05/06/2025 03:15 PM House HEALTH & SOCIAL SERVICES

           HJR 17-FEDERAL ENSURING LASTING SMILES ACT                                                                       
                                                                                                                                
3:22:59 PM                                                                                                                    
                                                                                                                                
CHAIR MINA  announced that the  first order of business  would be                                                               
HOUSE JOINT RESOLUTION NO. 17,  Urging the United States Congress                                                               
to pass the Ensuring Lasting  Smiles Act; and urging lawmakers to                                                               
advocate for  policies that guarantee  equitable access  to vital                                                               
healthcare.                                                                                                                     
                                                                                                                                
3:23:21 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE ALYSE  GALVIN, Alaska State Legislature,  as prime                                                               
sponsor, presented  HJR 17.   She  noted that  the other  body is                                                               
currently  considering  the  same   resolution.    She  read  the                                                               
prepared sponsor  statement [included in the  committee file] for                                                               
HJR 17, which read as follows [original punctuation provided]:                                                                  
                                                                                                                                
     House  Joint  Resolution  17 urges  the  United  States                                                                    
     Congress  to  pass  the  Ensuring  Lasting  Smiles  Act                                                                    
     (ELSA).  Currently,  individuals born  with  congenital                                                                    
     anomalies, such  as cleft lip, cleft  palate, and other                                                                    
     conditions, can  be denied coverage by  private medical                                                                    
     insurance  companies for  treatment  that is  medically                                                                    
     necessary. ELSA  will close  the federal  loophole that                                                                    
     allows   insurance  companies   to  deny   coverage  to                                                                    
     individuals   who  are   faced  with   a  lifetime   of                                                                    
     surgeries,  speech  therapy,  dental  care,  and  other                                                                    
     medical needs.                                                                                                             
                                                                                                                                
     Families in  Alaska with  children who  have congenital                                                                    
     dental anomalies  are faced with an  extraordinary cost                                                                    
     burden. The  financial costs  can exceed  $100,000 with                                                                    
     care denied based on the  misconception that the dental                                                                    
     work is cosmetic. Dental  health impacts overall health                                                                    
     and well-being.  Missing or malformed teeth,  cleft lip                                                                    
     and cleft  palate, cause a  myriad of  health problems.                                                                    
     Missing  teeth  can  affect  speech  patterns  and  the                                                                    
     ability   to  chew   food,  potentially   resulting  in                                                                    
     nutritional  deficiencies. Cleft  lip and  cleft palate                                                                    
     can  lead to  difficulties  with  speech, feeding,  and                                                                    
     breathing.  Congenital dental  anomalies  also carry  a                                                                    
     large psychological impact and  my contribute to social                                                                    
     isolation and negative self-perception.                                                                                    
                                                                                                                                
     All  individuals should  be  able  to access  necessary                                                                    
     medical  and  dental  care  without   the  fear  of  an                                                                    
     excessive financial burden. I  ask for the Alaska State                                                                    
     Legislature's  support of  HJR 17  and urge  the Alaska                                                                    
     Congressional Delegation  to champion  this legislation                                                                    
     to  close the  federal loophole  that denies  essential                                                                    
     dental treatment to  individuals affected by congenital                                                                    
     anomalies.                                                                                                                 
                                                                                                                                
REPRESENTATIVE GALVIN  further noted that the  Anchorage Assembly                                                               
has passed a similar resolution to  HJR 17 and that ELSA has also                                                               
been  reintroduced   in  the   119th  Congress   with  bipartisan                                                               
sponsorship in the House of Representatives and the U.S. Senate.                                                                
                                                                                                                                
3:27:19 PM                                                                                                                    
                                                                                                                                
CHAIR MINA opened public testimony on HJR 17.                                                                                   
                                                                                                                                
3:27:41 PM                                                                                                                    
                                                                                                                                
EMILY BRUBAKER, representing self,  shared that she was diagnosed                                                               
with  hypohidrotic   ectodermal  dysplasia   and  she   has  been                                                               
advocating for ELSA  since she was six years old.   She said that                                                               
currently  insurance companies  classify  medical procedures  for                                                               
cleft lips  and cleft palates  as cosmetic.  She  emphasized that                                                               
ELSA would  close a  loophole that allows  such procedures  to be                                                               
classified  as cosmetic  and unnecessary.   She  stated that  the                                                               
out-of-pocket costs  for procedures that  she would need  to have                                                               
in   the  future   would  cost   over   $100,000  without   ELSA.                                                               
Additionally, she  stated there are other  medical conditions for                                                               
which ELSA would apply.                                                                                                         
                                                                                                                                
3:30:27 PM                                                                                                                    
                                                                                                                                
BRIAN BRUBAKER, representing  self, stated that he  is the father                                                               
of Emily Brubaker and emphasized  the extreme out-of-pocket costs                                                               
his  family has  faced  for  her healthcare.    He asserted  that                                                               
dentistry healthcare is  not cosmetic.  He  thanked the committee                                                               
for considering HJR 17.                                                                                                         
                                                                                                                                
3:31:44 PM                                                                                                                    
                                                                                                                                
LLANA KERSCHBAUM, representing self,  testified in support of HJR
.   She  stated she  has a  son with  a rare  medical condition                                                               
called  oligodontia.   She  stated  that  the medical  treatments                                                               
required for her  son's condition would be very  costly and would                                                               
not be  covered by  health insurance.   She  stated that  she was                                                               
advised  to find  between  $100,000 and  $150,000  for her  son's                                                               
medically  necessary procedures.   Additionally,  she noted  that                                                               
there were  no specialists  in Alaska  at the  time of  her son's                                                               
diagnosis.  She described the  extensive care that she has sought                                                               
for her son outside of the  state, as well as the many procedures                                                               
to come.   She noted that the affected population  is a minority,                                                               
but  that other  families like  hers are  currently being  denied                                                               
healthcare that is not optional.                                                                                                
                                                                                                                                
3:35:30 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE PRAX  asked for clarification about  the insurance                                                               
coverage that Ms. Kerschbaum received.                                                                                          
                                                                                                                                
MS.  KERSCHBAUM  replied that  her  family  were insured  through                                                               
AETNA  and her  insurance  as  a teacher.    She reiterated  that                                                               
private insurers  consider all  the treatments  her son  needs as                                                               
cosmetic.                                                                                                                       
                                                                                                                                
MS. KERSCHBAUM,  in response to  a follow-up  from Representative                                                               
Prax,  clarified that  her son  had coverage  from birth  and was                                                               
dual insured.                                                                                                                   
                                                                                                                                
3:38:58 PM                                                                                                                    
                                                                                                                                
CHAIR MINA,  after ascertaining  that there was  no one  else who                                                               
wished to testify, closed public testimony on HJR 17.                                                                           
                                                                                                                                
3:39:20 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  RUFFRIDGE   sought  clarification  that   HJR  17                                                               
applied to  private insurance.  He  asked if the goals  of HJR 17                                                               
could be better  accomplished by the legislature  under Title 21,                                                               
rather than a resolution.                                                                                                       
                                                                                                                                
REPRESENTATIVE  GALVIN replied  that her  constituent, Ms.  Emily                                                               
Brubaker, noted  that there is  a loophole at the  federal level,                                                               
allowing  for  private insurance  companies  to  still not  cover                                                               
necessary dentistry  care for  patients.  She  said that  she has                                                               
not  explored what  could be  done  at the  state level,  through                                                               
Title 21.                                                                                                                       
                                                                                                                                
REPRESENTATIVE  RUFFRIDGE shared  concern  over the  "piece-meal"                                                               
insurance  system  and noted  that  dental  and vision  insurance                                                               
typically does not cover enough.                                                                                                
                                                                                                                                
REPRESENTATIVE GALVIN  reiterated testimony from  Ms. Kerschbaum,                                                               
providing the example that if her  son had been in a car accident                                                               
and  required dental  work, that  would  be considered  medically                                                               
necessary dental work.  She  added that ELSA affects thousands of                                                               
individuals across the nation.  She  said that she would be happy                                                               
to  work  offline  with   Representative  Ruffridge  to  consider                                                               
legislation at the state level.                                                                                                 
                                                                                                                                
3:43:31 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE   GRAY  offered   agreement  with   Representative                                                               
Ruffridge  and considered  making a  motion to  move HJR  17 from                                                               
committee.                                                                                                                      
                                                                                                                                
3:43:48 PM                                                                                                                    
                                                                                                                                
The committee took an at-ease from 3:43 p.m. to 3:44 p.m.                                                                       
                                                                                                                                
3:44:17 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE GRAY  agreed that it  is not  a good idea  to move                                                               
HJR 17 from committee at this time.                                                                                             
                                                                                                                                
3:44:36 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  PRAX  stated that  he  was  surprised because  he                                                               
believed,  under  state  statute,  congenital  abnormalities  and                                                               
birth defects are  supposed to be covered by insurance.   He said                                                               
that he previously  worked for an insurance  company that covered                                                               
congenital abnormalities, including cleft palates.                                                                              
                                                                                                                                
REPRESENTATIVE   GALVIN  noted   that   two  separate   insurance                                                               
companies  turned away  the previous  affected testifiers  due to                                                               
their recommended procedures being classified as cosmetic.                                                                      
                                                                                                                                
3:46:31 PM                                                                                                                    
                                                                                                                                
CHAIR MINA said that there may  be a difference in state statutes                                                               
regarding  coverage for  congenital  defects at  birth versus  an                                                               
ongoing medical condition.                                                                                                      
                                                                                                                                
REPRESENTATIVE PRAX  said that if HJR  17 is held over,  it would                                                               
be  worth the  committee's  time  to hear  from  the Division  of                                                               
Insurance to clear up concerns.                                                                                                 
                                                                                                                                
REPRESENTATIVE  GALVIN noted  that,  in some  cases, the  medical                                                               
conditions were not  evident at birth and that  may have impacted                                                               
insurance coverage.                                                                                                             
                                                                                                                                
3:48:17 PM                                                                                                                    
                                                                                                                                
CHAIR MINA announced that HJR 17 was held over.