Legislature(2009 - 2010)HOUSE FINANCE 519
04/10/2010 09:00 AM House FINANCE
| Audio | Topic |
|---|---|
| Start | |
| HJR35 | |
| HB356 | |
| HJR35 | |
| HJR42 | |
| Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
| + | HJR 35 | TELECONFERENCED | |
| + | HJR 42 | TELECONFERENCED | |
| + | HB 329 | TELECONFERENCED | |
| *+ | HB 356 | TELECONFERENCED | |
| + | TELECONFERENCED |
HOUSE JOINT RESOLUTION NO. 35
Proposing amendments to the Constitution of the State
of Alaska prohibiting passage of laws that interfere
with direct payments for health care services and the
right to purchase health care insurance from a
privately owned company, and that compel a person to
participate in a health care system.
9:07:00 AM
REPRESENTATIVE MIKE KELLY, SPONSOR, presented an overview
of the resolution. He emphasized the seriousness of the
legislation, noting that health care involves everyone and
that 36 states have the issue under consideration. He felt
health care should be a state issue and not a federal one.
He claimed that 85 percent of Americans were happy with
their healthcare system; there were a number of uninsured,
usually illegal immigrants and the young. The real number
of uninsured was close to 10 million; however, they were
all able to receive treatment paid for by others.
Representative Kelly asserted that many were upset by
recent legislation passed by Congress that they felt
represented a dramatic step toward turning the healthcare
system over to the federal government. He relayed that the
proposed resolution would allow the people to vote on
whether or not to participate, prohibit any fines or other
punitive actions surrounding the personal decision, protect
the right of the individual to purchase health care and the
right of doctors to provide lawful medical services without
government fines or penalties, and enshrine those rights in
the state constitution.
Representative Kelly suggested that the legislation would
turn Alaska against the federal government. He did not
believe health care was provided for in the U.S.
Constitution.
9:12:30 AM
CHRISTIE HERRERA, DIRECTOR, HEALTH AND HUMAN SERVICES TASK
FORCE, AMERICAN LEGISLATIVE EXCHANGE COUNCIL (ALEC) (via
teleconference), noted that ALEC was a non-partisan,
national association of state lawmakers. She spoke in
support of HJR 35, which was modeled after ALEC legislation
enacted in 41 states, the Freedom of Choice in Health Care
Act. She pointed out that the legislation was a national
effort endorsed by the Wall Street Journal and that 59
percent of likely voters believed states should have the
right to opt out of federal government programs.
Ms. Herrera stated three reasons why ALEC supported the
bill: It would ensure continued access to health services;
stop mandates that do not work, such as the Massachusetts
mandate; and render unconstitutional any attempt by the
state to require an individual to purchase healthcare
coverage or state prohibition against direct payment for
medical care. The legislation would also protect Alaska in
a constitutional challenge of the new federal health reform
law.
Ms. Herrera addressed several misconceptions that she felt
had come up in other committee hearings about HJR 35. She
assured the Finance Committee that the bill would not block
people from taking advantage of the federal law, but would
give citizens a choice. She dispelled the idea that
prohibiting an individual mandate would exacerbate the
"free rider" problem; she argued that people would continue
to show up in emergency rooms for free health care even
with the new federal mandate. She noted that the newly
insured would still be paid for with subsidies; the new
federal law dictates that a low-income family of four would
qualify for more than $20,000 in government subsidies
through the new exchange. She encouraged passage of the
resolution. She listed states where similar legislation has
already passed, including Virginia, Idaho, Arizona,
Alabama, Georgia, and Tennessee.
9:17:30 AM
Representative Gara commented that he was skeptical. He
asked whether a cost analysis had been done related to how
much it cost those who bought insurance (or the taxpayers)
to make up for those who did not. Ms. Herrera responded
that free riders would show up in the emergency room even
if there was a requirement to buy individual health
insurance. She claimed an individual mandate would
exacerbate the free-rider problem. She offered to provide
data showing that the primary free riders are people on
Medicaid; doctors have been refusing to see new Medicaid
patients because of the low reimbursement rate. The federal
law would put most of the newly insured into the Medicaid
program, which she felt delivered poor care.
Representative Gara asked whether Ms. Herrera had helped
write the constitutional amendment. Ms. Herrera related
that the resolution was modeled after legislation written
by ALEC, an organization of state lawmakers from all 50
states.
9:20:15 AM
DAVE ROLAND, ATTORNEY and POLICY ANALYST, SHOW-ME
INSTITUTE, MISSOURI (via teleconference), described himself
as an experienced constitutional attorney and discussed
constitutional implications of the bill at both the state
and federal levels. He referred to a countdown to an
"unprecedented intrusion" into individual liberty. He
asserted that the individual health-insurance mandate
recently passed by Congress would require citizens to
purchase a product they may not want, a step never before
taken. He maintained that the U.S. Constitution did not
offer protection of personal freedoms; therefore, states
could modify their constitutions to protect their citizens.
He believed HJR 35 would give Alaskans a chance to speak up
for freedom.
Mr. Roland acknowledged that questions had been raised
about the effectiveness of the proposed amendment. There
have been very few direct conflicts between a state's
protection of individual liberty and a federal government
demand. He highlighted a Missouri case; the federal
government had required the use of public funds for
educational purposes, but Missouri's constitution forbids
the use of public funds. In response, the U.S. Supreme
Court exhibited discomfort with applying the law because of
the Missouri constitution. The law was interpreted so that
there was no longer a conflict. He maintained that the same
pattern had held true through a number of U.S. Supreme
Court cases.
9:24:37 AM
PAT LUBY, ADVOCACY DIRECTOR, ALASKA ASSOCIATION OF RETIRED
PERSONS (AARP), ANCHORAGE (via teleconference), testified
in opposition to the resolution. He did not believe that
the state constitution should be amended, except for very
serious reasons. He argued that the federal government was
not taking over health care. He noted that 85 percent of
the population was content with current healthcare
coverage. He spoke of new managed-care models, the
importance of networking, and coordinated delivery of
services. He added that in Alaska, Medicaid pays better
than Medicare and maintained that providers see Medicaid
patients. He believed cost containment was necessary and
that something needed to be done about the uninsured.
Currently, 17 percent of Alaskans between the ages of 50
and 64 have no insurance at all. They often go to the
emergency room; those with insurance pick up the tab. The
average cost of the uninsured for every Alaska family was
$1,900 annually. Employers, including the state, also pick
up the cost of those employers who do not provide coverage
to their employees. He emphasized that AARP wants to make
sure all Alaskans participate in healthcare coverage in
order to end cost-shifting. The resolution would allow
people to opt out of coverage.
9:27:08 AM
Representative Kelly opined that Mr. Luby did not represent
all seniors. He had heard from seniors who disagreed with
the sentiments expressed.
Representative Fairclough asked how AARP had reached
consensus on the issue. Mr. Luby explained that the board
of directors had taken a position on the measure. He
maintained that the only way to bring down healthcare costs
was to end cost-shifting. If people were allowed to opt
out, the rest of the people would have to pay for them.
Representative Fairclough inquired whether the stated
position was an Alaskan or national one. Mr. Luby replied
that there was only one national board of directors; AARP
is a national organization and the states do not take
individual positions.
9:29:32 AM
MARIA RENSEL, FAIRBANKS (via teleconference), testified in
support of the resolution. She reported that she had
collected signatures of others who also strongly supported
the resolution; the people she had talked to did not want
to participate in the federal healthcare reform. She
refuted some of Representative Gara's comments; she
believed people should choose for themselves whether they
want health insurance.
9:32:10 AM
CAM CARLSON, FAIRBANKS (via teleconference), testified in
support of the resolution. She could not believe that a law
could be passed that prohibited people from buying health
services they wanted. She thought it important to protect
the individual's and the state's rights against intrusions
of the federal government. She did not think the federal
government had expertise in health care and had not done
well with Medicare or Medicaid. She disagreed with
Massachusetts' healthcare plan.
RANDY GRIFFIN, FAIRBANKS (via teleconference), testified in
support of the resolution challenging the federal
government. He believed that the state already regulated
insurance companies. He had concerns about his insurance
rates going up. He favored supporting those who could not
afford health insurance, although he did not think the
federal government should be involved. He distinguished
between rights and acts of mercy. He did not want young
people to develop a welfare mentality.
9:38:36 AM
PEGGY ANN MCCONNACHIE, NATIONAL FEDERATION OF INDEPENDENT
BUSINESSES (NFIB), voiced concerns about the federal
healthcare legislation. She spoke in support of HJR 35. She
wanted the right to choose whether to participate in a
health-insurance system. She did not want to be forced to
pay fees imposed by the federal government if she did not
choose to provide health insurance for her three companies.
She felt the resolution would help protect Alaskans and
Alaskan businesses and that Alaskans should have the right
to vote on whether or not they were subject to the federal
government's imposed healthcare restrictions. She noted
that NFIB has taken a position against mandates. She urged
the committee to pass the bill.
9:41:38 AM
Representative Fairclough asked whether NFIB's position was
Alaskan or national. Ms. McConnachie stated that the
position was an Alaskan one. She described NFIB as a group
of small Alaskan businesses ranging in size from one
individual to over one hundred. The businesses banded
together because they employed many people and were
concerned about federal mandates. Co-Chair Stoltze noted
that he has met many members and had become more aware of
the many businesses in the state.
9:43:41 AM
MARK REGAN, FAIRBANKS (via teleconference), spoke to
concerns about HJR 35. He reported that he had worked on
many lawsuits brought by Medicaid beneficiaries against the
government during the past 20 years. He maintained that the
language of the resolution would have an effect on existing
as well as future state laws and on the federal
government's authority to impose an individual mandate.
Mr. Regan discussed how the resolution might influence
state law and court rules related to medical child support.
A person with children who is divorced is supposed to have
a divorce decree stating who should purchase health
insurance for the children. He maintained that the
resolution would jeopardize the state medical child-support
system that ensures insurance by court order.
Mr. Regan called attention to HB 423, which was amended in
the Health and Social Services Committee to stipulate that
the freedom of choice policy was not to undercut anything
that was required or provided by the state (including by
state court order); the committee was headed in the
direction of allowing the systems to continue and be
modified. He felt that HJR 35 would jeopardize the right of
a state court to mandate health coverage for children. He
thought the language used might confuse voters.
Mr. Regan addressed the relationship between national
health reform and the individual mandate. The text of the
measure says that no law should be passed which is aimed at
the Alaska legislature and Alaska state law, and has no
necessary effect on anything that happens at the federal
level. He believed that the federal mandate was likely to
take effect without being challenged by HJR 35. He
speculated that the resolution was designed before the
federal law passed to prevent the state from requiring
people to purchase insurance the way Massachusetts requires
people to purchase insurance, to prevent a single-payer or
other mandatory contribution system at the state level. He
did not think the text was aimed (in spite of what the
sponsors intended) at federal healthcare reform individual
mandates, but at the state legislature and the state courts
to prevent a state law.
Mr. Regan spoke to what HJR 35 would do: Because of the way
federal way is structured, the resolution would take the
state out of a role of protecting Alaska citizens in terms
of the health-insurance exchanges through which people
might get subsidized health insurance from private
companies. He explained that the federal law stipulated
that starting in 2014 the health-insurance exchanges were
to be regulated by the states if the states signed on, and
regulated by the federal government directly or by some
non-profit if the states did not sign on. Each individual
state was given a choice. He suspected that if the language
was passed and enacted by the voters, the main effect it
would have on federal healthcare reform would be that the
state could not operate the exchanges. The state would then
no longer be engaged in healthcare regulation; the federal
government would run the exchanges.
Mr. Regan compared the situation with the federal
government's relationship to subsistence regulation. The
state is able to regulate under the Alaska National
Interest Lands Conservation Act (ANILCA) if it has laws
that do a certain set of things, but if the state does not
have those laws or if the laws are unconstitutional, as the
Alaska Supreme Court has found them to be, the federal
government does the regulating on federal land. He claimed
that the proposed constitutional amendment would put the
state in the same position. The state would be taking
itself out of the health-insurance business, and the state
would not be able to protect Alaskans through regulating
the exchanges.
Mr. Regan argued that if there is a constitutional
challenge to the individual mandate and to the exchanges,
it would not be assisted or undercut by passage of the
constitutional amendment.
9:52:27 AM
Representative Fairclough asked whether the amendment would
prohibit a parent mandated by the court to provide for
health insurance for a child in a custody situation. She
also wanted a response regarding the issue of taking Alaska
out of the role of making regulatory decisions.
DENNIS BAILEY, ATTORNEY, LEGISLATIVE AFFAIRS (via
teleconference), agreed that the first issue could be a
potential interpretation of the language in Section 2 of
the bill. He was not certain, but believed the second issue
also appeared to be correct: the federal government or non-
profits could run the programs if the state did not run the
exchange programs; then they could be run by non-profits or
by the federal government.
Co-Chair Stoltze queried the phrase "potential
interpretation." Mr. Baily replied that the language said
that it would prohibit the state from penalizing a person
for making a particular healthcare choice. For example, if
the state requires a parent to provide health insurance for
a child under a divorce decree, the constitutional
amendment could be interpreted to prohibit a penalty on the
choice of the individual not to do what the court says. He
opined that a conflict would be presented.
9:56:48 AM
Representative Austerman requested that Mr. Regan put his
testimony in writing. Mr. Regan agreed to do so.
Representative Kelly commented that the same questions were
being addressed in 36 states and suggested that there would
be many questions like the ones posed by Mr. Regan.
Representative Fairclough stated that she was supportive of
the legislation, but wanted to examine its unintended
consequences. She wanted to build a record for the courts
to look at. The intent of the resolution was that the
national government should not tell states what to do
regarding healthcare coverage in the state.
Co-Chair Stoltze also wanted to look at all possible
consequences of the federal mandate.
Representative Kelly agreed with the statements. He said
the bill process was just beginning and the committee's
comments would be on the record.
Representative Fairclough explained that she commented
about the intent on the record because the court uses
meeting minutes to consider legislative intent.
10:00:44 AM
BOB HOWARD, FAIRBANKS (via teleconference) urged support of
a constitutional amendment to protect Alaskans from the
federal government's overreaching legislation. He stated
that whether the amendment passed or not, the federal law
already existed. He requested strong language on other
possible federal mandates besides health care. He hoped for
a broader statement through a constitutional amendment that
would prohibit passage of any law that would compel a
person or an employer to purchase any good or service, or
that levied any penalty, tax, or surcharge on a person or
employer for failing to purchase any good or service.
10:03:15 AM
Representative Doogan asked who Mr. Howard was speaking
for. Mr. Howard replied that he was speaking on his own
behalf.
HUGH BROWNE, ANCHORAGE (via teleconference), opposed the
bill because he thought spending time fighting the
President or the federal legislation was a waste of time.
He agreed with statements made by Mr. Regan and the state
lawyer about possible unintended consequences. He was
against spending resources to fight a federal law that had
already been passed; the resolution would affect the state
and not the federal government. He maintained that the bill
could take liberties from Alaskans and that there were
beneficial things in the federal healthcare bill. He was
concerned that the bill would cause a constitutional fight
over health care. He thought the result would be
ineffectual since the language in the resolution says that
no law shall be passed; he emphasized that the federal law
had already been passed.
10:09:16 AM
Representative Kelly acknowledged that the passage of the
federal healthcare bill had stirred up discussion. He
reiterated that 36 other states had taken stands against
the federal bill. He noted that Alaska had been counseled
to proceed carefully and thoughtfully. The process was
underway in Alaska with the governor and the attorney
general looking at it. He pointed to additional legislation
related to the issue: HR 14 and HB 423. He maintained that
the issue would not go away. He stated that "America is on
the march" and maintained that the legislature must pay
attention. He urged considering unintended and intended
consequences. He concluded that the legislature should not
give up.
10:11:53 AM
Representative Gara offered to help make the resolution a
better piece of legislation. He believed that people should
get the medical care they needed, but he thought the
provision would work against people getting it. His major
concern was that he did not believe in creating false
expectations among the people who elected him. He stated
that the resolution was unenforceable and unconstitutional.
Representative Gara pointed out that there were people who
disliked other federal programs, such as the space program,
environmental regulations, and the federal tax system, but
in the end, Americans "get what they get" from Congress and
the President; if they don't like it, they can elect new
Congress people and a new president. He disagreed with
Alaskan legislators pretending to be Congressmen on
television and trying to change a congressional law with a
piece of state legislation, which he thought created false
expectations among the public.
Representative Gara maintained that he did not want to
write something blatantly unconstitutional into the state
constitution. He likened it to trying to change the First
Amendment through language in the state constitution, or
putting language into the state constitution removing the
right to freedom of religion. He argued that America does
not work that way. He did not want to pretend to the
Alaskan public that a measure like HJR 35 could change
something.
Representative Doogan voiced his opposition to the
resolution. He related that his father had helped write the
Alaska Constitution. Like any living document, it has been
amended several times. He believed that the resolution went
beyond being a sensible amendment and was purely a
political statement. He was opposed to enshrining political
statements in the state constitution, the basic document
governing who Alaskans are and what they do. He did not
know enough about law to know what consequence the
resolution could have in the end, but he did not want to
put a "passing political fancy" into the state
constitution.
10:16:40 AM
Representative Austerman inquired whether the chair was
planning to move the bill. Co-Chair Stoltze responded that
he preferred to have all 11 members present before doing
so.
Representative Kelly appreciated the committee's comments.
He believed that 70 percent of Americans were upset and
seeking ways to "unscrew the screwing." He acknowledged
that the process was fraught with difficulty, but he did
not believe people would back off. He thought the
resolution was one method that Americans could use to
change the situation or at least send a message. He
predicted change in the upcoming elections. He maintained
that he was not acting in order to be re-elected, but
because he believed in what he was doing. He believed he
was not alone and that the people were not done.
HJR 35 was set aside until later in the meeting.
10:19:54 AM AT EASE
10:39:56 AM RECONVENED
HOUSE JOINT RESOLUTION NO. 35
Proposing amendments to the Constitution of the State
of Alaska prohibiting passage of laws that interfere
with direct payments for health care services and the
right to purchase health care insurance from a
privately owned company, and that compel a person to
participate in a health care system.
7:01:14 PM AT EASE
7:02:05 PM RECONVENED
Representative Kelly MOVED to report HJR 35 out of
committee with individual recommendations and the
accompanying fiscal note.
Representative Doogan OBJECTED. He stated that he was
against the resolution. He WITHDREW his OBJECTION.
7:03:00 PM AT EASE
7:03:25 PM RECONVENED
There being NO further OBJECTION, it was so ordered.
HJR 35 was REPORTED out of committee with no recommendation
and with previously published fiscal note: FN 1 (GOV).
| Document Name | Date/Time | Subjects |
|---|---|---|
| HJR42 SWAMC Letter.docx |
HFIN 4/10/2010 9:00:00 AM |
HJR 42 |
| HB 329 Const_testimony.pdf |
HFIN 4/10/2010 9:00:00 AM |
HB 329 |
| 2 HJR 35 Sponsor Statement.pdf |
HFIN 4/10/2010 9:00:00 AM |
|
| 3 HJR 35 Sectional.pdf |
HFIN 4/10/2010 9:00:00 AM |
|
| 5 Feb 9th Hearing HESS Questions.pdf |
HFIN 4/10/2010 9:00:00 AM |
HJR 35 |
| 6 NFIB Ltr.pdf |
HFIN 4/10/2010 9:00:00 AM |
HJR 35 |
| 7 Goldwater Institute Q-A.pdf |
HFIN 4/10/2010 9:00:00 AM |
HJR 35 |
| 8 ALEC's Freedom of Choice in Health Care Act.pdf |
HFIN 4/10/2010 9:00:00 AM |
HJR 35 |
| 8 ALEC's Freedom of Choice in Health Care Act.pdf |
HFIN 4/10/2010 9:00:00 AM |
HJR 35 |
| 20100409133225145.pdf |
HFIN 4/10/2010 9:00:00 AM |
HCR 35 |
| 9 Health Care Reform Letter Jan13-2010.pdf |
HFIN 4/10/2010 9:00:00 AM |
HJR 35 |
| HJR42 -Sponsor Stmt VerP.pdf |
HFIN 4/10/2010 9:00:00 AM |
|
| HJR 42 Resolution ATIF[1].pdf |
HFIN 4/10/2010 9:00:00 AM |
HJR 42 |
| ATIF values w-out taxes.pdf |
HFIN 4/10/2010 9:00:00 AM |
|
| CSHB329-DOT-CO-3-14-10 NEW.pdf |
HFIN 4/10/2010 9:00:00 AM |
HB 329 |
| fund values with taxes.pdf |
HFIN 4/10/2010 9:00:00 AM |
|
| HB 329 AK Trans Finance Study.pdf |
HFIN 4/10/2010 9:00:00 AM |
HB 329 |
| HB 329 Sponsor Stmt.pdf |
HFIN 4/10/2010 9:00:00 AM |
HB 329 |
| HB 329 SWAMC Resolution.pdf |
HFIN 4/10/2010 9:00:00 AM |
HB 329 |
| HB 329 TRA Major Changes.pdf |
HFIN 4/10/2010 9:00:00 AM |
HB 329 |
| FY04-FY10 summary Capital Approp (2).pdf |
HFIN 4/10/2010 9:00:00 AM |
|
| HB356 Approp from ATIF.pdf |
HFIN 4/10/2010 9:00:00 AM |
HB 356 |
| HB 356 Sponsor.docx |
HFIN 4/10/2010 9:00:00 AM |
HB 356 |
| TRANSPORTATION_Fiscal_Plan_FY2011.pdf |
HFIN 4/10/2010 9:00:00 AM |
|
| HB329 Letters of Support.pdf |
HFIN 4/10/2010 9:00:00 AM |
HB 329 |
| HB 329 -ATIF major changes VerO.pdf |
HFIN 4/10/2010 9:00:00 AM |
HB 329 |
| HJR 42 Exec Summary AK Trans Finance Study.pdf |
HFIN 4/10/2010 9:00:00 AM |
HJR 42 |
| Illinois Research.pdf |
HFIN 4/10/2010 9:00:00 AM |
HB 329 |
| Persily Rpt Financing Transportation.pdf |
HFIN 4/10/2010 9:00:00 AM |
HJR 42 |
| HJR 42 Use of gas tax revenue by state.pdf |
HFIN 4/10/2010 9:00:00 AM |
HJR 42 |
| House Finance Letter HB 329 04 06 10.pdf |
HFIN 4/10/2010 9:00:00 AM |
HB 329 |
| HJR 35 Letter.pdf |
HFIN 4/10/2010 9:00:00 AM |
HJR 35 |
| CSHB329-FIN-DOA-DMV-04-09-10NEW.pdf |
HFIN 4/10/2010 9:00:00 AM |
HB 329 |
| HJR 42 Amendment #1 Kelly.pdf |
HFIN 4/10/2010 9:00:00 AM |