03/30/2023 03:30 PM Senate HEALTH & SOCIAL SERVICES

                 SJR 10-MEDICARE REIMBURSEMENT                                                                              
                                                                                                                                
3:31:02 PM                                                                                                                    
CHAIR  WILSON   announced  the  consideration  of   SENATE  JOINT                                                               
RESOLUTION NO.  10 Encouraging Alaska's  Congressional delegation                                                               
and the federal government to  raise Medicare reimbursement rates                                                               
to meet the actual cost of care for the state's senior citizens.                                                                
                                                                                                                                
3:31:25 PM                                                                                                                    
SENIOR  CATHY  GIESSEL,  speaking  as  the  sponsor  of  SJR  10,                                                               
provided the sponsor statement as follows:                                                                                      
                                                                                                                                
[Original punctuation provided.]                                                                                                
                                                                                                                                
     "Encouraging Alaska's Congressional  delegation and the                                                                  
     federal  government  to  raise  Medicare  reimbursement                                                                  
     rates to meet  the actual cost of care  for the state's                                                                  
     senior citizens."                                                                                                        
                                                                                                                                
     Alaska's  senior   population  has  been   the  fastest                                                                    
     growing, per  capita, in  the nation  for the  past ten                                                                    
     years, in  a state  whose medical  costs are  among the                                                                    
     highest in  the nation.  This increase has  triggered a                                                                    
     demand  for more  healthcare services,  from basic  in-                                                                    
     home  assistance  to high  levels  of  acute care.  The                                                                    
     medical   system   is   struggling   to   provide   the                                                                    
     appropriate level of care  for seniors under persistent                                                                    
     workforce  challenges   and  the   inadequate  Medicare                                                                    
     reimbursement rates  that simply do not  cover the cost                                                                    
     for services.                                                                                                              
                                                                                                                                
     This  untenable situation  elevates  the  need for  the                                                                    
     rebasing   of  Medicare   reimbursement  rates   as  an                                                                    
     immediate priority.                                                                                                        
                                                                                                                                
     Healthcare providers  who do accept Medicare  have long                                                                    
     been struggling  to stay  profitable and  retain staff.                                                                    
     Some  providers,  who   almost  exclusively  serve  the                                                                    
     senior  community,  have  had   to  shut  down  due  to                                                                    
     staffing issues originating  in part from uncompetitive                                                                    
     Medicare reimbursement  rates. For these  reasons, many                                                                    
     more medical  providers are choosing not  to accept new                                                                    
     Medicare  patients. This  has  left countless  Alaskans                                                                    
     without access to reliable  and affordable health care.                                                                    
     The  lack of  available Medicare  providers is  driving                                                                    
     more  and  more   financially  vulnerable  Alaskans  to                                                                    
     emergency rooms and urgent  care clinics, exposing them                                                                    
     to  unnecessarily   high  medical  bills   and  putting                                                                    
     further strain on the system.                                                                                              
                                                                                                                                
     The hard  truth is that  our aging seniors who  rely on                                                                    
     Medicare to  cover the cost  of their  medical services                                                                    
     do not have time to  wait for the long and deliberative                                                                    
     process of  policy making to  play out. This is  why we                                                                    
     must urge  the President and our  federal delegation to                                                                    
     act now.                                                                                                                   
                                                                                                                                
     Senate Joint  Resolution 10 sends  a strong  message to                                                                    
     our  federal   delegation  by   asking  them   to  take                                                                    
     immediate  action  on  lagging  Medicare  reimbursement                                                                    
     rates that  are detrimentally affecting  our healthcare                                                                    
     providers and access to appropriate care for Alaskans.                                                                     
                                                                                                                                
     Please join  me in support of  this critical resolution                                                                    
     that  seeks  to  help   Alaska's  seniors  by  bringing                                                                    
     Medicare's  lagging  rates  to  the  attention  of  our                                                                    
     federal representatives.                                                                                                   
                                                                                                                                
3:34:01 PM                                                                                                                    
CHAIR WILSON opened public testimony on SJR 10.                                                                                 
                                                                                                                                
3:34:17 PM                                                                                                                    
MIKE COONS, representing self, Palmer, Alaska, stated he is a                                                                   
70-year-old veteran who deals with Medicare and Veteran                                                                         
Administration health insurance. He  proposed an amendment adding                                                               
the Veteran's Administration (VA)  and TRICARE for Life insurance                                                               
to the resolution.  Medicare, VA, and TRICARE  for Life insurance                                                               
are  all  federal  programs.  He  provided  several  examples  of                                                               
medical claims  and the  limited payout  amounts that  his doctor                                                               
received.  He  opined that  doctors  need  to stay  in  business.                                                               
Limited payouts make it difficult  for doctors to accept Medicare                                                               
and  veteran patients.  He questioned  how  long Mat-Su  hospital                                                               
would  continue to  take Medicare  patients  when the  government                                                               
only pays pennies on the dollar.                                                                                                
3:39:38 PM                                                                                                                    
DR.  MICHAEL  SAVITT,  Chief Medical  Officer,  Anchorage  Health                                                               
Department, Anchorage, Alaska, stated  he supports SJR 10 because                                                               
it addresses  many clinics' concerns.  Elders need  continuity of                                                               
care. The closing  of the Alaska Regional  Senior Clinic resulted                                                               
from a  lack of staff due  to the pandemic. Its  closure has left                                                               
many seniors  without care, exacerbating an  existing problem. He                                                               
formed  a   task  force  to  help   Anchorage's  Medicare-insured                                                               
community obtain medical  care. He said it is difficult  to fix a                                                               
federal situation at a local  level. Local leaders have requested                                                               
federal  assistance, but  none is  forthcoming.  Many states  are                                                               
facing the same  problem. There is no quick fix.  Alaska needs to                                                               
become more  self-sufficient, creative  in recruitment,  and look                                                               
for short-term and long-term solutions.                                                                                         
3:43:56 PM                                                                                                                    
JEROME GEORGE, representing self,  Anchorage, Alaska, agreed with                                                               
the  points Dr.  Savitt  made.  He said  he  is  a retired  state                                                               
employee who  believes Alaska needs  to pay attention  because if                                                               
Medicare  goes bankrupt,  Alaska  will  be on  the  hook for  the                                                               
bills. It  is in the state's  best interest to see  that Medicare                                                               
survives.  He suggested  that the  "blackmail"  clause should  be                                                               
removed  because it  does not  allow doctors  to accept  Medicare                                                               
patients  with  supplemental  insurance unless  they  accept  all                                                               
Medicare patients.  He stated that  the clause made  it difficult                                                               
for Medicare  patients to find  doctors when the  Alaska Regional                                                               
Senior Clinic closed.  He said Alaska's seniors  are the fastest-                                                               
growing  and  largest group  of  voters  in  the state,  but  the                                                               
sector's  needs  are unmet.  He  said  education is  the  biggest                                                               
deterrent  to attracting  young  professionals  to Alaska,  which                                                               
affects Alaska's medical  crisis. He opined that  Alaska needs to                                                               
improve its school system.                                                                                                      
3:48:17 PM                                                                                                                    
ERIC GURLEY,  Executive Director, Access Alaska  Inc., Anchorage,                                                               
Alaska,  described   how  Access  Alaska  supports   seniors.  He                                                               
testified  in support  of SJR  10 and  said the  state of  Alaska                                                               
population  projections for  2021 to  2050 expect  the number  of                                                               
Alaskans  65  and  older  to  increase  by  30  percent.  Current                                                               
Medicare  rates do  not support  the access  seniors require  for                                                               
health  care problems.  Seniors having  to wait  for care  can be                                                               
life-changing.  Economic insecurity  and increasing  costs affect                                                               
seniors  with  fixed  incomes.  He  asked  that  the  legislature                                                               
continue to  work with  Alaska's congressional  representation to                                                               
increase Medicare  rates. He also  requested that  the government                                                               
address  the  lifelong penalty  for  late  enrollment, as  it  is                                                               
unfair.                                                                                                                         
                                                                                                                                
3:51:31 PM                                                                                                                    
CHAIR WILSON closed public testimony on SJR 10.                                                                                 
                                                                                                                                
3:51:40 PM                                                                                                                    
At ease.                                                                                                                        
                                                                                                                                
3:52:20 PM                                                                                                                    
CHAIR  WILSON  reconvened  the  meeting  and  asked  for  further                                                               
questions.                                                                                                                      
                                                                                                                                
3:52:29 PM                                                                                                                    
SENATOR  TOBIN  commented  that  millennials  recently  surpassed                                                               
seniors as the largest voting population in Alaska.                                                                             
                                                                                                                                
3:53:11 PM                                                                                                                    
CHAIR WILSON solicited a motion.                                                                                                
                                                                                                                                
3:53:14 PM                                                                                                                    
SENATOR  KAUFMAN  moved to  report  SJR  10 from  committee  with                                                               
individual recommendations and attached fiscal note(s).                                                                         
                                                                                                                                
3:53:27 PM                                                                                                                    
CHAIR WILSON found no objection and  SJR 10 was reported from the                                                               
Senate Health and Social Services Standing Committee.