Legislature(2001 - 2002)
02/14/2002 03:02 PM House HES
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* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
HB 367-MEDICAL ASSISTANCE PROGRAM COVERAGE CHAIR DYSON announced that the next order of business would be HOUSE BILL NO. 367, "An Act relating to coverage of children and pregnant women under the medical assistance program; and providing for an effective date." Number 1297 CYNTHIA EBELACKER, Alaska Nurse Practitioners; Alaska Nurses Association, testified via teleconference in opposition to HB 367. She is a nurse practitioner, and she owns a small clinic in Eagle River. She referenced written testimony that she submitted pertaining to HB 367. She acknowledged the importance of fiscal responsibility and offered to clear up misconceptions about who qualifies for Denali KidCare. She noted that her experience has been that "people aren't flooding in to get on Denali [Kid]Care." Some who do qualify are not aware that the program exists. She furnished that parents who qualify for the program are not white-collar workers with access to other insurance; they are blue-collar and self-employed workers. Eagle River is not an affluent community, she noted. At least 65 percent of her patients are able to see her only because they have Denali KidCare insurance. She indicated that her clinic staff members are well aware of their patients' economic status. These patients usually do not have other insurance, she added. MS. EBELACKER said: These families ... are working hard; they are the builders, ... the plumbers, ... the fast-food workers, and the Wal-Mart workers. They do pay taxes and they do vote. The difference is that three years ago, their children would almost never have received any preventative care, and they would have had to go to the emergency room when their kids were really ill. If their Denali [KidCare coverage] goes away, they will once again be forced to utilize the emergency room and their local "doc," and that's a much bigger financial burden to the state. MS. EBELACKER stated that she has spoken with people who work with insurance and Medicaid fraud, and they have indicated that evidence bears out the fact that not many people are abusing the system by concealing additional insurance coverage. Number 1126 JACKIE SUNNYBOY, Fairbanks Community Mental Health Center, testified via teleconference in opposition to HB 367. She reported that she works with the children's program at the center and pointed out that 44 of the center's 205 clients are covered by Denali KidCare; of the 50 clients on the waiting list, 11 have this coverage. These families and children, she noted, have severe emotional disturbances. Clinic staff is concerned that many of these families will not receive service without Denali KidCare insurance. These clients suffer from severe emotional, physical, and sexual abuse issues, she offered. The clinic also sees many children affected by fetal alcohol syndrome; they need all the assistance they can get, because these disabilities do not simply go away. These children have a right to services [through Denali KidCare] that they would otherwise not qualify for. Number 1084 CHAIR DYSON asked about the number of clients Ms. Sunnyboy referenced that would not qualify for Denali KidCare [under provisions in HB 367]. MS. SUNNYBOY said, "It's not that they wouldn't qualify, but without Denali KidCare, it would be very difficult to get services." Number 1084 CHAIR DYSON asked, "Does it mean that they wouldn't qualify for Denali KidCare if the threshold was lowered?" MS. SUNNYBOY replied that she had not had time to calculate the number of clients [whose income is] 150 to 200 percent [of poverty level]. Number 1043 CHARLES QUARRE testified via teleconference in opposition to HB 367. He cited statistics indicating that 3,821 children and 722 pregnant women will lose health care coverage should HB 367 be passed. He noted that if HB 367 passes, the state will save $5 million, but it will lose $11.9 million in federal funds. He stated that he applauds the effort to reduce state spending, but he believes this cut would be near the bottom of the list if the cuts were prioritized. Parents might wait until the last minute to seek treatment when the problem is serious and requires a trip to the emergency room, which will cost much more, he concluded. Number 0977 PATRICIA BOILY, Homer Medical Clinic, testified via teleconference. She stated that she has been involved in health care since 1980. She said: My feeling is that HB 367 is wrong-headed and should not be passed. Its target is pregnant women and children. They are the only direct beneficiaries of the Denali KidCare program. I was somewhat taken aback by [Representative] Coghill's sponsor statement because there were some errors in it. Denali KidCare does not base anything on 250 percent. Those figures are 150 to 200 percent of the federal poverty level, depending on whether or not you have primary health care insurance. MS. BOILY continued: The program is supported by more than 70 percent in federal dollars, and the state picks up the remainder, but we're talking about our children. The future of this state is its children. Since the state has failed to take any proactive movement towards affordable health insurance for its residents, it has an obligation to make sure that at least the children are healthy. Keep in mind that Denali KidCare is only for health-related coverage; it doesn't provide money, food, household expenses. Its purpose is only to ensure that pregnant women and children are getting whatever health-related needs they have attended to. MS. BOILY added: [Representative] Coghill stated that our unemployment rate is 5.8 percent; he must realize that not everyone employed in Alaska makes a living wage. There are many people holding down two or more jobs just make ends meet. And not all employers are inclined or can even afford to provide health insurance coverage to its employees. I have what's considered a good-paying job in the private sector. Yet my monthly premium [for] health insurance for me and my husband are in excess of $690 per month. And we have a thousand dollar deductible each. My employer contributes 18 percent, and the rest of it comes out of my paycheck. I pay more than $8,300 a year just for premiums. Then I have a thousand dollar's deductible before the insurance even takes effect. Then I still have 20 percent. If I still had dependent children, my premiums would be over [$]900 per month. MS. BOILY concluded: It's time for the legislators to recognize that affordable health insurance is just not available to the majority of Alaskans. Instead of focusing your energy on our most vulnerable citizens, you should be looking for solutions ... for the uninsured or underinsured working class. Also, if everyone had adequate health insurance, there'd be far fewer women and children on Denali KidCare. Thank you. Number 0841 CHAIR DYSON suggested that the 250 percent figure is based on Alaska's poverty rate, which begins with a 25 percent cost-of- living adjustment over the federal standards. The Denali KidCare qualifications set the income level at 200 percent of Alaska's poverty standard. The result is 250 percent above the national poverty level. He said, "I don't think it was the intention of the sponsor to be deceptive." Number 0793 DONNA JORDAN, Governor's Council on Disabilities and Special Education, testified via teleconference. She read a letter from a parent she has worked with. She read as follows: We are raising six children, four of which are adopted and prenatally exposed to alcohol and drugs. Our adopted children all receive Medicaid, for which we are extremely thankful, as their medical [and] psychological needs are many. Much to our surprise, our youngest child, born to us five years ago, has a speech delay. We thought, "No problem, the husband works for the school district; we have great insurance." What a shock to find out that private insurance only cover $400 maximum for speech for our son. MS. JORDAN continued to read: Basically, $400 covers the evaluation and two speech sessions. We applied for Denali KidCare for our child, ... [and] within a few weeks received the card and immediately were able to get the speech therapy our child needed. Denali KidCare had an extremely positive impact on this family by providing what our private insurance would not provide. I am pleased to say that our son's speech has greatly improved. He is not, at this time, requiring speech [therapy]. We feel that the early ... intervention of speech services at age four years has saved us in many ways for a long run, and our family is very thankful for Denali KidCare. In closing, let me share: If it works, do not fix it. For families who may not otherwise have coverage, Denali KidCare does work. MS. JORDAN added that she works with families in the Matanuska- Susitna area. There are many seasonal workers for whom Denali KidCare has been extremely beneficial. Several of these families have children with disabilities, and the costs associated with these disabilities are numerous. She stated that cutting the Denali KidCare program would create a problem by discouraging families from using preventative services; emergency medical bills would increase as a result. She expressed her opinion that bringing the permanent fund dividend (PFD) into the discussion is unfair; the PFD is not a consideration for Denali KidCare eligibility. Number 0616 SALLY BELTZ, MSN, RN, ARNP-C, Advanced Training Coordinator, Yukon-Kuskokwim Health Corporation, testified via teleconference. She paraphrased from a prepared written statement that reads as follows: My name is Sally Beltz, and I live in Bethel. I work for the women and children in the Yukon-Kuskokwim Delta. I work to ensure that, no matter what their income, they receive the best health screenings available in their home villages. I do this by training the health aides in 48 tribal villages to provide women's preventive health screenings and well child periodic examinations through the Denali KidCare Program. As I am sure you know, this program was created to provide health care insurance to uninsured children and pregnant women in working and non-working families. MS. BELTZ said: The price of ensuring that our children have health insurance coverage is relatively cheap - only $552 per year, per child in state funds. This program ensures that the children of Alaska can have a health and developmental screening and a head-to-toe physical examination. It also provides for a dental and vision screening; a hearing screen done by audiometer; a developmental assessment for gross and fine motor development; and an evaluation of self-help and self- care skills. They are also screened for social and emotional development and receive a determination of immunization and nutritional status. Their vital signs are checked and a hemoglobin, hematocrit, urinalysis and PPD are done. A pap smear and pelvic and breast exam are also performed if needed. All children are also screened for behavioral health issues such as tobacco, drug, or inhalant use and child abuse. All of these screens are performed during the examination that is provided through Denali KidCare. MS. BELTZ continued as follows: This program also ensures that pregnant women have the opportunity to have prenatal care. It is well-known that prenatal care is one of the most cost-effective health care dollar expenditures. Prenatal care increases the chance of a healthy pregnancy and ensures the best chances for the delivery of a healthy baby. Prenatal care is also the best method of assuring that the children of Alaska have a healthy start in life. If this bill is adopted by the legislature, it will cause approximately 3,821 children and 722 pregnant women to lose their health care coverage. That means 3,821 children will not be offered the opportunity to live their best lives. It means that 722 women and 722 unborn babies will not be offered the opportunity to have the best health outcomes possible. I ask that the legislature seriously consider the potential negative health outcomes for the women and children of Alaska if they are denied access to health care. Aren't our women and children worth $552 per year? I respectfully ask you to consider if Alaskans are really willing to be guilty of leaving 3,821 of our children behind? Number 0470 CHAIR DYSON said, "Many of those children in your area would ... still be covered under Indian Health Service, would they not?" MS. BELTZ replied, "Yes, some would." Number 0404 JONALYN NAJERA testified via teleconference. She is a parent on Denali KidCare. She offered a statistic from the National Alliance for the Mentally Ill: between 375 and 400 children will lose care if HB 367 passes. She indicated that her daughter, who suffers from early-onset bipolar disorder, would be among these. The cost for her daughter's mental health care, excluding hospitalization, was about $25,000 a year. Ms. Najera stated that she would not know how to help her daughter [without Denali KidCare insurance]. She offered that 25 percent of bipolar children commit suicide each year. Denali KidCare is very helpful, she said. She would be unable to get insurance, and if she did have insurance, she could not afford the co- payments. Number 0333 CHAIR DYSON asked about Ms. Najera's income. MS. NAJERA replied that her family of four's income is about $42,000 a year. Her husband has insurance through work, but to add herself and their children, the cost would be $800 a month in addition to the co-payments and deductibles, she said. The insurance, however, does not have much mental health coverage. Number 0273 JAN LYNDES testified via teleconference. She stated that she works with people covered by Denali KidCare. She was covered by the program for her pregnancy. She received ongoing care and education throughout her pregnancy due to the coverage. Delivery complications necessitated a Caesarian-section delivery; she offered that the decision to have a C-section may have been delayed due to expenses incurred without Denali KidCare coverage. This delay could have meant a long-term disability or death for her son. She said, "I feel like Denali KidCare allowed me to have a birth complication not affect my physical or mental health [or] my son without causing my family to live under the poverty level while paying for the birth." She stated that she is now a full-time mother, which pays no money and offers no health insurance; she is dependent on [Denali KidCare] for the health of her son. She urged members to reject HB 367. CHAIR DYSON asked, "Is it true, then, that you wouldn't qualify if this bill passed?" MS. LYNDES replied that this was correct. TAPE 02-11, SIDE A Number 0001 DANA LEE HALL, R.Ph., Village Operations Administrator, Yukon- Kuskokwim Health Corporation, testified via teleconference. CHAIR DYSON noted that the committee had received the fax sent by Ms. Hall. MS. HALL stated that she wished to follow up her testimony of February 12 by clarifying information on Indian Health Service (IHS) funds used by YKHC in Bethel. These funds are minority funding, she said, adding, "Last year they were 49 percent of our funding. This year they're actually 43 percent." She noted that this was less than the 60 percent indicated by Nancy Wheeler, Unit Manager, State, Federal, and Tribal Relations, Division of Medical Insurance, Department of Health and Social Services. This money is leveraged with other money, Ms. Hall stated. This has enabled YKHC to double its operating budget and, in turn, double its services. She offered that with only IHS dollars, staff would be forced to choose which services to provide; this choice would limit services to those giving the most immediate health benefit such as emergency-room services. Essentially, YKHC would provide acute care services exclusively and discontinue preventative care services. MS. HALL turned attention to the fax sent to members entitled "Price comparison between Anchorage and Shageluk." This chart shows the higher costs of grocery items and gasoline in Shageluk. Each grocery item identified is at least 2.4 times more costly in Shageluk than in Anchorage. She said that a household salary of $32,000 for a family of four does not go very far when these are the prices paid. CHAIR DYSON thanked Ms. Hall for the information. Number 0201 MARIE DARLIN, AARP, referred to a February 14 fax from AARP addressing HB 367. She stated that she was speaking in opposition to HB 367 on behalf of Alaska's 112,000 AARP members. She noted that AARP understands the legislature's need to address fiscal problems, but it believes that HB 367 is poor health policy and poor public policy. Most of Alaska's uninsured, she said, are in working families whose employers do not provide health insurance. "Denali KidCare is the only thing that they can rely on," she said. "It ... is one of the best preventative health programs that you can find." CHAIR DYSON asked Ms. Darlin if many AARP members were pregnant or had small children. MS. DARLIN replied, "Not that many. ... However, we have a great many grandparents and people who are taking care of children." She indicated that some of these were using Denali KidCare. She offered that the program increases the chances for good health in families. She said, "We support any fiscal decisions that the legislature might make that are fair and make sense. However, we do not feel it makes sense to take these people off of Denali KidCare. So we are recommending a nay vote." Number 0402 TONY LOMBARDO, Director of Advocacy, Covenant House, testified via teleconference. He noted that his remarks are based on the statistics that he has received from Denali KidCare on Covenant House's specific client population, teens 13-19 years old. He noted that this information indicates that 3,319 teenagers will lose coverage if this "rollback" of Denali KidCare occurs. He said, "Covenant House always champions better health and living conditions for all teens, but especially for homeless and at- risk kids." The loss of this coverage will harm uninsured, working families in Alaska; it will worsen the situation for the children in Covenant House. Covenant House opposes the rollback for this reason alone. Number 0474 MR. LOMBARDO stated his understanding that Alaska pays $5 million in state funds to receive $12 million in federal funds. He added his understanding that when the Native percentages are factored in, 40 percent of that $5 million comes back to the state. As a result, he offered that Alaska is spending $3 million to get $12 million of federal funding. Denali KidCare is not a wasteful program, and Covenant House encourages members to not cut this successful program. Number 0565 SUSAN WOHGLEMUTH testified via teleconference. She pointed out that even moderate-income families with health insurance benefits have insurance that provides only limited benefits for residential care for children with psychiatric disorders, eating disorders, or behavioral health problems. She noted that she knows a number of families aided by Denali KidCare who would have been destroyed by catastrophic expense. "Denali KidCare helped save my daughter's life, and it's a necessary and vital institution," she concluded. Number 0597 LYNDA THOMASSEN testified that her family commercial fishes and Denali KidCare has been a "lifesaver" to their children. She said, "I would hate to see us fall off the Denali KidCare if ... the guidelines are lowered." She noted that her family's income would put them "on the edge" of eligibility. Her son has asthma; the preventative care has saved money, and it has saved her son from more serious problems in the future. She noted that she formerly had employment with insurance but has been unable to work since the birth of her second son. "Denali KidCare has been great for me," she concluded. Number 0689 SUSAN DRATHMAN testified via teleconference. She urged members to leave Denali KidCare eligibility guidelines untouched. She said that she concurred with other witnesses' testimony. She said, "Healthy children are the foundation of a ... successful society, and it's about $500 per year per child. I can't think of a better investment. It's incredibly ... cost-effective." The program offers medical, dental, and mental health care coverage; mental health care coverage is not available to many families without Denali KidCare. Most insurance companies cap mental health care at a low rate. She cautioned against looking only at the eligibility income levels for families of 9 or 10; she ventured that most Alaskan families are smaller than this. Health insurance is out of reach for most people; a trip to the emergency room is expensive - an appendectomy costs $15,000 to $20,000 without complications, she stated. Health care providers or the state will eventually incur these costs, because people are unable to pay these large bills. MS. DRATHMAN pointed out three inaccuracies she had heard at the previous hearing on HB 367. She clarified that the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) does not offer medical care; it offers nutrition for pregnant women. Second, Alaska Natives are not automatically eligible for Medicaid; they must meet the same income guidelines as others. And third, all Alaska Natives do not have ready access to Native health centers: Homer Natives seeking services must travel to Anchorage, where they must wait in line for care. Number 0850 VALERIE DAVIDSON, Executive Vice-President, Yukon-Kuskokwim Health Corporation, testified via teleconference in opposition to HB 367. She said she would like members to remember as they deliberate that "the need for medical care ... doesn't distinguish whether a woman or a child is eligible for Denali KidCare." This means that the population in greatest need of medical care - low-income women and children - will be forced to pay for their own care with dollars they do not have, she said. MS. DAVIDSON pointed out the irony in the legislature's proposal to reduce eligibility when our nation as a whole is expanding services to women and children. She explained that 38 states and the District of Columbia now have Children's Health Insurance Plan (CHIP) coverage available to families whose income is 200 percent or higher than the federal poverty level. Before the CHIP program's inception, only 6 states offered coverage for infants at this income level. She said that states report that more than 75 percent of the children enrolled in CHIP in 2001 were between the ages of 6 and 18. California sets eligibility at 300 percent of the federal poverty level for children under 2 and at 250 percent for children ages 2 to 19. She noted that Minnesota sets the eligibility level at 280 and 275 percent, respectively. New York and Washington have an income eligibility at 250 percent of the federal poverty level. She added that other states that have the poverty level set at 200 percent offer other benefits; New Jersey covers both parents of CHIP-eligible children. Studies indicate that racial and ethnic minority groups are more likely than whites to be uninsured and are less likely to have job-based health insurance. MS. DAVIDSON concluded by pointing out that President Bush's FY- 03 budget makes available $3.2 billion to states in unused CHIP funds that would otherwise return to the federal treasury. Alaska stands to benefit from these underutilized CHIP funds. If Alaska underutilizes CHIP funds by reducing eligibility, Alaska CHIP funds will be redirected to other states. She requested that the Denali KidCare eligibility remain at the 200 percent of federal poverty level. Number 1037 SUE ZAHND, Member, AARP; National Association for the Education of Young Children (NAEYC), read from a written statement as follows: It is important to note that the people most affected by the reduction of Denali KidCare would be those families who provide stability and positive contributions to our community. As often happens, those with little, we care for, and those with much are not in need. It is the parents who don't make much money, who don't have access to group insurance, who do not have large savings accounts, who suffer. They work hard each day, keep this community functioning, furthering their education, striving to provide for their families as best they can. These are the people who end up without the means to care adequately for their family's health care needs. Insurance is either not available for them, does not provide for [preexisting] conditions, or is only available at costs far and above what they can pay. Individual doctor bills are problematic in the weekly budget, and catastrophic illness, prohibitive. They have the dilemma of whether to buy food, pay rent and child care, or go to the doctor. They wait until the need is severe, meaning that a minor illness may become a serious one, and untreated conditions become chronic ones with repercussions for the person in the community. MS. ZAHND continued: These same children attend schools and child care with other children, where they share play, learning, and germs, thus further jeopardizing [the] health of the community. Most importantly, when children aren't well and safe, we risk their positive development that could mean so much to the well-being of our whole community. At the present time we are quite conscious of the need for safety and talk about it in expansive terms. We need to be conscious that communal safety begins with how we protect our children - all of them, not just the very poor and not just the affluent. The contribution of Denali KidCare to the health of children in our community, and thus to the communal safety, has been significant. It is my opinion that families and their children will suffer if it is reduced, and the negative effects on the community will be long-term. Please keep your commitment to children [and] families, and focus as you make this decision and support Denali KidCare fully. Number 1178 FAYE NIETO testified via teleconference. She encouraged members to make a decision with their hearts as well as their heads. She serves parents with children who have developmental disabilities through Parents, Inc. As a nonprofit employer, Parents, Inc. is unable to provide full benefits to its 25-plus employees. Therefore, employees are needing to enroll [in Denali KidCare to offset insurance costs]. These employees are not making competitive wages in the nonprofit sector. She noted the importance of considering employers and working families. This proposed cut is a disincentive to former welfare recipients who are working hard to provide for their families. She noted her confidence that the House Health, Education and Social Services Standing Committee will make the best decision for Alaska's children. Number 1350 JOY LYON, Alaska Association for the Education of Young Children, noted the general agreement that health is critical to a child's learning. Denali KidCare has been successful in promoting children's learning through good health care. She commended members on their efforts to save money; however, this will not save the state money, she noted. She pointed out that reducing the income eligibility for Denali KidCare will result in a reduction of state expenditures only if the families affected by the reduction purchase health insurance for their children. If these families do not purchase insurance, higher costs will result from the greater number of uninsured families unable to pay hospital bills, she said. MS. LYON stated that the 722 pregnant women who [will not receive Denali KidCare coverage under provisions in HB 367] could incur $8,300 to $9,600 for a basic C-section delivery. [If these bills are unpaid] the costs will be transferred to future patients, she offered. Children who do not receive medical care eventually cost the state more through special education and other services. She reiterated that the real question at hand is whether the aforementioned families will obtain private medical insurance. Number 1400 MS. LYON indicated her first impression was that the $44,000 [income threshold for a family of four] sounded like a lot to her, so she conducted some research. She pointed out that the missing [expense] is the cost of child care. All of these families are working families; this means that they have very high child care costs, but are ineligible for child care assistance. To be eligible for assistance at 25 percent of child care costs, a family must be at 185 percent of the poverty level. She expressed her belief that this threshold would be reduced in the summer of 2002. MS. LYON stated that her research indicates that average monthly costs for a family of four are as follows: $424 for food [according to the Alaska Cooperative Extension]; $1,464 for rent, according to the Alaska Housing Finance Corporation; and $1,100 for child care. She concluded that with these expenses, there just isn't enough [money]. She offered her opinion that [Denali KidCare] is a bargain for the state. On behalf of the Alaska Association for the Education of Young Children, she urged members to maintain the eligibility level at the 200- percent-of-poverty level. Number 1482 NANCY KOON testified via teleconference in opposition to HB 367. She is the single mother of four children; her children receive Denali KidCare benefits. She has a 10-year-old daughter in an out-of-state placement. If HB 367 passes, Ms. Koon said her children would be ineligible for coverage, her daughter would be returned home, and she might need to quit her job to care for her daughter. She speculated that this would counter the state's goals. She offered her opinion that children around the state deserve these benefits, and it saves the state money in the long run. Her daughter's health care costs have exceeded $100,000 in the last two years. She would be unable to meet a co-payment of 20 percent; she would need food stamps [to make ends meet]. Ms. Koon explained that her 11-year-old child needs extensive back surgery in Seattle. She noted that she would be unable to pay these "devastating" medical bills on her own. She asked members to reject HB 367. Number 1577 CAREN ROBINSON, Lobbyist for Alaska Women's Lobby, requested members to reconsider the direction of HB 367. She reminded members that Denali KidCare is not a long-term program. Most women enroll in the program when they become pregnant; the coverage lasts for one month after the birth. The children are eligible for one year. She said, "Philosophically, we believe very strongly that we need to do everything in our power to assist pregnant women and children in getting the kinds of medical care that they need." Number 1624 SHAWNEE HART testified via teleconference, stating that she is a single mother of two biological children and one adopted child. She offered that she suspects that her adopted child is emotionally disturbed. One of her biological children has Aspbergers' Syndrome and the other is severely asthmatic. She noted that their medical bills are beyond her ability to pay. She has worked for four years since getting off welfare, she indicated. Her income level disqualifies her for food stamps and housing assistance. If she became ineligible for medical assistance, she stated, she would most likely be forced to quit her job or ask for reduced hours to keep her children covered. She noted her concern for pregnant women who would not qualify for Denali KidCare and would therefore lack necessary prenatal care. She said, "I know that raising a child alone is very hard work. I fear for the families that would ... be forced to separate or divorce in order to ensure that their children can receive medical coverage." She urged members to oppose HB 367. Number 1684 CATHERINE BURGESS testified via teleconference, noting that she is the single mother of four children; she is an Alaska Native and her children do receive IHS care. Denali KidCare serves as her secondary insurance. One of her children will require surgery Outside this year. If this bill passes, she will be unable to pay for insurance, she said. She opposes the passage of HB 367. Number 1730 ELMER LINDSTROM, Deputy Commissioner, Department of Health and Social Services, pointed out that a memo dated February 14 is in the committee packet. Attached to this memo is a matrix that outlines income levels, disposable income, and the out-of-pocket expenses for health insurance costs; these figures do not include child care, rent, and other expenses. He stated that Nancy Cornwell in the Anchorage office could answer any questions pertaining to the matrix. Also attached to the memo is a table showing the number of eligible children [whose family income is] 150 to 200 percent of the federal poverty level, by community. CHAIR DYSON suspended the hearing on HB 367.
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