Legislature(2003 - 2004)
04/24/2003 03:01 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 195-INDIVIDUAL HEALTH CARE INSURANCE Number 0087 CHAIR WILSON announced that the first order of business would be HOUSE BILL NO. 195, "An Act relating to coverage offered under an individual policy of health care insurance; and providing for an effective date." [Before the committee was CSHB 195(L&C).] REPRESENTATIVE NORMAN ROKEBERG, Alaska State Legislature, sponsor of HB 195, explained the purpose of the bill and answered questions from the members. He explained that this bill is actually two bills in one. The first part of the bill provides a mechanism to assist in lowering the costs of an individual health insurance policy. He commented that he believes all legislators recognize the health care crisis and the problem of the increasing costs of providing health care services to the citizens of the state and nation. The percentage of disposable income of most families is decreasing as the cost of health care and insurance premiums are increasing. There are many people who are not insured, estimates indicate that as many as 19 percent of Alaskans may be without health insurance. Number 0196 REPRESENTATIVE ROKEBERG told the committee one of his goals as a legislator is to try to make sure that the legislature does not do anything that would raise the cost of insurance to individuals. One main area of concern that past legislatures have addressed is the issue of mandates which require insurance companies to provide certain services in all types of insurance policies. This has been a large part of the cost driver that raises health insurance premiums. He pointed out that there is not one legislative mandate that has been enacted at the state or federal level that is not a good thing. However, when looking at what those mandates do to the cost of health insurance policies, he believes it is time to look at the creation of an insurance product that deletes those mandates. He summarized that the first part of HB 195 allows the insurance industry to write an individual health insurance policy that excludes those mandates. He referred to the memorandum in the file [Memorandum from Representative Rokeberg to House Health, Education and Social Services Standing Committee dated April 9, 2003] that specifically enumerates those mandates, such as acupuncture, eye care service, substance abuse treatment, mammography coverage, and prostate and cervical cancer screening. Number 0308 REPRESENTATIVE ROKEBERG pointed out there are also three federal mandates which would stay in place because of federal supremacy and thus those three mandates would not be affected by HB 195. Those mandates are coverage of newly born children, postpartum hospital stay coverage, and reconstructive surgery following mastectomies. Number 0391 REPRESENTATIVE ROKEBERG told the committee that the largest underwriter in the State of Alaska, Premier Blue Cross and Blue Shield of Washington and Alaska, support this bill. Blue Cross is the largest provider of health insurance and has more than 53 percent of the entire market in Alaska. He said he made a request to Blue Cross to provide the legislature with numbers specifying the kind of savings that could be realized by passing the bill. Although he has not yet received these figures, he related his hope that the Division of Insurance can provide those figures to the committee. Number 0408 REPRESENTATIVE ROKEBERG explained the second portion of the bill was brought to him by the Division of Insurance. He referred to Sections 2-9 of the bill, which cover the qualifications under the Fair Trade Adjustment Assistance (TAA) Reform Act of 2002. The TAA provides tax credits for up to 65 percent of the amount paid by an eligible individual for qualified health coverage. Therefore, those employees who have been displaced or lost their job because of the importation of commodities from overseas will be eligible for this credit. For example, if oil workers in Alaska lost their jobs because the United States is importing oil from overseas, then those displaced workers would qualify under the provisions of this statute, and therefore qualify to get a 65 percent reimbursement for the cost of their health insurance premiums under the Alaska Comprehensive Health Insurance Association (ACHIA). This bill would amend statute to allow the federal Comprehensive Health Insurance Association (CHIA), the state's insurer of last resort, to be able to write policies at a 65 percent discount for anyone who does not have insurance. REPRESENTATIVE ROKEBERG noted that members should be aware that ACHIA provides for residents under Alaska and federal law in the Health Insurance Portability and Accountability Act (HIPAA). If an Alaskan is turned down by an insurance company that individual can apply for insurance and be covered. The premiums are 150 percent of the market costs of similar health insurance. He explained that this program allows individuals to enroll in ACHIA and have a significant reduction in health insurance premiums. Even if an individual has existing insurance, for example, if the spouse has an insurance policy to which he/she has to contribute, he/she can still qualify under the TAA provisions for a federal discount. Number 0588 REPRESENTATIVE ROKEBERG summarized by saying HB 195 is a great piece of legislation in the sense that it is experimental. By saying the insurance industry does not have to underwrite policies with these mandates, thereby lowering the costs in the hope that people will be able to buy a policy that insurance companies might not otherwise be able to write is a risk. Secondly, this bill would allow unemployed individuals and other eligible individuals to obtain health insurance at substantially reduced rates because of the federal subsidies. Number 0664 CHAIR WILSON commented that affordable health care is a very important issue and she feels it is essential for the members to understand exactly what has transpired during the [committee] process because this version of the bill is very different from the original version. REPRESENTATIVE ROKEBERG confirmed that HB 195 is a completely different bill and should not to be confused with HB 10 which he and Representative Heinze introduced. Number 0683 REPRESENTATIVE SEATON turned to page 2, line 6, where the premium was reduced from 200 percent to 150 percent of the standard risk premium rate. Since there is no change in the fiscal note, he asked for clarification on this point. Number 0744 REPRESENTATIVE ROKEBERG replied that this is the premium for the ACHIA plan for which the premiums are paid by the individuals; therefore, it would not have any effect on state finances. Number 0761 REPRESENTATIVE CISSNA recalled that the ACHIA plan premium was 200 percent of the prevailing rates. Does this bill lower that amount, she asked. Number 0796 KATIE CAMPBELL, Life and Health Actuary, Division of Insurance, Department of Community and Economic Development, testified in support of HB 195 and explained that 150 percent is a requirement under the TAA. Under the TAA, the maximum an individual can be charged is 150 percent of what someone would pay out in the market. Number 0855 MS. CAMPBELL commented that the rates under the high risk pool for a number of years is at a maximum amount of 200 percent. The board of directors for the high-risk pool have experience across the states regarding what increasing that premium actually does to enrollment in the high-risk pools. [The board of directors] determined that once [the premium] is past 150 percent, the pool loses some of the healthier high-risk people. Therefore, the rate was set at 150 percent and there is no practical effect on the plan. REPRESENTATIVE ROKEBERG clarified that what Ms. Campbell's testimony means is that by making these statutory changes the state is reducing the 200 percent cap to 150 percent for all of ACHIA. This reflects the current practice. Representative Rokeberg reiterated that premiums are paid into ACHIA by individuals, but the difference between the premium income and the costs of the plan is paid for through a special assessment on all the insurance companies that do business in the state. Last year [that special assessment] amounted to a $2 million subsidy through the ACHIA program for high-risk individuals. Number 0937 REPRESENTATIVE CISSNA asked if Representative Rokeberg could help her understand provisions of the bill starting on page 1, line 8, where it says "a health care insurer may offer a health care insurance plan issued in the individual market that does not include the health insurance coverage required" and then it lists a number of statutes. Then on line 12 it says, "the coverage may be offered as optional coverage." She asked Representative Rokeberg if the language here means that the current statutory required services could be included in a policy if the insurance provider offered those provisions. Number 1014 REPRESENTATIVE ROKEBERG replied that is correct. He highlighted that one of the great things about this bill is, it allows individuals to pick from a menu of items, but takes the absolute mandate out of the coverage. The policies could be restructured under this law and would allow for that optional coverage. For example, if an individual wanted to include prostate and cervical cancer screening provisions in the policy, the individual could buy that coverage. Number 1077 CHAIR WILSON surmised that this is essentially allowing insurance companies to give people who are perfectly healthy inexpensive insurance coverage. However, if an individual has diabetes or some other chronic condition, those individuals would pay very high rates. REPRESENTATIVE ROKEBERG responded that the insurance companies do not cause the cost of high insurance rates; it is the providers who cause that. CHAIR WILSON related her belief that this bill is really not accomplishing as much as it might appear. This bill allows insurance companies to charge high rates if an individual wants to be covered for a chronic disease like diabetes. By allowing the insurance companies to opt out of all of the mandated health care services it will mean higher premiums for individuals who have medical problems. Number 1139 REPRESENTATIVE ROKEBERG clarified that this legislation is intended as a supplement to policies already offered, and provides a way for insurance companies to develop a different kind of product. This kind of policy would only be available to individuals, not to group plans. There are approximately 10,000 policies covering 14,000 individual plans in the state right now. He pointed out that most people are involved in some type of health plan and this would not be allowable for those plans. Representative Rokeberg said he believes Ms. Campbell would tell the committee that these policies would be somewhat cheaper to underwrite if this bill becomes law because insurance companies can put options in and out, and do some special underwriting. Typically, an individual policy would be cheaper than a group policy because group policies have to have a guarantee issue where no one can be turned down. Number 1186 REPRESENTATIVE ROKEBERG opined that many group plans have a contribution from the employer to help offset the dollar cost within the family's monthly budget. If an individual works for a company that offers health insurance, the company will pay a portion of the cost of the group plan. When an individual is out in the market that individual has to pay 100 percent of the premium, and therefore, he only focused on this issue. He said he does not want to override the entire policy articulated by previous legislatures in getting rid of mandates. This bill is simply an effort to target a small [group] with the highest costs because there is no company reimbursement to induce these individuals to buy health insurance coverage. For the consumer, the question is whether an individual can or cannot afford to purchase a health insurance policy. This would be an alternate product that would be potentially cheaper. Number 1262 CHAIR WILSON reiterated that this bill addresses policies for individuals who do not get health insurance through the work place. How many insurance companies in Alaska offer individual policies, she asked. Number 1286 REPRESENTATIVE ROKEBERG replied that he believes of the 150 underwriters registered, six underwriters offer individual policies. MS. CAMPBELL indicated her agreement with Representative Rokeberg's estimate. CHAIR WILSON asked if these policies would be offered in a cafeteria-style method. Number 1333 REPRESENTATIVE ROKEBERG replied no, and explained that individual policies are usually offered as a take it or leave it policy. The cafeteria method is only offered in the group plans. Representative Rokeberg clarified that if this bill passes, there would be flexibility in the kind of policies offered to individuals. CHAIR WILSON said that typically when coverage for mandated services is included in all policies, the high cost of insurance for those individuals that are sick is spread across all policyholders. However, under this bill healthy individuals will opt out of many of the formerly mandated services and those who are sick and need the coverage will pay extremely high premiums. She expressed concerned with the high costs that will result for chronically ill persons. REPRESENTATIVE ROKEBERG said that he does not know if cost shifting will happen. He related his hope that if this bill passes, it will serve as an inducement for individuals to buy health insurance even if all they get is major medical for hospital coverage. He said he believes it is a good social policy. Representative Rokeberg turned to Chair Wilson's concern that if everyone is not contributing to the pool that is covered by these mandates, the insurance premiums will be adjusted to compensate for the lack of contribution to the pool. He deferred to Ms. Campbell on this question. Number 1437 MS. CAMPBELL agreed that generally that would be true if the only people who selected an option were the people who were at risk for a chronic disease. On the other hand, she told the committee that in the individual market an insurance company will not sell an individual with a health condition a policy in the first place. Therefore, the condition would have to be something that occurred later on. If an individual were diabetic, the insurance company would not issue the policy. Those individuals would go into the high-risk pool. Diabetics are automatically eligible for high-risk coverage. Insurance companies will design a product in the individual market that may or may not cover some of the mandates. She agreed with Representative Rokeberg's opinion regarding the notion that a basic plan might be offered and the individual is also able to select some riders for an additional fee. This bill will give the companies the option to do the aforementioned. Number 1483 CHAIR WILSON said currently insurance companies would not offer a diabetic individual a policy anyway so that person would automatically be placed in a high-risk pool and pay a high premium. Number 1522 MS. CAMPBELL pointed out that individuals in the high-risk pool are guaranteed coverage regardless of what an individual's health condition may be. CHAIR WILSON commented that those individual's will have very high insurance premiums. MS. CAMPBELL specified that the premium will be approximately 150 percent of the standard rate. REPRESENTATIVE ROKEBERG said he believes the highest rate right now is $795.00. MS. CAMPBELL responded that she has some sample premiums for a $1,000 deductible. If an individual is 35 years of age, the premium is $486 per month. The plans go up to $10,000 deductible plans. Number 1545 CHAIR WILSON posed a hypothetical situation in which an individual buys a policy that does not include diabetes in the plan because at the time the individual was not diabetic. However, some time later the individual becomes diabetic. If this bill passes, will the individual be covered or will the person lose the health insurance policy because they have developed diabetes. Number 1561 MS. CAMPBELL replied that as long as the individual pays the premium the policy is guaranteed renewable. That guarantee specifying that an insurance company cannot terminate an individual's policy is actually found in federal and state law. CHAIR WILSON surmised then that individual would be covered. REPRESENTATIVE SEATON asked for clarification on that point. He related his understanding that while an individual may still have insurance, he/she will not be covered for anything related to diabetes because the selected plan did not cover diabetes. REPRESENTATIVE ROKEBERG explained that the plan would cover the individual, but the individual would have to pay out of pocket to cover the cost of diabetes treatment. MS. CAMPBELL said the mandate on diabetes is for education and training. It is not actually the prescriptions or medications that we are talking about in the mandate. The mandate covered a $1,500 limit in education and training for an individual to learn how to treat themselves. REPRESENTATIVE ROKEBERG emphasized that the mandate was only for the education and training portion of diabetes treatment and not the disease of diabetes per se. Number 1621 REPRESENTATIVE SEATON asked if an insurance policy could be offered that does not include treatment for a specific disease. MS. CAMPBELL responded that insurance companies can offer that kind of a policy right now, but they do not. If, for instance, an individual had cancer and applied for a policy, the insurance company would simply not cover that individual. REPRESENTATIVE SEATON asked again for clarification that insurance companies could write a policy that does not cover certain diseases. MS. CAMPBELL responded that is correct and noted that insurance companies certainly offer rider policies. For example, if an otherwise healthy individual has a known condition right now, but, the insurance company may place a rider on the policy that says it will not cover any of the costs associated with that particular condition. So the insurance policy will cover the individual for everything except what is on the rider. Number 1682 REPRESENTATIVE CISSNA told the committee she likes this legislation because it is a great idea and opens the discussion in addressing a serious problem. Estimates say there are between [100,000 to 120,000] individuals without insurance and a huge number of those people are working Alaskans. She asked if the above uninsured estimate is correct. REPRESENTATIVE ROKEBERG replied that no one really knows. REPRESENTATIVE CISSNA commented that although HB 10 will cover a certain number of those people, it certainly will not cover a huge amount because people need to be able to afford the premiums. The problem for people who earn about $12 per hour is that they are not going to be able to afford $400 monthly premiums, which is the cost of less expensive insurance. She said this bill is an effort to get a larger number of people insured. Although this legislation is not enough, it will do more. She said this is a good debate and noted her appreciation that the committee is looking at this problem. Number 1784 REPRESENTATIVE ROKEBERG told the committee he has been on this quest for about eight years to reduce the number of uninsured individuals in Alaska. He mentioned that he has been working with Bob Labbe [Deputy Commissioner, Office of the Commissioner, Department of Health and Social Services] and the insurance industry. One phenomena that Alaska has is the Indian Health Service (IHS) and those people are eligible for health care through that organization. He said he believes the number of uninsured individuals in Alaska is overstated because of the IHS, but the state does not have the tools to do the statistics. Representative Rokeberg said he worked with the Division of Insurance a few years ago to pass a bill to start counting covered individuals through annual insurance reports. Another problem in the state is that there are a lot of self-insured large corporations or groups. These individuals would not be in the statistical mix and the state does not have the data to pull that into the mix. There has been an effort to accumulate those numbers more accurately. The idea behind this bill is to get uninsured people insured, even if just partially insured. Number 1859 REPRESENTATIVE ROKEBERG explained the so-called "Phantom Health Tax" occurs when health provider systems step up and provide health services that are not reimbursable. When the aforementioned happens, all other service charges increase because the portion of charitable contributions from institutions such as hospitals, emergency rooms, and other health care providers that have provided the services need to [recover] these expenses. Other problems like the short paying for five years of Medicare and Medicaid costs is another part of that tax. Number 1875 CHAIR WILSON said that what is actually happening in Alaska is that people who work for businesses or government have their health care taken care of because the employer provides most of the costs. The people who are on welfare and do not work have their health care paid for through Medicare or Medicaid. But the working people who are really struggling to make ends meet have no way to get insurance because they cannot afford the premiums. These are the people who are falling through the cracks. This bill will actually provide at least basic insurance to help them. It is not great, but it is better than nothing, she said. REPRESENTATIVE ROKEBERG asked if Ms. Campbell can provide information about any savings that will be made by passing this bill. MS. CAMPBELL responded that she contacted Premier Blue Cross and Blue Shield of Washington and Alaska and asked for some estimates, but they have not provided them yet. REPRESENTATIVE ROKEBERG commented that even if it is $30 per month, it is something. Number 1926 CHAIR WILSON asked Representative Rokeberg to explain the cost savings to which he is referring. Are the cost savings the difference between what the insurance companies offer now and what they would offer if this bill becomes law. When do you anticipate that information would be available, she asked. REPRESENTATIVE ROKEBERG responded that is correct. He said he thought he would have the information by now and will try to get the information soon. Representative Rokeberg told the committee he knows there will be a savings, but the question is how much. There could be a savings of $35 per month for the substance abuse provision, for example. Number 1964 REPRESENTATIVE GATTO offered his understanding that Representative Rokeberg has an [real estate] business, and he surmised that Representative Rokeberg probably has some objections when the state makes decisions regarding how he does business. Representative Gatto made the analogy of a realtor being required to take on certain real estate transactions because it is good for people. Not everyone can afford a house, not everyone can afford a lot, and not everyone can afford a trailer. He asked Representative Rokeberg if this had been a decision based on owning a house, would he still be advocating for people that do not have access to a house. REPRESENTATIVE ROKEBERG replied that he would like to see affordable housing by lowering interest rates through Alaska Housing (Alaska Housing Finance Corporation). However, he said he is not completely clear on the analogy Representative Gatto is trying to draw. This bill provides that insurance companies do not have to do something the state has told them to do, and it also provides "may" language for options for riders. Number 2025 REPRESENTATIVE GATTO asked him who does not have to do what the state has told them to do. REPRESENTATIVE ROKEBERG responded that the underwriter or insurance company is required to offer these mandates now. If this legislation passes, the insurance companies will not have to offer these mandates. REPRESENTATIVE GATTO commented that what this bill would do, in part, is promote free enterprise. This bill would make it easier for the companies to offer a variety of options. How and why did the legislature get in this situation in which there are some restrictions on companies that the legislature is now trying to remove. What was the motivator that got us into this difficult situation in the first place, he asked. Representative Gatto commented that maybe there is something to keep in place here, but he does not know what it is. Number 2047 REPRESENTATIVE ROKEBERG responded that he does not want to offend anyone, but the legislature decided to require insurance companies to cover particular items because the legislature thought it was the best public policy. He said that each one of the mandated services on its merits is an undeniable benefit, but the point is that the cumulative effect really starts impacting the economics of the underwriter and the ability of individuals to buy insurance. This bill provides that there will be less government control by eliminating these mandates. Representative Rokeberg clarified that these mandates were government interference with the insurance product and he said he is trying to take that away and provide a cost savings to individuals. Number 2089 REPRESENTATIVE GATTO asked Ms. Campbell what she sees as the negative effects of the bill. MS. CAMPBELL replied that this bill simply provides an option for individuals. She pointed out that all of the mandates are not mandates for coverage of an illness; some are mandates for preventative type treatments. These are lower cost items. For example, an annual exam might cost $200 while hospitalization could cost $30,000. She said the mandates are for predictable items, with the exception of fetal phenylketonuria [PKU is a genetic disorder which prevents the normal use of protein food. The condition can be treated with a high degree of success if diagnosed shortly after birth]. Number 2150 REPRESENTATIVE SEATON told the committee he believes the mandated items were designed so that cheaper coverage can be offered to everyone. For example, if all men opt out of mammograms, the people who select coverage for mammograms are going to pay more because that cost is not shared by everyone. He said he is not commenting negatively. He said the services are small in cost with the exception of substance abuse treatment. Representative Seaton turned to diabetes treatment, which he understood Ms. Campbell to say is not really treatment. Number 2202 MS. CAMPBELL explained that the mandate covers the treatment of diabetes, but at the time the mandate was put in place every insurance company already covered insulin under the prescription drug plans. Insulin was never something that was excluded so from a practical standpoint what it added was the education and training piece of the treatment of diabetes. REPRESENTATIVE SEATON responded that he believes it is important to allow individuals to shop around, but he does not think the members should kid themselves that when an individual selects an option, it is going to make that selection more expensive because the cost is not being shared by everyone. The insurance company writes 3,000 individual policies all of which have the same items offered, but only 10 percent of the people actually have a particular procedure done. Therefore, the amount insurance companies are going to charge each one of those policyholders will be small. In the case where only people who will actually avail themselves of that service will select a particular option, the charge is going to be higher. Representative Seaton said that when the cost breakdown comes from Premier Blue Cross and Blue Shield of Washington and Alaska it will be interesting to see if the individual coverage and the base premiums are more than the current policy or whether they are equivalent. It comes down to cost shifting. He said he thinks the bill is good and he supports it, especially the Trade Adjustment Assistance (TAA) portion. Number 2257 REPRESENTATIVE CISSNA related her belief that in the perfect world, individuals would get these mandates. She said she sees value in having all these preventative services. If these health problems are caught early, the costs are small and the huge costs that put individuals into the ACHIA program can be avoided. Unfortunately, the problem is that insurance companies are leaving the state. The state is losing the ability to have private companies insure. She said she does not believe Alaska is ready for universal health care. As long as this is the case the legislature has to take care of Alaskans in every way it can. This may do it, she said. Number 2310 CHAIR WILSON posed a situation in which this bill passes and works well and saves money. She asked if the state would take note of the savings and look at providing exemptions in its group health care plan because it might be a lot cheaper. REPRESENTATIVE ROKEBERG responded that he does not think that would happen because this bill addresses the individual market, whereas the state insurance is a group plan. However, the state plan is a much smaller plan because Governor Knowles allowed the bargaining units to take their own groups out, which broke up the state's huge pool. Still, the state plan is a larger group. The costs savings [offered by this bill] are not going to be great, but it will be something. He told the committee the State of Washington is famous for doing a lot of experimental health insurance plans and it currently has a similar bill which is making its way through the State of Washington's legislature. Number 2361 REPRESENTATIVE CISSNA commented that it would be interesting to hear from individuals in the room who have their own individual policies regarding their feelings on cost shifting if there are no mandates. TAPE 03-36, SIDE B REPRESENTATIVE ROKEBERG closed his testimony by saying he hopes the committee will pass this bill. REPRESENTATIVE SEATON asked Chair Wilson if she is ready to move the bill. CHAIR WILSON responded that she would like to hold it until the committee has some facts, knows what the cost savings will be, and if it will make a difference. Number 2314 REPRESENTATIVE SEATON responded that what Chair Wilson said about part of the bill is correct, but the portion that deals with TAA eligibility is a huge savings for some individuals. He said many in the state such as those in the salmon industry, oil industry, and timber industry, have been impacted by international trade. There would be a 67 [65] percent savings on insurance if an individual is in that pool. Representative Seaton asked that the committee not hold this bill too long. CHAIR WILSON asked Ms. Campbell to explain the TAA portion of the bill. Number 2271 MS. CAMPBELL told the committee that a federal law that passed the U.S. Congress last year will be effective on August 1, 2003. The law provides for a monthly premium tax credit of 65 percent of the premiums for individuals who are eligible under the Act. She said timber, fishing, and oil industry workers who lose their jobs become eligible under that Act. If they apply for coverage through the high-risk pool in Alaska and are eligible, 65 percent of their premiums will be paid through the U.S. Department of Treasury or the IRS [Internal Revenue Service]. CHAIR WILSON inquired if everyone in those professions are included. MS. CAMPBELL responded that everyone in those professions who lose their job and meet the eligibility requirements would be included. Number 2230 CHAIR WILSON asked about fishermen who are still out there trying to fish. They have not lost their jobs, but are struggling. REPRESENTATIVES SEATON commented that a lot of fishermen are not fishing because of the economics; those are the people that would be impacted under this program. This would allow them to keep insurance. Even if they get an interim job, they will still qualify for this coverage and it will allow them to maintain their health insurance instead of dropping it. Number 2187 CHAIR WILSON asked how long these individuals would be qualified and still get this insurance. For instance, if they took another job how long could they continue coverage before they would lose this benefit. MS. CAMPBELL responded that these individuals are qualified for two years under the program. The Alaska Department of Labor [DOL] has a Trade Assistance Section that deals with this Act. They estimated that last year there would only be about 200 people in 2002, but over 1,500 people were approved in the last two months. That is a lot of people that would qualify for assistance under that Act. CHAIR WILSON questioned why this provision is in this bill. If it is federal law, why is it not automatically available to individuals. MS. CAMPBELL responded that there are four ways an individual can qualify for this credit, the state has to elect to use this one, while the other three are automatic. If you have COBRA coverage and an individual was laid off, it would pay the COBRA at the 65 percent rate. If an individual is covered on their spouse's plan, but the spouse's employer pays less than 50 percent of the individual's premium or if an individual already had an individual health insurance policy when the individual was employed, then, in all of these cases, the individual would receive credit for those coverage. She told the committee different states have different options. Alaska has a high-risk pool for everyone else who does not meet those three categories. In response to Chair Wilson, she said an individual does not have to be categorized as high risk to be included in the high- risk pool. Number 2086 CHAIR WILSON called a brief at ease at 4:02 p.m. The meeting reconvened at 4:05 p.m. Number 2077 REPRESENTATIVE WOLF moved to report CSHB 195(L&C) out of committee with individual recommendations, the accompanying fiscal notes, and the caveat that the sponsor provide answers requested by the committee. REPRESENTATIVE CISSNA objected to the motion. She told the committee that she served on the House Labor and Commerce Standing Committee under the chairmanship of Representative Rokeberg in 1999. One of the things that she discovered is that numerous pieces of legislation come before this body and it is like proofing a text. One member may not see problems with it, but others find many problems. She said the reason she was excited about seeing this legislation is the possibility of having the members really look at [the bill], tear it apart, and really find out what the general public thinks about it. That has not happened. She said she believes there are some reactions to this bill that the committee is not hearing. This committee should be looking at this issue, and therefore she believes it is wrong to pass this bill. Number 1980 REPRESENTATIVE SEATON said he believes this bill will do a lot of good. It offers another option and does not eliminate the current mandates. This is something an individual would have to select if the reductions in premiums were significant enough to stimulate them to do that. Representative Seaton told the committee he does not see a problem with the option being offered. Number 1907 A roll call vote was taken. Representatives Wilson, Seaton, and Wolf voted in favor of CSHB 195(L&C). Representative Cissna voted against it. Therefore, CSHB 195(L&C) failed by a vote of 3-1. [The committee took up HB 195 again later in the meeting.] HB 195-STATE HEALTH INSURANCE PLAN CHAIR WILSON returned attention to HOUSE BILL NO. 195, "An Act relating to coverage offered under an individual policy of health care insurance; and providing for an effective date." CHAIR WILSON said she would entertain a motion on CSHB 195(L&C). Number 0579 REPRESENTATIVE WOLF made a motion to rescind the committee's action in failing to move CSHB 195(L&C) from committee. Number 0624 REPRESENTATIVE CISSNA objected to the motion. She said she believes the bill needs more work before being moved from committee. A roll call vote was taken. Representatives Wilson, Coghill, Seaton, and Wolf voted in favor of the motion to rescind the committee's previous action failing to move CSHB 195(L&C) from committee. Representative Cissna voted against it. Therefore, the motion to rescind the previous action by the House Health, Education and Social Services Standing Committee passed by a vote of 4-1. Number 0702 REPRESENTATIVE SEATON moved to report CSHB 195(L&C) out of committee with individual recommendations and the accompanying fiscal, with the caveat that the sponsor provide answers requested by the committee. REPRESENTATIVE CISSNA objected. She reiterated her belief that the committee should continue to work on the bill. A roll call vote was taken. Representatives Wilson, Seaton, Wolf, and Coghill voted in favor of reporting CSHB 195(L&C) from committee. Representative Cissna voted against it. Therefore, CSHB 195 (L&C) was reported out of the House Health, Education and Social Services Standing Committee by a vote of 4-1.
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