Legislature(2025 - 2026)BUTROVICH 205
05/06/2025 03:30 PM Senate HEALTH & SOCIAL SERVICES
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| Audio | Topic |
|---|---|
| Start | |
| HJR9 | |
| SB178 | |
| Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
| *+ | HJR 9 | TELECONFERENCED | |
| += | SB 178 | TELECONFERENCED | |
ALASKA STATE LEGISLATURE
SENATE HEALTH AND SOCIAL SERVICES STANDING COMMITTEE
May 6, 2025
4:11 p.m.
MEMBERS PRESENT
Senator Forrest Dunbar, Chair
Senator Cathy Giessel, Vice Chair
Senator Matt Claman
Senator Löki Tobin
Senator Shelley Hughes
MEMBERS ABSENT
All members present
COMMITTEE CALENDAR
CS FOR HOUSE JOINT RESOLUTION NO. 9(HSS)
Urging the United States Congress to extend enhanced tax credits
for health insurance premiums under the Affordable Care Act.
- HEARD & HELD
SENATE BILL NO. 178
"An Act relating to early intervention services for certain
children; relating to optional services under the medical
assistance program; and providing for an effective date."
- MOVED SB 178 OUT OF COMMITTEE
PREVIOUS COMMITTEE ACTION
BILL: HJR 9
SHORT TITLE: EXTEND AFFORDABLE CARE ACT TAX CREDITS
SPONSOR(s): REPRESENTATIVE(s) MINA
02/12/25 (H) READ THE FIRST TIME - REFERRALS
02/12/25 (H) HSS
03/11/25 (H) HSS AT 3:15 PM DAVIS 106
03/11/25 (H) -- MEETING CANCELED --
03/18/25 (H) HSS AT 3:15 PM DAVIS 106
03/18/25 (H) Heard & Held
03/18/25 (H) MINUTE(HSS)
03/20/25 (H) HSS AT 3:15 PM DAVIS 106
03/20/25 (H) Heard & Held
03/20/25 (H) MINUTE(HSS)
03/25/25 (H) HSS AT 3:15 PM DAVIS 106
03/25/25 (H) Moved CSHJR 9(HSS) Out of Committee
03/25/25 (H) MINUTE(HSS)
03/28/25 (H) HSS RPT CS(HSS) 4DP 1DNP 2NR
03/28/25 (H) DP: FIELDS, GRAY, MEARS, MINA
03/28/25 (H) DNP: PRAX
03/28/25 (H) NR: SCHWANKE, RUFFRIDGE
04/28/25 (H) TRANSMITTED TO (S)
04/28/25 (H) VERSION: CSHJR 9(HSS)
04/30/25 (S) READ THE FIRST TIME - REFERRALS
04/30/25 (S) HSS
05/06/25 (S) HSS AT 3:30 PM BUTROVICH 205
BILL: SB 178
SHORT TITLE: EXPAND EARLY INTERVENTION SERVICES
SPONSOR(s): HEALTH & SOCIAL SERVICES
04/22/25 (S) READ THE FIRST TIME - REFERRALS
04/22/25 (S) HSS, FIN
04/29/25 (S) HSS AT 3:30 PM BUTROVICH 205
04/29/25 (S) Heard & Held
04/29/25 (S) MINUTE(HSS)
05/01/25 (S) HSS AT 3:30 PM BUTROVICH 205
05/01/25 (S) Heard & Held
05/01/25 (S) MINUTE(HSS)
05/06/25 (S) HSS AT 3:30 PM BUTROVICH 205
WITNESS REGISTER
MAKAYLA WILSON, Staff
Representative Genevieve Mina
Alaska State Legislature
POSITION STATEMENT: Introduced HJR 9 on behalf of the sponsor.
AMBER LEE, Owner
Amber Lee Strategies
Anchorage, Alaska
POSITION STATEMENT: Testified by invitation on HJR 9.
TREVOR STORRS, President and Chief Executive Officer
Alaska Children's Trust
Anchorage, Alaska
POSITION STATEMENT: Testified by invitation on HJR 9.
LORETTA GREGORY, representing self
Kake, Alaska
POSITION STATEMENT: Testified in support of HJR 9.
MEGAN LINGLE, representing self
Juneau, Alaska
POSITION STATEMENT: Testified in support of HJR 9.
KAY RILEY, representing self
Juneau, Alaska
POSITION STATEMENT: Testified in support of HJR 9.
LORI WING-HEIER, Director
Division of Insurance
Department of Commerce, Community,
and Economic Development
Juneau, Alaska
POSITION STATEMENT: Answered questions on HJR 9.
SUSAN KESSLER, Research Analyst 4
Senior and Disability Services Division
Department of Health
Fairbanks, Alaska
POSITION STATEMENT: Answered question on SB 178.
ACTION NARRATIVE
4:11:47 PM
CHAIR DUNBAR called the Senate Health and Social Services
Standing Committee meeting to order at 4:11 p.m. Present at the
call to order were Senators Claman, Hughes, and Chair Dunbar.
Senator Tobin and Senator Giessel arrived thereafter.
HJR 9-EXTEND AFFORDABLE CARE ACT TAX CREDITS
4:12:19 PM
CHAIR DUNBAR announced the consideration of CS FOR HOUSE JOINT
RESOLUTION NO. 9(HSS) Urging the United States Congress to
extend enhanced tax credits for health insurance premiums under
the Affordable Care Act.
4:12:44 PM
MAKAYLA WILSON, Staff, Representative Genevieve Mina, Alaska
State Legislature, introduced HJR 9 on behalf of the sponsor.
[Original punctuation provided.]
HJR 9 - SHSS
House Joint Resolution 9 urges Congress to extend the
Affordable Care Act enhanced Premium Tax Credits
(PTCs), which expires at the end of this year.
4:13:04 PM
MS. WILSON continued with the introduction of HJR 9:
Over 15 years ago, small business owners and people
working multiple jobs struggled to find affordable
health insurance.
Since the ACA passed in 2010, the Alaska Marketplace
made health care affordable, reducing uninsurance
rates. Premium tax credits have always been part of
the marketplace, which are federal tax credits based
on income and household size that reduce net premiums.
Over 80 percent of Alaskans on the marketplace qualify
for
4:13:32 PM
SENATOR TOBIN and SENATOR GIESSEL arrived at the meeting.
MS. WILSON continued the introduction of HJR 9:
subsidies but, those who don't are largely the middle-
class and entrepreneurial Alaskans that pay the
highest in health care premiums in the state.
During the COVID-19 pandemic, Congress passed enhanced
Affordable Care Act (ACA) premium tax credits (PTCs),
making the marketplace more affordable for 22,180
Alaskans. Enhanced PTCs lowered caps on premiums, made
plans more affordable for Alaskans getting off
Medicaid, and extended credits for people with incomes
above 400 percent ($78,200). Savings of an average of
$690 per person annually. Self-employed Alaskans and
small business owners are major beneficiaries. 28
percent of marketplace enrollees nationwide are self-
employed.
However, enhanced PTCs are set to expire by the end of
2025. 51 percent of those who would lose credit
eligibility are aged 5064, not yet eligible for
Medicare. Without extending enhanced PTCs, premiums
will increase on the marketplace. Overall loss to
Alaskans would be more than $287 million in annual tax
subsidies.
From the Division of Insurance:
A single 50 year old making $32,918/yr would see his
premiums jump from $27/mo to $129/mo - more than
QUADRUPLE what he's paying this year.
Family of 4 paying $667/mo would pay $3,333/mo (5 X)
More estimates.
A single parent earning $40,000/year would go from
paying $18/month to $130/month...SEVEN TIMES as much
as what she pays this year.
A family of four earning $60,000/year would go from
paying $28/month to $189/month...6.7x AS MUCH
4:15:14 PM
MS. WILSON continued with the introduction of HJR 9:
Expiration would also destabilize our health insurance
risk pools. Jeopardizes Alaska's reinsurance program,
which was developed in 2017 response to skyrocketing
premiums and has successfully lowered premiums on the
marketplace. But reinsurance depends on stable premium
levels.
In 2017, when Alaska faced skyrocketing premiums,
Alaska Division of Insurance Director Lori Wing-Heier,
implemented the reinsurance program in 2017,
controlling premium increases from 42 percent to 7
percent after its implementation leading 18 other
states to follow suit, and has sent the state roughly
$700 million in federal funds.
Health care costs cripple small business, our economy,
and entrepreneurship. While we are facing a tough
fiscal situation, enhanced PTCs costs no money to the
State of Alaska budget, but saves health care costs
for Alaskans because the ACA helps people get off of
Medicaid.
HJR 9 is integral for controlling health care costs
with no cost to the State budget, and strengthening
our economy.
Extension of enhanced PTCS is supported by:
Alaska Children's Trust
Alaska Hospital and Healthcare Association
Alaska Native Tribal Health Consortium
Anna Brawley
Alaska Chapter, National Association of Benefits and
Insurance Professionals
Protect Our Care
Mat-Su Reentry Coalition
Alaska Native Health Board
Juneau Reentry Coalition
Anchorage Chamber of Commerce
Without the tax credits, some Alaskans could face
premiums equivalent to or exceeding a mortgage
payment. Entrepreneurs may have to forego their small
businesses to find a job with health insurance. Our
health care and economy should not go backwards.
Please support HJR 9.
4:16:52 PM
CHAIR DUNBAR announced invited testimony on HJR 9.
4:17:10 PM
AMBER LEE, Owner, Amber Lee Strategies, Anchorage, Alaska,
testified by invitation on HJR 9. She shared that eight years
ago, during a routine exam, she was diagnosed with melanoma and
multiple leiomyomas, markers of Hereditary Leiomyomatosis and
Renal Cell Carcinoma (HLRCC), a rare genetic syndrome associated
with a highly fatal form of kidney cancer. She said at the time,
she was the COO of a digital advertising agency with health
insurance, though soon after lost both her job and insurance
coverage when the company lost a major client, coinciding with
an early-stage breast cancer diagnosis. Alaska's Medicaid
expansion provided critical coverage for her and her two
children, and later the Affordable Care Act allowed them to
obtain affordable marketplace insurance when they started a
consulting business, despite preexisting conditions. She said
living in Alaska, where health care costs are extremely high,
they have faced substantial out-of-pocket expenses, including
over $75,000 in one year. Extended premium tax credits have
helped make coverage manageable, however without congressional
renewal, premiums are expected to double. She emphasized that
affordable ACA coverage is essential for small business owners,
economic diversification in Alaska, and urges support for
extending these tax credits.
4:19:53 PM
TREVOR STORRS, President and Chief Executive Officer, Alaska
Children's Trust, Anchorage, Alaska, testified by invitation on
HJR 9. He stated that Alaska Children's Trust (ACT) supports
policies that expand access to health care for children, youth,
and families. ACT backs HJR 9 urging Congress to extend enhanced
ACA premium tax credits. The Affordable Care Act significantly
reduced the number of uninsured Alaskans, including thousands of
families with children, and enhanced tax credits have made
health insurance more affordable and accessible. He said
maintaining these credits is critical to ensuring continued
coverage, promoting health and well-being, and supporting
economic stability for thousands of Alaska's families.
4:21:20 PM
CHAIR DUNBAR opened public testimony on HJR 9.
4:21:51 PM
LORETTA GREGORY, representing self, Kake, Alaska, testified in
support of HJR 9. She argued that health care is a basic need,
not a privilege, and described how underfunded and overextended
tribal and Indian Health Service systems force long waits and
costly travel for specialty care. The Affordable Care Act and
premium tax credits have expanded access to local providers,
prescriptions, and emergency care without overwhelming medical
bills, while allowing clinics to reinvest in services. She said
letting these tax credits expire would increase costs for
families and further strain the federal health system.
4:24:00 PM
MEGAN LINGLE, representing self, Juneau, Alaska, testified in
support of HJR 9. She emphasized that affordable health coverage
is vital for families, noting that while she currently has
employer sponsored insurance, job loss or medical emergencies
could quickly jeopardize coverage. She said, in that case, the
Affordable Care Act (ACA) and premium tax credits would be
essential to remain insured, as Indian Health Service and tribal
clinics alone cannot meet all specialty and emergency care
needs. The ACA provides flexible coverage when families need it
most. It supports tribal health systems by allowing clinics to
be reimbursed and reinvest in care. She concluded that health
care should not depend on location or sudden changes in
employment.
4:25:39 PM
KAY RILEY, representing self, Juneau, Alaska, testified in
support of HJR 9. She explained that the Affordable Care Act has
made it possible to receive life-changing treatment for multiple
sclerosis despite a preexisting condition, allowing a her to
remain mobile through medication she could not otherwise afford.
She noted that enhanced ACA tax credits have lowered premiums
for more than 23,000 Alaska families, small business owners,
self-employed individuals, and hourly workers. Allowing these
credits to expire would make coverage unaffordable, force
families to choose between medical care and basic needs,
increase strain on state and emergency services, and destabilize
the individual insurance market. She urged support for HJR 9 as
a bipartisan step to keep health care accessible and protect
Alaskans.
4:27:25 PM
CHAIR DUNBAR closed public on HJR 9.
4:27:32 PM
SENATOR HUGHES explained that premium tax credits can be
confusingly named, however they function like other tax credits
by providing financial assistance. In this case, the premium tax
credit helps offset health insurance premiums based on an
individual's income, making coverage more affordable. She asked
for clarification on the status of this issue in Congress,
including whether it is being considered as part of the Budget
Reconciliation Act, and where Congress stands overall, as well
as the position of our congressional delegation on the matter.
4:28:30 PM
MS. WILSON deferred the question to Ms. Wing-Hier.
4:28:45 PM
LORI WING-HEIER, Director, Division of Insurance, Department of
Commerce, Community, and Economic Development, Juneau, Alaska,
answered questions on HJR 9. She answered that she is unsure
whether the enhanced premium tax credits are included in the
Budget Reconciliation Act and notes they are currently set to
expire on December 31, 2025. She said there is active discussion
in Washington, DC about these credits. She stated that despite
confusing terminology it is her belief that the credits are
important and should be renewed.
4:29:33 PM
SENATOR HUGHES asked for confirmation from Ms. Wing-Heier that
Congress appears inclined to extend the enhanced premium tax
credits, though it is unclear whether this will occur through
the Budget Reconciliation Act.
MS. WING-HEIER replied that she cannot speak for members of
Congress. She said there is concern and active interest, as
lawmakers have reached out for information and data on how
extending or ending the tax credits would affect Alaska and its
reinsurance program.
4:30:23 PM
SENATOR HUGHES asked how expiration of the tax credits would
affect Alaska beyond higher premiums for many individuals and
their families. She asked for more information on impacts to the
reinsurance program and any broader consequences for the state.
MS. WING-HEIER replied that since the enhanced premium tax
credits were implemented, about $75 million was passed through
to Alaska's reinsurance program. She said with the credits set
to expire, the state will have sufficient funding for 2026, and
by 2027, the program's $140 million limit may need to be
reduced. Currently, roughly $120 million comes from federal
funds, supplemented by the $75 million in tax credits, leaving
about $25 million for 2026. She stated that she doesn't have an
idea of how to replace the expired funds and the program's
limits will need reevaluation.
4:31:56 PM
SENATOR HUGHES asked for an estimate of the annual cost to the
state if the enhanced premium tax credits are not renewed.
MS. WING-HEIER replied that the state cannot fund the
reinsurance program if the tax credits expire, as doing so would
be unaffordable and reduce benefits to consumers. She said
premiums would rise, and the program's limit would need to be
lowered, though they may explore other federal options.
4:32:44 PM
CHAIR DUNBAR emphasized that Alaska's reinsurance program has
been highly effective in controlling premiums, and losing its
funding would be undesirable.
4:33:23 PM
CHAIR DUNBAR held HJR 9 in committee.
4:33:24 PM
At ease.
SB 178-EXPAND EARLY INTERVENTION SERVICES
4:34:30 PM
CHAIR DUNBAR reconvened the meeting and announced the
consideration of SENATE BILL NO. 178 "An Act relating to early
intervention services for certain children; relating to optional
services under the medical assistance program; and providing for
an effective date."
4:35:15 PM
SENATOR HUGHES asked whether the appropriation request of
$440,000 is coming from the mental health trust budget.
4:35:44 PM
SUSAN KESSLER, Research Analyst 4, Senior and Disability
Services Division, Department of Health, Fairbanks, Alaska,
answered question on SB 178. She replied that the additional
funding is not coming from the budget of the Alaska Mental Trust
Authority; it comes from general state funds.
4:36:11 PM
SENATOR HUGHES noted that the second, larger fiscal note
involves Medicaid funding of $5.459 million, split roughly half
federal and half state, with $2.729 million coming from the
state's general fund. She highlighted the challenges posed by
fiscal constraints.
4:36:43 PM
MS. KESSLER stated her belief that additional funding would also
come from the general fund, alongside efforts to create new
early-intervention Medicaid billing codes and establish rates.
She said a combination of state and federal Medicaid funds would
pay for these services over the long term.
4:37:42 PM
At ease.
4:38:00 PM
CHAIR DUNBAR reconvened the meeting and solicited the will of
the committee.
4:38:09 PM
SENATOR GIESSEL moved to report SB 178, work order 34-LS0918\A,
from committee with individual recommendations and attached
fiscal note(s).
4:38:23 PM
CHAIR DUNBAR found no objection and SB 178 was reported from the
Senate Health and Social Services Standing Committee.
4:39:01 PM
There being no further business to come before the committee,
Chair Dunbar adjourned the Senate Health and Social Services
Standing Committee meeting at 4:39 p.m.
| Document Name | Date/Time | Subjects |
|---|---|---|
| HJR 9 Version I 3.28.25.pdf |
SHSS 5/6/2025 3:30:00 PM |
HJR 9 |
| HJR 9 Fiscal Note.pdf |
SHSS 5/6/2025 3:30:00 PM |
HJR 9 |
| Supporting Document DOI 03.21.25.pdf |
SHSS 5/6/2025 3:30:00 PM |
HJR 9 |
| HJR 9 Sponsor Statement Version N.pdf |
SHSS 5/6/2025 3:30:00 PM |
HJR 9 |
| HJR 9 LOS as of 04.28.25.pdf |
SHSS 5/6/2025 3:30:00 PM |
HJR 9 |