05/13/2023 11:00 AM House LABOR & COMMERCE
| Audio | Topic |
|---|---|
| Start | |
| SB45 | |
| Adjourn |
+ teleconferenced
= bill was previously heard/scheduled
| + | TELECONFERENCED | ||
| += | SB 45 | TELECONFERENCED | |
| += | HB 47 | TELECONFERENCED | |
ALASKA STATE LEGISLATURE
HOUSE LABOR AND COMMERCE STANDING COMMITTEE
May 13, 2023
2:06 p.m.
MEMBERS PRESENT
Representative Jesse Sumner, Chair
Representative Justin Ruffridge, Vice Chair
Representative Mike Prax
Representative Dan Saddler
Representative Stanley Wright
Representative Ashley Carrick
Representative Zack Fields
MEMBERS ABSENT
All members present
COMMITTEE CALENDAR
CS FOR SENATE BILL NO. 45(L&C) AM
"An Act relating to insurance; relating to direct health care
agreements; relating to the duties of the director of the
division of insurance in the Department of Commerce, Community,
and Economic Development; and providing for an effective date."
- MOVED HCS CSSB 45(L&C) OUT OF COMMITTEE
PREVIOUS COMMITTEE ACTION
BILL: SB 45
SHORT TITLE: DIRECT HEALTH AGREEMENT: NOT INSURANCE
SPONSOR(s): SENATOR(s) WILSON
01/25/23 (S) READ THE FIRST TIME - REFERRALS
01/25/23 (S) HSS, L&C
02/07/23 (S) HSS AT 3:30 PM BUTROVICH 205
02/07/23 (S) Heard & Held
02/07/23 (S) MINUTE(HSS)
02/09/23 (S) HSS AT 3:30 PM BUTROVICH 205
02/09/23 (S) Heard & Held
02/09/23 (S) MINUTE(HSS)
02/21/23 (S) HSS AT 3:30 PM BUTROVICH 205
02/21/23 (S) Scheduled but Not Heard
02/23/23 (S) HSS AT 3:30 PM BUTROVICH 205
02/23/23 (S) Moved CSSB 45(HSS) Out of Committee
02/23/23 (S) MINUTE(HSS)
02/24/23 (S) HSS RPT CS 1DP 4NR SAME TITLE
02/24/23 (S) DP: WILSON
02/24/23 (S) NR: TOBIN, KAUFMAN, GIESSEL, DUNBAR
03/27/23 (S) L&C AT 1:30 PM BELTZ 105 (TSBldg)
03/27/23 (S) Heard & Held
03/27/23 (S) MINUTE(L&C)
04/05/23 (S) L&C AT 1:30 PM BELTZ 105 (TSBldg)
04/05/23 (S) Heard & Held
04/05/23 (S) MINUTE(L&C)
04/19/23 (S) L&C AT 1:30 PM BELTZ 105 (TSBldg)
04/19/23 (S) Moved CSSB 45(L&C) Out of Committee
04/19/23 (S) MINUTE(L&C)
04/21/23 (S) L&C RPT CS 1DP 2NR NEW TITLE
04/21/23 (S) DP: BJORKMAN
04/21/23 (S) NR: DUNBAR, GRAY-JACKSON
05/10/23 (S) TRANSMITTED TO (H)
05/10/23 (S) VERSION: CSSB 45(L&C) AM
05/10/23 (H) L&C AT 3:15 PM BARNES 124
05/10/23 (H) -- MEETING CANCELED --
05/11/23 (H) READ THE FIRST TIME - REFERRALS
05/11/23 (H) L&C
05/12/23 (H) L&C AT 3:15 PM BARNES 124
05/12/23 (H) Scheduled but Not Heard
05/13/23 (H) L&C AT 11:00 AM BARNES 124
WITNESS REGISTER
JASMIN MARTIN, Staff
Senator David Wilson
Alaska State Legislature
Juneau, Alaska
POSITION STATEMENT: On behalf of the prime sponsor, Senator
Wilson, answered questions during the hearing on HCS SB 45,
Version R.
SENATOR DAVID WILSON
Alaska State Legislature
Juneau, Alaska
POSITION STATEMENT: As prime sponsor, answered questions during
the hearing on HCS SB 45, Version R.
PAM VENTGEN, Executive Director
Alaska State Medical Association
Anchorage, Alaska
POSITION STATEMENT: Testified in support of SB 45.
WADE ERICKSON, MD, representing self
Wasilla, Alaska
POSITION STATEMENT: Testified in support of SB 45.
ACTION NARRATIVE
2:08:20 PM
CHAIR JESSE SUMNER called the House Labor and Commerce Standing
Committee meeting to order at 2:08 p.m. Representatives
Saddler, Prax, Carrick, Rufferidge, and Sumner were present at
the call to order. Representatives Fields and Wright arrived as
the meeting was in progress.
SB 45-DIRECT HEALTH AGREEMENT: NOT INSURANCE
2:08:44 PM
CHAIR SUMNER announced that the only order of business would be
CS FOR SENATE BILL NO. 45(L&C)am, "An Act relating to insurance;
relating to direct health care agreements; relating to the
duties of the director of the division of insurance in the
Department of Commerce, Community, and Economic Development;
relating to unfair trade practices; and providing for an
effective date." [Before the committee, adopted as a working
document on 4/19/23, was the House committee substitute (HCS)
for SB 45, Version 33-LS0211\R, Wallace, 4/5/23 ("Version R").]
2:08:52 PM
REPRESENTATIVE SADDLER moved to adopt Conceptual Amendment 1 to
HCS SB 45, Version R. He stated that the amendment would delete
language on page 1, line 14 through page 2, line 10 requiring
direct care providers to provide care to Medicaid patients;
however, it would leave in the requirement for these providers
to serve Medicare and uninsured patients. There being no
objections, Conceptual Amendment 1 to HCS SB 45, Version R, was
adopted.
2:09:36 PM
REPRESENTATIVE SADDLER moved to adopt Conceptual Amendment 2 to
HCS SB 45, Version R, as amended. He stated that the conceptual
amendment would add a new section which would require a health
care business or health care provider under a direct health care
agreement to be subject to AS 21.36. It would also insert a new
section which would assert that a health care business or health
care provider under a direct health care agreement that complies
with this section is not subject to the section.
2:10:36 PM
REPRESENTATIVE RUFFRIDGE objected for the purpose of discussion.
He asked for clarification regarding Conceptual Amendment 2.
2:11:29 PM
JASMIN MARTIN, Staff, Senator David Wilson, Alaska State
Legislature, on behalf Senator Wilson, prime sponsor of SB 45,
answered that Conceptual Amendment 2 would remove certain
penalty language from the proposed bill and make changes to the
section pertaining to air ambulances.
2:12:34 PM
REPRESENTATIVE RUFFRIDGE questioned the original language of the
proposed legislation.
MS. MARTIN answered that it was added by the Senate Labor and
Commerce Standing Committee prior to other aspects of bill
changes.
2:13:38 PM
REPRESENTATIVE RUFFRIDGE withdrew his objection. There being no
further objection, Conceptual Amendment 2 was adopted.
2:13:44 PM
REPRESENTATIVE WRIGHT moved to adopt Conceptual Amendment 3 to
HCS SB 45, Version R, as amended, to change the definition of
"health care business" to be in line with the original
legislation. He maintained that this change is necessary as the
requirement of residency would be unconstitutional.
2:14:04 PM
REPRESENTATIVE RUFFRIDGE objected. He asked whether the bill is
designed to prevent larger health care entities from entering
into direct health care agreements. In response to a request to
repeat the question, he stated that the companion bill had
defined only smaller physician-owned practices would be able to
participate in a direct health care agreement. He questioned
whether Conceptual Amendment 3 would retain this language or
broaden it to allow larger health care systems.
2:15:33 PM
SENATOR DAVID WILSON, Alaska State Legislature, as prime sponsor
of SB 45, answered that the main concern of the amendment is
residency requirements. He said that Legislative Legal Services
notified his office of concerns relating to discrimination of an
individual based on residency, without just cause.
2:17:28 PM
REPRESENTATIVE RUFFRIDGE expressed the concern that the proposed
bill would be too narrow, as many health care businesses are not
entirely health care provider owned.
SENATOR WILSON responded that many health care businesses in the
state are owned by primary care providers, and there have been
concerns regarding the inclusion of corporate entities, such as
adventurist capitalist groups. He said that the proposed bill
is meant to cater toward health care businesses not owned by
corporations and doing this without running afoul of residency-
related questions.
MS. MARTIN added that the amendment would broaden the definition
to strike a balance.
2:21:13 PM
The committee took an at-ease from 2:21 p.m. to 2:23 p.m.
2:23:29 PM
A roll call vote was taken. Representatives Carrick, Wright,
Prax, Saddler, and Sumner voted in favor of Conceptual Amendment
3 to HCS SB 45, Version R, as amended. Representative Ruffridge
voted against it. Therefore, Conceptual Amendment 3 was adopted
by a vote of 5-1.
2:23:55 PM
REPRESENTATIVE WRIGHT stated that he would not offer Conceptual
Amendment 4.
2:24:09 PM
REPRESENTATIVE RUFFRIDGE moved to adopt Conceptual Amendment 5
to HCS SB 45, Version R, as amended. There being no objection,
Conceptual Amendment 5 was adopted.
2:24:25 PM
The committee took an at-ease from 2:24 p.m. to 2:26 p.m.
2:26:19 PM
REPRESENTATIVE RUFFRIDGE moved to adopt Conceptual Amendment 6
to HCS SB 45, Version R, as amended. There being no objection,
Conceptual Amendment 6 was adopted.
2:26:28 PM
REPRESENTATIVE CARRICK moved to adopt Conceptual Amendment 7 to
HCS SB 45, Version R, as amended.
REPRESENTATIVE SADDLER objected.
2:26:39 PM
REPRESENTATIVE CARRICK explained that Conceptual Amendment 7
would expand health care options for Alaskans. She stated that
direct health care agreements have the potential to be more
affordable and accessible. She added that Conceptual Amendment
7 would also provide this affordability and accessibility by
expanding insurance coverage for contraceptives and birth
control.
2:28:07 PM
SENATOR WILSON expressed opposition to Conceptual Amendment 7,
as there is similar legislation in the Senate which has not yet
received a hearing.
2:28:51 PM
REPRESENTATIVE SADDLER expressed opposition to Conceptual
Amendment 7.
2:29:23 PM
A roll call vote was taken. Representatives Fields and Carrick
voted in favor of Conceptual Amendment 7. Representatives Prax,
Ruffridge, Wright, Saddler, and Sumner voted against it.
Therefore, Conceptual Amendment 7 failed by a vote of 2-5.
2:30:06 PM
CHAIR SUMNER opened public testimony on HCS SB 45, Version R.
2:30:28 PM
PAM VENTGEN, Executive Director, Alaska State Medical
Association, stated that the Alaska State Medical Association
supports SB 45 because it would allow providers flexibility in
how patients receive services. She noted that direct health
care is legal in Alaska, but it requires a provider to register
as an insurance company, and the bill would eliminate this
unnecessary requirement. She added that regulating direct
health care agreements as insurance creates a costly and
unnecessary burden for both patients and health care providers.
2:34:21 PM
WADE ERICKSON, MD, representing self, expressed support for the
proposed legislation, and he noted that over 40 other states
have had success with such a model.
2:36:00 PM
CHAIR SUMNER, after ascertaining there was no one else who
wished to testify, closed public testimony on HCS SB 45, Version
R.
2:36:48 PM
The committee took a brief at-ease.
2:36:51 PM
REPRESENTATIVE RUFFRIDGE moved to report HCS SB 45, Version 33-
LS0211\R, Wallace, 4/5/23, as amended, out of committee with
individual recommendations and the accompanying fiscal notes and
to allow Legislative Legal Services to make any necessary
conforming changes to the bill. There being no objection, HCS
CSSB 45(L&C) was reported out of the House Labor and Commerce
Standing Committee.
2:37:44 PM
ADJOURNMENT
There being no further business before the committee, the House
Labor and Commerce Standing Committee meeting was adjourned at
2:37 p.m.
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