Legislature(2025 - 2026)BARNES 124
04/25/2025 09:00 AM House LABOR & COMMERCE
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| Audio | Topic |
|---|---|
| Start | |
| Board of Veterinary Examiners | |
| HB178 | |
| Board of Veterinary Examiners | |
| Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
| += | HB 193 | TELECONFERENCED | |
| *+ | HB 192 | TELECONFERENCED | |
| *+ | HB 178 | TELECONFERENCED | |
| + | TELECONFERENCED | ||
| + | TELECONFERENCED |
ALASKA STATE LEGISLATURE
HOUSE LABOR AND COMMERCE STANDING COMMITTEE
April 25, 2025
9:09 a.m.
DRAFT
MEMBERS PRESENT
Representative Carolyn Hall, Co-Chair
Representative Zack Fields, Co-Chair
Representative Ashley Carrick
Representative Robyn Niayuq Burke
Representative Dan Saddler
Representative Julie Coulombe
Representative David Nelson
MEMBERS ABSENT
All Members Present
COMMITTEE CALENDAR
CONFIRMATION HEARING(S):
Board of Professional Counselors
Mary Elkins Anchorage
Crystal Herring Anchorage
Ashley Martin Anchorage
Carrie-Elaine Border Anchorage
- CONFIRMATION(S) HEARD
Board of Public Accountancy
Donovan Neal Juneau
James Doughty - Anchorage
- CONFIRMATION(S) HEARD
State Board of Registration for Architects, Engineers, & Land
Surveyors
Samson Shepherd Anchorage
- CONFIRMATION(S) HEARD
Marijuana Control Board
Lacy Wilcox Juneau
- CONFIRMATION(S) HEARD
Occupational Safety & Health Review Board
Isaac Diboue Anchorage
Ryan Sharratt Kodiak
Zachary Schasteen - Unalaska
- CONFIRMATION(S) HEARD
Real Estate Commission
Jimi Cash Fairbanks
Susan Wilcox Soldotna
Yolanda Logan - Anchorage
- CONFIRMATION(S) HEARD
State Physical Therapy & Occupational Therapy Board
Victoria Daugherty Juneau
Jonathan Gates - Kenai
- CONFIRMATION(S) HEARD
Board of Veterinary Examiners
Robert Gerlach - Chugiak
- CONFIRMATION(S) HEARD
HOUSE BILL NO. 178
"An Act relating to medical debt and consumer credit reporting
agencies; relating to discriminatory practices based on the
medical debt of a person; and providing for an effective date."
- HEARD & HELD
HOUSE BILL NO. 193
"An Act establishing a paid parental leave program; relating to
unemployment benefits; relating to the collection of child
support obligations; and relating to the duties of the
Department of Labor and Workforce Development."
- BILL HEARING CANCELED
HOUSE BILL NO. 192
"An Act relating to the payment of unemployment compensation
benefits; relating to a penalty for late unemployment benefit
payments; relating to inflation adjustments to unemployment
benefit amounts; relating to an insured worker's availability
for work; and providing for an effective date."
- BILL HEARING CANCELED
PREVIOUS COMMITTEE ACTION
BILL: HB 178
SHORT TITLE: MEDICAL DEBT: INFORMATION, DISCRIMINATION
SPONSOR(s): REPRESENTATIVE(s) MINA
04/09/25 (H) READ THE FIRST TIME - REFERRALS
04/09/25 (H) L&C, FIN
04/25/25 (H) L&C AT 9:00 AM BARNES 124
WITNESS REGISTER
DONOVAN NEAL, Appointee
Board of Public Accountancy
Juneau, Alaska
POSITION STATEMENT: Testified as appointee to the Board of
Public Accountancy.
JAMES DOUGHTY, Appointee
Board of Public Accountancy
Anchorage, Alaska
POSITION STATEMENT: Testified as an appointee to the Board of
Public Accountancy.
MARY ELKINS, Appointee
Board of Professional Counselors
Anchorage, Alaska
POSITION STATEMENT: Testified as an appointee to the Board of
Professional Counselors.
CRYSTAL HERRING, Appointee
Board of Professional Counselors
Anchorage, Alaska
POSITION STATEMENT: Testified as an appointee to the Board of
Professional Counselors.
ASHLEY MARTIN, Appointee
Board of Professional Counselors
Anchorage, Alaska
POSITION STATEMENT: Testified as an appointee to the Board of
Professional Counselors.
CARRIE-ELAINE BORDER, Appointee
Board of Professional Counselors
Anchorage, Alaska
POSITION STATEMENT: Testified as an appointee to the Board of
Professional Counselors.
ROBERT GERLACH, DVM, Appointee
Board of Veterinary Examiners
Chugiak, Alaska
POSITION STATEMENT: Testified as an appointee to the Board of
Veterinary Examiners.
SAMSON SHEPERD, Appointee
State Board of Registration for Architects, Engineers & Land
Surveyors
Anchorage, Alaska
POSITION STATEMENT: Testified as an appointee to the State
Board of Registration for Architects, Engineers & Land
Surveyors.
REPRESENTATIVE GENEVIEVE MINA
Alaska State Legislature
Juneau, Alaska
POSITION STATEMENT: As prime sponsor, presented HB 178.
CLARK HANSEN, Managing Director of Advocacy
ALS Association
Juneau, Alaska
POSITION STATEMENT: Gave invited testimony on HB 178.
ADAM ZARRIN, Director of State Government Affairs, Leukemia &
Lymphoma Society (LLS)
Sacramento, California
POSITION STATEMENT: Gave invited testimony on HB 178.
CLAIRE LUBKE, Economic Justice Lead
Alaska Public Interest Research Group
Anchorage, Alaska
POSITION STATEMENT: Gave invited testimony on HB 178.
LACY WILCOX, Appointee
Marijuana Control Board
Juneau, Alaska
POSITION STATEMENT: Testified as an appointee to the Marijuana
Control Board.
ISAAC DIBOUE, Appointee
Occupational Safety & Health Review Board
Anchorage, Alaska
POSITION STATEMENT: Testified as an appointee to the
Occupational Safety & Health Review Board.
ZACHERY SCHASTEEN, Appointee
Occupational Safety & Health Review Board
Unalaska, Alaska
POSITION STATEMENT: Testified as an appointee to the
Occupational Safety & Health Review Board.
JIMI CASH, Appointee
Real Estate Commission
POSITION STATEMENT: Fairbanks, Alaska( Testified as an
appointee to the Real Estate Commission.
VICTORIA DAUGHTERY, Appointee
State Physical Therapy & Occupational Therapy Board
Juneau, Alaska
POSITION STATEMENT: Testified as an appointee to the State
Physical Therapy & Occupational Therapy Board.
JONATHAN GATES, Appointee
State Physical Therapy & Occupational Therapy Board
Anchorage, Alaska
POSITION STATEMENT: Testified as an appointee to the State
Physical & Occupational Therapy Board.
YOLANDA LOGAN, Appointee
Real Estate Commission
Anchorage, Alaska
POSITION STATEMENT: Testified as an appointee to the Real
Estate Commission.
RYAN SHARRAT, Appointee
Occupational Safety & Health Review Board
Anchorage, Alaska
POSITION STATEMENT: Testified as an appointee to the
Occupational Safety & Health Review Board.
ACTION NARRATIVE
9:09:33 AM
CO-CHAIR CAROLYN HALL called the House Labor and Commerce
Standing Committee meeting to order at 9:09 a.m.
Representatives Saddler, Nelson, Carrick, Burke, Coulombe, and
Hall were present at the call to order. Representative Fields
arrived as the meeting was in progress.
^CONFIRMATION HEARING(S): Board of Professional Counselors
CONFIRMATION HEARING(S): Board of Professional Counselors
^Board of Public Accountancy
Board of Public Accountancy
^State Board of Registration for Architects, Engineers & Land
Surveyors
State Board of Registration for Architects, Engineers & Land
Surveyors
^Board of Veterinary Examiners
Board of Veterinary Examiners
[Contains discussion of HB 121 and SB 54.]
9:10:57 AM
CO-CHAIR HALL announced that the first order of business would
be confirmation hearings on the governor's appointees to various
boards.
9:11:20 AM
DONOVAN NEAL, Appointee, Board of Public Accountancy, testified
as appointee to the Board of Public Accountancy. He began his
testimony by stating he has been a licensed Certified Public
Accountant (CPA) for 25 years, noting that he has spent 10 years
in public accounting and another 15 years "in industry." He
further stated that he has participated on a few non-profit
boards, which were notated on his resume that had been provided
to the committee members. He welcomed questions from the
committee.
9:12:30 AM
REPRESENTATIVE SADDLER asked what APICDA stood for, referring to
Mr. Neal's resume.
MR. NEAL explained that it stood for Aleutian Pribilof Island
Community Development Association, which was a non-profit
community development quota (CDQ) group that is focused on the
Bering Sea region.
REPRESENTATIVE SADDLER, referring to HB 121, asked Mr. Neal's
opinion on the proposed legislation.
MR. NEAL explained that, at one point in the public accounting
area, there were a lot of candidates and a lot of competition
for jobs. He stated that, in recent years, its been more
difficult to attract qualified candidates to the CPA profession.
He noted that HB 121 was a part of a nationwide movement in
efforts to reduce the additional requirement to attract more
applicants to the CPA profession.
9:14:29 AM
REPRESENTATIVE COULOMBE asked what issues Mr. Neal foresees that
would need to be addressed by the Board of Public Accountancy.
MR. NEAL noted that the board meets four times annually, and
oversees a number of things, including applications for new
accountancy, regulation changes, and alternative pathways to CPA
licensure. He stated that the board also looks at application
renewals.
9:16:27 AM
JAMES DOUGHTY, Appointee, Board of Public Accountancy, He stated
that he started in public accounting in 2006 after receiving his
bachelor's in accounting from the University of Alaska Anchorage
(UAA). He stated that he became a CPA in 2009. He noted that
he has worked for corporations, government clients, non-profits
organizations, et cetera. He stated that he looked forward to
tackling various issues as a member of the board, noting that
the proposed changing credit requirements for CPA was the
primary reason that he applied for the board. He stated that he
would like to see the proposed changing credit requirements pass
the legislature, noting that there was a nationwide shortage of
CPAs.
9:17:37 AM
REPRESENTATIVE SADDLER asked whether Mr. Doughty found the
disclosure requirements for his application to the board
onerous.
MR. DOUGHTY replied that he found the application process easy.
9:18:04 AM
REPRESENTATIVE CARRICK asked for clarification whether his
application was for appointment or re-appointment.
MR. DOUGHTY clarified that this was his initial application.
9:18:45 AM
MARY ELKINS, Appointee, Board of Professional Counselors,
testified as an appointee to the Board of Professional
Counselors. She stated that she had applied to the board to
ensure that Alaska's counseling regulations reflect the work "on
the ground."
9:19:22 AM
REPRESENTATIVE SADDLER asked whether this was a re-appointment.
MS. ELKINS explained that she was appointed in June [2025].
REPRESENTATIVE SADDLER asked what issues she saw facing the
mental health industry in Alaska.
MS. ELKINS replied that the industry was changing significantly,
particularly with the advent of artificial intelligence (AI).
She asserted that there was a great need for increased access to
mental healthcare, reporting that there are underserved clients
through Medicaid. She further asserted that private health
insurance plans are challenging, noting that, while mental
health care should be a weekly or twice weekly appointment, many
private health insurance plans offer coverage capping at a few
times a year.
9:21:28 AM
REPRESENTATIVE CARRICK asked for the term length on the Board of
Professional Counselors.
MS. ELKINS stated that she thought it was a two- or three-year
term.
REPRESENTATIVE CARRICK noted that Ms. Elkins' resume was very
robust, seeming to serve in a lot of positions simultaneously in
the last decade. She asked how the Board of Professional
Counselors would fit into Ms. Elkins' life.
MS. ELKINS acknowledged that she was very busy but stated that
she did not find it difficult to juggle many roles. She noted
that her roles were concurrent, stating that she was the CEO of
her business, and that she additionally started a community
behavioral health clinic.
MS. ELKINS, in response to a follow-up question from
Representative Carrick, identified "providing guidance and
supervision" to help individuals become "fantastic counselors"
as her number one role.
9:24:37 AM
REPRESENTATIVE SADDLER asked Ms. Elkins opinion on the
integration of behavioral health providers in public school and
further asked her to identify any regulations in need of change
with regards to behavioral health services in Alaska.
MS. ELKINS opined that the present of behavioral health
professionals in schools was very important. She identified the
COVID-19 pandemic as very impactful on children, noting that
access to mental health professionals would be very helpful.
She stated that behavioral health services needed to be
expanded. She noted that she would like to see private
insurances cover what is typically covered under Medicaid.
9:27:16 AM
CRYSTAL HERRING, Appointee, Board of Professional Counselors,
testified as an appointee to the Board of Professional
Counselors. She stated that she was originally from
Mississippi, and she has lived in Alaska for the past 24 years.
She stated that she had been in the counseling profession for
about 28 years, and that she had been a licensed professional
counselor (LPC) in Alaska since 2013. She identified keeping up
with current practices and making regulatory changes as needed
as goals in the name of serving her community.
9:28:35 AM
REPRESENTATIVE SADDLER asked what challenges Ms. Herring saw in
the mental health industry.
MS. HERRING replied that she agreed with Ms. Elkins on the
regulation of AI technology, noting that AI had a large impact
on the mental health field as it was heavily unregulated and
there was a lot of concern about confidentiality.
REPRESENTATIVE SADDLER asked whether Ms. Herring's appointment
was a re-appointment.
MS. HERRING replied that her appointment was new and that she
had never served on a board.
9:31:26 AM
ASHLEY MARTIN, Appointee, Board of Professional Counselors, She
stated that she has been in the behavioral health field for the
past 17 years, noting that she received her LPC in 2019. She
reported that past experience included work in both inpatient
and outpatient substance use treatment programs, and a mental
health crisis recovery center. She stated that, through her
current position as a behavioral health officer at Catholic
Social Services, she helps homeless individuals and individuals
who reside at shelters. She emphasized the importance of
qualify supervision for individuals working towards their LPCs
and stated that she hoped to be a part of "retaining quality
counselors for my community."
9:32:50 AM
REPRESENTATIVE SADDLER asked what Ms. Martin saw as the biggest
issues facing the behavioral health industry.
MS. MARTIN replied that lack of counselors was a problem in
Alaska. She offered her agreement with previous appointees on
changing technologies and the potential impacts on the mental
health profession. She additionally spoke to barriers to
access, such as lack of transportation in rural areas, as an
issue.
MS. MARTIN, in response to a follow-up question from
Representative Saddler, stressed the importance of allowing
licenses to transfer upon relocation to Alaska.
9:35:11 AM
REPRESENTATIVE CARRICK asked what the board was doing to
communicate with and address regional issues in Alaska, noting
that every appointee to the Board of Professional Counselors was
located in Anchorage, Alaska.
MS. MARTIN emphasized access to supervision in their region
while earning their license. She noted that new graduates in
rural areas may not have a licensed supervisor in their area.
9:37:51 AM
CARRIE-ELAINE BORDER, Appointee, Board of Professional
Counselors, testified as an appointee to the Board of
Professional Counselors. She stated that she has 14 years of
experience in the mental health field, with 7 years of
experience as a supervisory LPC. She further stated that she
had 16 years of experience with medical billing, noting that she
was a Medicare and Medicaid billing specialist prior to becoming
a counselor. She said that she had a bachelor's in teaching.
She stated that she had helped with the legislative efforts to
create an Associate Counselor license type, a new license that
allows counselors to practice under supervision as a step
towards LPC.
9:40:02 AM
REPRESENTATIVE SADDLER appreciated Ms. Borders technical
experience and history with medical billing. He asked what
policy changes the legislature should consider to prevent mental
health crises.
MS. BORDER answered that LPCs needed more accountability and
noted that the renewal process was simplistic and did not
provide for actual accountability.
MS. BORDER further stating that blending Medicaid services with
healthcare services to classify what kind of services are being
provided, the cost of actual services, and to whom. She
specified that it was important to identify who had the greatest
need for mental healthcare and quantify the effectiveness of
care.
9:44:29 AM
CO-CHAIR HALL asked what accountability looks like for LPCs.
MS. BORDER replied that accountability means "showing that you
have done what you said you would do."
CO-CHAIR HALL queried the mechanisms by which accountability
could be taken.
MS. BORDER responded that technology could be used to show
progress, and additional paperwork that could be sent to the
Board of Professional Counselors to prove supervision.
9:46:26 AM
ROBERT GERLACH, DVM, Appointee, Board of Veterinary Examiners,
testified as an appointee to the Board of Veterinary Examiners.
He stated that, after receiving his veterinary degree from the
University of Pennsylvania, he practiced in Delaware,
Pennsylvania, and Maryland, primarily on dairy cattle. He
stated that he moved to Anchorage, where he worked in private
practices for 13 years. He stated that he had a background in
physiology and toxicology and began working for the State of
Alaska to study contaminants in fisheries in Alaska. He stated
that he had previously served as the Alaska State Veterinarian
and had worked with the Board of Veterinary Examiners in the
past and was encouraged by the former chair to apply for a
position on the board.
9:50:00 AM
REPRESENTATIVE SADDLER asked whether his appointment was a re-
appointment.
DR. GERLACH stated that this would be his initial appointment.
REPRESENTATIVE SADDLER asked Dr. Gerlach to comment on Alaska's
readiness to deal with pathogenic diseases of mammalian or avian
origin.
DR. GERLACH stated that, due to the challenges of remote
operations around Alaska, his approach to addressing pathogenic
diseases and outbreaks was highly collaborative with both state
and federal entities the United States Department of
Agriculture (USDA), the U.S. Department of Interior (DOI), the
U.S. Fish and Wildlife Service (USFWS) and the Department of
Fish & Game (ADF&G). He stated that, as the State Veterinarian,
he and others performed an extensive evaluation of bird flu in
both wild and domestic avian populations in Alaska. He further
explained that his office trained wildlife biologists and
technicians in the appropriate collection of samples, which
avoided travel delays.
DR. GERLACH, in response to a follow-up question from
Representative Saddler, offered his belief that the state was in
good shape to respond to disease outbreaks, and highlighted the
importance of collaboration between state and federal entities.
REPRESENTATIVE SADDLER asked for Dr. Gerlach's opinion on the
proposed Department of Agriculture.
DR. GERLACH stated that the Office of the State Veterinarian was
very small, with three staff members, and relies on the
laboratory in the Department of Environment Conservation (DEC)
to provide a number of services for sample processing and
analysis. He stated that the State Veterinary Office also
relies on individuals in DEC and the Food Safety & Sanitation
[Program] to response to outbreaks in agricultural and dairy
products. He stated that these collaborations allow the State
Veterinary Office to provide "a wide variety of services with
efficient use of resources." He said that the State
Veterinarian position was very integrated within DEC. He noted
that moving the position to a new location [with the creation of
the Department of Agriculture] could mean a possible expansion
of staff and it could also provide challenges with regard to
laboratory support and sample handling.
9:55:28 AM
CO-CHAIR HALL thanked Dr. Gerlach for his testimony.
9:56:06 AM
SAMSON SHEPERD, Appointee, State Board of Registration for
Architects, Engineers & Land Surveyors, testified as appointee
to the State Board of Registration for Architects, Engineers &
Land Surveyors. He offered his education and work background.
He said he is a small business owner and expressed excitement
about the opportunity to serve the board.
9:56:50 AM
REPRESENTATIVE SADDLER spoke to an effort in legislature [SB 54]
to add interior designers to the board.
MR. SHEPERD stated that he did not have any comment on that
piece of legislation.
REPRESENTATIVE SADDLER asked what issues Mr. Sheperd saw with
the board.
MR. SHEPERD noted that there appeared to be a lack of appointees
to the board.
9:58:30 AM
ADJOURNMENT
CO-CHAIR HALL recessed the House Labor and Commerce Standing
Committee meeting to 3:15 p.m.
3:42:22 PM
CO-CHAIR CAROLYN HALL called the House Labor and Commerce
Standing Committee back to order at 3:42 p.m. Members present
at the call back to order were Representatives Saddler, Fields,
Carrick, Coulombe, Burke, and Hall.
HB 178-MEDICAL DEBT: INFORMATION, DISCRIMINATION
3:42:30 PM
CO-CHAIR HALL announced that the next order of business would be
HOUSE BILL NO. 178, "An Act relating to medical debt and
consumer credit reporting agencies; relating to discriminatory
practices based on the medical debt of a person; and providing
for an effective date."
3:42:50 PM
REPRESENTATIVE GENEVIEVE MINA, Alaska State Legislature, as
prime sponsor, presented HB 178. She gave the sponsor statement
[included in the committee file], which read as follows
[original punctuation provided]:
No one is immune to the possibility of a costly
medical bill from an unforeseen sickness, out-of-
network care, or billing errors. Navigating the
bureaucracy of the American health care industry can
financially upend a household living paycheck-to-
paycheck. Approximately 41% of American adults have
some form of medical debt. In 2021, 14% of Alaskans
had medical debt in collections, with a median amount
of approximately $1,500 (twice the national average).
A working Alaskan who lacks sufficient emergency
savings and cannot pay a medical bill could have their
debt sent to collections, lowering their credit score
and creating insurmountable financial consequences.
Low credit scores specifically entrench low-income
individuals into a vicious cycle of poverty by
creating barriers to economic mobility and making
loans, housing, and employment more difficult to
obtain.
Since medical debt is rarely chosen and difficult to
avoid, it should not be used a predictor of financial
trustworthiness. Medical debt is an unreliable
indicator of default and other types of payment
behavior. Moreover, when medical debt is removed from
credit reporting, credit scores increase by an average
of 20 points. In January 2025, the federal Consumer
Protection Finance Bureau (CFPB) issued a ruling to
ban the inclusion of medical debt on credit reports,
but implementation has been delayed to June, and its
future is uncertain.
HB 178 would ban the reporting of medical debt on
credit reports in state statute, emulating the CFPB
rule. It would prohibit the furnishing of medical debt
to credit reporting companies and prevent them from
displaying any medical debt information in the first
place. Furthermore, this bill bans landlords and
employers from using medical debt as eligibility
criteria for considering tenants and employe[es].
With wages failing to keep up with inflation and
rising living costs, credit is essential for low-
income households to pay their bills. HB 178 improves
the self-sufficiency of Alaskans by ensuring that
illness or disability do not impact access to credit
and economic opportunity.
REPRESENTATIVE MINA moved to a PowerPoint presentation
[included in the committee file], titled "Medical Debt:
178," and gave a background on credit scores, shown on the
second slide, which read [original punctuation provided]:
? Forms of credit evaluation have existed since the
early 1800s --mostly through subjective means (like
word-of-mouth) and discriminatory means (such as
gender, age, marital status, ethnic background).
? Attempts to nationally standardize credit scores
only manifested after the Equal Credit Opportunity Act
of 1974,which required equitable opportunity to credit
regardless of race, religion, and other aforementioned
factors.
? In 1989, the FICO score(formerly called Fair, Isaac,
and Company) became the model for creditworthiness to
assess financial reliability. FICO scores puts certain
percentage weights on payment history, amounts owed,
length of credit history, new credit, debts in
collections (including medical debt!), and credit mix
in an attempt to be objective.
? Today, 90% of top lenders use the FICO model to
assess eligibility
? Today, 60% of employers use credit reports to
evaluate job candidates (despite a lack of evidence
that credit history correlates to performance or
fraud) 1
? Utility and cell phone companies are also
complicit in using credit reports to make sales and
pricing decisions
? FICO scores also determine housing
opportunities, be it in rental or mortgage scenarios
REPRESENTATIVE MINA gave an overview of criticisms in
recent years of credit reporting, shown on the third slide,
which read [original punctuation provided]:
? Rising costs and stagnant incomes mean greater
reliance on credit; at the same time, the FICO scoring
model has faced increased scrutiny and suspicion. The
FICO model, like all models, is inherently imperfect.
It also furthers economic divide and entrenches folks
in cycles of poverty.
? Those who acquire lower credit score become
subject to:
i. Crippling interest rates (then have to be
relegated to payday loans, etc.)
ii. Higher down payments
iii. Difficulty securing rentals and affordable
mortgages
iv. Denied employment opportunities, etc.
entrenching folks in cycles of poverty.
v. Higher insurance premiums
vi. Higher utility costs
? Nationally, the score difference between white and
non-white areas is near 80 points, which can cost
families up to $100 more a month for a conventional
mortgage.
? The FICO model unduly punishes student loan holders
for their debt
? Furthermore, credit scoring can skew unreliable,
with individuals having debts reported they did not
incur. Research suggests that more than 20 million
Americans could have material errors on their credit
reports.
REPRESENTATIVE MINA moved to the fourth slide and gave a
history of medical debt reporting in the United States,
which read as follows [original punctuation provided]:
? Occasionally, hospitals report to credit agencies
directly. Most of the time, the health care industry
sells their debt off to the debt collector, who then
reports to the credit agencies.
? March 2023:Experian, Transunion, and Equifax removed
reporting medical debt <$500.
? January 2025: The Consumer Financial Protection
Bureau (CFPB) finalized rules to:
? Stop credit reporting companies from sharing
medical debts with lender
? Prohibit lenders from making lending decisions
based on existing medical debt
i. The CFPB has estimated by removing medical
debt, scores would raise an average of 20 points
ii. The CFPB also estimated that this would lead
to the approval about 22,000 mortgages
? The January rules were supposed to take into effect
in March, but the current administration has pushed it
until June.
? The Executive Branch may try to retract the
ruling via Executive Order
? Simultaneously, Congress is trying to quash the
rule under the Congressional Review Act through House
Joint Resolution 74 and Senate Joint Resolution 36.
H.R.J. 74 is expected to pass the house.
REPRESENTATIVE MINA gave a summary of medical debt in
Alaska, shown on the fifth slide, which read [original
punctuation provided]:
? Nationally, most people 72 percent, according to
one estimate attribute their medical debt to bills
from acute care, such as a single hospital stay or
treatment for an accident.13Nearly 30 percent of
adults who owe medical debt owe it entirely for
hospital bills.14
? Based on national polling from the Kaiser Family
Foundation, an estimated 40% of Alaskans have some
form of medical debt, including those in collections 1
? In 2021, 14.1% of Alaskan residents had medical
debt that went to collections,according to data
compiled by the institute in August 2021 2
? The median debt in collections was $1,533,
nearly double the national average of $870
? 17% of Alaskans have a debt in collections
? In 2020, medical debt represented nearly half
of Alaskans with debt in collections
REPRESENTATIVE MINA moved briefly to the sixth slide,
drawing committee members' attention to a pie chart
representative of the percentage of individuals in Alaska
with medical debt in collections [14 percent] and not in
collections [86 percent].
REPRESENTATIVE MINA gave an overview of policies
implemented by other states regarding medical debt credit
reporting, shown on the seventh slide, which read as
follows [original punctuation provided]:
BANNED MEDICAL DEBT CREDIT REPORTING:
? California
? Connecticut
? New Jersey
? Virginia
? Illinois
? Rhode Island
? Minnesota
OTHER MEDICAL DEBT PROTECTIONS NATIONWIDE:
? Florida and Virginia now bar medical debt collection
lawsuits unless they're initiated within three years
of the debt
? Delaware prohibits creditors from foreclosing on
patients' homes to collect on unpaid medical bills
? New Jersey recently appropriated $10 million to
cancel up to a $1 billion in medical debt
REPRESENTATIVE MINA moved to the eighth slide and gave an
overview of HB 178, which read [original punctuation
provided]:
? HB 178 prohibits debt collectors and other entities
from furnishing information to credit reporting
agencies
? HB 178 prohibits credit reporting agencies from
reporting medical debt
? HB 178 prohibits landlords or employers from asking
about medical debt and/or using it as a qualifying
factor
? If a debt collector violates this rule, the debt is
rendered null and void
REPRESENTATIVE MINA gave a summary of the impacts of
medical debt in collections, shown on the tenth slide,
which read [original punctuation provided]:
? Anyone can get hit with a surprise medical bill from
an unforeseen sickness out-of-network care, or billing
errors. Righting the bureaucracy of the American
health care industry can upend a household living
paycheck-to-paycheck.
? Since medical debt is rarely chosen and difficult to
avoid, it should not be used a predictor of financial
trustworthiness.
? Low credit scores specifically entrench low-income
individuals into a vicious cycle of poverty by
creating barriers to economic mobility and making
loans, housing, and employment more difficult to
obtain.
? When a bad credit report makes life more expensive,
and makes it hardest to earn the means by which one
can pay for those expenses (i.e. jobs), it forces some
consumers to take on more debt on worse debts which
makes life more expensive, reinforcing the cycle of
poverty.
? Furthermore, medical debt has been proven to be an
unreliable indicator of defaulting, or financial
reliability. (In general, debts types do not reflect
other payment behaviors.)
REPRESENTATIVE MINA concluded by asserting that HB 178
would help Alaskans to be self-sufficient and ensure
factors outside their control will not impede their ability
to be "economically mobile."
CO-CHAIR HALL announced the committee would hear invited
testimony.
3:51:33 PM
CLARK HANSEN, Managing Director of Advocacy, ALS Association,
began his invited testimony on HB 178, by introducing himself as
an advocate for patients with amyotrophic lateral sclerosis
(ALS). He emphasized his support for HB 178, which he said
would address the critical issues of medical debt and its impact
on the lives of Alaskans. He said he has witnessed firsthand
the financial burdens that medical expenses can impose. He
described ALS as a progressive, neurodegenerative disease that
requires extensive medical care, including frequent doctor
visits and, in the case of Alaskans, travel to the Lower 48
states for care. Beyond that, the disease requires specialized
equipment and, sometimes, around-the-clock care. These
necessary treatments and care, averaging between $150,000 to
$200,000 per year per patient, often lead to significant medical
debt, which can have a devastating effect on patients lives
beyond their health.
MR. HANSEN continued his testimony, indicating the key reasons
the association supports the proposed legislation is because it
would: make it unlawful for an employer to discriminate against
based on medical debt; make it illegal for property owners to
refuse to lease or rent to individuals due to their medical
debt; and prohibit the inclusion of medical debt in credit
reports. He added that a fair credit rating can effect a
person's ability to access necessary resources. He advised that
HB 178 would increase access to employment and housing, thereby
leading ASL patients to greater access to employment and housing
opportunities, allowing them to live with dignity and
independence. They would be allowed to live without the added
stress of financial discrimination.
3:55:58 PM
ADAM ZARRIN, Director of State Government Affairs, Leukemia &
Lymphoma Society (LLS), gave invited testimony on HB 178. He
identified curing blood cancer and supporting friends and family
of those diagnosed as the society's mission. He explained that
a patient diagnosed with acute leukemia typically spends an
estimated $500,000 after the first year of diagnosis, noting
that healthcare costs are rising. He further stated that four
out of ten patients opt to delay or skip treatment due to high
costs. He stated that patients that do start treatment often
dip into savings or take out loans, and reported that 42 percent
of patients, two years after diagnosis, will have depleted their
lifesavings. He asserted that medical debt is fundamentally
different from all kinds of debts, noting that no one chooses to
get sick. He stated that medical debt is often fraught with all
kinds of billing errors with charges that should have been
covered by insurance. He stated that life-saving treatment can
significantly impact an individuals financial and emotional
health. He asserted that blood cancer "should have no bearing"
on an individual's credit worthiness or their ability to find
housing or appointment. He asserted that HB 178 would help
patients stabilize their lives and pay off their debt. He
offered his support for HB 178. In response to a question, he
clarified that represented the western regions of LLS.
3:58:42 PM
CLAIRE LUBKE, Alaska Public Interest Research Group (AKPIRG),
Economic Justice Lead, She began her invited testimony by
stating that AKPIRG was the only non-profit consumer advocacy
organization in Alaska. She stated that credit scores carry
important information. She reported that medical debt is not a
good indicator of a person's credit worthiness and echoed the
former speaker in stating that no person chooses to get sick and
medical billing if often fraught with errors. She stated that,
since 2022, there has been a 50 percent increase in the cost of
premiums through the government.
4:02:03 PM
REPRESENTATIVE CARRICK asked how medical debt is different from
loan debt.
MS. LUBKE said that she would follow up with the committee
members in writing.
4:03:50 PM
REPRESENTATIVE SADDLER asked if any debt was a predictor of
someone's likelihood to default on loans and asked if it was
"fair" to a mortgage lender to not report medical debt on a loan
application.
MS. LUBKE answered that the purpose of a FICO calculation was an
assessment of a person's ability to pay back their debt. She
said that her previous testimony answered Representative
Saddler's second question.
4:07:25 PM
REPRESENTATIVE CARRICK asked if states have any control over
what can and cannot be considered in a person's loan
application. She asked for confirmation as to whether or not
debt incurred in a state other than Alaska could appear on a
loan application.
REPRESENTATIVE MINA answered that she was not sure of an answer
to Representative Carrick's question.
MR. HANSEN, in response to Representative Carrick's second
question, said yes.
4:10:34 PM
REPRESENTATIVE COULOMBE asked for an example of how medical debt
might affect employment, noting that she has hired many people
and has never checked for medical debt.
MR. HANSON offered his understanding that many employers took
into account a prospective employee's outstanding debt.
REPRESENTATIVE COULOMBE noted that medical debt would affect
someone's ability to make payments of any kind and asked for
confirmation that the proposed legislation would prohibit
reporting of all medical debt.
REPRESENTATIVE MINA stated that the proposed legislation would
prohibit the reporting of any medical debt to an employer.
4:16:30 PM
REPRESENTATIVE SADDLER suggested that two credit scores could be
provided, one with medical debt and one without medical debt.
REPRESENTAIVE MINA stated that the intention of the proposed
bill was that medical debt is not the best indicator of whether
someone has had reliable payment history in other matters.
4:19:28 PM
CO-CHAIR FIELDS said "we have like, 20 appointees online, we
should probably go through since they're waiting for us.
4:19:40 PM
REPRESENTATIVE COULOMBE said "it's really money in, money out
4:20:49 PM
CO-CHAIR HALL announced that HB 178 would be held over.
^CONFIRMATION HEARING(S): Marijuana Control Board
CONFIRMATION HEARING(S): Marijuana Control Board
^Occupational Safety and Health Review Board
Occupational Safety and Health Review Board
^Real Estate Commission
Real Estate Commission
^State Board of Registration for Architects, Engineers & Land
Surveyors
State Board of Registration for Architects, Engineers & Land
Surveyors
^State Physical Therapy & Occupational Therapy Board
State Physical Therapy & Occupational Therapy Board
^Board of Veterinary Examiners
Board of Veterinary Examiners
4:21:00 PM
CO-CHAIR HALL announced that the final order of business would
be a series of confirmation hearings of appointees for various
boards and commissions.
4:21:57 PM
LACY WILCOX, Appointee, Marijuana Control Board, testified as an
appointee to the Marijuana Control Board. She explained her
history in working in public health and reviewed her
qualifications to serve on the Marijuana Control Board.
4:24:39 PM
REPRESENTATIVE SADDLER asked which seat Ms. Wilcox was appointed
to and whether this was her initial appointment.
MS. WILCOX clarified that it was her initial appointment, and it
was to the public - industry seat.
REPRESENTATIVE SADDLER asked whether local governments should be
allowed to restrict or prohibit the sale of marijuana even if
the state government allows it.
MS. WILCOX noted that individuals could petition their municipal
local governments to opt-out of the legality of marijuana use.
4:26:06 PM
ISAAC DIBOUE, Appointee, Occupational Safety & Health Review
Board, He shared his experience in working in occupational
safety and reviewed his qualifications to serve on the
Occupational Safety and Health Review Board (OHSRB).
4:28:21 PM
ZACHERY SCHASTEEN, Appointee, Occupational Safety & Health
Review Board, Testified as an appointee to the Occupational
Safety & Health Review Board. He shared his experience in
working in occupational safety and reviewed his qualifications
to serve on the OHSRB.
4:30:38 PM
JIMI CASH, Appointee, testified as an appointee to the Real
Estate Commission. He stated that he was a general contractor
by trade and had been a general contractor for 23 years. He
stated that this would be his first appointment to any
commission in the state and reviewed his qualifications to serve
on the Real Estate Commission.
4:31:36 PM
REPRESENTATIVE CARRICK asked Mr. Cash to speak to the value of
having people from different regions on the various boards and
commissions.
MR. CASH responded that diversity on boards and commissions was
very important, particularly with regards to real estate, noting
that real estate in Interior Alaska was vastly different from
real estate in Southcentral or Southeast Alaska.
4:34:26 PM
REPRESENTATIVE SADDLER asked what issues Mr. Cash saw with the
Real Estate Commission and asked what functions the commission
had.
MR. CASH stated that he was representative of the public
perspective of the Real Estate Commission and said that it was a
regulatory body to assist in the licensing of real estate
realtors and brokers.
4:37:38 PM
VICTORIA DAUGHTERY, Appointee, State Physical Therapy &
Occupational Therapy Board, testified as an appointee to the
State Physical Therapy & Occupational Therapy Board. She shared
her history working in Alaska as an occupational therapist and
reviewed her qualifications to serve on the State Physical
Therapy & Occupational Therapy Board (PTOTB).
4:38:53 PM
REPRESENTATIVE SADDLER asked Ms. Daughtery what her thoughts
were with regard to licensing reciprocity for physical
therapists in the state.
MS. DAUGHTERY said that there was currently a need for more
occupational and physical therapists in the state.
4:40:38 PM
JONATHAN GATES, Appointee, State Physical Therapy & Occupational
Therapy Board, testified as an appointee to the State Physical &
Occupational Therapy Board. He shared his history working in
the state and reviewed his qualifications to serve on the PTOTB.
4:42:26 PM
YOLANDA LOGAN, Appointee, Real Estate Commission, testified as
an appointee to the Real Estate Commission.
4:43:13 PM
REPRESENTATIVE SADDLER asked Ms. Logan what issues she saw
coming before the commission she wished to serve on.
MS. LOGAN answered that she wanted to address the unsuredness of
consumers with regard to who their broker of realtor might be.
4:44:54 PM
RYAN SHARRAT, Appointee, Occupational Safety & Health Review
Board, Testified as an appointee to the Occupational Safety &
Health Board. He began his testimony by explaining his history
in occupational health & safety and explained why he would like
to serve on the board.
4:46:20 PM
CO-CHAIR HALL opened public testimony on the confirmation
hearings. After ascertaining that there was no one who wished
to testify, she closed public testimony on the confirmation
hearings.
[The confirmation hearings were set aside for a later date.]
4:46:31 PM
ADJOURNMENT
There being no further business before the committee, the House
Labor and Commerce Standing Committee meeting was adjourned at
4:46 p.m.