Legislature(2007 - 2008)HOUSE FINANCE 519
04/03/2007 01:30 PM House FINANCE
| Audio | Topic |
|---|---|
| Start | |
| HB198 | |
| HB61 | |
| HB92 | |
| HB166 | |
| Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
| + | HB 92 | TELECONFERENCED | |
| + | HB 166 | TELECONFERENCED | |
| + | TELECONFERENCED | ||
| += | HB 198 | TELECONFERENCED | |
| += | HB 61 | TELECONFERENCED | |
HOUSE BILL NO. 198
"An Act establishing the Alaska senior assistance
payment program; repealing the senior care and
longevity bonus payment programs; and providing for an
effective date."
Representative Crawford MOVED to ADOPT Amendment #3:
Page 1, line 2:
Delete "and longevity bonus programs"
Insert "program"
Page 1, line 14:
Delete "former"
Page 2, lines 12 - 19:
Delete all material.
Renumber the following bill sections accordingly.
Page 2, lines 23 - 25:
Delete all material.
Renumber the following bill sections accordingly.
Page 6, lines 14 - 17:
Delete all material.
Renumber the following bill sections accordingly.
Page 9, lines 2 - 4:
Delete all material and insert:
"* Sec. 12. AS 47.45.320 is repealed."
Renumber the following bill sections accordingly.
Page 9, line 12:
Delete "sec. 12"
Insert "sec. 9"
Page 9, line 19:
Delete "sec. 7"
Insert "sec. 4"
Page 9, line 25, through page 10, line 4:
Delete all material and insert:
"* Sec. 17. The uncodified law of the State of
Alaska is amended by adding a new section to read:
RETROACTIVITY AND REVIVAL. If secs. 1 - 12 of this
Act take effect after June 30, 2007,
(1) AS 47.45.300 - 47.45.390, as amended by
this Act, the repeal of AS 47.45.320, and secs. 11, 12,
and 14 of this Act, are retroactive to June 30, 2007;
and
(2) AS 47.45.300, 47.45.310, 47.45.330,
47.45.340, 47.45.350, 47.45.360, and 47.45.390, as
amended by this Act, are revived.
* Sec. 18. Sections 15, 16(b), and 17 of this Act
take effect immediately under AS 01.10.070(c).
* Sec. 19. Except as provided in sec. 18 of this
Act, this Act takes effect June 30, 2007."
Representative Hawker OBJECTED.
Representative Crawford explained that he would like to
remove the mention of the longevity bonus from the bill. He
wanted to vote to pass HB 198 without killing the longevity
bonus.
Representative Hawker spoke against the amendment. He
related that the purpose of the bill is to replace the
longevity bonus and senior care payment programs. He
addressed the lowering of the poverty level rate and his
work with state agencies to develop policy direction for the
state in the future. He spoke in favor of the higher
poverty allowance because the battle of pitting the rich vs.
the poor is removed due to this legislation. He described
HB 198 as a very good policy decision, which melds the best
features of all ideas.
Representative Crawford disagreed that the senior benefits
payment program replaces the longevity bonus program, a
promise made to those eligible for the program.
1:46:05 PM
Co-Chair Meyer asked if there are legal concerns regarding
reinstating the longevity bonus. Representative Hawker
recalled testimony in the Health and Social Services
Subcommittee that the attorney general's office had made the
determination that a statutory change would be required to
re-establish the longevity bonus program. He asked that the
neediest populations be served.
A roll call vote was taken on the motion.
IN FAVOR: Crawford, Gara
OPPOSED: Joule, Kelly, Nelson, Thomas, Foster, Hawker,
Chenault, Meyer
Vice-Chair Stoltz was absent from the vote.
The MOTION FAILED (2-8).
1:48:55 PM
Representative Kelly MOVED to ADOPT Amendment #4:
Page 5, line 8,
Delete "175"
Insert "150"
Page 6, line 1,
Delete "175"
Insert "150"
Page 7, line 2,
Delete "175"
Insert "150"
Page 7, line 15,
Delete "175"
Insert "150"
Representative Hawker OBJECTED.
Representative Kelly explained how the amendment would
impact Denali Kid Care and the senior benefits payment
program by changing the proposed poverty level from 175
percent to 150 percent. His concern is that the state is
entering a period of deficit spending. He stated support
for the senior benefits program, but not at the level of 175
percent of poverty level. He maintained that this program
at this level is not sustainable. He emphasized that the
Department of Health and Social Services budget is
approaching $2 billion. He called for personal
responsibility. He requested a "yes" vote on Amendment #4.
1:52:53 PM
Representative Hawker reminded the committee that Alaska is
the wealthiest state in the nation and the legislature lacks
the vision and will to do "what's right by our communities."
This bill addresses the "bookends" of the state's
population, the most needy children and elders. He
maintained that front-end loading the health care system
saves future costs. He related how inflation has impacted
social services for children.
Representative Hawker addressed the benefits regarding
seniors. The most empowering way to give seniors assistance
is through a cash assistance payment. This bill is not
beyond Alaska's means. He opined that the two areas
addressed in HB 198 are the priorities needed at this time.
1:57:50 PM
Representative Joule testified against Amendment #4. He
brought up the fact that there is a sunset clause and the
matter can be re-addressed in five years. He recalled the
number of seniors who need these extra funds.
Representative Thomas also spoke against Amendment #4. He
opined that the bill is needed to help children and seniors.
2:00:01 PM
A roll call vote was taken on the motion.
IN FAVOR: Kelly, Foster, Meyer, Chenault
OPPOSED: Nelson, Thomas, Crawford, Gara, Hawker, Joule
Vice-Chair Stoltz was absent from the vote.
The MOTION FAILED (4-6).
2:01:07 PM
Representative Gara MOVED to ADOPT Amendment #5:
Page 1, line 3, following "age":
Insert ", for pregnant women, and for disabled
persons; relating to the poverty guideline and cost
sharing for certain recipients of medical assistance"
Page 4, lines 29 - 31:
Delete "official poverty line applicable to a
family of that size according to the federal Office of
Management and Budget"
Insert "federal poverty guideline for Alaska set
by the United States Department of Health and Human
Services [OFFICIAL POVERTY LINE] applicable to a family
of that size [ACCORDING TO THE FEDERAL OFFICE OF
MANAGEMENT AND BUDGET]"
Page 5, line 31, through page 6, line 11:
Delete all material and insert:
"(14) pregnant women who are not
covered under (a) of this section and whose
household income does not exceed 175 percent of
the federal poverty guideline for Alaska set by
the United States Department of Health and Human
Services
[(A) $2,208 A MONTH IF THE
HOUSEHOLD CONSISTS OF TWO PERSONS;
(B) $2,782 A MONTH IF THE
HOUSEHOLD CONSISTS OF THREE PERSONS;
(C) $3,355 A MONTH IF THE
HOUSEHOLD CONSISTS OF FOUR PERSONS;
(D) $3,928 A MONTH IF THE
HOUSEHOLD CONSISTS OF FIVE PERSONS;
(E) $4,501 A MONTH IF THE
HOUSEHOLD CONSISTS OF SIX PERSONS;
(F) $5,074 A MONTH IF THE
HOUSEHOLD CONSISTS OF SEVEN PERSONS;
(G) $5,647 A MONTH IF THE
HOUSEHOLD CONSISTS OF EIGHT PERSONS;
(H) $5,647 A MONTH, PLUS AN
ADDITIONAL $574 A MONTH FOR EACH EXTRA PERSON
ABOVE EIGHT PERSONS WHO IS IN THE HOUSEHOLD
IF THE HOUSEHOLD CONSISTS OF NINE PERSONS OR
MORE];"
Page 6, following line 13:
Insert new bill sections to read:
"* Sec. 6. AS 47.07 is amended by adding a new
section to read:
Sec. 47.07.022. Extended medical assistance
coverage for children; costs. (a) In addition to
the persons specified in AS 47.07.020, a person
who resides in the state and who meets the
criteria under (b) of this section is eligible for
extended medical assistance coverage equivalent to
the mandatory and optional services described
under AS 47.07.030 if the person submits an annual
application and contribution as specified in (c)
of this section.
(b) The department shall administer a
program of extended medical assistance coverage
for a person who is under 19 years of age and
whose household income is between 200 and 350
percent of the federal poverty guideline for
Alaska set by the United States Department of
Health and Human Services.
(c) The program administered under this
section must include an annual application and
sliding scale contribution, payable under terms
specified in regulations adopted by the
department. The regulations must
(1) include the option of an assignment
of an applicant's permanent fund dividend and the
permanent fund dividend of a parent, legal
guardian, or other authorized representative of an
applicant; and
(2) set the contribution amount for an
applicant in an amount that, except as provided in
(d) and (e) of this section, is not more than one-
half percent of the federal poverty guideline for
Alaska for the annual household income of a family
of two if the applicant's income is between 200
percent and 225 percent of the federal poverty
guideline for Alaska, and increases progressively
to not more than three percent for an annual
household income for a family of two that is
between 300 percent and 350 percent of the federal
poverty guideline for Alaska.
(d) In addition to the annual contribution
established under (c) of this section, the
department may impose a co-payment of not more
than 20 percent of medical services and
prescription drug costs covered under the program
for a person whose household income is between 250
and 350 percent of the federal poverty guideline
for Alaska.
(e) Except as provided in (f) of this
section, the department may set the contribution
amount for an applicant in an amount less than the
amount specified in (c) and (d) of this section if
a lesser amount is required to obtain federal
approval for the maximum level of federal
financial participation in the state's program
under 42 U.S.C. 1396 - 1396v (Title XIX, Social
Security Act) or 42 U.S.C. 1397aa - 1397jj (Title
XXI, Social Security Act), whichever is
applicable.
(f) The department may not provide for a
contribution amount less than the amounts provided
in (c) and (d) of this section for an applicant
whose household income is not less than 250
percent of the federal poverty guideline for
Alaska and who qualifies for coverage under a
separate health insurance policy if the policy
provides coverage that is equivalent to the
coverage available under AS 47.07.030 for that
applicant.
(g) The department may limit or exclude a
person's eligibility for coverage under this
section by regulation for an applicant who
qualifies for coverage, with or without payment of
an insurance premium, under a separate health
insurance policy if the policy
(1) provides coverage that is
equivalent to the coverage available under
AS 47.07.030 for the applicant;
(2) is provided at a cost that does not
create an undue hardship for the applicant or the
applicant's family; the department shall describe
in regulation the standards for finding an undue
hardship; and
(3) would exclude an applicant from
coverage under 42 U.S.C. 1396 - 1396v (Title XIX,
Social Security Act) or 42 U.S.C. 1397aa - 1397jj
(Title XXI, Social Security Act) or otherwise
jeopardize federal approval of the state plan
submitted under this section.
(h) The department may adopt regulations
necessary to implement this section.
* Sec. 7. AS 47.07.042(d) is amended to read:
(d) In addition to the requirements
established under (a) and (b) of this section, the
department shall [MAY] require premiums or cost-
sharing contributions from recipients who are
eligible for benefits under AS 47.07.022. The
[AS 47.07.020(b)(13) AND WHOSE HOUSEHOLD INCOME IS
GREATER THAN THE APPLICABLE AMOUNT SET OUT IN (f)
OF THIS SECTION. IF THE DEPARTMENT REQUIRES
PREMIUMS OR COST-SHARING CONTRIBUTIONS UNDER THIS
SUBSECTION, THE] department
(1) shall adopt in regulation a sliding
scale for those premiums or contributions based on
household income;
(2) may not exceed the maximums allowed
under federal law; and
(3) shall implement a system by which
the department or its designee collects those
premiums or contributions."
Renumber the following bill sections accordingly.
Page 9, following line 6:
Insert a new bill section to read:
"* Sec. 19. AS 47.07.042(f) is repealed."
Renumber the following bill sections accordingly.
Page 9, following line 7:
Insert a new bill section to read:
"* Sec. 21. The uncodified law of the State of
Alaska is amended by adding a new section to read:
NOTIFICATION OF FEDERAL APPROVAL. The commissioner
of health and social services shall notify the revisor
of statutes when federal approval under sec. 23 of this
Act is obtained."
Renumber the following bill sections accordingly.
Page 9, line 12:
Delete "sec. 12"
Insert "sec. 14"
Page 9, line 19:
Delete "sec. 7"
Insert "sec. 9"
Page 9, line 22, following "proceed":
Insert "to seek federal approval and"
Page 9, line 27:
Delete "secs. 1 - 17"
Insert "secs. 1 - 5, 8 - 18, and 20"
Page 9, line 30:
Delete "secs. 14, 15, and 17"
Insert "secs. 16, 17, and 20"
Page 10, line 2:
Delete "Sections 18, 19(b), and 20"
Insert "Sections 21, 22, 23(b), and 24"
Page 10, following line 3:
Insert a new bill section to read:
"* Sec. 26. Sections 6, 7, and 19 of this Act take
effect six months from the effective date of sec. 23 of
this Act or upon the approval of the changes
necessitated by secs. 6 and 7 of this Act by the United
States Department of Health and Human Services,
whichever is later."
Renumber the following bill section accordingly.
Page 10, line 4:
Delete "sec. 21"
Insert "secs. 25 and 26"
Representative Hawker OBJECTED.
Representative Gara explained that the amendment is a
scaled-back version of a proposal of universal health
coverage for kids by Senator Wielechowski and himself. It
would take advantage of a 70 percent federal match. He
spoke about Denali Kid Care and the ability to buy into the
program once the 175 percent level has been reached. He
referred to page 3 of an attachment to Amendment #5 (copy on
file), a spreadsheet addressing modifications of the Denali
Kid Care program. He explained that this would extend
coverage to families that cannot afford health insurance,
and cost about $500 to $1,300 per person. He pointed out
that HB 198 would cost the state about $1.5 million more
than what is currently being paid. This amendment would
cost the state around $1.5 million more than that.
2:04:16 PM
Representative Gara spoke about the savings to the state
from covering the uninsured. Six other states are doing
some version of this plan. It would affect about 18,000
people in Alaska.
Representative Hawker pointed out that the amendment
introduces a significant new policy initiative into the
statutory framework. He emphasized that universal health
care coverage does not belong in this bill, which is an
attempt to "fix what we have", not to expand programs. The
amendment goes beyond his comfort level. He agreed that
this issue needs to be addressed, but not in this bill.
2:07:14 PM
Co-Chair Chenault asked for clarification on an earlier
comment made by Representative Gara regarding if a higher
level of income results in higher health care needs.
Representative Gara explained that children's health
insurance costs the state about $1,200 to $1,400 per child
with the federal government picking up about 70 percent of
that. If higher income families are allowed to buy in, a
higher proportion with kids with significant health needs
are going to buy in, according to the Department of Health
and Social Services. Co-Chair Chenault assumed that there
are two scenarios; families with private health insurance,
or those who have no health insurance at all.
Representative Hawker pointed out that this discussion shows
how complex the topic of universal health care is.
Representative Gara WITHDREW Amendment #5.
2:10:35 PM
JANET CLARKE, ASSISTANT COMMISSIONER, DIVISION OF FINANCE
AND MANAGEMENT SERVICES, DEPARTMENT OF HEALTH AND SOCIAL
SERVICES, addressed the four fiscal notes by the department.
The fiscal note with the component labeled "Senior Care"
incorporates yesterday's Amendment #1. She related that the
total cost is $20,163,100 with the bulk of the costs for
benefits. The attachments describe the estimated case load
for FY 08, the dollar amount for each federal poverty
guideline amount, and the estimated benefit cost for each
level.
Co-Chair Chenault asked if the proposal is to roll over four
positions from the Senior Care program and hire two
additional case load managers. Ms. Clarke said that is
correct. The two additional staff are due to the increased
case load and the complexity of verification of income
eligibility.
Representative Hawker explained how the fiscal note relates
to the human services budget on the House Floor today. All
costs were removed from Senior Care expenses; none are
duplicated.
2:14:18 PM
Representative Kelly referenced the old Senior Care program
and wondered if there was a Medicaid match in the new
program. Ms. Clarke explained that the old Senior Care was
a combination of cash and a Medicaid match for the
prescription drug program, which was quite small. The
general fund for that program was about $10.6 million.
Representative Kelly summarized that the old and new
programs were very similar.
Ms. Clarke pointed out that the remaining three fiscal notes
relate to the Denali Kid Care program. She addressed the
Behavioral Health Medicaid Services component fiscal note, a
request for $455,900. It is an estimate of the number of
children who might need the services. Representative
Hawker asked how much is general funds and how much is
federal matching funds. Ms. Clarke replied that the federal
receipts are estimated at $311,100 and the general fund
match is $144,800.
2:17:13 PM
Ms. Clarke addressed the Health Care Services - Medicaid
Services fiscal note and clarified that $617,800 is general
funds and $1,577,600 is federal funds. She related that
these are all direct benefit programs.
Ms. Clarke spoke to the Public Assistance Field Services
fiscal note, the component where eligibility is determined.
The request is for one eligibility worker to be added. The
FY 08 costs are less because it is estimated that it will
take time to hire that individual.
Co-Chair Chenault asked for what percent of children the
state picks up costs. Ms. Clarke thought between 40 to 50
percent.
Representative Kelly asked if the federal match of 70
percent on the Denali Kid Care has increased or decreased
over the last five years. Ms. Clarke replied that it has
decreased slightly. In response to a question from
Representative Kelly, Ms. Clarke said the fiscal note takes
the decrease into account.
2:20:45 PM
Representative Gara asked if the general fund cost of Kid
Care at 175 percent is about $750,000. Ms. Clarke said
$784,000. Representative Gara asked how many kids would be
at 175 percent and how many would be at 200 percent. Ms.
Clarke reported that there would be just under 1,300
children at 175 percent, and double that at 200 percent.
Co-Chair Meyer expressed gratitude to Representative Hawker
for his work on the bill.
2:22:39 PM
Representative Foster thanked Representative Hawker, also.
He pointed out the twelve additional sponsors of the bill,
including himself.
Representative Crawford expressed strong feelings against
the legislation. He maintained that the longevity bonus is
a separate issue. He indicated that he is in a difficult
position when asked to vote for the bill.
2:24:30 PM
Representative Thomas reported that he did not feel the same
way, even as a former co-sponsor for the longevity bonus
bill, because the Pioneers of Alaska and AARP expressed
support for this legislation. He said he feels comfortable
voting in support of the bill.
Representative Foster MOVED to REPORT CSHB 198 (FIN) out of
Committee with individual recommendations and the
accompanying fiscal notes. There being NO OBJECTION, it was
so ordered.
CSHB 198 (FIN) was REPORTED out of Committee with a "do
pass" recommendation and with zero fiscal note #1 by the
Department of Administration and with four new fiscal notes
by the Department of Health and Social Services.
2:26:13 PM
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