Legislature(2013 - 2014)HOUSE FINANCE 519
02/27/2014 01:30 PM House FINANCE
| Audio | Topic |
|---|---|
| Start | |
| SB49 | |
| HB204 | |
| HB306 | |
| Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
| + | HB 204 | TELECONFERENCED | |
| *+ | HB 306 | TELECONFERENCED | |
| + | TELECONFERENCED | ||
| += | SB 49 | TELECONFERENCED | |
SPONSOR SUBSTITUTE FOR SENATE BILL NO. 49 am
"An Act relating to women's health services and
defining 'medically necessary abortion' for purposes
of making payments under the state Medicaid program."
1:46:29 PM
Representative Costello discussed the bill's three fiscal
notes including two indeterminate notes from Department of
Health and Social Services (DHSS) and one fiscal impact
note from DHSS with a cost of $55,200 in FY 15.
1:47:51 PM
Representative Gara MOVED to ADOPT Amendment 1:
Page 1, line 1, after "Act" insert "relating to
women's health services and"
Page 1, line 4, insert a new section to read:
Section 1. AS 4 7.07 .030 is amended by adding a
new subsection to read:
(g) The department shall make available to
eligible recipients a program for women's health
for the purpose of providing family planning
services, health screening examinations, and
related services.
Page 3, line 6, insert a new section to read:
Sec. 3. The uncodified law of the State of Alaska
is amended by adding a new section to read:
WOMEN'S HEALTH PROGRAM UNDER STATE MEDICAID.
The Department of Health and Social Services
shall immediately prepare and submit to the
United States Department of Health and Human
Services, for approval in accordance with the
provisions of 42. U.S.C. 1396a (Title XIX, Social
Security Act), an amendment
Co-Chair Stoltze OBJECTED and ruled Amendment 1 out of
order. He stated that the amendment was identical to a vote
that had previously taken place on the adoption of the CS
[the CS previously adopted by the House Finance Committee
had removed language that Amendment 1 would reinsert].
Representative Gara replied that the topic had been fully
debated before the committee had all of the information
about the women's health program. He believed that the
amendment should be discussed given the updated information
the committee had received.
Vice-Chair Neuman MOVED to REPORT HCS SSSB 49(FIN) out of
committee with individual recommendations and the
accompanying fiscal notes.
Representative Guttenberg OBJECTED. He spoke to the
contentious nature of the bill topic. He remarked that a
considerable portion of the bill had been removed following
its passage from the Senate. He stated that if the goal was
to reduce the number of abortions, the most immediate way
was to prevent them from taking place. He stressed that the
CS eliminated the consideration from the bill. He remarked
that the constitutional issue would be played out in the
Alaska courts. He believed that without a prevention
component, the bill guaranteed the number of abortions
would increase. He was equally bothered by the definition
used in the legislation because it did not consider the
health or well-being of the mother or who the responsible
party would be for the unborn child. He believed that the
legislation's definition treated the mother as the vessel
carrying a child; that the mother had no responsibility and
that government was responsible. He found it problematic
that the bill did not honor a woman's decision about her
own health, especially if the decision related to mental
health. He believed the bill moved further away from a
point where people could agree on a definition that would
make things healthier for women and unborn children. He
emphasized that the bill did not come near to resolving the
issue. He noted that the courts had spoken on the issue; he
knew no one liked making end-runs around the courts. He
stated that the legislature was not getting closer to a
definitive answer because it was refusing to acknowledge
some of the more serious problems on the issue.
1:53:42 PM
Representative Gara discussed that there were many
individuals in Alaska who were pro-choice and many others
who were not. However, constituents expected legislators to
come together where they agreed. He stated that there was
an opportunity to reduce the number of abortions by
adopting a women's family planning program that would have
covered 90 percent of the cost for contraception. He
believed the number of abortions should be reduced through
family planning. He believed it was a mistake to remove the
provision from the bill. He thought the bill may increase
the number of abortions and may also make them more
dangerous for women who could not afford to go to a medical
provider. He stated that women who had no children and were
not pregnant would be covered by a women's health program.
He stressed that contraception would result in fewer
unintended pregnancies and fewer abortions. He believed it
was a win-win for people on both sides of the pro-choice
pro-life debate. He addressed former comments by a bill
sponsor related to public health clinics. He discussed that
many public health clinics provided some family planning
services; however, women should have the right to go to
their personal doctor. He did not believe there should be a
law preventing women from going to their doctor when they
wanted family planning services. He noted there were no
public health clinics in Denali Park, Arctic Village,
Barrow, Kotzebue, Togiak, Naknek, or King Salmon. He
stressed that there had been an easy way for the bill to
limit the number of abortions; he intended to have the
discussion on the House floor.
Representative Gara addressed the bill as a whole. He
discussed that he was pro-choice, but that the topic of
abortion made him uncomfortable. He did not like having
fights in the legislature related to the divisive issue.
The system created by the bill allowed middle class and
wealthy woman to choose to have an abortion; however, it
did not cover lower class women. He stated that a similar
system had existed sometime in the past; unsafe abortions
had led to the death and serious injury of mothers. He
opined that states should each have a robust debate on the
right to choose; he believed the right should exist. He did
not believe in creating two classes of women; those who
could afford a safe abortion and those who could not.
1:59:22 PM
Representative Gara continued to discuss his objection to
the legislation. He reiterated that the bill would increase
the number of abortions for women due to a lack in family
planning services and would also make abortions less safe.
He did not support the legislation.
Representative Munoz observed that federal law limited
public funds for abortions. She noted that 547 abortions
had been performed the past year. She believed it was clear
that more abortions were happening than were medically
necessary. She wondered why the bill's definition did not
include diagnosed mental disabilities.
Co-Chair Stoltze relayed his intent to allow the sponsor to
provide clarity on the specific point.
Representative Guttenberg remarked that the committee was
in the middle of a motion and the sponsor was providing
comments on the legislation.
Co-Chair Stoltze explained his intent to have the sponsor
address the topic as part of the committee deliberation.
2:01:57 PM
Senator Coghill replied that the Alaska Mental Health Trust
Authority talked about the need for commitment. The sponsor
felt that the bill language left the issue well within the
purview of a doctor. He stated that if a mental condition
created a question [about the safety of a pregnancy] the
doctor would have every right to make the decision.
Representative Wilson spoke to her question from the prior
day. She pointed to occurrences in 2012 and who paid for
the service; she listed Medicaid, cash, insurance, and
other. She did not know if the "other" category was the
possibility for women to have the procedure who did not
have insurance or Medicaid. She stated that if the "other"
was another group taking care of women who did not qualify
under other insurance then the question became who paid for
the procedure. She was concerned about not knowing what the
other was. She was hoping to have the question answered
before it went to the House floor. She was bothered by the
difference between items that were paid for by state
insurance compared to Medicaid; she noted that state
insurance paid only for medically necessary abortions. She
stated that if a person did not qualify for a procedure
under state insurance they were on their own to determine
how to pay for it. She remarked on a definition used by
private insurance that appeared to work given that there
had been no legal suits. She was concerned that the state
may get sued in the future because regulations already
existed. She wondered why the state did not use the proven
method used by other insurances versus going in the
direction the bill went. She stressed that the state would
get sued under the current method. She continued that if
the state lost on the definition it cost money and meant
the legislature would be required to discuss the issue
again. She stressed that the term medically necessary was
used for all medical procedures. She believed the issue
should not have been made a "women's issue." She was
willing to let the bill out of committee, but reiterated
her hope for answers prior to hearing it on the House
floor.
2:06:41 PM
Co-Chair Austerman stated that he had always been pro-
choice. He acknowledged the efforts of the sponsors to
create a definition. He recognized that the debate was not
about pro-choice or pro-life. His concern was about pro-
life efforts to cumulatively move towards the pro-life
goal. He believed any movement down a cumulative path to
stop pro-choice created a long-term problem. He opposed the
legislation.
Representative Holmes was disappointed that the bill did
not include a family planning program. She believed that
working to avoid unwanted pregnancies was the area that
everyone came together on. She urged the sponsors and
committee members to include family planning. She spoke to
the underlying language of the bill. She understood that
the topic pertained to funding and was not about pro-life
or pro-choice. The discussion related to who paid and under
what circumstances. She pointed to the list included in the
bill. She did not want to continue debating the issue, but
did not know if the nail had been hit on the head. She
believed the definition equated to the legislature telling
a doctor what was and was not medically necessary. She
agreed that under current laws Medicaid was only supposed
to pay for medically necessary abortions; she was okay with
that, but was uncomfortable with the list.
2:10:00 PM
Representative Costello commented on the family planning
portion that would not move forward with the legislation.
She believed there was a place for a discussion about
family planning, but she did not believe the language
belonged in the current bill. She noted that adoption was
not mentioned in the bill; she hoped that adoption would be
discussed when family planning was addressed at some point.
She shared personal information related to adoption.
Representative Edgmon had hoped to be given the opportunity
to vote on the family planning element. He discussed the
cause and effect relationship of family planning services
related to cost savings. He highlighted the lack of
facilities in his rural district. He believed that in the
current social environment (where there was an increased
need for Village Public Safety Officers) there were many
things occurring that family planning would enhance. He
believed the objective supported by all was fewer unwanted
pregnancies and abortions. He stated that without the
family planning element it was difficult for him to support
the legislation. He respected the sponsor, but he could not
support the legislation.
Vice-Chair Neuman spoke for the life of an unborn child. He
believed the definition represented a good effort to find a
scope of what medically necessary abortion meant. He
believed there were some issues related to family planning
that needed to be addressed. He supported bringing babies
to full term so they could be adopted into families. He
addressed Representative Wilson's concern related to
private insurance. He thought insurance companies may
choose to pay for an abortion even if a procedure was not
medically necessary if it may save the insurance company
money. He supported the bill and believed it was necessary
to include descriptive language in statute.
2:14:49 PM
Representative Costello MOVED to RESCIND previous motion on
the fiscal notes. There being NO OBJECTION, it was so
ordered. She moved two indeterminate and one fiscal impact
fiscal notes from the Department of Health and Social
Services.
A roll call vote was taken on the motion to report the bill
from committee.
IN FAVOR: Costello, Neuman, Thompson, Munoz, Wilson,
Stoltze
OPPOSED: Guttenberg, Gara, Holmes, Edgmon, Austerman
The MOTION PASSED (6/5).
There being NO further OBJECTION, HCS SSSB 49(FIN) was
REPORTED out of committee with "no recommendation" and with
two indeterminate fiscal notes and one fiscal impact note
from the Department of Health and Social Services.
2:16:19 PM
AT EASE
2:24:47 PM
RECONVENED