Legislature(2013 - 2014)
2013-04-09 Senate Journal
Full Journal pdf2013-04-09 Senate Journal Page 1072 SB 49 SPONSOR SUBSTITUTE FOR SENATE BILL NO. 49 "An Act defining 'medically necessary abortion' for purposes of making payments under the state Medicaid program" was read the third time. Senator Gardner moved that the bill be returned to second reading for the purpose of a specific amendment, that being Amendment No. 1. Without objection, the bill was returned to second reading. Senators Gardner, Ellis offered Amendment No. 1 : Page 1, line 1, following "Act": Insert "relating to women's health services and" Page 1, following line 3: Insert a new bill section to read: "* Section 1. AS 47.07.030 is amended by adding a new subsection to read: (g) The department shall make available to eligible recipients a program for women's health for the purpose of providing family planning services, health screening examinations, and related services." Page 1, line 4: Delete "Section 1" Insert "Sec. 2" Page 3, following line 5: Insert a new bill section to read: "* Sec. 3. The uncodified law of the State of Alaska is amended by adding a new section to read: WOMEN'S HEALTH PROGRAM UNDER STATE MEDICAID. The Department of Health and Social Services shall immediately prepare and submit to the United States Department of Health and Human Services, for approval in accordance with the provisions of 42 U.S.C. 1396a (Title XIX, Social Security Act), an amendment to the state plan consistent with AS 47.07.030, enacted by sec. 1 of this Act." 2013-04-09 Senate Journal Page 1073 Senator Gardner moved for the adoption of Amendment No. 1. Senator Coghill objected, then withdrew his objection. There being no further objection, Amendment No. 1 was adopted. SPONSOR SUBSTITUTE FOR SENATE BILL NO. 49 am "An Act relating to women's health services and defining 'medically necessary abortion' for purposes of making payments under the state Medicaid program" was automatically in third reading. Senator Gardner moved that the bill be returned to second reading for the purpose of a specific amendment, that being Amendment No. 2. Without objection, the bill was returned to second reading. Senators Gardner, Ellis offered Amendment No. 2 : Page 1, line 1, following "Act": Insert "relating to Medicaid funding; and" Page 3, following line 5: Insert a new bill section to read: "* Sec. 2. The uncodified law of the State of Alaska is amended by adding a new section to read: STATE MEDICAID FUNDING FOR FAMILY PLANNING SERVICES. Notwithstanding any other provision of law, the Department of Health and Social Services shall pay, for additional family planning services for eligible medical assistance recipients under AS 47.07.020, an amount equal to the difference between the amount paid from the general fund for abortion services covered under AS 47.07.030 in the 12 months immediately preceding the first date on which this Act is first implemented and the amount paid from the general fund for abortion services under AS 47.07.030 in the 12 months immediately following the first date on which this Act is first implemented. The amount paid for family planning services under this section may not supplant funds available from any other source for family planning services for the same period." Senator Gardner moved for the adoption of Amendment No. 2. Senator Coghill objected. 2013-04-09 Senate Journal Page 1074 Senator Gardner moved and asked unanimous consent to withdraw Amendment No. 2. Without objection, Amendment No. 2 was withdrawn. SPONSOR SUBSTITUTE FOR SENATE BILL NO. 49 am was automatically in third reading. Senator Wielechowski moved that the bill be returned to second reading for the purpose of a specific amendment, that being Amendment No. 3. Without objection, the bill was returned to second reading. Senator Wielechowski offered Amendment No. 3 : Page 1, line 1: Delete "defining 'medically necessary abortions' for purposes of making payments" Insert "establishing standards for payment for abortion services" Page 1, line 5, through page 3, line 5: Delete all material and insert: "Sec. 47.07.068. Payment for abortion services. (a) The department shall pay a provider for abortion services provided to a recipient of medical assistance under this chapter if the provider submits a completed form approved by the department that certifies, based on all of the information available to the provider, that the abortion services were (1) provided to a recipient whose pregnancy was the result of an act of rape or incest; (2) necessary because of a physical disorder, physical injury, or physical illness, including a life-endangering physical condition caused by or arising from the pregnancy itself, that would have placed the woman in danger of death had the abortion not been performed; or (3) medically necessary for reasons other than the conditions in (a)(1) and (2) of this section. (b) The department shall seek federal funding available for abortion services provided for reasons specified in (a)(1) and (2) of this section." 2013-04-09 Senate Journal Page 1075 Senator Wielechowski moved for the adoption of Amendment No. 3. Senator Coghill objected. The question being: "Shall Amendment No. 3 be adopted?" The roll was taken with the following result: SSSB 49 am Second Reading Amendment No. 3 YEAS: 7 NAYS: 13 EXCUSED: 0 ABSENT: 0 Yeas: Egan, Ellis, French, Gardner, Hoffman, Stedman, Wielechowski Nays: Bishop, Coghill, Dunleavy, Dyson, Fairclough, Giessel, Huggins, Kelly, McGuire, Meyer, Micciche, Olson, Stevens and so, Amendment No. 3 failed. SPONSOR SUBSTITUTE FOR SENATE BILL NO. 49 am was automatically in third reading. Senator Wielechowski moved that the bill be returned to second reading for the purpose of a specific amendment, that being Amendment No. 4. Without objection, the bill was returned to second reading. Senators Wielechowski, Ellis, French, Gardner offered Amendment No. 4 : Page 1, line 1, following "Act": Insert "relating to eligibility requirements for medical assistance for certain children and pregnant women;" Page 1, line 3, following "program": Insert "; and providing for an effective date" 2013-04-09 Senate Journal Page 1076 Page 1, following line 3: Insert new bill sections to read: "* Section 1. AS 47.07.020(b) is amended to read: (b) In addition to the persons specified in (a) of this section, the following optional groups of persons for whom the state may claim federal financial participation are eligible for medical assistance: (1) persons eligible for but not receiving assistance under any plan of the state approved under 42 U.S.C. 1381 - 1383c (Title XVI, Social Security Act, Supplemental Security Income) or a federal program designated as the successor to the aid to families with dependent children program; (2) persons in a general hospital, skilled nursing facility, or intermediate care facility, who, if they left the facility, would be eligible for assistance under one of the federal programs specified in (1) of this subsection; (3) persons under 21 years of age who are under supervision of the department, for whom maintenance is being paid in whole or in part from public funds, and who are in foster homes or private child-care institutions; (4) aged, blind, or disabled persons, who, because they do not meet income and resources requirements, do not receive supplemental security income under 42 U.S.C. 1381 - 1383c (Title XVI, Social Security Act), and who do not receive a mandatory state supplement, but who are eligible, or would be eligible if they were not in a skilled nursing facility or intermediate care facility to receive an optional state supplementary payment; (5) persons under 21 years of age who are in an institution designated as an intermediate care facility for the mentally retarded and who are financially eligible as determined by the standards of the federal program designated as the successor to the aid to families with dependent children program; (6) persons in a medical or intermediate care facility whose income while in the facility does not exceed 300 percent of the supplemental security income benefit rate under 42 U.S.C. 1381 - 1383c (Title XVI, Social Security Act) but who would not be eligible for an optional state supplementary payment if they left the hospital or other facility; 2013-04-09 Senate Journal Page 1077 (7) persons under 21 years of age who are receiving active treatment in a psychiatric hospital and who are financially eligible as determined by the standards of the federal program designated as the successor to the aid to families with dependent children program; (8) persons under 21 years of age and not covered under (a) of this section [,] who would be eligible for benefits under the federal program designated as the successor to the aid to families with dependent children program [,] except that they have the care and support of both their natural and adoptive parents; (9) pregnant women not covered under (a) of this section and who meet the income and resource requirements of the federal program designated as the successor to the aid to families with dependent children program; (10) persons under 21 years of age not covered under (a) of this section who the department has determined cannot be placed for adoption without medical assistance because of a special need for medical or rehabilitative care and who the department has determined are hard-to-place children eligible for subsidy under AS 25.23.190 - 25.23.210; (11) persons who can be considered under 42 U.S.C. 1396a(e)(3) (Title XIX, Social Security Act, Medical Assistance) to be individuals with respect to whom a supplemental security income is being paid under 42 U.S.C. 1381 - 1383c (Title XVI, Social Security Act) because they meet all of the following criteria: (A) they are 18 years of age or younger and qualify as disabled individuals under 42 U.S.C. 1382c(a) (Title XVI, Social Security Act); (B) the department has determined that (i) they require a level of care provided in a hospital, nursing facility, or intermediate care facility for the mentally retarded; (ii) it is appropriate to provide their care outside of an institution; and (iii) the estimated amount that would be spent for medical assistance for their individual care outside an institution is not greater than the estimated amount that would otherwise be expended individually for medical assistance within an appropriate institution; 2013-04-09 Senate Journal Page 1078 (C) if they were in a medical institution, they would be eligible for medical assistance under other provisions of this chapter; and (D) home and community-based services under a waiver approved by the federal government are either not available to them under this chapter or would be inappropriate for them; (12) disabled persons, as described in 42 U.S.C. 1396a(a)(10)(A)(ii)(XIII), who are in families whose income, as determined under applicable federal regulations or guidelines, is less than 250 percent of the official poverty line applicable to a family of that size according to the United States Department of Health and Human Services, and who, but for earnings in excess of the limit established under 42 U.S.C. 1396d(q)(2)(B), would be considered to be individuals with respect to whom a supplemental security income is being paid under 42 U.S.C. 1381 - 1383c; a person eligible for assistance under this paragraph who is not eligible under another provision of this section shall pay a premium or other cost-sharing charges according to a sliding fee scale that is based on income as established by the department in regulations; (13) persons under 19 years of age who are not covered under (a) of this section and whose household income does not exceed 200 [175] percent of the federal poverty line as defined by the United States Department of Health and Human Services and revised under 42 U.S.C. 9902(2); (14) pregnant women who are not covered under (a) of this section and whose household income does not exceed 200 [175] percent of the federal poverty line as defined by the United States Department of Health and Human Services and revised under 42 U.S.C. 9902(2); (15) persons who have been diagnosed with breast or cervical cancer and who are eligible for coverage under 42 U.S.C. 1396a(a)(10)(A)(ii)(XVIII). * Sec. 2. AS 47.07.042(d) is amended to read: (d) In addition to the requirements established under (a) and (b) of this section, the department may require premiums or cost- sharing contributions from recipients who are eligible for benefits under AS 47.07.020(b)(13) and whose household income is between 150 and 200 [175] percent of the federal poverty line. If 2013-04-09 Senate Journal Page 1079 the department requires premiums or cost-sharing contributions under this subsection, the department (1) shall adopt in regulation a sliding scale for those premiums or contributions based on household income; (2) may not exceed the maximums allowed under federal law; and (3) shall implement a system by which the department or its designee collects those premiums or contributions." Page 1, line 4: Delete "Section 1" Insert "Sec. 3" Renumber the following bill section accordingly. Page 3, following line 5: Insert a new bill section to read: "* Sec. 4. Sections 1 and 2 of this Act take effect immediately under AS 01.10.070(c)." Senator Wielechowski moved for the adoption of Amendment No. 4. Senator Coghill objected. The question being: "Shall Amendment No. 4 be adopted?" The roll was taken with the following result: SSSB 49 am Second Reading Amendment No. 4 YEAS: 6 NAYS: 14 EXCUSED: 0 ABSENT: 0 Yeas: Egan, Ellis, French, Gardner, Stedman, Wielechowski Nays: Bishop, Coghill, Dunleavy, Dyson, Fairclough, Giessel, Hoffman, Huggins, Kelly, McGuire, Meyer, Micciche, Olson, Stevens and so, Amendment No. 4 failed. SPONSOR SUBSTITUTE FOR SENATE BILL NO. 49 am was automatically in third reading. 2013-04-09 Senate Journal Page 1080 The question being: "Shall SPONSOR SUBSTITUTE FOR SENATE BILL NO. 49 am "An Act relating to women's health services and defining 'medically necessary abortion' for purposes of making payments under the state Medicaid program" pass the Senate?" The roll was taken with the following result: SSSB 49 am Third Reading - Final Passage YEAS: 14 NAYS: 6 EXCUSED: 0 ABSENT: 0 Yeas: Bishop, Coghill, Dunleavy, Dyson, Fairclough, Giessel, Hoffman, Huggins, Kelly, McGuire, Meyer, Micciche, Olson, Stevens Nays: Egan, Ellis, French, Gardner, Stedman, Wielechowski and so, SPONSOR SUBSTITUTE FOR SENATE BILL NO. 49 am passed the Senate. Senator Coghill gave notice of reconsideration.