Legislature(2025 - 2026)BUTROVICH 205
05/13/2025 03:30 PM Senate HEALTH & SOCIAL SERVICES
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| Audio | Topic |
|---|---|
| Start | |
| SB4 | |
| HB36 | |
| Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
| += | SB 4 | TELECONFERENCED | |
| += | HB 36 | TELECONFERENCED | |
SB 4-HEALTH CARE PRICES AND INCENTIVE PROGRAMS
4:07:27 PM
CHAIR DUNBAR announced the consideration of SENATE BILL NO. 4
"An Act relating to a health care insurance policy incentive
program; relating to health care services; and providing for an
effective date."
4:08:13 PM
SENATOR HUGHES speaking as the sponsor of SB 4, provided a brief
recap of SB 4 stating it is a mechanism by which people can use
tools to apply free market principles in finding health care.
4:09:38 PM
SENATOR GIESSEL arrived at the meeting.
4:10:01 PM
CHAIR DUNBAR opened public testimony on SB 4.
4:10:28 PM
JARED KOSIN, President and Chief Executive Officer, Alaska
Hospital and Healthcare Association, Anchorage, Alaska,
testified in opposition to SB 4. He stated that he supports
transparency and cost-effective care. He stated his concern that
SB 4 focuses on cost without considering quality, potentially
incentivizing out-of-state care and weakening Alaska's
healthcare system. He stated that because insurance costs vary
widely, price comparisons do not reflect what individuals
actually pay. Given the complexity and administrative costs, the
bill's return on investment is questionable and unlikely to
meaningfully reduce costs.
4:12:13 PM
CHAIR DUNBAR closed public testimony on SB 4.
4:12:37 PM
SENATOR CLAMAN asked whether health insurance companies
currently have the ability to share price information with
insured individuals for cost comparison, or whether changes to
law or regulation would be required to allow this.
4:13:01 PM
LORI WING-HEIER, Director, Division of Insurance, Department of
Commerce, Community and Economic Development (DCCED), Juneau,
Alaska, answered questions on SB 4. She stated that based on
discussions with insurance companies, changes to current law
would be required for them to openly share price differences
between providers. She said insurance companies can provide
median cost estimates but they cannot disclose individual data.
SENATOR CLAMAN asked for confirmation that allowing insurers to
share provider information would require less than SB 4 but do
more than the status quo.
4:13:38 PM
MS. WING-HEIER replied that is her understanding.
4:13:45 PM
SENATOR HUGHES noted that in SB 4, page 2, insurers are required
to share the patient's cost-sharing amount, not contracted
provider rates, thereby avoiding antitrust concerns. SB 4 does
not prevent insurers from recommending higher-value or higher-
quality providers, and insurers like Moda already provide
comparisons of selected, best-value, and next best-value
providers with estimated costs. She emphasized that value
reflects both quality and cost, and research consistently shows
that higher cost does not necessarily mean higher quality in
healthcare.
4:15:23 PM
SENATOR TOBIN noted that she doesn't see a letter from Moda on
BASIS and asked for the letter to be shared.
4:15:39 PM
SENATOR HUGHES responded that the letter was in fact from Ms.
Wing-Heier, Director of the Division of Insurance.
CHAIR DUNBAR noted that the letter was from DCCED, and the
letter included Moda's response to questions DCCED asked.
4:15:57 PM
SENATOR GIESSEL asked whether insurance companies would be
allowed to share with consumers which provider offers the lowest
cost.
SENATOR HUGHES replied that insurance companies disclose the
lowest patient cost-sharing amounts and base incentive payments
on median contracted rates, though they do not make those
contracted rates public.
4:16:29 PM
SENATOR GIESSEL asked about the possibility of referring Alaska
patients to the lower 48 for lower costs.
SENATOR HUGHES replied that SB 4 is written by geographic
location and referring patients would be determined by
regulations.
4:17:25 PM
SENATOR HUGHES said SB 4, page 2, line 19, references payment
information, which reads, "provided in the same policy year and
geographic region."
4:17:47 PM
SENATOR GIESSEL asked whether Alaska is one geographic region or
is it divided into four regions.
SENATOR HUGHES answered that information is not specified and
deferred the question to Ms. Wing-Heier.
CHAIR DUNBAR asked how geographic regions are typically defined
in these types of regulations and whether they might include
cities like Seattle or Portland. He noted that Alaskans often
seek medical care out of state, which may be unique compared to
other states.
4:18:43 PM
MS. WING-HEIER responded that geographic regions would likely
follow those already used by insurers, which may vary by state.
She said if a patient seeks care out of state, the cost
comparison would be based on the geographic region where the
care is received, not compared to Alaska. This approach avoids
cross-region comparisons between Alaska and the Lower 48 and
reflects how geographic regions are defined in SB 4.
4:19:35 PM
SENATOR GIESSEL asked for confirmation that SB 4 would not
restrict Alaskans from seeking care and would preserve their
ability to choose lower-cost care options.
MS. WING-HEIER replied that, as the department reads the bill,
it would not restrict Alaskans from seeking the lowest-cost care
in Alaska.
4:19:57 PM
CHAIR DUNBAR asked if a patient is paying Alaska premiums at
Alaska rates, would the care still be covered by that patient's
insurance, and how would they access it. Additionally, how would
reimbursement work and what costs would be covered.
4:20:23 PM
MS. WING-HEIER replied that it is difficult to determine exact
savings because SB 4 focuses on patient cost-sharing, which
varies by insurance plan, network status, and whether the out-
of-pocket maximum has been met. These factors affect what a
patient ultimately pays and whether any savings occur.
4:20:52 PM
CHAIR DUNBAR asked whether this may be done algorithmically, or
would it require manual review by the Department of Insurance,
or would insurers perform the calculations.
SENATOR HUGHES replied that the insurer would perform the
calculations and include the information in the required annual
report on incentives and participation. The process could be
supported by calculator tools or AI to improve efficiency. She
explained that Alaska insurance plans do not restrict care to
in-state providers. She mentioned a personal experience and said
patients can and do seek major or specialized care out of state,
sometimes with better coverage or lower costs, leading to
significant travel outside Alaska for major medical care.
4:22:32 PM
CHAIR DUNBAR asked if an Alaskan's insurer is headquartered
outside the state and directs the individual to receive care
outside Alaska, would that insurer have any basis to claim this
law does not apply because the relevant activity occurs outside
Alaska.
4:23:03 PM
MS. WING-HEIER replied that insurers regulated by Alaska must
comply with Alaska law and the policy terms purchased,
regardless of whether care is received in or out of state. She
said if adopted, the law would apply to those insurers, subject
to the policy's cost-sharing and copayment provisions.
4:23:57 PM
CHAIR DUNBAR held SB 4 in committee.
| Document Name | Date/Time | Subjects |
|---|---|---|
| AHHA Letter of Opposition - SB 4.pdf |
SHSS 5/13/2025 3:30:00 PM |
SB 4 |
| SB 4 DOI Response to SHSS 5.9.25 (002).pdf |
SHSS 5/13/2025 3:30:00 PM |
SB 4 |
| HB 36 Fiscal Note FCS CSM 5.8.25.pdf |
SHSS 5/13/2025 3:30:00 PM |
HB 36 |