Legislature(2007 - 2008)BELTZ 211
03/11/2008 01:30 PM Senate LABOR & COMMERCE
| Audio | Topic |
|---|---|
| Start | |
| HJR25 | |
| SB289 | |
| SB294 | |
| SB297 | |
| SB160 | |
| Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
| *+ | SB 294 | TELECONFERENCED | |
| *+ | SB 297 | TELECONFERENCED | |
| += | SB 160 | TELECONFERENCED | |
| += | SB 289 | TELECONFERENCED | |
| += | HJR 25 | TELECONFERENCED | |
SB 160-MANDATORY UNIVERSAL HEALTH CARE
2:34:14 PM
CHAIR ELLIS announced SB 160 to be up for consideration. The
committee had CSSB 160(L&C), 25-LS0728\T to consider.
SENATOR FRENCH, sponsor of SB 160, said he would comment on CSSB
160(L&C), 25-LS0728\T. He said it makes six changes, some small
and some fairly significant. The first change is on page 3,
lines 15-17, that broadens the view points that are represented
on the Health Care Board. Concerns were heard from insurers that
the definition of entities that would make up the insurance
representatives on the board was too narrow. So now the two
representatives are one large scale wholesaler and small scale
retailer. He explained the retailer is called an "insurance
producer," an industry term that refers to the customer oriented
on-the-ground insurance retailer.
2:36:20 PM
The second change is on page 5, lines 6-8, and clearly gives the
duty to the board of making a plan that can effectively protect
an individual from severe financial hardship in times of medical
need - taking into account a household's income and other
relevant financial criteria. He said, "It will make certain that
insurance is meaningful for each Alaskan since a $10,000
deductible health care plan isn't much use to a household that
earns $15,000 a year."
2:36:50 PM
SENATOR FRENCH said the third change came in response to a
concern of Senator Stevens. It removes a few words from what was
subsection 7 on page 6. It used to say that Indian Health
Service (IHS) benefits had to meet or exceed the benefits for
essential health care services as defined in the legislation.
That has been removed to make it clear that individuals who are
satisfied with the care they receive through IHS facilities
won't be subject to the requirement to have additional coverage
- even if the IHS benefits don't line up exactly with essential
health care services. To a large extent, this alleviates the
fine decisions the board would have to make as to each IHS
recipient and whether the benefits they receive met or exceeded
those adopted by the plan.
He said he worked with tribal representatives, and the important
facts to keep in mind when looking at the interplay between SB
160 and the IHS system are first, that any third party payer
will be first in line if an IHS beneficiary with third-party
insurance walks into a clinic anywhere if they have third party
insurance. The second thing to remember is that the amount of
money dedicated by the federal government to IHS beneficiaries
is fixed every year; it is distributed at the beginning of the
year and that's the end of it. It is not limitless. They have
enough money for day-to-day clinic visits and check ups, but
when it comes to bone marrow transplants or a knee replacement
or heart surgery, they may be "rationed out," because the amount
of money allocated that year has been used up. So in essence SB
160 helps add to the care of any IHS beneficiary in the state.
SENATOR FRENCH said IHS beneficiaries receive on average about
$2,000 per individual spread across the entire population
whereas someone outside the IHS receives about $4,000 to $5,000.
SB 160 allows any IHS beneficiary to join the plan if they
choose or not depending on how satisfied they are with their own
personal situation. Senator French said, "SB 160 will not back
out a single federal dollar that is currently being received in
Alaska for the benefit of IHS beneficiaries." He said this was
the most complex change even though it was just the reduction of
a few words.
The fourth change was on page 6, lines 11-14, that has to do
with concerns on behalf of the Christian Science Religion who
eschew modern medical practices. So SB 160 has allowed an
exemption for those individuals. If they can demonstrate to the
board that their deeply held religious beliefs are contrary to
this program, they don't have to participate. Exemptions will be
rigorously granted.
SENATOR FRENCH said the next change is how "employees" and the
"employer levy" are defined. There was concern that "employee"
was defined too broadly. Imagine a business that employed
nothing but military spouses or spouses of state or federal
employees - all covered by health insurance. There is absolutely
no need to apply an employer levy against that employer, because
not a single one of those individuals needs health insurance. So
an "employee" is defined as someone who is required to
participate in the Alaska Health Care Plan on page 8, lines 11-
20 and that means they don't have coverage anywhere else.
2:42:06 PM
He said the second change is with counting the number of
employees, because you get into problems of defining how many
hours a week that is. So, they went with the payroll number,
which is roughly equal to what one would imagine 10 full-time
employee equivalents is - the $500,000 figure. He explained if
your total payroll of employees that don't have coverage
anywhere else is $500,000 or less, no levy whatsoever. If it's
between $500,000 and $1,000,000 it's 1 percent; if it's over
$1,000,000 it's 2 percent. This is more business friendly and
easier to understand.
Finally, he said language on page 12, line 18, changes the
effective dates to comport with concerns Legislative Legal had
regarding adoption of regulations.
2:43:48 PM
MARY RAYMOND, representing herself from Homer, said after
listening to task forces and various bills to get affordable
insurance for the last 20 years this is very exciting. Her
concern that it was promoted as compulsory had been addressed.
2:45:09 PM
PATRICK DALTON, Delta Junction, representing himself, agreed
with the public oversight provision. He also suggested having
two alternative health professionals on the Health Care Board -
naturopath or herbologist. However, he asserted the legislature
has no constitutional authority to require a citizen to contract
into any health care plan whatsoever.
Second, Mr. Dalton said, an element of hypocrisy exists because
SB 160 requires everyone to have a health care card and then it
turns around and denies coverage to any Alaskan who does not
have one. He said the "preamble" of the bill clearly states that
all Alaskans are eligible for this and he suggested just
expanding health care coverage to any Alaskan who can prove they
are a citizen or a resident. That way compliance doesn't have to
be forced. Furthermore, he asked what criminal penalties there
are for not partaking in the system. Finally, he said if they
have to require health care coverage, even though he doesn't
think they have the right to do that, he suggested having an
opt-out system. He also asked how someone can demonstrate they
have a firmly held religious belief that being a subjective
matter.
CHAIR ELLIS thanked everyone for sharing their thoughts and said
he would hold SB 160 for further work. There being no further
business to come before the committee, he adjourned the meeting
at 2:49:27 PM.
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