Legislature(2011 - 2012)BELTZ 105 (TSBldg)
02/08/2011 02:00 PM Senate LABOR & COMMERCE
Audio | Topic |
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Start | |
SB34 | |
SB70 | |
Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
*+ | SB 70 | TELECONFERENCED | |
+ | TELECONFERENCED | ||
= | SB 34 | ||
SB 70-ALASKA HEALTH BENEFIT EXCHANGE 2:18:57 PM CHAIR EGAN announced SB 70 to be up for consideration. SENATOR HOLLIS FRENCH, sponsor of SB 70, introduced the bill and read the sponsor statement, as follows: Competition improves quality, lowers cost and gives consumers a meaningful choice. The Alaska Health Benefit Exchange will make private health insurance companies more responsive to health care consumers in Alaska. Buying health insurance can be difficult and complicated. This legislation helps consumers identify and enroll in a health insurance policy that will serve them well, regardless of what their future holds. The Exchange will promote competition among plans by providing information to consumers on a leveled playing field. Today, individuals shopping for airline tickets can log onto the internet and in minutes view competing itineraries, sorted by route, schedule, carrier and price. In this same way, the web based portal created by this bill will allow health insurance consumers to compare carriers, cost- sharing, benefit design, and premium costs of different plans, all in a manner of minutes. The legislation helps make health coverage affordable for Alaskans. The exchange will determine eligibility for health insurance tax credits, cost-sharing assistance, medical assistance programs like Medicaid. Through the Small Business Health Options Program (SHOP), the exchange will connect small businesses with tax incentives and an insurance pooling mechanism, which can stabilize premiums and make coverage more affordable. Finally, the exchange establishes the mechanism to exempt people from the requirement to have health coverage, if affordable insurance products aren't available. An exchange can open the door to innovative ways that keep health care costs down. For years, the idea of buying and selling health insurance across state lines has been cited as a competitive response to small insurance pools. This legislation will ask the Exchange board to consider interstate compacts, and if one makes sense for Alaskans, legislation can be proposed to make it happen. Forty-nine other states are working towards the establishment of an exchange, and while other elements of health reform are controversial, the exchange idea is championed by Governors of both parties - even by those who are suing the federal government to stop reform. 'State exchanges are good from a conservative standpoint because they involve consumer choice and markets, said former US Senate Majority Leader Bill Frist, a Tennessee Republican, in an Associated Press article (1/22/11). 'Each state can develop the exchange that best meets the needs of their people.' Finally, this legislation is our last chance to create a health insurance exchange on our own terms. By 2014, the state is required to have a consumer- centered exchange that makes buying health insurance easier for individuals and small businesses in Alaska. If we don't act now, the federal government will. Please join me in supporting an Alaskan-based solution which puts Alaskans first. 2:24:30 PM ANDY MADEROW, staff to Senator French, presented a sectional analysis of SB 70, as follows: Section 1, through page 2, line 5, provides the intent language for SB 70; fundamental to the aim of SB 70 is connecting individuals and small business with quality health policies to reduce the number of uninsured Alaskans. Section 2, starting on page 2, line 6, establishes the health benefit exchange as a public corporation of the state. Section 21.51.210 establishes a board of directors to oversee exchange; the board has 13 members. Section 21.54.220 outlines powers and duties of the health benefit exchange. The primary duty of the exchange is to facilitate purchase and sale of qualified health plans. Sections (a) 3 and (a) 13 both establish the Small Business Health Options Program (SHOP). 2:27:51 PM Section (a)4 provides for a telephone call center. Section (a)5 requires that enrollment periods be held annually to facilitate the changing of plans. Section (a)6 provides for the creation of an internet marketplace to connect individuals with health insurance coverage. Section (a)7 provides for certification and decertification of health plans sold through the exchange. Sections (a)8 and (a)9 require the exchange to compare health plans on metrics of quality and price. Section (a)10 requires the exchange to use a standardized format for presenting health benefit options in the exchange Section (a)11 requires the exchange to determine potential eligibility for state or local medical assistance programs, such as Medicaid and Denali KidCare. If qualified, the exchange will assist with the enrollment process. Section (a)12 establishes a tax credit calculator. Section (a)14 requires that the exchanges exempt Alaskans from requirement to retain health insurance if certain criteria is met. Section (a)15 relates to sharing information about individuals exempted from the health insurance requirement. Section (a)16 notifies an employer when an employee receives premium assistance from the government, either because the employer doesn't offer a plan, or offers a plan which doesn't meet minimum standards or is unaffordable. Section (a)17 explicitly states that the exchange will assist consumers by determining eligibility for premium tax credits, reduced-cost sharing, or exemptions from the insurance mandate. Section (a)18 sets up the framework for Navigator Grants. These grants can be pursued by most organizations or trade groups for the purposes of helping the exchange fulfill its goals. Navigator duties include enrollment assistance, information sharing, and assistance with dispute resolution. Section (a)19 requires the board to consider the rate of premium growth within and outside the exchange, in an effort to evaluate the effect and benefit of incorporating larger employers within SHOP exchange Section (a)20 asks the board to consider policy and procedures that minimize adverse selection, both inside the exchange and between plans sold within and outside the exchange. Section (a)21 requires the exchange to provide credit for any "free choice voucher" that an employer provides an employee for the purpose of covering premium costs. Sections (a)23 and 24 outline accounting procedures and submission of receipts for review, to both federal and state stakeholders. Section (a)25 allows for cooperation with any investigation or audit by the Secretary of Health and Human Services. Section (a)26 allows a health insurer to offer a limited dental plan as part of a qualified health plan, so long as pediatric dental benefits are included. Section (a)27 requires the exchange to apply for planning and establishment grants for the exchange. Grants of up to $1 million have been awarded to each of 49 states to date for planning. Section (a)28 requires the exchange board to offer recommendations about potential interstate compacts that would permit the sale and purchase of health insurance across state lines. Section (b)1, found on page 8 lines 21-27, allows the exchange to contract out some of the responsibilities outlined in this legislation. Section (b)2 allows the exchange to share information with federal and state agencies, provided that confidentiality protections are upheld. Section (b)3 allows the exchange to receive grants to finance operations. Section (c) prohibits certain expenses to keep costs down for consumers. Section (d) ensures individuals won't be penalized if they change coverage because they are newly eligible for that coverage, or if employer sponsored coverage becomes affordable. 2:36:15 PM Proposed Section 21.54.230 of the new title, found on page 9, line 14, through page 13, line 7, relates to health plan certification. 2:38:13 PM SENATOR GIESSEL asked why the exchange is established as a public corporation. SENATOR FRENCH explained that this was a policy decision made to emphasize that the exchange is more market-based than government-based. 2:39:35 PM RON KREIER, Acting Director, Division of Public Assistance, Department of Health and Social Services (DHSS), stated the division had prepared a fiscal note under the assumption that it would receive information directly from the exchange and would issue benefits. 2:40:55 PM CHAIR EGAN responded the committee does not have that fiscal note and would not move SB 70 today. MR. KRIER replied the fiscal note would be delivered to the committee as soon as possible. SENATOR DAVIS asked why the fiscal note came from his division. Mr. KRIER said his assumption was that the health care exchange would not make actual determinations of benefits; rather, the division would do that through public assistance. SENATOR DAVIS asked if the department had consulted with the Division of Insurance. 2:43:45 PM MR. KRIER replied that he had not discussed this issue with the Division of Insurance. CHAIR DAVIS noted that other consumers would also use the exchange, and she thought the division of insurance would have an interest. LINDA HALL, Director, Division of Insurance, Department of Commerce, Community and Economic Development (DCCED), noted there has been a substantial amount of work on fiscal notes. The division is in the process of reviewing numbers, trying to make the fiscal note as accurate as possible. SENATOR DAVIS noted that Alaska is the only state that has not accepted federal money to set up a health care exchange. MS. HALL confirmed that was true. SENATOR DAVIS asked if the money was still available. MS. HALL replied the money was still available, but there was a short timeline. SENATOR MENARD asked if Utah has set up an exchange program. MS. HALL said yes, also Massachusetts. SENATOR MENARD asked if the Division of Insurance is in contact with those states. MS. HALL said they are in contact with a number of states, and research is being done, especially with regard to what might benefit Alaskans.
Document Name | Date/Time | Subjects |
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SB 70 Disability Law Center lttr supporting.PDF |
SL&C 2/8/2011 2:00:00 PM |
SB 70 |