02/21/2002 03:04 PM House HES

HB 367-MEDICAL ASSISTANCE PROGRAM COVERAGE                                                                                    
                                                                                                                                
CHAIR DYSON announced that the  committee would take testimony on                                                               
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."                                                                                               
                                                                                                                                
[Although the  hearing on HB  367 had been  officially postponed,                                                               
Chair  Dyson accommodated  the following  out-of-town witness  by                                                               
allowing him to testify.]                                                                                                       
                                                                                                                                
Number 0754                                                                                                                     
                                                                                                                                
CHRIS  DEVLIN,  Executive   Director,  Eastern  Aleutian  Tribes,                                                               
thanked Chair  Dyson for the  opportunity to testify.   He stated                                                               
that  HB 367's  provision to  lower  the poverty  level from  200                                                               
percent to 150  percent is a mistake.  He  characterized the 200-                                                               
percent  level as  a  safety boat;  the  150-percent level  would                                                               
throw people overboard.   This causes problems  beyond the people                                                               
directly  affected; he  explained  that a  ripple effect  occurs.                                                               
Eastern Aleutian  Tribes is the first  tribal health organization                                                               
in the  state to apply for  community health center funding.   He                                                               
referenced  health centers  in Fairbanks  and  Anchorage.   These                                                               
community  health centers  operate very  close to  the break-even                                                               
point;  they need  the Medicaid  funding to  continue to  provide                                                               
service to those who "fall outside the boat," he said.                                                                          
                                                                                                                                
MR.  DEVLIN  encouraged  members   to  involve  community  health                                                               
centers in the  discussion of the bill, which will  have a direct                                                               
impact on  the centers' ability  to provide  care.  He  said, "If                                                               
you wanted  to work  on some  creative measures  to try  to bring                                                               
some revenue  in, maybe  the place to  consider would  be between                                                               
the 200  and the  250 or  the 200  and the  300 percent.   That's                                                               
where some other states have set  their target."  He offered that                                                               
people with  incomes of $35,000  to $40,000 are unable  to afford                                                               
$1,000 a month for health insurance.   He advised, "We have to be                                                               
very  careful when  we start  lowering that  safety net  that was                                                               
provided, because ... they're going  to end up costing the system                                                               
more in the long run."                                                                                                          
                                                                                                                                
Number 0854                                                                                                                     
                                                                                                                                
CHAIR DYSON asked Mr. Devlin about his other work experience.                                                                   
                                                                                                                                
MR. DEVLIN said  he had worked in Barrow and  Bethel, but this is                                                               
his first job as the boss.                                                                                                      
                                                                                                                                
CHAIR DYSON asked about a pattern of children's health problems.                                                                
                                                                                                                                
MR. DEVLIN  replied that care  for children is the  logical place                                                               
to invest  funds; keeping  children healthy will  pay off  in the                                                               
future.   Currently,  oral  health care  is a  big  concern.   He                                                               
stated  that the  children in  the Aleutians  region are  "loaded                                                               
with  cavities."   Denali KidCare  has  allowed Eastern  Aleutian                                                               
Tribes to send more people in  for dental treatment.  He said the                                                               
health  issues with  children  are significant.    He noted  that                                                               
lower-middle-class and working  poor people are not  going to pay                                                               
for  preventive health  care; they  will wait  until the  problem                                                               
becomes serious.   He indicated  Denali KidCare's passage  made a                                                               
big change  in getting more children  in for care.   He suggested                                                               
finding  of a  different way  to save  the little  that would  be                                                               
saved by lowering  the eligibility percentage.  It  will cost the                                                               
state more in the long run, he concluded.                                                                                       
                                                                                                                                
CHAIR DYSON inquired where children are sent for dental care.                                                                   
                                                                                                                                
MR.  DEVLIN  replied that  they  are  sent  to Anchorage  with  a                                                               
thousand-dollar  airfare  bill.    He said  the  Aleutian  region                                                               
probably has  some of  the highest airfares.   In  some instances                                                               
when preventative care  is not given, the  health problem results                                                               
in a Medivac,  he reported.  Adults in his  region have been sent                                                               
recently via  Medivac for dental  purposes, which he  pointed out                                                               
is extremely expensive.  [End of testimony on HB 367.]