05/15/2025 03:15 PM House HEALTH & SOCIAL SERVICES

           HB 185-MEDICAL ASSISTANCE; FAMILY PLANNING                                                                       
                                                                                                                                
4:31:26 PM                                                                                                                    
                                                                                                                                
CHAIR MINA  announced that the  final order of business  would be                                                               
HOUSE  BILL  NO. 185,  "An  Act  relating to  medical  assistance                                                               
eligibility for  family planning  services; and providing  for an                                                               
effective date."                                                                                                                
                                                                                                                                
4:32:02 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE CAROLYN  HALL, Alaska State Legislature,  as prime                                                               
sponsor of HB  185, reviewed that the  proposed legislation would                                                               
create a family planning state  plan amendment (SPA) that expands                                                               
Medicaid  coverage   to  provide  family  planning   services  to                                                               
Alaskans.   She highlighted that  the proposed  legislation would                                                               
turn the existing  temporary 1115 waiver to a  permanent SPA, one                                                               
benefit  of  which  is  that  it would  increase  the  number  of                                                               
Alaskans eligible for family planning  services to 225 percent of                                                               
the federal poverty  level.  She introduced her  staff to respond                                                               
to questions asked at the previous hearing on HB 185.                                                                           
                                                                                                                                
4:33:32 PM                                                                                                                    
                                                                                                                                
JJ  JACKSON, Staff,  Representative  Carolyn  Hall, Alaska  State                                                               
Legislature, on  behalf of Representative Hall,  prime sponsor of                                                               
HB 185,  read [from  a handout available  in the  committee file]                                                               
responses to previous questions,  which read as follows [original                                                               
punctuation provided]:                                                                                                          
                                                                                                                                
     What are Family Planning Services?                                                                                       
                                                                                                                                
     ...Alaska Administrative Code  (AAC) 110.230(f) defines                                                                    
     "family planning services" as:                                                                                             
     "Services and  materials provided  with the  purpose of                                                                    
     postponing,   avoiding,   or   terminating   pregnancy;                                                                    
     includes  the dispensing  of  birth  control drugs  and                                                                    
     devices for  males and females, and  the performance of                                                                    
     vasectomies,  sterilizations,  and  abortions  for  the                                                                    
     purpose of avoiding or terminating pregnancy."                                                                             
                                                                                                                                
     State Planning Amendments (SPA)  are narrow branches of                                                                    
     Medicaid that  provide specific  services. In  the case                                                                    
     of  the Family  Planning  (FP) SPA,  HB  185 would  not                                                                    
     include abortion  services. As stated on  page 2, lines                                                                    
     10  and 11  of the  bill, these  services would  be for                                                                    
     "individuals   of  child-bearing   age   who  are   not                                                                    
     pregnant."                                                                                                                 
                                                                                                                                
     Are there examples of other SPAs in other states?                                                                        
                                                                                                                                
     According to  a Kaiser Family Foundation  (KFF) report,                                                                    
     thirty states  have a Centers  for Medicare  & Medicaid                                                                    
     Services  (CMS) waiver  or SPA  to  cover FP  services.                                                                    
     Alaska  has  expanded  Medicaid  with  SPAs,  with  the                                                                    
     passage  of HCS  SB 58  in  2023, a  bill sponsored  by                                                                    
     Governor Dunleavy,  regarding Medicaid  eligibility for                                                                    
     postpartum mothers.                                                                                                        
                                                                                                                                
     More information about Preterm Births                                                                                    
     In a 2025 study conducted  by Dr. Micah Hahn from UAA's                                                                    
     Institute of Circumpolar Health,  there are a myriad of                                                                    
     factors that contribute to preterm births:                                                                                 
     • Pre-pregnancy diabetes                                                                                                   
     • Hypertension                                                                                                             
     • Tobacco during pregnancy                                                                                                 
     • Less than eleven prenatal care visits                                                                                    
     • Travelling for birth                                                                                                     
     • Inadequate prenatal care                                                                                                 
                                                                                                                                
     More  information  regarding   Congenital  Syphilis  in                                                                  
     Alaska                                                                                                                   
     Based  on information  provided  in a  State of  Alaska                                                                    
     Epidemiology  Bulletin  (which   is  provided  in  this                                                                    
     packet),  "Congenital  Syphilis  (CS)   is  a  form  of                                                                    
     syphilis  passed  from  the mother  to  the  developing                                                                    
     fetus."  CS has  serious health  risks, which  include:                                                                    
     "neurologic  or musculoskeletal  disabilities or  death                                                                    
     of  the  fetus."  According  to  former  Department  of                                                                    
     Health Chief  Medical Officer Dr.  Anne Zink, CS  is "A                                                                    
     completely preventable  condition." Access  to prenatal                                                                    
     care  covered by  an  FP SPA  could  help decrease  the                                                                    
     rates of CS in Alaska.                                                                                                     
                                                                                                                                
4:37:15 PM                                                                                                                    
                                                                                                                                
CHAIR  MINA   opened  public   testimony  on   HB  185.     After                                                               
ascertaining there was  no one who wished to  testify, she closed                                                               
public testimony.                                                                                                               
                                                                                                                                
4:37:31 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  PRAX  noted  that  the bill  specifies  that  the                                                               
family  planning  services  would  be   for  those  who  are  not                                                               
pregnant.    He  asked  for confirmation  that  that  "eliminates                                                               
paying for abortion services."                                                                                                  
                                                                                                                                
REPRESENTATIVE HALL  confirmed that is  correct.  In  response to                                                               
follow-up comments, she spoke briefly  about increasing access to                                                               
care, then she  deferred to a representative  from the Department                                                               
of Health (DOH).                                                                                                                
                                                                                                                                
4:40:37 PM                                                                                                                    
                                                                                                                                
KRISTIN DELFINO, Division  Operations Manager, Director's Office,                                                               
Division  of Healthcare  Services, Department  of Health,  stated                                                               
that  she  is  not  aware  of any  specific  programs  where  "an                                                               
individual with congenital syphilis can  come into a facility and                                                               
gain  eligibility  through that  avenue."    She said  there  are                                                               
programs for  those who need  hospitalization services  where the                                                               
hospital can  preemptively determine eligibility for  a period of                                                               
time  that must  be  verified through  DOH's  Division of  Public                                                               
Assistance.                                                                                                                     
                                                                                                                                
REPRESENTATIVE  PRAX concluded  that  that may  be  an issue  for                                                               
another time but  it is not the  point of HB 185.   He reiterated                                                               
his remark  about abortion, noting  that it would not  be correct                                                               
to think the proposed legislation would cover it.                                                                               
                                                                                                                                
4:42:00 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE HALL underlined  that the emphasis of  the bill is                                                               
for people who are not pregnant.                                                                                                
                                                                                                                                
4:42:28 PM                                                                                                                    
                                                                                                                                
MR.  JACKSON proffered  that family  planning typically  includes                                                               
abortion; however, an  amendment passed by Congress  in 1976 made                                                               
federal funding for abortion services illegal.                                                                                  
                                                                                                                                
4:43:18 PM                                                                                                                    
                                                                                                                                
The committee took a brief at-ease at 4:43 p.m.                                                                                 
                                                                                                                                
4:44:00 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  GRAY asked,  "Is  there any  way  that this  bill                                                               
could be used to fund abortions."                                                                                               
                                                                                                                                
REPRESENTATIVE HALL answered, "Absolutely not."                                                                                 
                                                                                                                                
4:44:29 PM                                                                                                                    
                                                                                                                                
CHAIR MINA announced that HB 185 was held over.