Legislature(2023 - 2024)
2024-04-05 House Journal
Full Journal pdf2024-04-05 House Journal Page 2065 SB 45 The following, which was held in second reading from the April 3 calendar (page 2049), was before the House: HOUSE CS FOR CS FOR SENATE BILL NO. 45(2d L&C) "An Act relating to insurance; relating to direct health care agreements; and relating to the duties of the director of the division of insurance in the Department of Commerce, Community, and Economic Development." Amendment No. 1 was offered by Representative Eastman: Page 1, lines 8 - 11: Delete "A patient is not eligible to enter into a direct health care agreement under this section if the patient is eligible to receive assistance under AS 47.07 (Medical Assistance for Needy Persons) or AS 47.08 (Assistance for Catastrophic Illness and Chronic or Acute Medical Conditions)." Representative Eastman moved and asked unanimous consent that Amendment No. 1 be adopted. Representative McCabe objected. The question being: "Shall Amendment No. 1 be adopted?" The roll was taken with the following result: HCS CSSB 45(2d L&C) Second Reading Amendment No. 1 YEAS: 3 NAYS: 36 EXCUSED: 1 ABSENT: 0 Yeas: Eastman, Gray, Josephson 2024-04-05 House Journal Page 2066 Nays: Allard, Armstrong, Baker, Carpenter, Carrick, Coulombe, Cronk, Dibert, Edgmon, Fields, Foster, Galvin, Groh, Hannan, Himschoot, C.Johnson, D.Johnson, McCabe, McCormick, McKay, Mears, Mina, Ortiz, Prax, Rauscher, Ruffridge, Saddler, Schrage, Shaw, Story, Stutes, Sumner, Tilton, Tomaszewski, Vance, Wright Excused: Stapp And so, Amendment No. 1 was not adopted. Amendment No. 2 was offered by Representative Eastman: Page 4, following line 31: Insert a new subsection to read: "(n) This section does not apply to an agreement between a health care provider or health care business and a patient or the representative of a patient if the health care provider or health care business does not refer to the agreement as a direct health care agreement." Reletter the following subsection accordingly. Page 5, line 4: Following "patient": Insert "(A)" Following "fee;": Insert "and (B) that is referred to by the health care provider or health care business as a direct health care agreement;" Page 6, line 24: Delete "AS 21.03.025(n)" Insert "AS 21.03.025(o)" Page 6, line 25: Delete "AS 21.03.025(n)" Insert "AS 21.03.025(o)" Page 6, line 27: Delete "AS 21.03.025(n)" Insert "AS 21.03.025(o)" 2024-04-05 House Journal Page 2067 Representative Eastman moved and asked unanimous consent that Amendment No. 2 be adopted. Representative McCabe objected. The question being: "Shall Amendment No. 2 be adopted?" The roll was taken with the following result: HCS CSSB 45(2d L&C) Second Reading Amendment No. 2 YEAS: 1 NAYS: 38 EXCUSED: 1 ABSENT: 0 Yeas: Eastman Nays: Allard, Armstrong, Baker, Carpenter, Carrick, Coulombe, Cronk, Dibert, Edgmon, Fields, Foster, Galvin, Gray, Groh, Hannan, Himschoot, C.Johnson, D.Johnson, Josephson, McCabe, McCormick, McKay, Mears, Mina, Ortiz, Prax, Rauscher, Ruffridge, Saddler, Schrage, Shaw, Story, Stutes, Sumner, Tilton, Tomaszewski, Vance, Wright Excused: Stapp And so, Amendment No. 2 was not adopted. Amendment No. 3 was offered by Representative Eastman: Page 5, line 30, through page 6, line 4: Delete all material. Reletter the following subsections accordingly. Representative Eastman moved and asked unanimous consent that Amendment No. 3 be adopted. Representative McCabe objected. The question being: "Shall Amendment No. 3 be adopted?" The roll was taken with the following result: 2024-04-05 House Journal Page 2068 HCS CSSB 45(2d L&C) Second Reading Amendment No. 3 YEAS: 1 NAYS: 38 EXCUSED: 1 ABSENT: 0 Yeas: Eastman Nays: Allard, Armstrong, Baker, Carpenter, Carrick, Coulombe, Cronk, Dibert, Edgmon, Fields, Foster, Galvin, Gray, Groh, Hannan, Himschoot, C.Johnson, D.Johnson, Josephson, McCabe, McCormick, McKay, Mears, Mina, Ortiz, Prax, Rauscher, Ruffridge, Saddler, Schrage, Shaw, Story, Stutes, Sumner, Tilton, Tomaszewski, Vance, Wright Excused: Stapp And so, Amendment No. 3 was not adopted. Amendment No. 4 was offered by Representative Eastman : Page 6, lines 5 - 8: Delete all material. Reletter the following subsections accordingly. Representative Eastman moved and asked unanimous consent that Amendment No. 4 be adopted. Representative McCabe objected. The question being: "Shall Amendment No. 4 be adopted?" The roll was taken with the following result: HCS CSSB 45(2d L&C) Second Reading Amendment No. 4 YEAS: 9 NAYS: 30 EXCUSED: 1 ABSENT: 0 Yeas: Eastman, Galvin, Gray, Groh, Hannan, Himschoot, Josephson, Mina, Ortiz 2024-04-05 House Journal Page 2069 Nays: Allard, Armstrong, Baker, Carpenter, Carrick, Coulombe, Cronk, Dibert, Edgmon, Fields, Foster, C.Johnson, D.Johnson, McCabe, McCormick, McKay, Mears, Prax, Rauscher, Ruffridge, Saddler, Schrage, Shaw, Story, Stutes, Sumner, Tilton, Tomaszewski, Vance, Wright Excused: Stapp And so, Amendment No. 4 was not adopted. Amendment No. 5 was offered by Representative Eastman: Page 6, lines 9 - 21: Delete all material. Reletter the following subsection accordingly. Page 6, line 27: Delete ";" Insert "." Page 6, line 28: Delete all material. Representative Eastman moved and asked unanimous consent that Amendment No. 5 be adopted. Representative McCabe objected. The question being: "Shall Amendment No. 5 be adopted?" The roll was taken with the following result: HCS CSSB 45(2d L&C) Second Reading Amendment No. 5 YEAS: 1 NAYS: 38 EXCUSED: 1 ABSENT: 0 Yeas: Eastman 2024-04-05 House Journal Page 2070 Nays: Allard, Armstrong, Baker, Carpenter, Carrick, Coulombe, Cronk, Dibert, Edgmon, Fields, Foster, Galvin, Gray, Groh, Hannan, Himschoot, C.Johnson, D.Johnson, Josephson, McCabe, McCormick, McKay, Mears, Mina, Ortiz, Prax, Rauscher, Ruffridge, Saddler, Schrage, Shaw, Story, Stutes, Sumner, Tilton, Tomaszewski, Vance, Wright Excused: Stapp And so, Amendment No. 5 was not adopted. Amendment No. 6 was offered by Representative Eastman: Page 5, lines 27 - 29: Delete "parenthood, or any other characteristic of a class of persons protected by a state law that prohibits discrimination" Insert "or parenthood" Representative Eastman moved and asked unanimous consent that Amendment No. 6 be adopted. Representative McCabe objected. The question being: "Shall Amendment No. 6 be adopted?" The roll was taken with the following result: HCS CSSB 45(2d L&C) Second Reading Amendment No. 6 YEAS: 4 NAYS: 35 EXCUSED: 1 ABSENT: 0 Yeas: Eastman, D.Johnson, Tomaszewski, Vance Nays: Allard, Armstrong, Baker, Carpenter, Carrick, Coulombe, Cronk, Dibert, Edgmon, Fields, Foster, Galvin, Gray, Groh, Hannan, Himschoot, C.Johnson, Josephson, McCabe, McCormick, McKay, Mears, Mina, Ortiz, Prax, Rauscher, Ruffridge, Saddler, Schrage, Shaw, Story, Stutes, Sumner, Tilton, Wright Excused: Stapp And so, Amendment No. 6 was not adopted. 2024-04-05 House Journal Page 2071 Amendment No. 7 was offered by Representative Fields: Page 1, line 1 (title amendment): Delete "and" Page 1, line 3, following "Development": Insert "; and providing for an effective date" Page 5, following line 21: Insert new bill sections to read: "* Sec. 2. AS 21.42.375(e) is amended to read: (e) In this section, (1) "diagnostic breast examination" means an examination of the breast using contrast-enhanced mammography, diagnostic mammography, breast magnetic resonance imaging, breast ultrasound, or other equipment dedicated specifically for mammography conducted to evaluate an abnormality (A) detected or suspected in a screening examination for breast cancer; or (B) detected by another means of examination; (2) "low-dose mammography screening" and "mammogram" mean the X-ray examination of the breast using equipment dedicated specifically for mammography, including the X-ray tube, filter, compression device, screens, films, and cassettes, with an average radiation exposure delivery of less than one rad mid-breast, with two views for each breast; (3) "supplemental breast examination" means an examination of the breast using contrast-enhanced mammography, diagnostic mammography, breast magnetic resonance imaging, breast ultrasound, or other equipment dedicated specifically for mammography conducted based on (A) the insured's personal or family medical history of breast cancer; or (B) other factors that may increase the insured's risk of breast cancer. * Sec. 3. AS 21.42.375 is amended by adding a new subsection to read: (f) Except as necessary to qualify a plan as a high deductible health plan eligible for a health savings account tax deduction 2024-04-05 House Journal Page 2072 under 26 U.S.C. 223 (Internal Revenue Code), a health care insurer that offers, issues, delivers, or renews a health care insurance plan in the individual or group market in the state that provides coverage for mammography screening, diagnostic breast examinations, and supplemental breast examinations may not impose cost sharing, a deductible, coinsurance, a copayment obligation, or another similar out-of-pocket expense on an insured for coverage of a low-dose mammography screening, diagnostic breast examination, or supplemental breast examination." Renumber the following bill sections accordingly. Page 6, following line 30: Insert new bill sections to read: "* Sec. 6. The uncodified law of the State of Alaska is amended by adding a new section to read: APPLICABILITY. AS 21.42.375(e), as amended by sec. 2 of this Act, and AS 21.42.375(f), added by sec. 3 of this Act, apply to an insurance policy or contract issued, delivered, or renewed on or after the effective date of secs. 2 and 3 of this Act. * Sec. 7. The uncodified law of the State of Alaska is amended by adding a new section to read: TRANSITION: REGULATIONS. The director of the division of insurance may adopt regulations necessary to implement secs. 2 and 3 of this Act. The regulations take effect under AS 44.62 (Administrative Procedure Act), but not before the effective date of the law implemented by the regulation. * Sec. 8. Section 7 of this Act takes effect immediately under AS 01.10.070(c). * Sec. 9. Sections 2 and 3 of this Act take effect January 1, 2025." Representative Fields moved and asked unanimous consent that Amendment No. 7 be adopted. There was objection. Representative Fields moved and asked unanimous consent to withdraw Amendment No. 7. There being no objection, it was so ordered. 2024-04-05 House Journal Page 2073 Amendment No. 8 was offered by Representatives Fields and McCabe: Page 1, line 8, following "agreement.": Insert "Health care services provided under a direct health care agreement are limited to the type of health care services that a primary care provider may provide to a patient." Page 5, line 21, following "AS 21.87.330": Insert "; (10) "primary care provider" has the meaning given in AS 21.07.250" Representative Fields moved and asked unanimous consent that Amendment No. 8 be adopted. Representative Eastman objected. The question being: "Shall Amendment No. 8 be adopted?" The roll was taken with the following result: HCS CSSB 45(2d L&C) Second Reading Amendment No. 8 YEAS: 38 NAYS: 1 EXCUSED: 1 ABSENT: 0 Yeas: Allard, Armstrong, Baker, Carpenter, Carrick, Coulombe, Cronk, Dibert, Edgmon, Fields, Foster, Galvin, Gray, Groh, Hannan, Himschoot, C.Johnson, D.Johnson, Josephson, McCabe, McCormick, McKay, Mears, Mina, Ortiz, Prax, Rauscher, Ruffridge, Saddler, Schrage, Shaw, Story, Stutes, Sumner, Tilton, Tomaszewski, Vance, Wright Nays: Eastman Excused: Stapp And so, Amendment No. 8 was adopted. Amendment No. 9 was offered by Representatives Fields and McCabe: 2024-04-05 House Journal Page 2074 Page 1, following line 11: Insert a new subsection to read: "(b) To be eligible to enter into a direct health care agreement under this section, a health care provider or health care business must (1) accept new patients who are enrolled in the Medicare program; or (2) maintain a practice in which 20 percent or more of the patients (A) are enrolled in the Medicare program; or (B) do not have health insurance." Reletter the following subsections accordingly. Page 3, line 30: Delete "(c) or (g)" Insert "(d) or (h)" Page 4, line 1: Delete "(f) or (g)" Insert "(g) or (h)" Page 6, line 24: Delete "AS 21.03.025(n)" Insert "AS 21.03.025(o)" Page 6, line 25: Delete "AS 21.03.025(n)" Insert "AS 21.03.025(o)" Page 6, line 27: Delete "AS 21.03.025(n)" Insert "AS 21.03.025(o)" Representative Fields moved and asked unanimous consent that Amendment No. 9 be adopted. Representative Ruffridge objected. 2024-04-05 House Journal Page 2075 The question being: "Shall Amendment No. 9 be adopted?" The roll was taken with the following result: HCS CSSB 45(2d L&C) am H Second Reading Amendment No. 9 YEAS: 34 NAYS: 5 EXCUSED: 1 ABSENT: 0 Yeas: Allard, Armstrong, Baker, Carpenter, Carrick, Coulombe, Cronk, Dibert, Edgmon, Fields, Foster, Galvin, Gray, Groh, Hannan, Himschoot, C.Johnson, D.Johnson, Josephson, McCabe, McCormick, McKay, Mears, Mina, Ortiz, Prax, Saddler, Schrage, Shaw, Story, Stutes, Sumner, Tilton, Wright Nays: Eastman, Rauscher, Ruffridge, Tomaszewski, Vance Excused: Stapp And so, Amendment No. 9 was adopted. Amendment No. 10 was offered by Representatives Fields and McCabe: Page 2, lines 24 - 25: Delete "or AS 21.36 (Trade Practices and Frauds)" Page 4, following line 14: Insert a new subsection to read: "(l) A direct health care agreement and a health care provider or health care business providing health care services under a direct health care agreement are subject to AS 21.36 (Trade Practices and Frauds) to the extent applicable and when not in conflict with the express provisions of this section." Reletter the following subsections accordingly. Page 4, line 17: Delete "or AS 21.36 (Trade Practices and Frauds)" Page 6, line 24: Delete "AS 21.03.025(n)" Insert "AS 21.03.025(o)" 2024-04-05 House Journal Page 2076 Page 6, line 25: Delete "AS 21.03.025(n)" Insert "AS 21.03.025(o)" Page 6, line 27: Delete "AS 21.03.025(n)" Insert "AS 21.03.025(o)" Representative Fields moved and asked unanimous consent that Amendment No. 10 be adopted. There was objection. Amendment No. 1 to Amendment No. 10 was offered by Representative Sumner: Page 1, line 1 of the amendment: Delete all material. Insert "Page 1, line 3 (title amendment): Following "Development": Insert "; and providing for an effective date" Page 2, lines 20 - 22: Delete all material. Renumber the following paragraph accordingly. Page 2, lines 24 - 25: Delete "or AS 21.36 (Trade Practices and Frauds)" Page 3, line 24: Delete "and in AS 45.45.915" Page 4, lines 15 - 31: Delete all material and insert: "(l) A health care provider or health care business may not decline to enter into a direct health care agreement with a new patient or terminate a direct health care agreement with an existing patient solely because of the patient's race, religion, color, national 2024-04-05 House Journal Page 2077 origin, age, sex, physical or mental disability, marital status, change in marital status, pregnancy, parenthood, or any other characteristic of a class of persons protected by a state law that prohibits discrimination. (m) A health care provider or health care business may decline to enter into a direct health care agreement with a new patient if the health care provider or health care business (1) is unable to provide to the patient the health care services the patient requires; or (2) does not have the capacity to accept new patients. (n) A health care provider or health care business may terminate a direct health care agreement with an existing patient based on the patient's health status only if the health care provider is unable to provide to the patient the health care services the patient requires or in accordance with this section. (o) A health care provider or health care business may not make, publish, disseminate, circulate, broadcast, or place before the public, or cause, directly or indirectly, to be made, published, disseminated, circulated, broadcast, or placed before the public, in a newspaper, magazine, or other publication, or in the form of a notice, circular, pamphlet, letter, or poster, or over a radio or television station, or in any other way, an advertisement, announcement, or statement containing an assertion, representation, or statement that is untrue, deceptive, or misleading with respect to (1) the terms of or the benefits or advantages provided by a direct health care agreement; (2) the characterization of a direct health care agreement, including the characterization of a direct health care agreement as health care insurance or an alternative to health care insurance; (3) the business of a direct health care agreement." Reletter the following subsection accordingly. Page 5, line 22, through page 6, line 30: Delete all material. Page 6, following line 30: Insert a new section to read: * Sec. 4. "This act takes effect January 1, 2025"" 2024-04-05 House Journal Page 2078 Representative Sumner moved and asked unanimous consent that Amendment No. 1 to Amendment No. 10 be adopted. Representative Eastman objected. The question being: "Shall Amendment No. 1 to Amendment No. 10 be adopted?" The roll was taken with the following result: HCS CSSB 45(2d L&C) am H Second Reading Amendment No. 1 to Amendment No. 10 YEAS: 38 NAYS: 1 EXCUSED: 1 ABSENT: 0 Yeas: Allard, Armstrong, Baker, Carpenter, Carrick, Coulombe, Cronk, Dibert, Edgmon, Fields, Foster, Galvin, Gray, Groh, Hannan, Himschoot, C.Johnson, D.Johnson, Josephson, McCabe, McCormick, McKay, Mears, Mina, Ortiz, Prax, Rauscher, Ruffridge, Saddler, Schrage, Shaw, Story, Stutes, Sumner, Tilton, Tomaszewski, Vance, Wright Nays: Eastman Excused: Stapp And so, Amendment No. 1 to Amendment No. 10 was adopted. The question being: "Shall Amendment No. 10 as amended be adopted?" The roll was taken with the following result: HCS CSSB 45(2d L&C) am H Second Reading Amendment No. 10 as amended YEAS: 38 NAYS: 1 EXCUSED: 1 ABSENT: 0 Yeas: Allard, Armstrong, Baker, Carpenter, Carrick, Coulombe, Cronk, Dibert, Edgmon, Fields, Foster, Galvin, Gray, Groh, Hannan, Himschoot, C.Johnson, D.Johnson, Josephson, McCabe, McCormick, McKay, Mears, Mina, Ortiz, Prax, Rauscher, Ruffridge, Saddler, Schrage, Shaw, Story, Stutes, Sumner, Tilton, Tomaszewski, Vance, Wright Nays: Eastman Excused: Stapp 2024-04-05 House Journal Page 2079 And so, Amendment No. 10 as amended was adopted and the new title follows: HOUSE CS FOR CS FOR SENATE BILL NO. 45(2d L&C) am H(efd add H) "An Act relating to insurance; relating to direct health care agreements; relating to the duties of the director of the division of insurance in the Department of Commerce, Community, and Economic Development; and providing for an effective date." (technical title change) Amendment No. 11 was offered by Representative Fields: Page 4, following line 31: Insert new subsections to read: "(n) In addition to any other penalty provided by law, if the director determines under AS 21.06.170 - 21.06.240 that a health care provider or health care business has violated a provision of this section, the director may (1) impose (A) a civil penalty of not more than $10,000 for each violation; or (B) if the director determines that the person wilfully violated the provisions of this section, a civil penalty of not more than $25,000 for each violation; (2) prohibit the health care provider or health care business from entering into or renewing a direct health care agreement; and (3) suspend or revoke the business registration of a health care provider or health care business for repeat violations. (o) An order issued by the director that levies a civil penalty must specify the period within which the civil penalty must be fully paid. The period may not be less than 15 days or more than one year after the date of the order." Reletter the following subsection accordingly. Page 6, line 24: Delete "AS 21.03.025(n)" Insert "AS 21.03.025(p)" 2024-04-05 House Journal Page 2080 Page 6, line 25: Delete "AS 21.03.025(n)" Insert "AS 21.03.025(p)" Page 6, line 27: Delete "AS 21.03.025(n)" Insert "AS 21.03.025(p)" Representative Fields moved and asked unanimous consent that Amendment No. 11 be adopted. Representative McCabe objected. The question being: "Shall Amendment No. 11 be adopted?" The roll was taken with the following result: HCS CSSB 45(2d L&C) am H(efd add H) Second Reading Amendment No. 11 YEAS: 14 NAYS: 25 EXCUSED: 1 ABSENT: 0 Yeas: Armstrong, Dibert, Fields, Gray, Groh, Hannan, Himschoot, Josephson, McCormick, Mears, Mina, Ortiz, Schrage, Story Nays: Allard, Baker, Carpenter, Carrick, Coulombe, Cronk, Eastman, Edgmon, Foster, Galvin, C.Johnson, D.Johnson, McCabe, McKay, Prax, Rauscher, Ruffridge, Saddler, Shaw, Stutes, Sumner, Tilton, Tomaszewski, Vance, Wright Excused: Stapp And so, Amendment No. 11 was not adopted. Amendment No. 12 was offered by Representative Fields: Page 5, line 6: Delete "employs health care providers" Insert "is entirely owned by physicians licensed under AS 08.64 who have established residency in the state under AS 01.10.055" Representative Fields moved and asked unanimous consent that Amendment No. 12 be adopted. 2024-04-05 House Journal Page 2081 Representative Sumner objected. Amendment No. 1 to Amendment No. 12 was offered by Representative Sumner: Page 1, line 3 of the amendment: Delete "is entirely owned by physicians licensed under AS 08.64 who have established residency in the state under AS 01.10.055" Insert "has an ownership share of 51% or greater by individuals who are licensed to practice health care under AS 08." Representative Sumner moved and asked unanimous consent that Amendment No. 1 to Amendment No. 12 be adopted. Representative Eastman objected. The question being: "Shall Amendment No. 1 to Amendment No. 12 be adopted?" The roll was taken with the following result: HCS CSSB 45(2d L&C) am H(efd add H) Second Reading Amendment No. 1 to Amendment No. 12 YEAS: 36 NAYS: 3 EXCUSED: 1 ABSENT: 0 Yeas: Allard, Armstrong, Baker, Carpenter, Carrick, Coulombe, Dibert, Edgmon, Fields, Foster, Galvin, Gray, Groh, Hannan, Himschoot, C.Johnson, D.Johnson, Josephson, McCabe, McCormick, McKay, Mears, Mina, Ortiz, Prax, Rauscher, Saddler, Schrage, Shaw, Story, Stutes, Sumner, Tilton, Tomaszewski, Vance, Wright Nays: Cronk, Eastman, Ruffridge Excused: Stapp And so, Amendment No. 1 to Amendment No. 12 was adopted. Representative Ruffridge moved and asked unanimous consent to rescind previous action in adopting Amendment No. 1 to Amendment No. 12. There was objection. 2024-04-05 House Journal Page 2082 The question being: "Shall the House rescind previous action in adopting Amendment No. 1 to Amendment No. 12?" The roll was taken with the following result: HCS CSSB 45(2d L&C) am H(efd add H) Second Reading Rescind Previous Action in Adopting Amendment No. 1 to Amendment No. 12 YEAS: 16 NAYS: 22 EXCUSED: 1 ABSENT: 1 Yeas: Armstrong, Carpenter, Coulombe, Cronk, Eastman, Groh, C.Johnson, D.Johnson, McCabe, McKay, Ortiz, Prax, Rauscher, Ruffridge, Saddler, Vance Nays: Allard, Baker, Carrick, Dibert, Edgmon, Fields, Foster, Galvin, Gray, Hannan, Himschoot, Josephson, McCormick, Mears, Mina, Schrage, Story, Stutes, Sumner, Tilton, Tomaszewski, Wright Excused: Stapp Absent: Shaw And so, the motion failed. The question being: "Shall Amendment No. 12 as amended be adopted?" The roll was taken with the following result: HCS CSSB 45(2d L&C) am H(efd add H) Second Reading Amendment No. 12 as amended YEAS: 18 NAYS: 20 EXCUSED: 1 ABSENT: 1 Yeas: Armstrong, Carrick, Dibert, Fields, Galvin, Gray, Groh, Hannan, Himschoot, Josephson, McCormick, Mears, Mina, Ortiz, Schrage, Story, Stutes, Sumner Nays: Allard, Baker, Carpenter, Coulombe, Cronk, Eastman, Edgmon, Foster, C.Johnson, D.Johnson, McCabe, McKay, Prax, Rauscher, Ruffridge, Saddler, Tilton, Tomaszewski, Vance, Wright Excused: Stapp Absent: Shaw And so, Amendment No. 12 as amended was not adopted. 2024-04-05 House Journal Page 2083 Amendment No. 13 was not offered. Amendment No. 14 was offered by Representative Gray: Page 4, following line 31: Insert a new subsection to read: "(n) To be eligible to enter into a direct health care agreement under this section, a health care provider or health care business must accept new patients until at least 20 percent or more of the patients of the health care provider or health care business (1) are eligible to receive assistance under AS 47.07 or AS 47.08; or (2) are enrolled in the Medicare program." Reletter the following subsection accordingly. Page 5, following line 21: Insert a new bill section to read: "* Sec. 2. AS 21.97 is amended by adding a new section to read: Sec. 21.97.040. Direct health care and insurance agreements. To be eligible to enter into a contract with a health care insurer under this title, a health care provider or health care business must accept new patients until at least 20 percent or more of the patients of the health care provider or health care business (1) are eligible to receive assistance under AS 47.07 or AS 47.08; or (2) are enrolled in the Medicare program." Renumber the following bill sections accordingly. Page 6, line 24: Delete "AS 21.03.025(n)" Insert "AS 21.03.025(o)" Page 6, line 25: Delete "AS 21.03.025(n)" Insert "AS 21.03.025(o)" Page 6, line 27: Delete "AS 21.03.025(n)" Insert "AS 21.03.025(o)" 2024-04-05 House Journal Page 2084 Page 6, following line 30: Insert a new bill section to read: "* Sec. 5. The uncodified law of the State of Alaska is amended by adding a new section to read: APPLICABILITY. AS 21.97.040, added by sec. 2 of this Act, applies to contracts entered into on or after the effective date of this Act." Representative Gray moved and asked unanimous consent that Amendment No. 14 be adopted. Representative Eastman objected. The question being: "Shall Amendment No. 14 be adopted?" The roll was taken with the following result: HCS CSSB 45(2d L&C) am H(efd add H) Second Reading Amendment No. 14 YEAS: 9 NAYS: 28 EXCUSED: 1 ABSENT: 2 Yeas: Galvin, Gray, Hannan, Josephson, McCormick, Mears, Schrage, Story, Stutes Nays: Allard, Armstrong, Baker, Carpenter, Carrick, Coulombe, Cronk, Dibert, Eastman, Edgmon, Foster, Groh, Himschoot, C.Johnson, D.Johnson, McCabe, McKay, Mina, Ortiz, Prax, Rauscher, Ruffridge, Saddler, Sumner, Tilton, Tomaszewski, Vance, Wright Excused: Stapp Absent: Fields, Shaw And so, Amendment No. 14 was not adopted. Amendment No. 15 was offered by Representative Gray: Page 1, line 1 (title amendment): Following "Act": Insert "establishing a single-payer health care program;" Delete "and" 2024-04-05 House Journal Page 2085 Page 1, line 3, following "Development": Insert "; and providing for an effective date" Page 1, following line 4: Insert a new bill section to read: "* Section 1. AS 18.09 is amended by adding a new section to read: