Legislature(2023 - 2024)BARNES 124
05/13/2023 11:00 AM House LABOR & COMMERCE
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| Audio | Topic |
|---|---|
| Start | |
| SB45 | |
| Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
| + | TELECONFERENCED | ||
| += | SB 45 | TELECONFERENCED | |
| += | HB 47 | TELECONFERENCED | |
SB 45-DIRECT HEALTH AGREEMENT: NOT INSURANCE
2:08:44 PM
CHAIR SUMNER announced that the only order of business would be
CS FOR SENATE BILL NO. 45(L&C)am, "An Act relating to insurance;
relating to direct health care agreements; relating to the
duties of the director of the division of insurance in the
Department of Commerce, Community, and Economic Development;
relating to unfair trade practices; and providing for an
effective date." [Before the committee, adopted as a working
document on 4/19/23, was the committee substitute (CS) for SB
45, Version 33-LS0211\R, Wallace, 4/5/23 ("Version R").]
2:08:52 PM
REPRESENTATIVE SADDLER moved to adopt Conceptual Amendment 1 to
CSSB 45, Version R. He stated that the amendment would delete
lines on page 1, line 14 through page 2, line 10. He stated
this would delete the lines that reference the requirement for
direct care providers to provide care to Medicaid patients;
however, it would leave in the requirement for these providers
to serve Medicare and uninsured patients. There being no
objections, Conceptual Amendment 1 to CSSB 45, Version R, was
adopted.
2:09:36 PM
REPRESENTATIVE SADDLER moved to adopt Conceptual Amendment 2 to
CSSB 45, Version R, as conceptually amended. He stated that the
conceptual amendment would add a new section which would require
a health care business or health care provider under a direct
health care agreement to be subject to AS 21.36. It would also
insert a new section which would assert that a health care
business or health care provider under a direct health care
agreement that complies with this section is not subject to the
section.
2:10:36 PM
REPRESENTATIVE RUFFRIDGE objected for the purpose of discussion.
He asked for an explanation of the amendment.
2:11:17 PM
LORI WING-HEIER, Director, Division of Insurance, Department of
Commerce, Community and Economic Development, deferred to staff
of Senator David Wilson for the explanation.
2:11:29 PM
JASMIN MARTIN, Staff, Senator David Wilson, Alaska State
Legislature, on behalf of the prime sponsor, Senator Wilson,
answered questions during the hearing on CSSB 45, Version R.
She stated that the amendment would remove certain penalty
language from the proposed bill and make changes to the section
pertaining to air ambulances.
2:12:34 PM
REPRESENTATIVE RUFFRIDGE questioned the original language of the
proposed legislation.
MS. MARTIN answered that it was added by the Senate Labor and
Commerce Standing Committee prior to other aspects of bill
changes.
2:13:38 PM
REPRESENTATIVE RUFFRIDGE withdrew his objection. There being no
further objection, Conceptual Amendment 2 to CSSB 45, Version R,
as conceptually amended, was adopted.
2:13:44 PM
REPRESENTATIVE WRIGHT moved to adopt Conceptual Amendment 3 to
CSSB 45, Version R, as conceptually amended. He said that the
amendment would change the definition of "healthcare business"
to be in line with the original legislation. He maintained that
this change is necessary as the requirement of residency would
be unconstitutional.
2:14:04 PM
REPRESENTATIVE RUFFRIDGE objected. He asked whether the bill is
designed to prevent larger health care entities from entering
into direct health care agreements. In response to a request to
repeat the question, he stated that the companion bill had
defined only smaller physician-owned practices would be able to
participate in a direct health care agreement. He questioned
whether the conceptual amendment would retain this language, or
would it be broadened to allow larger health care systems.
2:15:33 PM
SENATOR DAVID WILSON, Alaska State Legislature, as prime
sponsor, answered that the main concern of the amendment is
residency requirements. He said that Legislative Legal Services
notified his office of concerns relating to discrimination of an
individual based on residency, without just cause.
2:17:28 PM
REPRESENTATIVE RUFFRIDGE expressed the concern that the proposed
bill would be too narrow, as many healthcare businesses are not
entirely healthcare provider owned.
SENATOR WILSON responded that many health care businesses in the
state are owned by primary care providers, and there has been
concerns regarding allowing corporate entities, such as
adventurist capitalist groups. He said that the proposed bill
is meant to cater towards healthcare businesses not owned by
corporations and doing this without running afoul of residency
related questions.
MS. MARTIN added that the amendment would broaden the definition
to strike a balance.
2:21:13 PM
The committee took an at-ease from 2:21 p.m. to 2:23 p.m.
2:23:29 PM
A roll call vote was taken. Representatives Carrick, Wright,
Prax, Saddler, and Sumner voted in favor of Conceptual Amendment
3 to CSSB 45, Version R, as conceptually amended.
Representative Ruffridge voted against it. Therefore,
Conceptual Amendment 3 was adopted by a vote of 5-1.
2:23:55 PM
REPRESENTATIVE WRIGHT stated that he would not offer Conceptual
Amendment 4.
2:24:09 PM
REPRESENTATIVE RUFFRIDGE moved to adopt Conceptual Amendment 5
to CSSB 45, Version R, as conceptually amended. There being no
objection, Conceptual Amendment 5 was adopted.
2:24:25 PM
The committee took an at-ease from 2:24 p.m. to 2:26 p.m.
2:26:19 PM
REPRESENTATIVE RUFFRIDGE moved to adopt Conceptual Amendment 6
to CSSB 45, Version R, as conceptually amended. There being no
objection, Conceptual Amendment 6 was adopted.
2:26:28 PM
REPRESENTATIVE CARRICK moved to adopt Conceptual Amendment 7 to
CSSB 45, Version R, as conceptually amended.
REPRESENTATIVE SADDLER objected.
2:26:39 PM
REPRESENTATIVE CARRICK explained that Conceptual Amendment 7
would expand health care options for Alaskans. She stated that
direct health care agreements have the potential to be more
affordable and accessible. She stated Conceptual Amendment 7
would also provide this affordability and accessibility by
expanding insurance coverage for contraceptives and birth
control.
2:28:07 PM
SENATOR WILSON expressed opposition to Conceptual Amendment 7,
as there is similar legislation in the Senate which has not yet
received a hearing, nor has the bill sponsor requested a bill
hearing.
2:28:51 PM
REPRESENTATIVE SADDLER expressed opposition to Conceptual
Amendment 7, as the bill would be to provide options other than
insurance, rather than add insurance options.
2:29:23 PM
A roll call vote was taken. Representatives Fields and Carrick
voted in favor of Conceptual Amendment 7 to CSSB 45, Version R,
as conceptually amended. Representatives Prax, Ruffridge,
Wright, Saddler, and Sumner voted against it. Therefore,
Conceptual Amendment 7 failed by a vote of 5-2.
2:30:06 PM
CHAIR SUMNER opened public testimony on SB 45.
2:30:28 PM
PAM VENTGEN, Executive Director, Alaska State Medical
Association, stated that the Alaska State Medical Association
supports SB 45 because it would allow providers flexibility in
how patients receive services. She noted that direct health
care is legal in Alaska, but it requires a provider to register
as an insurance company, and the bill would eliminate this
unnecessary requirement. She added that regulating direct
health care agreements as insurance creates a costly and
unnecessary burden for both patients and healthcare providers.
2:34:21 PM
WADE ERICKSON, MD, representing self, expressed support for the
proposed legislation, and he noted that over 40 other states
have had success with such a model.
2:36:00 PM
CHAIR SUMNER, after ascertaining there was no one else who
wished to testify, closed public testimony.
2:36:48 PM
The committee took a brief at-ease.
2:36:51 PM
REPRESENTATIVE RUFFRIDGE moved to report CSSB 45(L&C)am, Version
33-LS0211\R, Wallace, 4/5/23, as conceptually amended, out of
committee with individual recommendations and the accompanying
fiscal notes. There being no objection, HCS CSSB 45(L&C) was
reported out of the House Labor and Commerce Standing Committee.
It was recommended that Legislative Legal Services make the
necessary conforming changes to the bill for any conceptual
amendments the committee adopted.
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