04/07/2025 01:30 PM Senate LABOR & COMMERCE
| Audio | Topic |
|---|---|
| Start | |
| SB83 | |
| SB21 | |
| Adjourn |
+ teleconferenced
= bill was previously heard/scheduled
| += | SB 21 | TELECONFERENCED | |
| + | SB 83 | TELECONFERENCED | |
ALASKA STATE LEGISLATURE
SENATE LABOR AND COMMERCE STANDING COMMITTEE
April 7, 2025
1:32 p.m.
MEMBERS PRESENT
Senator Jesse Bjorkman, Chair
Senator Kelly Merrick, Vice Chair
Senator Elvi Gray-Jackson
Senator Forrest Dunbar
Senator Robert Yundt
MEMBERS ABSENT
All members present
COMMITTEE CALENDAR
SENATE BILL NO. 83
"An Act relating to health care insurance; relating to insurance
reimbursement for health care services provided through
telehealth; and providing for an effective date."
- HEARD & HELD
SENATE BILL NO. 21
"An Act establishing the Alaska Work and Save Program;
establishing the Alaska Retirement Savings Board; and providing
for an effective date."
- MOVED CSSB 21(L&C) OUT OF COMMITTEE
PREVIOUS COMMITTEE ACTION
BILL: SB 83
SHORT TITLE: TELEHEALTH REIMBURSEMENT RATES
SPONSOR(s): SENATOR(s) CLAMAN
01/31/25 (S) READ THE FIRST TIME - REFERRALS
01/31/25 (S) HSS, FIN
02/11/25 (S) HSS AT 3:30 PM BUTROVICH 205
02/11/25 (S) Heard & Held
02/11/25 (S) MINUTE(HSS)
02/25/25 (S) HSS AT 3:30 PM BUTROVICH 205
02/25/25 (S) Heard & Held
02/25/25 (S) MINUTE(HSS)
03/13/25 (S) HSS AT 3:30 PM BUTROVICH 205
03/13/25 (S) Moved CSSB 83(HSS) Out of Committee
03/13/25 (S) MINUTE(HSS)
03/14/25 (S) HSS RPT CS 2DP 1DNP 1AM NEW TITLE
03/14/25 (S) DP: DUNBAR, CLAMAN
03/14/25 (S) DNP: HUGHES
03/14/25 (S) AM: GIESSEL
03/26/25 (S) FIN REFERRAL WAIVED
03/26/25 (S) L&C REFERRAL ADDED AFTER HSS
04/07/25 (S) L&C AT 1:30 PM BELTZ 105 (TSBldg)
BILL: SB 21
SHORT TITLE: AK WORK & SAVE PROGRM; RETIRE. SAVINGS BD
SPONSOR(s): SENATOR(s) WIELECHOWSKI
01/10/25 (S) PREFILE RELEASED 1/10/25
01/22/25 (S) READ THE FIRST TIME - REFERRALS
01/22/25 (S) L&C, FIN
03/31/25 (S) L&C AT 1:30 PM BELTZ 105 (TSBldg)
03/31/25 (S) Heard & Held
03/31/25 (S) MINUTE(L&C)
04/07/25 (S) L&C AT 1:30 PM BELTZ 105 (TSBldg)
WITNESS REGISTER
SENATOR MATT CLAMAN, District H
Alaska State Legislature
Juneau, Alaska
POSITION STATEMENT: Sponsor of SB 83.
SARENA HACKENMILLER, Staff
Senator Matt Claman
Alaska State Legislature
Juneau, Alaska
POSITION STATEMENT: Provided the sectional analysis SB 83.
JIM REBITZER, Economist
Boston University
Boston, Massachusetts
POSITION STATEMENT: Testified by invitation on SB 83.
HOWARD DETWILER, Owner
Arctic Behavior Health LLC
Anchorage, Alaska
POSITION STATEMENT: Testified by invitation on SB 83.
SENATOR BILL WIELECHOWSKI, District K
Alaska State Legislature
Juneau, Alaska
POSITION STATEMENT: Presented a recap of SB 21.
MARGE STONEKING, State Advocacy Director
American Association of Retired Persons (AARP)
Anchorage, Alaska
POSITION STATEMENT: Testified by invitation on SB 21.
DAVE YOUNG, Treasurer
Colorado Department of Treasury
Denver, Colorado
POSITION STATEMENT: Testified by invitation on SB 21.
JAYNE ANDREW, representing self
Douglas, Alaska
POSITION STATEMENT: Testified in support of SB 21.
ACTION NARRATIVE
1:32:40 PM
CHAIR BJORKMAN called the Senate Labor and Commerce Standing
Committee meeting to order at 1:32 p.m. Present at the call to
order were Senators Merrick, Gray-Jackson, Dunbar, Yundt and
Chair Bjorkman.
SB 83-TELEHEALTH REIMBURSEMENT RATES
[CSSB 83(HSS)was before the committee.]
1:33:38 PM
CHAIR BJORKMAN announced the consideration of CS FOR SENATE BILL
NO. 83(HSS) "An Act relating to health care insurance; relating
to insurance reimbursement for health care services provided
through telehealth; relating to telehealth; providing for an
effective date by repealing the effective date of secs. 9 and
10, ch. 38, SLA 2022; and providing for an effective date."
1:34:02 PM
SENATOR MATT CLAMAN, District H, Alaska State Legislature,
Juneau, Alaska, as the sponsor of SB 83, he the bill:
[Original punctuation provided.]
Senate Bill 83 was brought forward by health care
providers in my district who provide both in-person
and telehealth services to Alaskans across the state.
SB 83 will ensure pay parity for telehealth, requiring
health care insurers to reimburse at the same payment
rate for telehealth services as in-person care.
1:34:31 PM
SENATOR CLAMAN continued with his presentation:
Telehealth reduces barriers to care and allows
patients to receive timely and convenient care from
the comfort of their own homes. In Alaska, barriers to
care affect individuals in rural areas, those with
disabilities, and those with limited transportation
options. Telehealth is especially important for
chronic disease management, mental health services,
and preventative care.
The COVID-19 pandemic highlighted the critical need
for telehealth access, prompting the Centers for
Medicare & Medicaid Services (CMS) to temporarily
implement telehealth parity. While this federal
mandate has expired, some telehealth provisions remain
in place. What was once a temporary need is now
standard practice, and many states have made efforts
to solidify permanent access to these services. Over
33 states have enacted similar legislation to SB 83 to
ensure fair reimbursement for telehealth services.
Alaska's Medicaid program already has telehealth pay
parity. This legislation builds upon that existing
framework to require the same parity by private
insurers. In our previous committee, we amended to
remove the sunset language in Alaska's Medicaid
telehealth statutes, ensuring that it will remain in
law.
Passage of this legislation will expand access to
care, improve and maintain quality of care, and
incentivize continued telehealth utilization.
1:36:13 PM
SARENA HACKENMILLER, Staff, Senator Matt Claman, Alaska State
Legislature, Juneau, Alaska, provided the sectional analysis for
SB 83:
[Original punctuation provided.]
Sectional Analysis Version O
Section 1
AS 21.42.422(b). Coverage for telehealth. Adds new
paragraph (3) and references the definition of "health
care provider" as given in AS 21.07.250.
1:36:38 PM
MS. HACKENMILLER continued with the sectional analysis of SB 83,
version O:
Section 2
AS 21.42.422. Coverage for telehealth. Establishes a
new subsection requiring health care insurers to
reimburse health care providers for telehealth
services, including behavioral health services, at the
same rate as for in-person services.
Section 3
AS 29.10.200. Limitation of home rule powers. Adds new
paragraph (68) "AS 29.20.420 (health care insurance
plans)" to the list of provisions which apply to home
rule municipalities
Section 4
AS 29.20.420. Health care insurance plans. Establishes
a new section requiring a home rule or general law
municipality offering a group health care insurance
plan to meet the requirements of AS 21.42.422(c)
(Section 2). Provides the definition of "health care
insurance plan" as given in AS 21.52.500.
Section 5
AS 39.30.090(a). Authorization for self-insurance and
excess loss insurance. Adds a new subsection (13)
requiring a policy or policies of group insurance
covering state employees and other specific employee
groups under the Department of Administration to meet
to the requirements of AS 21.42.422(c) (Section 2).
Section 6
AS 39.30.091. Authorization for self-insurance and
excess loss insurance. Amends this statute to require
those employers with a self-insured group health
insurance plan covering active state employees to meet
the requirements of AS 21.42.422(c) (Section 2).
Section 7
Repeals Sections 9, 10, and 13 of ch. 38, SLA 2022.
Section 8
Repeals Section 14 of ch. 38, SLA 2022.
Section 9
Establishes an effective date of January 1, 2026.
1:38:22 PM
CHAIR BJORKMAN announced invited testimony on SB 83.
1:38:40 PM
JIM REBITZER, Economist, Boston University, Boston,
Massachusetts, testified by invitation on SB 83:
[Original punctuation provided.]
I am here to testify about a new piece of legislation
regarding reimbursement for telehealth services. The
bill requires a health insurer to reimburse for
telehealth services on the same basis and at least at
the same rate as comparable healthcare services
provided in person.
Let me start with my conclusion: This legislation is
reasonable and deserving of your support. However, the
reasoning behind it may be of greater use to the
committee than my conclusion.
As an economist studying management, I generally
believe that a state legislature should not determine
how much private insurers pay for services. Typically,
legislatures lack essential information and
incentives, and they respond too slowly to set
appropriate reimbursement rates. It is better to leave
this to negotiations between insurers and providers.
However, telehealth might be the exception that proves
the rule. Mandating equal payment can help address an
economic issue that private parties cannot resolve
independently.
Like every new treatment modality, telehealth requires
providers to develop new capabilities for delivering
care at a distance. Payers may be willing to
compensate providers to encourage these costly
investments, but will they pay enough on their own?
Perhaps not. In our fragmented payment system, each
provider treats patients from many different payers:
Medicare, Medicaid, the State of Alaska, private
insurers, and private employers. This diversity of
payers creates an opportunity for free riding.
1:41:27 PM
MR. REBITZER continued with his testimony on SB 83:
Suppose a provider deals with 10 different payers,
each paying $50 for a telehealth visit. Suppose
providers are happy to invest adequately in telehealth
capacity at this price. What would happen if one payer
decided to pay $40 for a telehealth visit? Providers
might still be willing to deliver telehealth care to
this payer because they have already borne the cost of
developing the telehealth capacity. The insurer who
pays $40 would, in effect, be "free riding" on the
other payers' generosity. That would be annoying to
the other payers. If the rest followed suit, the
result would be an inadequate investment in telehealth
capacity or, in the extreme case, no investment at
all.
You can see where this is heading. The proposed bill
can be beneficial as it makes it more difficult for a
single insurer to take advantage of investments in
telehealth funded by other payers.
Some who object to payment parity might argue that the
marginal cost of telehealth is less than in-person
health, so "parity" in payments means you are
overpaying for telehealth. This reasoning makes sense
until you think about it for a minute. Much of the
cost of delivering telehealth is determined by what
else providers could do with their time. Payment
parity has the advantage of not making it more
expensive for providers who deliver telehealth
services.
Although I am not an Alaskan, I am impressed by the
vast distances' healthcare providers must travel to
reach all Alaskans. The cost of underinvestment in and
under provision of telehealth is especially severe for
Alaska, so the proposed legislation's value is likely
to be high.
1:44:25 PM
HOWARD DETWILER, Owner, Arctic Behavior Health LLC, Anchorage,
Alaska, testified by invitation on SB 83 and gave an example of
when a snowstorm, in Anchorage, prevented two clients from
visiting the office, requiring remote consultations for
medication management. The technological costs and system
failures for telehealth can equal or exceed in-person visits and
may increase the risk of emergency consultations. He emphasized
an experience of developing military telehealth systems in Iraq
and Afghanistan, emphasizing that telehealth is essential for
healthcare delivery in Alaska.
1:46:43 PM
CHAIR BJORKMAN asked Mr. Detwiler to give examples of how SB 83
would directly affect his business.
1:46:58 PM
MR. DETWILER replied that a snowstorm prevented two clients from
visiting the office for restricted medications, making in-person
evaluation and prescription continuation impossible. He said
telehealth is essential to maintain continuity of care,
especially given Alaska's distances and challenging climate.
[CHAIR BJORKMAN held SB 83 in committee.]
1:49:18 PM
At ease.
SB 21-AK WORK & SAVE PROGRM; RETIRE. SAVINGS BD
1:51:38 PM
CHAIR BJORKMAN reconvened the meeting and announced the
consideration of SENATE BILL NO. 21 "An Act establishing the
Alaska Work and Save Program; establishing the Alaska Retirement
Savings Board; and providing for an effective date." CHAIR
BJORKMAN stated that a committee substitute (CS) for SB 21 was
adopted during the first hearing of the bill.
1:52:18 PM
SENATOR BILL WIELECHOWSKI, District K, Alaska State Legislature,
Juneau, Alaska, presented a recap of SB 21 and stated that the
Alaska Work and Save bill establishes an auto-IRA program for
all Alaskan employees, addressing the lack of retirement
savings, with over half of American households that do not have
a retirement, especially among small businesses, 64 percent of
which currently offer no retirement plan. He said the program
provides an affordable, simplified savings option, helping small
businesses compete for quality talent, supporting Alaskans'
financial security, and improving long-term quality of life. He
said 70 percent of small businesses would support a savings plan
if there were reasonable options. Similar programs exist in 17
other states.
1:53:58 PM
CHAIR BJORKMAN announced invited testimony on SB 21.
1:54:10 PM
MARGE STONEKING, State Advocacy Director, American Association
of Retired Persons (AARP), Anchorage, Alaska, testified by
invitation on SB 21:
[Original punctuation provided.]
AARP is the largest nonprofit, nonpartisan membership
organization in Alaska and in the country. Financial
security is a key component of our advocacy agenda for
Alaskans 50+ and that begins with saving for
retirement throughout one's working years.
AARP's mission is to empower people to choose how they
live as they age.
Retirement readiness is a big part of having choices
for how one lives in retirement, and Social Security
is not enough to live on. Retirement readiness is good
for Alaskans and for Alaska.
The less retirement income you have the more likely
you are to have to rely on public programs like
Medicaid, Senior Benefits, and SNAP to meet basic
needs.
Retirement readiness for the private sector requires a
workplace savings option for all employees.
The retirement crisis in this country is not a new
challenge but one that has persisted for several
decades. Today, over half of the nation's households
are at risk of not having enough money to maintain
their standard of living in retirement and being
unable to afford necessities such as food, utilities,
and healthcare.
Although some individuals are merely not saving
enough, a vast number are not saving at all. 20
percent of adults age 30 and older have no retirement
savings at all and 14 percent have less than $10,000
saved for retirement.
1:56:07 PM
MS. STONEKING continued with her testimony of SB 21:
A critical reason for this shortage of savings is that
a lack of access to workplace savings plans has
remained low for decades. Roughly just half of
private-sector workers have access to a way to save
from their regular paycheck at work. Employers,
particularly small business owners, often cannot
provide a retirement plan to their employees due to
their confusing, costly, and time-consuming nature.
Without access to a retirement savings plan at work,
nearly all workers fail to save. AARP Research has
found that Americans are about 15 times more likely to
save for retirement when they have can do so at work.
Work and Save is designed to address the retirement
savings gap using tools, such as payroll deduction and
automatic enrollment, that are proven to work.
Work and Save programs are changing the landscape on
retirement readiness by giving businesses an easy, no-
cost retirement program and giving workers a portable
retirement savings program allowing workers to build
the savings they need to be retirement ready.
And according to the National Institute on Retirement
Security's research on Americans' Views of State-
Facilitated Retirement Programs, the vast majority of
Americans agree that state-facilitated, privately
managed retirement savings programs are a good idea.
That support holds across party lines and across
generations. This policy has consistent bi-partisan
support in polling among the public and small-business
owners across the country and across time.
And, we know from instate polling that that across
political ideology, Alaska small businesses also
support a publicprivate retirement savings option.
Seven in ten Alaska small business owners support a
privately managed, ready-to-go retirement savings
option that would help small businesses offer
employees a way to save for retirement (Republican: 71
percent; Democrat: 70 percent; Independent: 76
percent). Additionally, most small business owners
agree that state legislators should support a bill to
make it easier for small business owners to access a
retirement savings option for their employees and
themselves, such as SB21 does.
AARP stands ready to work with the Alaska Legislature
to pass Alaska Work and Save so that generations of
Alaskans can save and become retirement ready.
2:00:13 PM
DAVE YOUNG, Treasurer, Colorado Department of Treasury, Denver,
Colorado, testified by invitation on SB 21 and stated that he
wanted to focus on page 7, line 14 of the bill which allows
through legislation the ability to enter into an agreement with
other states to provide services related to retirement age
programs. He said Colorado's Secure Savings Program, established
by legislation in 2020 and launched in 2023, is a state-run
auto-IRA program designed to expand retirement savings. He said
Colorado's IRA program created the "Partnership for a Dignified
Retirement" to help other states launch programs quickly by
leveraging Colorado's procurement work for fund managers,
program managers, and consultants. Partner states benefit from
reduced costs, shared resources, and lower fees for savers due
to negotiated price breaks based on assets under management. He
said the program has grown to 75,000 funded accounts and over
$100 million in assets, and early partner states are beginning
to be successful. The program is designed to complement, not
compete with, private sector plans, allowing businesses to
choose either option. The goal is to increase regular retirement
savings participation, providing a scalable, collaborative model
for states struggling to establish their own programs.
2:05:37 PM
CHAIR BJORKMAN asked whether participants in Colorado generally
keep their funds in their IRA accounts to let them grow long
term or do more people withdraw their money early for short-term
needs and how has that trend played out.
2:06:07 PM
MR. YOUNG replied that since launching in 2023, Colorado's
program shows growing average account balances, indicating
participants are keeping funds invested rather than withdrawing
early. As a Roth IRA, penalties discourage premature
withdrawals, and many savers are using automatic contribution
increases while retaining flexibility to adjust or opt out. He
said overall, the trend suggests people are leaving their money
in and letting it grow.
2:08:28 PM
CHAIR BJORKMAN asked what is the opt out rate in Colorado.
2:08:33 PM
MR. YOUNG replied he will need to consult with his staff on what
the opt-out rate is.
CHAIR BJORKMAN asked how have employers responded to the
program, and what level of time or effort is typically required
from employers when processing payroll.
MR. YOUNG replied that every potential saver must go through a
process called Know Your Customer (KYC), of the people that are
cleared by the KYC process, 20 percent of them opt out of the
program. He said employers report that the program is quick and
simple to use. He said the program was intentionally designed as
the "easy button" to reduce administrative burden. Small
businesses especially value being able to offer retirement
savings as part of compensation, and many employees are excited
to save for the first time. While some busy businesses find it
challenging to add new tasks, the program has generally been
well-received and easy to maintain.
2:11:56 PM
SENATOR YUNDT asked if the contributions would be on a pre-tax
basis.
2:12:13 PM
MR. YOUNG replied that the contributions would be post tax
because this program is Roth IRA.
2:12:24 PM
SENATOR YUNDT asked if the plan provides different investment
options such as low, medium, or high risk, so participants can
choose the strategy that best fits their stage of life.
2:12:41 PM
MR. YOUNG replied that his office did some research on the
different types of options to offer and found that too many
investment choices can discourage saving, as people often find
the options confusing. He said to simplify, the program provides
a default target date fund for long-term growth, while offering
limited additional options based on saver feedback to ensure the
lineup meets actual demand without overwhelming participants.
2:14:16 PM
SENATOR YUNDT asked if there was an employer match option.
2:14:30 PM
MR. YOUNG responded that the program is structured as a Roth
IRA, so employer matches aren't allowed. While Congress is
considering fixes of the SECURE 2.0 legislation through the
"saver's match", many small businesses prefer the current setup
since they aren't fiduciaries or responsible for matching
contributions. He said employers who want to offer matching can
instead choose private plans like 401(k)s. Meanwhile, Colorado's
plan offers a simple investment lineup, including capital
preservation, fixed income, domestic and international equity,
and target-date funds.
2:17:08 PM
SENATOR YUNDT asked since the fund was created, how has its
performance compared to major benchmarks like the Dow Jones or
the S&P 500.
2:17:32 PM
MR. YOUNG replied that the program is designed for long-term
sustainable performance, with fund managers guided by benchmarks
developed with investment consultants, while also being measured
against major indexes. He stated that the focus of Colorado's
retirement programs is long-term investing, not short-term
trading. By diversifying portfolios and managing risk, he aims
to provide sustainable, reliable returns that people can depend
on in retirement.
2:19:28 PM
CHAIR BJORKMAN opened public testimony on SB 21.
2:19:44 PM
JAYNE ANDREW, representing self, Douglas, Alaska, testified in
support of SB 21 and stated that she didn't start retirement
planning until her late 30s, having previously worked in small
businesses and nonprofits that offered little beyond basic
savings options. She emphasized the importance of providing
retirement opportunities, recalling how even modest savings were
valued by employees. Drawing on family history of financial
hardship and reliance on Social Security, she stressed the need
to ensure today's workers have secure retirement options as the
aging population grows.
2:21:57 PM
CHAIR BJORKMAN closed public testimony on SB 21.
2:22:10 PM
CHAIR BJORKMAN solicited the will of the committee.
2:22:13 PM
SENATOR MERRICK moved to report CSSB 21, work order 34-LS0254\N,
from committee with individual recommendations and attached
fiscal note(s).
2:22:28 PM
CHAIR BJORKMAN found no objection and CSSB 21(L&C) was reported
from the Senate Labor and Commerce Standing Committee.
2:22:59 PM
There being no further business to come before the committee,
Chair Bjorkman adjourned the Senate Labor and Commerce Standing
Committee meeting at 2:22 p.m.
| Document Name | Date/Time | Subjects |
|---|---|---|
| SB83 ver O.pdf |
SL&C 4/7/2025 1:30:00 PM |
SB 83 |
| SB83 Sponsor Statement ver O.pdf |
SL&C 4/7/2025 1:30:00 PM |
SB 83 |
| SB83 Sectional Analysis ver O.pdf |
SL&C 4/7/2025 1:30:00 PM |
SB 83 |
| SB83 Fiscal Note-DCCED-DOI 03.14.25.pdf |
SL&C 4/7/2025 1:30:00 PM |
SB 83 |
| SB83 Fiscal Note-DOA-DRB 02.04.25.pdf |
SL&C 4/7/2025 1:30:00 PM |
SB 83 |
| SB83 Supporting Document-AMA-State telehealth policy trends 11.30.23.pdf |
SL&C 4/7/2025 1:30:00 PM |
SB 83 |
| SB83 Supporting Document-AMA-Supporting equitable payment for telehealth 06.21.23.pdf |
SL&C 4/7/2025 1:30:00 PM |
SB 83 |
| SB83 Public Testimony-Combined Letters of Support 04.04.25.pdf |
SL&C 4/7/2025 1:30:00 PM |
SB 83 |