Legislature(2009 - 2010)CAPITOL 120
04/12/2010 01:00 PM House JUDICIARY
| Audio | Topic |
|---|---|
| Start | |
| SB284 | |
| SB244 | |
| HB423 | |
| SB239 | |
| Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
| + | SB 244 | TELECONFERENCED | |
| + | SB 239 | TELECONFERENCED | |
| + | HB 423 | TELECONFERENCED | |
| + | TELECONFERENCED | ||
| += | SB 284 | TELECONFERENCED | |
HB 423 - POLICY FOR SECURING HEALTH CARE SERVICES
1:23:19 PM
CHAIR RAMRAS announced that the next order of business would be
HOUSE BILL NO. 423, "An Act stating a public policy that allows
a person to choose or decline any mode of securing health care
services, and providing for enforcement of that policy by the
attorney general." [Before the committee was CSHB 423(HSS).]
CHAIR RAMRAS noted that members' packets include a memorandum
from Legislative Legal and Research Services dated April 9,
2010, that addresses constitutional issues raised by HB 423.
REPRESENTATIVE GATTO presented HB 423 on behalf of the sponsor,
the House Judiciary Standing Committee. He said HB 423 would
specify in statute that the State of Alaska has a policy that a
person has the right to choose or decline any mode of obtaining
health care services, and, if passed, would be known in
uncodified law as the Alaska Health Freedom Act. He indicated
that HB 423 was introduced in response to the recent passage of
federal healthcare reform legislation - the Patient Protection
and Affordable Care Act (PPACA). He ventured that if the PPACA
does get challenged, the court might decide that those states
that already have a specific policy in place - such as would
occur with the passage of HB 423 - need not follow federal law.
In response to a question, he indicated that a prior version of
the bill directed the attorney general to take certain actions,
but that language is no longer contained in the bill because it
is already the job of the attorney general to look after the
State's legal rights.
1:29:05 PM
DAVID JONES, Senior Assistant Attorney General, Opinions,
Appeals, & Ethics, Civil Division (Anchorage), Department of Law
(DOL), in response to questions, relayed that he is unable to
say with certainty whether passage of HB 423 would either help
or hinder any forthcoming action the attorney general might
choose to take regarding the federal PPACA.
CHAIR RAMRAS expressed favor with HB 423, opining that it
reflects the offense taken by some over passage of the federal
PPACA.
REPRESENTATIVE GATTO, in response to comments and a question,
acknowledged that CSHB 423(HSS) is now simply making a policy
statement that will have no value if the U.S. Supreme Court
should eventually rule that the PPACA is constitutional.
REPRESENTATIVE GRUENBERG asked why the DOL has submitted an
indeterminate fiscal note for HB 423.
MR. JONES said it's because the DOL doesn't know what impact the
bill would have on the DOL's fiscal operations.
1:41:57 PM
THOMAS REIKER, Staff, Representative Carl Gatto, Alaska State
Legislature, on behalf of Representative Gatto, added that he
and Representative Gatto, too, had concerns with the DOL's
analysis of the bill's potential fiscal impact, considering that
analysis to be unclear, and so the DOL has agreed to submit a
revised fiscal note for the bill's next committee of referral -
the House Finance Committee.
REPRESENTATIVE GATTO went on to explain that because all State
of Alaska employees are required to have health insurance and
because sometimes the courts can order a person to purchase
health insurance, CSHB 423(HSS) now contains language which
specifies that the policy outlined in the bill doesn't apply to
health care services provided or required by the state, a
political subdivision of the state, or a court of the state.
MR. REIKER indicated that a forthcoming amendment would further
clarify that exemption.
1:47:29 PM
REPRESENTATIVE GATTO made a motion to adopt Amendment 1, which
read [original punctuation provided]:
Page 1, line 9:
Delete "and may choose or"
Page 1, line 13:
Delete "provided or"
REPRESENTATIVE HOLMES objected for the purpose of discussion.
REPRESENTATIVE GATTO, in response to a question, indicated that
Amendment 1 is a technical amendment, and that he is seeking to
simplify the language currently in CSHB 423(HSS).
REPRESENTATIVE GRUENBERG indicated disfavor with Amendment 1.
REPRESENTATIVE GATTO observed that with the adoption of
Amendment 1's proposed change to page 1, line 9, the language of
the bill would then in part read: "a person has the right to
decline any mode of obtaining health care services".
MR. REIKER, in response to comments, said the concern is that
the federal PPACA might take away a person's right to decline
health insurance he/she doesn't want. He then explained that
with regard to Amendment 1's proposed change to page 1, line 13,
the concern with the current language of the bill is that it
might be used to force the State of Alaska to provide health
care services to someone who would otherwise be ineligible for
those services.
REPRESENTATIVE HOLMES offered her understanding, however, that
Amendment 1's proposed change to page 1, line 13, would be
deleting language that was suggested by the DOL, and that
without that language, the exemption outlined in the bill
wouldn't function as desired.
REPRESENTATIVE GRUENBERG suggested that Amendment 1 be divided
such that its proposed change to page 1, line 9, be considered
Amendment 1a, and its proposed change to page 1, line 13, be
considered Amendment 1b.
REPRESENTATIVE GATTO instead withdrew Amendment 1.
1:51:56 PM
REPRESENTATIVE GATTO made a motion to adopt Amendment 2, which
read [original punctuation provided]:
Page 1, line 8, after (a), insert:
Pursuant to the Ninth and Tenth Amendments of the U.S.
Constitution,
REPRESENTATIVE HOLMES objected for the purpose of discussion.
REPRESENTATIVE GRUENBERG pointed out that although Amendment 2
has some merit, it might be too specific and thereby
unnecessarily limit the situations under which the policy
outlined in the bill would apply.
REPRESENTATIVE GATTO acknowledged that point, and withdrew
Amendment 2.
1:53:58 PM
REPRESENTATIVE HOLMES referred to the aforementioned memorandum
from Legislative Legal and Research Services, and noted that it
says in part [original punctuation, although with some
formatting changes, provided]:
to the extent that the recently signed Patient
Protection and Affordable Care Act ... specifically
regulates state insurance by requiring everyone to
obtain health care insurance, the federal law would
likely be found to preempt state law on the subject.
... if a power is delegated to Congress by the
Constitution, the Tenth Amendment does not protect the
states from the exercise of that federal power. The
federal Constitution gives Congress the power to
control commerce. In light of the ruling in U.S. v.
South-Eastern Underwriters Assn., supra, that the
business of insurance is part of interstate commerce,
it is reasonable to conclude that the power to
regulate commerce and thus regulate insurance has been
delegated to the United States Congress by the
Constitution. Therefore, it seems unlikely that a
court would hold that the Tenth Amendment would
prevent the federal government from implementing a
bill specifically regulating insurance.
REPRESENTATIVE HOLMES said she reads that language to mean that
the bill isn't going to accomplish its stated goal. She
explained that her main concern is that no one really
understands what effects the bill will have, either on any
future actions the DOL might decide to take with regard to the
federal PPACA, or on the Department of Health and Social
Services (DHSS) and the DOL, or on other federal programs.
CHAIR RAMRAS said he shares Representative Gatto's concerns
about the PPACA, and opined that passage of HB 423 would be good
for Alaskans.
REPRESENTATIVE GATTO, after reading excerpts from something
pertaining to the PPACA, opined that it would be beneficial for
Alaska to have - via passage of HB 423 - a specific policy on
the issue of health care services already in place, but again
acknowledged that the bill would be rendered meaningless if the
U. S. Supreme Court should eventually rule that the PPACA is
constitutional.
REPRESENTATIVE HERRON pointed out, though, that the bill makes
no reference to the federal PPACA, and opined that the committee
should instead focus solely on the constitutionality of the
proposed state policy regarding obtaining health care services.
REPRESENTATIVE GRUENBERG added that he would be more comfortable
with the bill if it weren't being used as a political tool
against as-yet unfinished federal legislation, a tool that's
going to draw the state into litigation. Expressing some
disfavor with the title of HB 423, he acknowledged that as a
generic statement, the language in the bill is fairly benign.
He asked whether there was any way around using the bill as a
means of drawing the state into a political battle.
REPRESENTATIVE GATTO acknowledged that if the federal PPACA
hadn't passed, HB 423 would "almost be laughable." The bill is
about people's rights, he remarked, both the right to do
something and the right to not have to do something.
REPRESENTATIVE GRUENBERG said that the policy statement
encompassed in the bill has its own merits, and he likes the
idea behind it.
2:07:03 PM
REPRESENTATIVE DAHLSTROM moved to report CSHB 423(HSS) out of
committee with individual recommendations and the accompanying
indeterminate fiscal note.
REPRESENTATIVE HOLMES objected.
A roll call vote was taken. Representatives Lynn, Dahlstrom,
Herron, Gatto, and Ramras voted in favor of reporting the bill
from committee. Representatives Gruenberg and Holmes voted
against it. Therefore, CSHB 423(HSS) was reported out of the
House Judiciary Standing Committee by a vote of 5-2.