Legislature(2023 - 2024)
2024-04-05 House Journal
Full Journal pdf2024-04-05 House Journal Page 2059 HOUSE JOURNAL ALASKA STATE LEGISLATURE THIRTY-THIRD LEGISLATURE SECOND SESSION Juneau, Alaska Friday April 5, 2024 Eighty-first Day Pursuant to adjournment the House was called to order by Speaker Tilton at 10:46 a.m. Roll call showed 39 members present. Representative Stapp had been excused from a call of the House today. The invocation was offered by the Chaplain, Reverend Guy Crockroft of Love In the Name of Christ. Representative Vance moved and asked unanimous consent that the invocation be spread on the journal. There being no objection, it was so ordered. With the deepest respect for the religious beliefs of all Alaskans, I offer the following prayer: Dear Heavenly Father, I thank you for this day and this beautiful state of Alaska. Thank you for this governing body, the Alaska House of Representatives. Please help each Representative to be good stewards of their positions so that all Alaskans may benefit from their efforts, and that they themselves may be blessed. Lord Jesus, help us love each other as you have loved us. I'm reminded of your encouragement to love our neighbors as we love ourselves. As Romans 13:10 says Love does no harm to a neighbor; therefore love is the fulfillment of the law. In Jesus' name, I pray. Amen. 2024-04-05 House Journal Page 2060 The Pledge of Allegiance was led by Representative Fields. CERTIFICATION OF THE JOURNAL Representative Saddler moved and asked unanimous consent that the journal for the 79th and 80th legislative days, House Journal Supplement No. 8, and House and Senate Joint Journal Supplement No. 17 be approved as certified by the Chief Clerk. There being no objection, it was so ordered. MESSAGES FROM THE SENATE SB 46 A message dated April 3 was read stating the Senate concurred in the House amendment to: SENATE BILL NO. 46 "An Act establishing the month of March as Brain Injury Awareness Month." thus adopting: HOUSE CS FOR SENATE BILL NO. 46(STA) "An Act establishing the month of March as Brain Injury Awareness Month; and providing for an effective date." (technical title change) A message dated April 3 was read stating the Senate passed the following, and they are transmitted for consideration: FIRST READING AND REFERENCE OF SENATE RESOLUTIONS SCR 9 SENATE CONCURRENT RESOLUTION NO. 9 by Senators Dunbar, Giessel, Gray-Jackson, Claman, Kiehl, and Tobin: Recognizing the need for parity in the provision of mental health and substance use disorder medical assistance benefits in the state; 2024-04-05 House Journal Page 2061 and urging the Department of Health to adopt regulations that ensure parity in the provision of mental health and substance use disorder medical assistance benefits in the state. was read the first time and referred to the Rules Committee. FIRST READING AND REFERENCE OF SENATE BILLS SB 154 SENATE BILL NO. 154 by Senators Wielechowski, Dunbar, Kawasaki, Tobin, Gray-Jackson, Claman, and Myers, entitled: "An Act relating to bidder preferences in state procurement." was read the first time and referred to the House Special Committee on Military & Veterans' Affairs. SB 179 CS FOR SENATE BILL NO. 179(CRA) by the Senate Community and Regional Affairs Committee, entitled: "An Act prohibiting municipalities from levying a tax on the transfer of real property; prohibiting the state from levying a tax on the transfer of real property; and relating to municipal taxation of mobile telecommunications services." was read the first time and referred to the Community & Regional Affairs Committee. REPORTS OF STANDING COMMITTEES The Health & Social Services Committee reviewed the qualifications of the following and recommends the appointments be forwarded to a joint session for consideration: Kayla Green as a member of the Board of Marital and Family Therapy. 2024-04-05 House Journal Page 2062 David Barnes as a member of the State Medical Board. Rebecca Dean as a member of the State Physical Therapy and Occupational Therapy Board. Denise Albert as a member of the Board of Veterinary Examiners. The report was signed by Representative Prax, Chair; and Representatives Fields, Sumner, Ruffridge, McCormick, and Mina. HCR 13 The State Affairs Committee considered: HOUSE CONCURRENT RESOLUTION NO. 13 Recognizing and commending the National Conference of State Legislatures on its 50th anniversary in 2025. The report was signed by Representative Shaw, Chair, with the following individual recommendations: Do pass (5): Wright, Carrick, Story, Carpenter, Shaw Do not pass (1): Allard The following fiscal note(s) apply: 1. Zero, House State Affairs Committee HCR 13 was referred to the Rules Committee. HB 230 The Education Committee considered: 2024-04-05 House Journal Page 2063 HOUSE BILL NO. 230 "An Act repealing the limit on the number of years of out-of-state school experience that may be substituted for in-state experience in teacher salary scales." The report was signed by Representatives Allard and Ruffridge, Co- chairs, with the following individual recommendations: Do pass (6): Story, Himschoot, McKay, McCormick, Prax, Ruffridge Amend (1): Allard The following fiscal note(s) apply: 1. Zero, Dept. of Education & Early Development HB 230 was referred to the Rules Committee. SB 91 The Health & Social Services Committee considered: CS FOR SENATE BILL NO. 91(FIN) "An Act relating to telehealth; relating to multidisciplinary care teams; and relating to the practice of medicine." The report was signed by Representative Prax, Chair, with the following individual recommendations: Do pass (5): Fields, Ruffridge, McCormick, Mina, Prax No recommendation (1): Sumner The following fiscal note(s) apply: 3. Fiscal, Dept. of Commerce, Community, & Economic Development CSSB 91(FIN) was referred to the Finance Committee. 2024-04-05 House Journal Page 2064 INTRODUCTION OF CITATIONS The following citations were introduced and referred to the Rules Committee for placement on the calendar: Honoring – Hannah Shaha By Representative Saddler Honoring – Trevor Townsend By Representative Edgmon Honoring – Keet Gooshi Heen Elementary School By Representative Himschoot; Senator Stedman Honoring – Dian Gurtler By Senator Bishop Honoring – Bettye Davis East Anchorage High School, 2024 Boys Basketball Team, 4A State Champions By Senator Dunbar; Representatives Mears, Mina Honoring – Chugiak High School Mustangs, 2023 Division 1 Softball Champions By Senator Merrick; Representative Saddler Honoring – Fort Yukon Eagles Girls' Basketball, ASAA 1A Championship By Senator Bishop; Representative Cronk Honoring – Chugiak High School Mustangs, 2023 Girls Track & Field Champions By Senator Merrick; Representative Saddler In Memoriam – Malachy McCourt By Representatives Gray, Himschoot, Galvin In Memoriam – M. Susan Condon By Senators Dunbar, Tobin; Representative Gray In Memoriam – Jim "Clutch" Lounsbury By Senators Bishop, Kawasaki; Representative Carrick 2024-04-05 House Journal Page 2065 In Memoriam – Frederick James "Jim" McConnell By Senator Merrick CONSIDERATION OF THE DAILY CALENDAR SENATE BILLS IN SECOND READING 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: Article 3A. Single-payer health care program. Sec. 18.09.400. Single-payer health care program. (a) The department, in consultation with the director of the division of insurance, shall design and implement a program to provide coverage for health care services from participating providers in the state where the services are necessary or appropriate for the prevention, diagnosis, treatment, maintenance, or rehabilitation of an injury, disability, or disease. At a minimum, the program under this section must provide (1) coverage for (A) hospital services; (B) medical and other professional services furnished by participating providers; (C) laboratory tests and imaging procedures; (D) home health care for state residents requiring services performed by or under the supervision of professional or technical personnel, including home health care for acute and chronic illness and personal care attendant services; (E) rehabilitative services for state residents receiving therapeutic care; (F) prescription drugs and devices; (G) mental health services; (H) substance use disorder treatment; (I) primary and acute dental services; (J) vision appliances, including lenses, frames, and contact lenses; (K) medical supplies, durable medical equipment, and selected assistive devices; and (L) hospice care; (2) delivery of covered health care services through organized delivery systems; (3) payment for covered health care services provided to a state resident while the resident is in the state or out of the state; 2024-04-05 House Journal Page 2086 (4) payment for a reasonable amount charged for medically necessary health care services; (5) fair rates of compensation with participating providers and organized delivery systems; and (6) for negotiation with pharmaceutical companies for similarly classified pharmaceuticals. (b) Subject to appropriation, the department shall provide the coverage required in (a) of this section for each state resident who (1) is not (A) eligible to receive assistance under AS 47.07 or AS 47.08; or (B) enrolled in the Medicare program; and (2) has an income that is below 250 percent of the federal poverty line. (c) In this section, "federal poverty line" means the poverty line defined by the United States Department of Health and Human Services and updated annually by federal regulation." Page 1, line 5: Delete "Section 1" Insert "Sec. 2" Renumber the following bill sections accordingly. Page 6, following line 30: Insert new bill sections to read: "* Sec. 5. The uncodified law of the State of Alaska is amended by adding a new section to read: TRANSITION: WAIVER REQUEST; REGULATIONS. (a) The Department of Health and any other affected department or agency shall apply for all waivers, exemptions, and approvals from the federal government that are necessary to fully implement the program established under AS 18.09.400. (b) The commissioner of health and director of the division of insurance may adopt regulations necessary to implement sec. 1 of this Act. The regulations adopted under this section are not subject to AS 44.62 (Administrative Procedure Act). * Sec. 6. Section 5 of this Act takes effect immediately under AS 01.10.070(c). * Sec. 7. Section 1 of this Act takes effect January 1, 2025." 2024-04-05 House Journal Page 2087 Representative Gray moved and asked unanimous consent that Amendment No. 15 be adopted. There was objection. Representative D. Johnson rose to a point of order regarding relevance of debate and impugning the motives of others. The Speaker cautioned the member to follow rules concerning decorum. Representative McCabe rose to a point of order regarding improper debate. The Speaker cautioned the member to proceed in order. Representative Saddler moved and asked unanimous consent that Representative Shaw be excused from a call of the House today. There was objection. The question being: "Shall Representative Shaw be excused from a call of the House today?" The roll was taken with the following result: Representative Shaw to be excused today YEAS: 31 NAYS: 6 EXCUSED: 1 ABSENT: 2 Yeas: Allard, Armstrong, Baker, Carpenter, Coulombe, Cronk, Dibert, Eastman, Edgmon, Foster, Galvin, Gray, Groh, C.Johnson, D.Johnson, Josephson, McCabe, McCormick, McKay, Mina, Ortiz, Prax, Rauscher, Ruffridge, Saddler, Story, Sumner, Tilton, Tomaszewski, Vance, Wright Nays: Carrick, Hannan, Himschoot, Mears, Schrage, Stutes Excused: Stapp Absent: Fields, Shaw And so, Representative Shaw was excused from a call of the House today. 2024-04-05 House Journal Page 2088 The Speaker ruled Amendment No. 15 out of order. Representative Eastman objected. The question being: "Shall the ruling of the Chair be sustained?" The roll was taken with the following result: HCS CSSB 45(2d L&C) am H(efd add H) Second Reading Sustain Ruling of the Chair/Amendment No. 15 Ruled Out of Order YEAS: 23 NAYS: 14 EXCUSED: 2 ABSENT: 1 Yeas: Allard, Baker, Carpenter, Coulombe, Cronk, Edgmon, Foster, C.Johnson, D.Johnson, McCabe, McCormick, McKay, Ortiz, Prax, Rauscher, Ruffridge, Saddler, Stutes, Sumner, Tilton, Tomaszewski, Vance, Wright Nays: Armstrong, Carrick, Dibert, Eastman, Galvin, Gray, Groh, Hannan, Himschoot, Josephson, Mears, Mina, Schrage, Story Excused: Shaw, Stapp Absent: Fields And so, Amendment No. 15 was ruled out of order. Amendment No. 16 was offered by Representative Armstrong: Page 5, line 26, following "sex,": Insert "sexual orientation, gender identity, gender expression," Representative Armstrong moved and asked unanimous consent that Amendment No. 16 be adopted. Representative McCabe objected. Representative McCabe rose to a point of order regarding confining remarks to the amendment before the body. Representative Schrage, citing section 233 of Mason's Manual, rose to a point of order regarding citation of rules when rising for a point of order. 2024-04-05 House Journal Page 2089 The Speaker cautioned the member to confine remarks to the amendment before the body. The question being: "Shall Amendment No. 16 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. 16 YEAS: 17 NAYS: 20 EXCUSED: 2 ABSENT: 1 Yeas: Armstrong, Carrick, Dibert, Foster, Galvin, Gray, Groh, Hannan, Himschoot, Josephson, McCormick, Mears, Mina, Ortiz, Schrage, Story, Stutes Nays: Allard, Baker, Carpenter, Coulombe, Cronk, Eastman, Edgmon, C.Johnson, D.Johnson, McCabe, McKay, Prax, Rauscher, Ruffridge, Saddler, Sumner, Tilton, Tomaszewski, Vance, Wright Excused: Shaw, Stapp Absent: Fields And so, Amendment No. 16 was not adopted. Amendment Nos. 17 and 18 were not offered. Representative Saddler moved and asked unanimous consent that HCS CSSB 45(2d L&C) am H(efd add H) be considered engrossed, advanced to third reading, and placed on final passage. There was objection. Representative Eastman moved and asked unanimous consent to rescind previous action in adopting Amendment No. 9. There was objection. The question being: "Shall the House rescind previous action in adopting Amendment No. 9?" The roll was taken with the following result: 2024-04-05 House Journal Page 2090 HCS CSSB 45(2d L&C) am H(efd add H) Second Reading Rescind Previous Action in Adopting Amendment No. 9 YEAS: 1 NAYS: 36 EXCUSED: 2 ABSENT: 1 Yeas: Eastman Nays: Allard, Armstrong, Baker, Carpenter, Carrick, Coulombe, Cronk, Dibert, Edgmon, Foster, Galvin, Gray, Groh, Hannan, Himschoot, C.Johnson, D.Johnson, Josephson, McCabe, McCormick, McKay, Mears, Mina, Ortiz, Prax, Rauscher, Ruffridge, Saddler, Schrage, Story, Stutes, Sumner, Tilton, Tomaszewski, Vance, Wright Excused: Shaw, Stapp Absent: Fields And so, the motion failed. HCS CSSB 45(2d L&C) am H(efd add H) will advance to third reading on the April 8 calendar. THIRD READING OF HOUSE RESOLUTIONS HJR 7 The Speaker stated that, without objection, the following, which was held from the April 3 calendar (page 2051), would be held to the April 8 calendar: CS FOR HOUSE JOINT RESOLUTION NO. 7(W&M) Proposing amendments to the Constitution of the State of Alaska relating to the permanent fund, relating to transfers out of the permanent fund, and requiring payment of a dividend to eligible state residents. LEGISLATIVE CITATIONS Representative Saddler moved and asked unanimous consent that the House approve the citations on the calendar. There was objection. 2024-04-05 House Journal Page 2091 The question being: "Shall the House approve the citations on the calendar?" The roll was taken with the following result: Approve Citation(s) on the Calendar YEAS: 36 NAYS: 1 EXCUSED: 2 ABSENT: 1 Yeas: Allard, Armstrong, Baker, Carpenter, Carrick, Coulombe, Cronk, Dibert, Edgmon, Foster, Galvin, Gray, Groh, Hannan, Himschoot, C.Johnson, D.Johnson, Josephson, McCabe, McCormick, McKay, Mears, Mina, Ortiz, Prax, Rauscher, Ruffridge, Saddler, Schrage, Story, Stutes, Sumner, Tilton, Tomaszewski, Vance, Wright Nays: Eastman Excused: Shaw, Stapp Absent: Fields And so, the following citations were approved and sent to enrolling: Honoring – Alan Rockwood By Representative Ortiz; Senator Stedman Honoring – Lora Volden By Representative Saddler Honoring – Metlakatla High School, Miss Chiefs Girls' Basketball Team, 2024 ASAA 2A State Champions By Representative Ortiz; Senator Stedman Honoring – Alaska Broadcasters Association, 60th Anniversary By Representative Galvin; Senator Gray-Jackson Honoring – Chief Thomas R. Opie By Senator Olson; Representative Baker Honoring – United Fishermen of Alaska By Senators Stevens, Kiehl, Bjorkman; Representative Stutes Honoring – Chugiak High School 60th Anniversary By Senator Merrick; Representative Saddler 2024-04-05 House Journal Page 2092 In Memoriam – Juliana Mary "Emuguak" & Howard Farley, Sr. By Representatives Foster, Cronk; Senator Olson In Memoriam – Steven Ross Gibson By Senators Stevens, Bjorkman; Representative Vance In Memoriam – Bob Summer By Senator Bjorkman SENSE OF THE HOUSE The following Sense of the House was offered by Representative Eastman: "It is the sense of the House that Ukraine not join NATO at this time." Representative Eastman moved and asked unanimous consent that the Sense of the House be adopted. Representative D. Johnson moved and asked unanimous consent that the Sense of the House be referred to the State Affairs Committee. Representative Schrage objected. The question being: "Shall the Sense of the House be referred to the State Affairs Committee?" The roll was taken with the following result: Sense of the House Refer to STA Committee YEAS: 22 NAYS: 14 EXCUSED: 2 ABSENT: 2 Yeas: Allard, Baker, Carpenter, Coulombe, Cronk, Edgmon, Foster, Hannan, C.Johnson, D.Johnson, Josephson, McCabe, McCormick, McKay, Prax, Saddler, Stutes, Sumner, Tilton, Tomaszewski, Vance, Wright Nays: Armstrong, Carrick, Dibert, Eastman, Galvin, Gray, Groh, Himschoot, Mears, Mina, Ortiz, Ruffridge, Schrage, Story Excused: Shaw, Stapp Absent: Fields, Rauscher And so, the motion passed. 2024-04-05 House Journal Page 2093 UNFINISHED BUSINESS HB 347 Representatives Rauscher, Hannan, and Vance added as cosponsors to: HOUSE BILL NO. 347 "An Act relating to assessment of property, boards of equalization, and certification of assessors; and providing for an effective date." SCR 9 Representative Armstrong added as a cross sponsor to: SENATE CONCURRENT RESOLUTION NO. 9 Recognizing the need for parity in the provision of mental health and substance use disorder medical assistance benefits in the state; and urging the Department of Health to adopt regulations that ensure parity in the provision of mental health and substance use disorder medical assistance benefits in the state. SB 88 Representative Josephson added as a cross sponsor to: CS FOR SENATE BILL NO. 88(FIN) "An Act relating to the Public Employees' Retirement System of Alaska and the teachers' retirement system; providing certain employees an opportunity to choose between the defined benefit and defined contribution plans of the Public Employees' Retirement System of Alaska and the teachers' retirement system; and providing for an effective date." SB 170 Representative Vance added as a cross sponsor to: CS FOR SENATE BILL NO. 170(FIN) "An Act relating to the Alaska longevity bonus program and the Alaska senior benefits payment program; and providing for an effective date." ANNOUNCEMENTS House committee schedules are published under separate cover. 2024-04-05 House Journal Page 2094 The following meetings today were changed: Finance Committee CHANGED TO: 3:00 p.m. Judiciary Committee CANCELED Labor & Commerce Committee CHANGED TO: 15 min. after adjournment of Resources Committee or 3:15 p.m. Resources Committee CHANGED TO: 10 min. after adjournment ADJOURNMENT Representative Saddler moved and asked unanimous consent that the House adjourn until 11:00 a.m., April 8. There being no objection, the House adjourned at 3:11 p.m. Crystaline Jones Chief Clerk