Legislature(2023 - 2024)ADAMS 519
04/20/2023 01:30 PM House FINANCE
Note: the audio ![]()
and video ![]()
recordings are distinct records and are obtained from different sources. As such there may be key differences between the two. The audio recordings are captured by our records offices as the official record of the meeting and will have more accurate timestamps. Use the icons to switch between them.
| Audio | Topic |
|---|---|
| Start | |
| HB58 | |
| HB59 | |
| Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
| += | HB 58 | TELECONFERENCED | |
| += | HB 59 | TELECONFERENCED | |
| + | TELECONFERENCED |
HOUSE BILL NO. 59
"An Act relating to Medicaid eligibility; expanding
eligibility for postpartum mothers; conditioning the
expansion of eligibility on approval by the United
States Department of Health and Human Services; and
providing for an effective date."
1:50:46 PM
Co-Chair Foster requested a brief summary of the
legislation and a review of the fiscal notes.
EMILY RICCI, DEPUTY COMMISSIONER, DEPARTMENT OF HEALTH,
explained that the bill would extend postpartum coverage
from 60 days to 12 months. The department provided an
overview and presentation of the bill to the committee the
previous week. She reviewed the fiscal note OMB component
number 3234, control code IgvwY. The fiscal note was based
on an FY 25 starting date, which would provide the
Department of Health (DOH) sufficient time to enact the
regulatory and federal state plan amendment changes
necessary to extend coverage from 60 days to 12 months. She
remarked that the department would do the work faster if
possible. The total estimated funds were around $9 million,
which included anticipated claims costs contained on the
Medicaid Services line with a combined funding source of
$6.4 million in federal receipts and $2.6 million in UGF
annually. She added the costs could change depending on the
actual experience incurred by individuals over the next
year to five years. The funding ratio reflected
approximately 28 percent UGF match to 72 percent federal
receipt authority. There were no positions requested in the
fiscal note.
Ms. Ricci reviewed an analysis of underlying the claims
assumptions created by DOH. She relayed that the Division
of Health Care Services looked back at 2018 through 2020 to
identify the number of women who had a gap in coverage or
lost coverage between the 60-day mark and the proposed 12-
month period. There were a total of just over 3,600
beneficiaries who lost or experienced a gap in coverage
during the time period. She detailed that just under 1,600
of the total lost coverage completely after the 60-day
period and did not reenroll in the Medicaid program through
another eligibility category. She explained that the
individuals may have had other coverage, remained
uninsured, or could have participated in the federal
exchange. About 2,000 of the total experienced a gap in
coverage between the 60-day period and 12-month period. She
elaborated that perhaps individuals were disenrolled after
that 60-day period but were reenrolled in another Medicaid
eligibility category two to five months later (sometime
between the 60 days and 12 months).
Ms. Ricci continued to explain the methodology behind the
numbers in the fiscal note. The department looked at the
number of beneficiaries who had lost coverage or had a gap
in coverage and had calculated what the estimated monthly
cost would be without a gap or discontinuation of coverage
for individuals during the time period [between 60 days and
12 months]. The cost was calculated to be approximately
$566 per beneficiary per month. The department then applied
the different federal match that would be available
depending on the category of eligibility the individual may
be covered under. For example, the typical match was 50
percent federal/50 percent state; however, tribal health
members or beneficiaries received 100 percent federal
match. Based on the information, the division estimated $9
million in additional claims with approximately 28 percent
state match to 78 percent federal match.
1:55:51 PM
Representative Josephson considered a scenario where the
program coverage time could be extended more rapidly. He
used a January 15 [2024] start date as an example. He asked
if the department would bring it online and seek
supplemental funding. He communicated eagerness to get
going.
Ms. Ricci answered that the department did not ever intend
to seek to ask for supplemental funding; DOH tried to make
sure its budget aligned with its estimated costs. She
believed in the event the department was able to bring the
extended coverage online earlier, DOH would work with its
team managing federal receipt authority and general funds
to ensure the additional costs could be covered. She
highlighted the importance of estimating claims costs and
building them into the foundational budget when extending
coverage long-term.
Representative Josephson stated that the presentation had
made a real impression on the committee, which was the
reason for his question.
Representative Galvin requested follow up information from
the department depicting the timeline for the
implementation process. She offered to help in any way.
1:58:01 PM
Co-Chair Foster OPENED public testimony.
BROOKE IVY, VICE PRESIDENT, POLICY AND ADVOCACY, ALASKA
CHILDREN'S TRUST (ACT), ANCHORAGE (via teleconference),
relayed that ACT was the statewide lead agency on the
prevention of child abuse and neglect in Alaska. The agency
fully supported extending postpartum coverage to 12 months.
She stated it was a perfect example of primary prevention
and it could not align more with ACT's mission. She
elaborated that extending the coverage would give new moms
more time to deal with any post-birth health issues such as
postpartum depression, which often did not occur until six
months or more after a baby was born. She stated that 41
percent of the child abuse cases in Alaska involved
children from birth to four years of age, with children
from birth to one as the highest risk. Postpartum
depression was associated with an array of negative
outcomes including decreased child safety practices,
decreased child checkups, and bonding difficulty between
mother and child. The bill would reduce maternal mortality
rates and would protect new parents from medical debt in
the first year of their child's life. She relayed that
th
Alaska ranked 44 in the nation in health. The agency was
excited to see Alaska join over 35 other states to make the
extension permanent. She urged swift passage of the
legislation.
Co-Chair Foster stated the committee would return to Ms.
Ivy after the next testifier.
Co-Chair Foster noted that Representative Ortiz had joined
the meeting.
2:00:56 PM
JAMIE MORGAN, GOVERNMENT RELATIONS REGIONAL LEAD, AMERICAN
HEART ASSOCIATION (AHA), SACRAMENTO, CALIFORNIA (via
teleconference), testified in favor of the legislation. She
relayed that maternal mortality rates had more than doubled
in the United States. She detailed that instances in
maternal morbidity had lasting health consequences and
resulted in avoidable medical expenses. She stated action
was needed to improve health outcomes for mothers and
babies. The AHA recently released a policy statement call-
to-action on maternal health and saving mothers. The
statement set a new policy agenda to ensure healthy
pregnancies, healthy births, and healthy moms. She relayed
that extending postpartum Medicaid coverage was a key
recommendation. The bill would ensure parents would have
access to care during pregnancy and in the first full year
after birth, providing parents and their babies the best
possible start. The agency supported the bill and urged the
committee's support.
2:02:51 PM
Ms. Ivy continued her previous testimony. She relayed that
postpartum depression was associated with an array of
negative outcomes and the resulting bonding difficulty was
a primary predictor of child abuse. The agency looked
forward to seeing Alaska join more than 35 other states
that had made the postpartum extension permanent. She urged
swift passage of the bill due to the long implementation
timeline. She thanked the governor for bringing the bill
forward, the Senate for passing the bill to the House, and
the committee for providing the opportunity to testify.
Co-Chair Foster CLOSED public testimony. He reviewed the
email address for public testimony.
HB 59 was HEARD and HELD in committee for further
consideration.
Co-Chair Foster relayed the committee would await the
Senate bills the following week. He reviewed the schedule
for the following day.
| Document Name | Date/Time | Subjects |
|---|---|---|
| HB 59 Public Testimony Rec'd by 4-17-23.pdf |
HFIN 4/20/2023 1:30:00 PM |
HB 59 |
| HB 59 HFIN Response questions 041823.pdf |
HFIN 4/20/2023 1:30:00 PM |
HB 59 |