Legislature(2009 - 2010)HOUSE FINANCE 519
04/14/2009 08:30 AM House FINANCE
| Audio | Topic |
|---|---|
| Start | |
| HB204 | |
| HB222 | |
| Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
| + | HB 204 | TELECONFERENCED | |
| + | HB 222 | TELECONFERENCED | |
| + | TELECONFERENCED |
HOUSE BILL NO. 222
"An Act prohibiting discrimination by health care
insurers based on genetic information; requiring a
health care insurer to offer coverage for the treatment
of alcoholism or drug abuse; providing continuity of
coverage for college students during medically
necessary leaves of absence from college; requiring
health care insurers in the group market to provide
parity in the application of mental health and
substance abuse benefits that comply with federal
requirements; amending the definition of 'dentist' to
include out-of-state dentists for purposes of certain
dental insurance requirements; and providing for an
effective date."
REPRESENTATIVE LINDSEY HOLMES, SPONSOR, explained that the
bill implements federal law. It gives the Division of
Insurance the ability to implement new federal laws that
will kick in this summer. She summarized the sections of
the bill:
Section 1: This section incorporates requirements in 42
U.S.C. 300gg-53 into state law. 42 U.S.C. 300gg-54
prohibits health care insurers from discriminating
against individuals on the basis of genetic
information. It prohibits health care insurers from
requiring individuals to undergo genetic testing as a
condition of insurance.
Section 2: This section changes the requirements for
insurance coverage for treatment of alcoholism or drug
abuse. Currently, insurers are mandated to provide
coverage for treatment of alcoholism and drug abuse to
employer groups with 20 or more employees and mandates
that insurers offer such coverage to employer groups
with fewer than 20 employees. This section would
replace that mandate and only require insurers to offer
coverage for substance abuse to all employer groups.
Under the mental health parity provisions in Section 6
of the bill insurers are prohibited from placing limits
on substance abuse coverage that are not placed on the
general medical coverage of the plan.
Section 3: This section amends the definition of
dentist for insurance purposes to cover dentists who
are not licensed in Alaska.
Section 4: This section incorporates requirements in 42
U.S.C. 300gg-54 and 42 U.S.C. 300gg-7 into state law.
Those sections of federal statute require that health
care insurers continue to cover college students under
their parent's health insurance coverage when the
students take leave from school for medical reasons.
Section 5: This section has two changes to enrollment
requirements for employees who are eligible for their
employer's health insurance plans but have previously
chosen to not enroll in that plan. The first change
allows a person who was covered by Medicaid or similar
plan and loses eligibility for that plan, to enroll in
their employer's health insurance plan. The second
change allows a person to enroll in their employer's
health insurance plan if they become eligible for
assistance to help pay for their employer's health
insurance plan from Medicaid or a similar plan.
Section 6: This section incorporates requirements in 42
U.S.C. 300gg-5 to apply to state law. The federal
requirements are that a health care insurer may not
place restrictions on mental health and substance use
coverage in an insurance plan that are not placed on
the general medical coverage of that plan.
Section 7: This section provides an effective date for
section 1 of the bill.
Section 8: This section provides an effective date for
sections 4 and 6 of the bill.
9:59:48 AM
Co-Chair Hawker inquired why Representative Holmes chose to
sponsor this legislation. Representative Holmes reported
that Linda Hall, the Director of the Division of Insurance
in the Department of Commerce, Community and Economic
Development, requested the bill.
Representative Kelly voiced concern about the lack of
doctors who will see Medicare patients. He pointed out that
the Division of Insurance will now be required to expand
services. He was concerned about senior medical coverage
under a "leveling" program.
10:04:13 AM
Co-Chair Hawker shared those concerns. He requested more
information.
LINDA HALL, DIRECTOR, DIVISION OF INSURANCE, DEPARTMENT OF
COMMERCE, COMMUNITY AND ECONOMIC DEVELOPMENT, observed that
all items in the bill, with the exception of the dental
definition, are federal mandates that will be adopted and
enforced on a federal level. The request is to incorporate
them into Alaska law for enforcement reasons and to prevent
conflicts, particularly in the mental health area. The
federal laws will preempt state laws and will present
conflicts. She emphasized that the federal mandates are
geared to larger employees and, if coverage is offered, then
it will be on parity with the other health plan.
10:06:58 AM
Representative Kelly did not want the seniors to buy their
insurance in the same category with drug abusers and mental
health patients. He maintained that the bill is not going
to help seniors obtain health insurance. He called it
discrimination.
Co-Chair Hawker concurred that it was an unfunded federal
mandate. He asked if the Division of Insurance supports the
bill.
Ms. Hall reported that the Division of Insurance supports
the legislation. Co-Chair Hawker asked if the governor
supports the bill. Ms. Hall replied that the governor
authorized the bill.
Co-Chair Hawker spoke of the problematic issue of holding
the legislature responsible for the outcome of the bill.
Ms. Hall reported that she is looking at the ability to
enforce health insurance provisions.
10:10:00 AM
Representative Kelly asked if Ms. Hall requested the bill.
Ms. Hall said she did.
Representative Gara thought Ms. Hall was in a difficult
position. Ms. Hall said she had listened to previous
discussions and implied that she was aware of the situation.
Representative Gara understood Representative Kelly's
concerns. He shared his understanding of the bill. He
thought it was a constituent service bill. He described a
scenario of what would happen if the bill does pass. Ms.
Hall agreed. He thought the bill was needed.
10:12:51 AM
Co-Chair Hawker didn't see that the legislature had any
choice but to adopt the legislation.
Representative Fairclough wanted to know the effective date
of the change. Ms. Hall reported that there were different
effective dates. The genetic information nondiscrimination
section is effective May 21, 2009; the coverage of dependent
students section is effective October 9, 2009; the special
enrollment for Medicaid and Denali Kid Care-type programs
are effective April 1, 2009; and the mental health parity
section is effective January 1, 2010.
Representative Fairclough asked when the federal government
passed the changes. Ms. Hall reported on enrollment dates,
which were recent. Representative Fairclough reported on
another bill which contained a good faith effort for
extensions for implementation. She wondered if that was
included in this bill. Ms. Hall thought it was not.
Representative Fairclough commented that some state might
not be meeting in time to address these changes, so she
assumed there was an extension provision.
10:15:47 AM
Co-Chair Hawker reported that the same situation occurred
with the Federal Stimulus Act.
Representative Holmes summarized that the federal rules
would go into effect, but the Director of Insurance would
have no ability to act in the event that a constituent had a
problem.
Representative Fairclough related that the Committee has had
many conversations about the federal government overstepping
into state rights.
10:17:03 AM
Representative Kelly asked for information about the
consequences if the legislation is not passed. Ms. Hall did
not have that information, but thought that the provisions
of the bill would be enforced through the Department of
Labor.
Representative Kelly wished to know the exact consequences.
Representative Crawford commented that he does not feel
pressured by the federal government at all. He thought all
requests were the right thing to do.
Co-Chair Hawker opened public testimony.
10:19:45 AM
JEFF JESSEE, CHIEF EXECUTIVE OFFICER, ALASKA MENTAL HEALTH
TRUST AUTHORITY, testified in favor of HB 222. He responded
to Representative Kelly's concerns. One of the concerns in
the health care system is that insurance companies can
dictate the rules. They would rather have the private
sector - government - have the primary responsibility for
providing the services. When people can't get coverage
through private insurance for mental health and substance
abuse problems, the state government ends up paying. The
idea behind health insurance is to spread the risk across a
group of people for their medical needs. Currently,
insurance companies have decided not to meet certain groups'
needs. He thought the bill was headed in the right
direction.
10:22:17 AM
Representative Kelly asked if Mr. Jessee was happy with the
Medicare situation in Alaska. Mr. Jessee related that he
was not. He thought it was imperative to deal with health
care costs. Representative Kelly talked about what has
crippled the Medicare system. He commented on the problems
with the social security system.
Mr. Jessee shared some of Representative Kelly's concern.
He spoke of needing to keep the boat from sinking.
Representative Kelly commented that the problem remains
unsolved.
10:25:37 AM
Co-Chair Stoltze preferred to move the bill out of Committee
unless there was more testimony.
Co-Chair Hawker closed public testimony.
10:26:38 AM
Co-Chair Hawker pointed out the zero fiscal notes.
Co-Chair Stoltze MOVED to report HB 222 out of Committee
with individual recommendations and the accompanying fiscal
notes. There being NO OBJECTION, it was so ordered.
HB 222 was REPORTED out of Committee with a "do pass"
recommendation and with two new zero fiscal notes by the
Department of Health and Social Services, and fiscal note #1
by the Department of Commerce, Community and Economic
Development.
| Document Name | Date/Time | Subjects |
|---|---|---|
| Frequently Asked Questions.pdf |
HFIN 4/14/2009 8:30:00 AM |
HB 204 |
| AARP.pdf |
HFIN 4/14/2009 8:30:00 AM |
HB 204 |
| HB222-DHSS-MS-04-11-09NEW.pdf |
HFIN 4/14/2009 8:30:00 AM |
HB 222 |
| HB222-DHSS-BHMS-04-11-09NEW.pdf |
HFIN 4/14/2009 8:30:00 AM |
HB 222 |
| HB 222 Sectional.pdf |
HFIN 4/14/2009 8:30:00 AM |
HB 222 |
| HB 222 Sponsor Statement.pdf |
HFIN 4/14/2009 8:30:00 AM |
HB 222 |
| Stateof AlaskaDeptHSS.pdf |
HFIN 4/14/2009 8:30:00 AM |
HB 204 |
| Sponsor Statement WWAMI (3).pdf |
HFIN 4/14/2009 8:30:00 AM |
HB 204 |
| Physician Shortage Fact Sheet Header.pdf |
HFIN 4/14/2009 8:30:00 AM |
HB 204 |
| HB 204 - Increase WWAMI Class Size.pdf |
HFIN 4/14/2009 8:30:00 AM |
HB 204 |