abuse.  He                                                               
declared his support for HCR 3.                                                                                                 
                                                                                                                                
4:56:02 PM                                                                                                                    
                                                                                                                                
CHAIR  SPOHNHOLZ  closed public  testimony  and  stated that  the                                                               
resolution would be held over.                                                                                                  
                                                                                                                                
4:57:28 PM                                                                                                                    
                                                                                                                                
ADJOURNMENT                                                                                                                   
                                                                                                                                
There being no  further business before the  committee, the House                                                               
Health  and  Social  Services   Standing  Committee  meeting  was                                                               
adjourned at 4:57 p.m.                                                                                                          

Document Name Date/Time Subjects
HCR003 ver A 2.23.16.pdf HHSS 3/9/2017 3:00:00 PM
HHSS 3/23/2017 3:00:00 PM
HCR 3
HCR003 Sponsor Statement 2.23.17.pdf HHSS 3/9/2017 3:00:00 PM
HHSS 3/23/2017 3:00:00 PM
HCR 3
HCR003 Fiscal Note - Prepared by House H&SS.pdf HHSS 3/9/2017 3:00:00 PM
HHSS 3/23/2017 3:00:00 PM
HCR 3
HCR003 Letters of Support A 2.23.17.pdf HHSS 3/9/2017 3:00:00 PM
HHSS 3/23/2017 3:00:00 PM
HCR 3
HCR003 Letters of Support B 2.23.17.pdf HHSS 3/9/2017 3:00:00 PM
HHSS 3/23/2017 3:00:00 PM
HCR 3
HCR003 Supporting Document - Governor Parnell Proclamation HCR21 2014 2.23.17.pdf HHSS 3/9/2017 3:00:00 PM
HHSS 3/23/2017 3:00:00 PM
HCR 3
HCR003 Supporting Document - Providence Hospital Facts About Child Sexual Abuse 2.23.17.pdf HHSS 3/9/2017 3:00:00 PM
HHSS 3/23/2017 3:00:00 PM
HCR 3
HCR003 Supporting Document - Governor Walker Proclamation Child Abuse Prevention and Awareness Month March 2016 2.23.17.pdf HHSS 3/9/2017 3:00:00 PM
HHSS 3/23/2017 3:00:00 PM
HCR 3
HCR003 Supporting Document - Governor Walker Proclamation Sexual Assault Awareness Month March 2016 2.23.17.pdf HHSS 3/9/2017 3:00:00 PM
HHSS 3/23/2017 3:00:00 PM
HCR 3
HCR003 Supporting Document - Office of Child Welfare Consequences of Child Abuse and Neglect 2.23.17.pdf HHSS 3/9/2017 3:00:00 PM
HHSS 3/23/2017 3:00:00 PM
HCR 3
HB025 ver A 2.16.17.PDF HHSS 2/28/2017 3:00:00 PM
HHSS 3/9/2017 3:00:00 PM
HHSS 4/6/2017 3:00:00 PM
HHSS 4/11/2017 3:00:00 PM
HB 25
HB025 Sponsor Statement 2.16.17.pdf HHSS 2/28/2017 3:00:00 PM
HHSS 3/9/2017 3:00:00 PM
HHSS 4/6/2017 3:00:00 PM
HHSS 4/11/2017 3:00:00 PM
HB 25
HB025 Sectional Analysis ver A 2.16.17.pdf HHSS 2/28/2017 3:00:00 PM
HHSS 3/9/2017 3:00:00 PM
HHSS 4/6/2017 3:00:00 PM
HHSS 4/11/2017 3:00:00 PM
HB 25
HB025 Fiscal Note DHSS-Medicaid Services 2.28.17.pdf HHSS 2/28/2017 3:00:00 PM
HHSS 3/9/2017 3:00:00 PM
HHSS 4/6/2017 3:00:00 PM
HHSS 4/11/2017 3:00:00 PM
HB 25
HB025 Fiscal Note DHSS-DHCS 2.28.17.pdf HHSS 2/28/2017 3:00:00 PM
HHSS 3/9/2017 3:00:00 PM
HHSS 4/6/2017 3:00:00 PM
HHSS 4/11/2017 3:00:00 PM
HB 25
HB025 Fiscal Note DCCED-DIO 2.28.17.pdf HHSS 2/28/2017 3:00:00 PM
HHSS 3/9/2017 3:00:00 PM
HHSS 4/6/2017 3:00:00 PM
HHSS 4/11/2017 3:00:00 PM
HB 25
HB025 Supporting Document-ADN Commentary 2.16.17.pdf HHSS 2/28/2017 3:00:00 PM
HHSS 3/9/2017 3:00:00 PM
HHSS 4/6/2017 3:00:00 PM
HHSS 4/11/2017 3:00:00 PM
HB 25
HB025 Supporting Document-Cost Savings Study 2.16.17.pdf HHSS 2/28/2017 3:00:00 PM
HHSS 3/9/2017 3:00:00 PM
HHSS 4/6/2017 3:00:00 PM
HHSS 4/11/2017 3:00:00 PM
HB 25
HB025 Supporting Document-Guttmacher Alaska Statistics 2.16.17.pdf HHSS 2/28/2017 3:00:00 PM
HHSS 3/9/2017 3:00:00 PM
HHSS 4/6/2017 3:00:00 PM
HHSS 4/11/2017 3:00:00 PM
HB 25
HB025 Supporting Document-Guttmacher Public Costs from Unintended Pregnancies 2.16.17.pdf HHSS 2/28/2017 3:00:00 PM
HHSS 3/9/2017 3:00:00 PM
HHSS 4/6/2017 3:00:00 PM
HHSS 4/11/2017 3:00:00 PM
HB 25
HB025 Supporting Document-HB025 Support Emails 2.27.17.pdf HHSS 3/9/2017 3:00:00 PM
HHSS 4/6/2017 3:00:00 PM
HHSS 4/11/2017 3:00:00 PM
HB 25
HB025 Supporting Document-Letter Kachemak Bay Family Planning Clinic 2.23.17.pdf HHSS 2/28/2017 3:00:00 PM
HHSS 3/9/2017 3:00:00 PM
HHSS 4/6/2017 3:00:00 PM
HHSS 4/11/2017 3:00:00 PM
HB 25
HB025 Supporting Document-Letter League of Women Voters Alaska 2.24.17.pdf HHSS 2/28/2017 3:00:00 PM
HHSS 3/9/2017 3:00:00 PM
HHSS 4/11/2017 3:00:00 PM
HB 25
HB025 Supporting Document-UCSF Study Newspaper Article 2.16.17.pdf HHSS 2/28/2017 3:00:00 PM
HHSS 3/9/2017 3:00:00 PM
HHSS 4/11/2017 3:00:00 PM
HB 25
HB025 Supporting Document-Unintended Pregnancies Study 2.16.17.pdf HHSS 2/28/2017 3:00:00 PM
HHSS 3/9/2017 3:00:00 PM
HHSS 4/6/2017 3:00:00 PM
HHSS 4/11/2017 3:00:00 PM
HB 25
HB025 Supporting Document-Letter Planned Parenthood Votes Northwest & Hawaii 2.16.17.pdf HHSS 2/28/2017 3:00:00 PM
HHSS 3/9/2017 3:00:00 PM
HHSS 4/6/2017 3:00:00 PM
HHSS 4/11/2017 3:00:00 PM
HB 25
HB025 Supporting Document-Letter Dr. Tina Tomsen 2.27.17.pdf HHSS 2/28/2017 3:00:00 PM
HHSS 3/9/2017 3:00:00 PM
HHSS 4/6/2017 3:00:00 PM
HHSS 4/11/2017 3:00:00 PM
HB 25
HB025 Supporting Document-Support Emails 2.27.17.pdf HHSS 2/28/2017 3:00:00 PM
HHSS 3/9/2017 3:00:00 PM
HHSS 4/6/2017 3:00:00 PM
HHSS 4/11/2017 3:00:00 PM
HB 25
HB025 Supporting Document-HB025 Support Emails 3.7.17.pdf HHSS 3/9/2017 3:00:00 PM
HHSS 4/6/2017 3:00:00 PM
HHSS 4/11/2017 3:00:00 PM
HB 25
HB025 Supporting Document-Letter Anne Green 3.3.17.pdf HHSS 3/9/2017 3:00:00 PM
HHSS 4/6/2017 3:00:00 PM
HB 25
HB025 Supporting Document-Letter Alaska Nurses Association 3.6.17.pdf HHSS 3/9/2017 3:00:00 PM
HHSS 4/6/2017 3:00:00 PM
HB 25
HB025 Supporting Document-Letters of Support 3.8.2017.pdf HHSS 3/9/2017 3:00:00 PM
HHSS 4/6/2017 3:00:00 PM
HB 25
HB025 Opposing Document-Letters of Opposition 3.8.2017.pdf HHSS 3/9/2017 3:00:00 PM
HHSS 4/6/2017 3:00:00 PM
HHSS 4/11/2017 3:00:00 PM
HB 25
HB025 Opposing Document-Letter NFIB 2.16.17.pdf HHSS 2/28/2017 3:00:00 PM
HHSS 3/9/2017 3:00:00 PM
HHSS 4/6/2017 3:00:00 PM
HHSS 4/11/2017 3:00:00 PM
HB 25
HB025 Opposing Document-America's Health Insurance Plans 2.27.17.pdf HHSS 2/28/2017 3:00:00 PM
HHSS 3/9/2017 3:00:00 PM
HHSS 4/6/2017 3:00:00 PM
HHSS 4/11/2017 3:00:00 PM
HB 25
HB0123 ver O 2.22.17.PDF HHSS 3/2/2017 3:00:00 PM
HHSS 3/9/2017 3:00:00 PM
HB 123
HB0123 Sponsor Statement 2.22.17.pdf HHSS 3/2/2017 3:00:00 PM
HHSS 3/9/2017 3:00:00 PM
HB 123
HB 123 Sectional Analysis 2.22.17.pdf HHSS 3/2/2017 3:00:00 PM
HHSS 3/9/2017 3:00:00 PM
HB 123
HB 123 Fiscal Note DHSS DPH 3.1.17.pdf HHSS 3/2/2017 3:00:00 PM
HHSS 3/9/2017 3:00:00 PM
HB 123
HB0123 Supporting Document-AAMC Price Transparency in the News 2.22.17.pdf HHSS 3/2/2017 3:00:00 PM
HHSS 3/9/2017 3:00:00 PM
HB 123
HB0123 Supporting Document-American's For Progress-Price Transparency 2.22.17.pdf HHSS 3/2/2017 3:00:00 PM
HHSS 3/9/2017 3:00:00 PM
HB 123
HB0123 Supporting Document-Article ADN-A Doctor's Quest to Remain Human Inside an Insane Medical System 2.22.17.pdf HHSS 3/2/2017 3:00:00 PM
HHSS 3/9/2017 3:00:00 PM
HB 123
HB0123 Supporting Document-Truven Health Analytics-Save $36 Billion in US Healthcare Spending Through Price Transparency 2.22.17.pdf HHSS 3/2/2017 3:00:00 PM
HHSS 3/9/2017 3:00:00 PM
HB 123
HB123 Draft Proposed Blank CS ver T 3.9.2017.pdf HHSS 3/9/2017 3:00:00 PM
HB 123
HB123 Explanation of Changes ver T 3.9.2017.pdf HHSS 3/9/2017 3:00:00 PM
HB 123