Legislature(2013 - 2014)CAPITOL 106

04/02/2013 03:00 PM House HEALTH & SOCIAL SERVICES


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03:05:13 PM Start
03:06:13 PM HJR14
03:46:16 PM HB54
04:04:27 PM Alaska Children's Services
04:37:55 PM HB134
05:06:09 PM Adjourn
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ Presentation: Alaska's Children's Services TELECONFERENCED
*+ HJR 14 DELAY IMPLEMENTING AFFORDABLE CARE ACT TELECONFERENCED
Moved CSHJR 14(HSS) Out of Committee
+= HB 54 PLACEMENT OF A CHILD IN NEED OF AID TELECONFERENCED
Moved CSSSHB 54(HSS) Out of Committee
+ Bills Previously Heard/Scheduled TELECONFERENCED
+= HB 134 MEDICAID PAYMENT FOR MEDISET PRESCRIPTION TELECONFERENCED
Heard & Held
         HJR 14-DELAY IMPLEMENTING AFFORDABLE CARE ACT                                                                      
                                                                                                                                
3:06:13 PM                                                                                                                    
                                                                                                                                
CHAIR HIGGINS  announced that the  first order of  business would                                                               
be HOUSE  JOINT RESOLUTION NO.  14, Requesting the  United States                                                               
Congress  and the  Governor to  take actions  necessary to  delay                                                               
implementation  of the  Patient  Protection  and Affordable  Care                                                               
Act.                                                                                                                            
                                                                                                                                
REPRESENTATIVE  BILL STOLTZE,  Alaska  State Legislature,  stated                                                               
that  he had  drafted  this  resolution out  of  concern for  the                                                               
implementation  of the  Patient  Protection  and Affordable  Care                                                               
Act, and  offered his belief that  this act was not  well vetted.                                                               
He suggested that the Supreme Court  had identified the act as "a                                                               
massive tax  increase."  He said  that the crux of  this proposed                                                               
resolution  was  to seek  delay  for  the implementation  of  the                                                               
Patient Protection and  Affordable Care Act.  He  stated that his                                                               
goal was  not to  oppose it, but  delay its  implementation until                                                               
Congress had examined  all the employer costs and  impacts on the                                                               
private sector.   He declared that he had  contacted the National                                                               
Federation of Independent Business (NFIB),  which he deemed to be                                                               
an advocacy group  for "watching and protecting  the interests of                                                               
the mom and  pops in small businesses" which "make  up the fabric                                                               
of  our economy."   He  pointed  out that  the act  did not  take                                                               
effect until  2014.  He  questioned how  many jobs would  be lost                                                               
with the  act.   He offered his  belief that this  act was  a tax                                                               
policy,  declaring that  "taxes  affect behavior."   He  surmised                                                               
that  the application  of  the act  would  affect employment  and                                                               
business.   He  opined  that  this was  one  of  the largest  tax                                                               
increases in U.S. history.                                                                                                      
                                                                                                                                
3:11:41 PM                                                                                                                    
                                                                                                                                
The committee took a brief at-ease.                                                                                             
                                                                                                                                
3:12:19 PM                                                                                                                    
                                                                                                                                
CHAIR HIGGINS  brought the  committee back  to order,  and opened                                                               
public testimony.                                                                                                               
                                                                                                                                
3:12:38 PM                                                                                                                    
                                                                                                                                
MARK REGAN  said that the  State of Alaska,  by not setting  up a                                                               
health exchange  and not actively regulating  health insurance in                                                               
Alaska,  had created  a  position whereby  there  was little  the                                                               
state  could do  to stop  the Patient  Protection and  Affordable                                                               
Care Act  from going  into effect.   [indisc.] He  suggested that                                                               
the   business   community  was   not   as   nervous  about   the                                                               
implementation of the act, as it  had been earlier.  He expressed                                                               
his hope  that the  committee would  delay consideration  of this                                                               
resolution until it had heard more balanced information.                                                                        
                                                                                                                                
3:14:21 PM                                                                                                                    
                                                                                                                                
KEN HELANDER,  Associate Director  for Advocacy, AARP,  said that                                                               
he was speaking  on behalf of the 95,000 AARP  members in Alaska,                                                               
and  that  AARP strongly  objected  to  HJR  14  and a  delay  to                                                               
implementation  of the  Patient  Protection  and Affordable  Care                                                               
Act.  He stated that HJR  14 did little to advance any meaningful                                                               
purpose, pointing  out that the  act had been  repeatedly upheld.                                                               
He  suggested  that  the  legislature should  look  for  ways  to                                                               
improve the opportunity for all  Alaskans, instead of looking for                                                               
ways to  stand in the  way.  He  declared that the  act presented                                                               
many opportunities  for growth and  economic stimulus  in Alaska.                                                               
He referenced  the Northern Economic  study which  concluded that                                                               
the Medicaid  expansion would  add an  additional $15  in federal                                                               
funds for  every state dollar,  would generate 4,000 new  jobs by                                                               
2017, and  would generate a  cumulative economic  benefit between                                                               
2014 and  2019 of $2.3 billion.   [indisc.]  He  pointed out that                                                               
Alaska  had  opted  not  to   create  its  own  health  insurance                                                               
exchange, which  would bring federal involvement  for a federally                                                               
facilitated exchange.   He emphasized that  implementation of the                                                               
act  in Alaska  would allow  all Alaskans  access to  affordable,                                                               
comprehensive health care coverage.   He declared that AARP would                                                               
act  collaboratively   with  policy  makers  to   ensure  that  a                                                               
successful  marketplace  would   be  established,  providing  all                                                               
Alaskans with health care coverage.                                                                                             
                                                                                                                                
3:17:54 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE NAGEAK asked  for the written comments  to be sent                                                               
to the committee.                                                                                                               
                                                                                                                                
3:18:39 PM                                                                                                                    
                                                                                                                                
PEGGYANN  MCCONNOCHIE,   Owner,  Cycle  Alaska,  said   that  her                                                               
company, Cycle Alaska, employed  "just under the amount necessary                                                               
for mandated health  care."  She said that her  company wanted to                                                               
grow.   She declared support for  proposed HJR 14.   She reviewed                                                               
that  the annual  [health care]  premium for  the average  family                                                               
would increase  by $2100, while  the IRS estimated that  a family                                                               
insurance plan in  2013 would be $20,000.  She  declared that her                                                               
insurance cost had just increased  by 13 percent.  She referenced                                                               
a  report   by  the  Congressional  Budget   Office  (CBO)  which                                                               
estimated  that  7  million  people  would  lose  employer  based                                                               
coverage, and she opined that  this was due to employer penalties                                                               
for lack  of employee  insurance.   She suggested  that employers                                                               
would recommend  for employees to purchase  insurance through the                                                               
various  health  exchanges.   She  reported  that other  business                                                               
owners were not hiring, were  dividing their companies into units                                                               
of  fewer than  50 employees,  or were  reducing hours  from full                                                               
time  employment  in order  to  avoid  this requirement.    Again                                                               
referencing  the CBO,  she  declared there  were  1 trillion  new                                                               
taxes under the Patient Protection  and Affordable Care Act.  She                                                               
declared that  she did not  "need or want  any more taxes."   She                                                               
offered an anecdote about her  pre-existing health condition, and                                                               
stated that she had always had  health care.  She opined that the                                                               
act would increase  her health care costs, and  would remove some                                                               
of her current choices.  She urged support for HJR 14.                                                                          
                                                                                                                                
3:21:30 PM                                                                                                                    
                                                                                                                                
CHAIR HIGGINS closed public testimony.                                                                                          
                                                                                                                                
3:21:47 PM                                                                                                                    
                                                                                                                                
The committee took a brief at-ease.                                                                                             
                                                                                                                                
3:22:35 PM                                                                                                                    
                                                                                                                                
CHAIR HIGGINS brought the committee back to order.                                                                              
                                                                                                                                
[CHAIR HIGGINS passed the gavel to Vice Chair Keller.]                                                                          
                                                                                                                                
CHAIR HIGGINS brought attention  to proposed Amendment 1, labeled                                                               
28-LS0187\U.1, Bailey, 4/1/13, which read:                                                                                      
                                                                                                                                
     Page 1, line 1:                                                                                                            
          Delete "and the Governor"                                                                                             
          Insert ", the Governor, and the state's                                                                               
     congressional delegation"                                                                                                  
                                                                                                                                
     Page 5, following line 12:                                                                                                 
     Insert new material to read:                                                                                               
          "FURTHER   RESOLVED   that    the   Alaska   State                                                                  
     Legislature   calls   on  the   state's   Congressional                                                                    
     delegation to introduce, sponsor,  support, and vote to                                                                    
     pass legislation  in both houses  of the  United States                                                                    
     Congress  that will  delay  the  implementation of  the                                                                    
     Patient  Protection and  Affordable  Care  Act until  a                                                                    
     full  analysis of  the economic  effect of  the Act  on                                                                    
     Alaskans and  Alaska can be clearly  quantified; and be                                                                    
     it"                                                                                                                        
                                                                                                                                
CHAIR  HIGGINS  explained  that   the  proposed  amendment  added                                                               
another whereas  which would also  urge the  Alaska congressional                                                               
delegation  in   Washington,  D.C.   to  take  action   to  delay                                                               
implementation of the act.                                                                                                      
                                                                                                                                
VICE  CHAIR  KELLER  moved  to adopt  Amendment  1,  labeled  28-                                                               
LS0187\U.1, Bailey, 4/1/13.  [Text included above]                                                                              
                                                                                                                                
REPRESENTATIVE PRUITT objected for discussion.                                                                                  
                                                                                                                                
REPRESENTATIVE  STOLTZE expressed  appreciation for  the proposed                                                               
amendment which was consistent with his stated intent.                                                                          
                                                                                                                                
VICE  CHAIR  KELLER explained  that  proposed  Amendment 1  would                                                               
delete "and  the Governor"  on page  1, line  1, and  insert "the                                                               
Governor, and  the state's congressional  delegation".   He noted                                                               
that,  on page  5, line  12, a  new "Further  Resolved" would  be                                                               
added, and he read:                                                                                                             
                                                                                                                                
     further  resolved  that  the Alaska  State  Legislature                                                                    
     calls  on  the   state's  Congressional  delegation  to                                                                    
     introduce,   sponsor,  support,   and   vote  to   pass                                                                    
     legislation  in  both  houses   of  the  United  States                                                                    
     Congress  that will  delay  the  implementation of  the                                                                    
     Patient  Protection and  Affordable  Care  Act until  a                                                                    
     full  analysis of  the economic  effect of  the Act  on                                                                    
     Alaskans and Alaska can be clearly quantified;                                                                             
                                                                                                                                
3:24:44 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE PRUITT removed his objection.                                                                                    
                                                                                                                                
VICE CHAIR KELLER objected.                                                                                                     
                                                                                                                                
REPRESENTATIVE NAGEAK asked if there  would be further discussion                                                               
on the proposed resolution.                                                                                                     
                                                                                                                                
VICE CHAIR KELLER  stated that there would  be further discussion                                                               
and he removed his objection.   There being no further objection,                                                               
Amendment 1 was approved.                                                                                                       
                                                                                                                                
3:25:13 PM                                                                                                                    
                                                                                                                                
The committee took a brief at-ease.                                                                                             
                                                                                                                                
[Vice Chair Keller returned the gavel to Chair Higgins]                                                                         
                                                                                                                                
CHAIR HIGGINS brought the committee back to order.                                                                              
                                                                                                                                
3:25:41 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  NAGEAK  questioned why  there  had  not been  any                                                               
testimony from the  rest of the state regarding  proposed HJR 14.                                                               
He pointed  out that  the committee had  not heard  anything from                                                               
municipalities or tribal governments.   He remarked that comments                                                               
about a resolution of this  magnitude should have been heard from                                                               
the rest of the state.                                                                                                          
                                                                                                                                
3:26:56 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE KELLER declared that  he supported the resolution.                                                               
He  said the  resolution had  been properly  posted to  allow the                                                               
public to  offer its comments.   He  offered his belief  that the                                                               
estimated costs to  the act would increase.  He  noted that there                                                               
were now more taxes, which created an unsustainable burden.                                                                     
                                                                                                                                
3:28:21 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE STOLTZE offered his belief  that AARP "cut a deal"                                                               
to  market  its  insurance.   He  expressed  his  agreement  with                                                               
earlier testimony  that things  had changed  in the  previous six                                                               
months, although,  he opined, things  had not "gotten  rosier" as                                                               
the  public  and  private sector  were  simply  more  acquiescent                                                               
toward the  issues.  He offered  his belief that the  stakes were                                                               
elevating   even  higher,   referencing  some   recent  newspaper                                                               
articles.    He suggested  that  the  public  was "numbed."    He                                                               
offered  his  belief  that the  NFIB  testimony  represented  the                                                               
private   sector  and   small  businesses.     He   suggested  to                                                               
Representative Nageak that  he "be careful about having  a lot of                                                               
trust in  that long term;  what the federal government  gives, it                                                               
can yank away, and does routinely."                                                                                             
                                                                                                                                
3:31:44 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE KELLER  commented that a tension  from the Patient                                                               
Protection  and Affordable  Care Act  (PPACA) was  that it  "cuts                                                               
huge amounts out  of Medicare."  He deemed that  the provider had                                                               
to pay  the difference as Medicare  was reduced.  He  opined that                                                               
this  would  create a  dependence  on  Medicaid, "a  needs  based                                                               
program."    He  expressed  his   concern  for  seniors,  and  he                                                               
suggested  that a  delay of  the act  would allow  time for  more                                                               
thought.                                                                                                                        
                                                                                                                                
3:33:17 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  STOLTZE   concluded  that  he  had   focused  his                                                               
objections, and  that "government  can't give us  anything unless                                                               
they yank it away from someone else first."                                                                                     
                                                                                                                                
3:33:58 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  NAGEAK acknowledged  that he  was not  personally                                                               
concerned as  he had  very good insurance,  but he  expressed his                                                               
unease for those who could not afford insurance.                                                                                
                                                                                                                                
3:35:03 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE   REINBOLD  offered   her  belief   that  it   was                                                               
"important to look  out for the fabric of  America that's holding                                                               
our economy  together."  She  said "this is an  unbelievable bill                                                               
and  I think  it's really  important  that we  slow this  process                                                               
down."                                                                                                                          
                                                                                                                                
3:35:28 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  TARR, reporting  on  the history  of the  Patient                                                               
Protection  and Affordable  Care Act,  referenced the  individual                                                               
mandate discussions during the early  1990s.  She opined that the                                                               
individual  mandate  was  the  crux  of this  act  and  had  been                                                               
supported  by the  Alaska congressional  delegation,  as well  as                                                               
endorsed by the Heritage Foundation,  which was a well-known pro-                                                               
business,  conservative organization.    She  declared that  this                                                               
history  was  important  to  remember.   She  remarked  that  the                                                               
catalyst for change  resulted from the rising  health care costs,                                                               
which were hurting  businesses.  She declared  that "she wouldn't                                                               
want  us to  kick  the can  down  the road  and  not address  the                                                               
issue."   She  shared  her  interest in  ensuring  that "as  many                                                               
Alaskans  as  possible  have health  insurance,  have  access  to                                                               
affordable health  insurance."   She pointed  out that  the state                                                               
with  the  most insured  citizens  was  Massachusetts, under  its                                                               
health  care  program,  known  as  "Romneycare."    She  directed                                                               
attention  to a  table  titled, "Health  Care Model  Comparison."                                                               
[Included   in  members'   packets]     She  declared   that  the                                                               
Massachusetts  model  was similar  to  the  PPACA, although  more                                                               
restrictive  with regard  to the  employer  mandate for  required                                                               
insurance coverage.                                                                                                             
                                                                                                                                
3:37:39 PM                                                                                                                    
                                                                                                                                
CHAIR  HIGGINS  stated  that  this   discussion  was  not  for  a                                                               
comparison   of   Massachusetts   care   to   PPACA,   and   that                                                               
Representative Tarr should "wrap this up."                                                                                      
                                                                                                                                
REPRESENTATIVE TARR replied that her  comments were valid for the                                                               
record,  and that  she  did not  appreciate  her discussion  time                                                               
being shortened as this was a  very important issue.  She opined:                                                               
"I  don't  think 35  minutes  in  committee over  something  that                                                               
affects thousands  and thousands of  Alaskans is too  much time."                                                               
She pointed to the success  of Massachusetts with insuring a high                                                               
number of individuals, and suggested  a look at the components of                                                               
the  Massachusetts  plan,  as  they   were  important  pieces  of                                                               
information  for  developing  a  plan  to  attain  this  goal  of                                                               
insuring more Alaskans.                                                                                                         
                                                                                                                                
3:38:39 PM                                                                                                                    
                                                                                                                                
CHAIR  HIGGINS  stated that  he  had  previously heard  arguments                                                               
about  the  Massachusetts  plan,  which  he  deemed  were  "about                                                               
Massachusetts  only  and  not  about any  other  state,  so  it's                                                               
comparing  apples  to  oranges, it's  completely  different,  and                                                               
that's why the numbers are different."                                                                                          
                                                                                                                                
3:39:16 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  KELLER commented:   "I  really think  we need  to                                                               
really go  slow on this."   He indicated a statistic  from a 2010                                                               
Institute  of Social  and Economic  Research  (ISER) study  which                                                               
said that Alaskans spent $7.5  billion for health care, which was                                                               
projected to  double.  He  said that this was  approximately half                                                               
of the  earnings of all Alaskans.   He offered his  belief that a                                                               
change was  forthcoming, and  that it would  affect the  lives of                                                               
the elderly and others in Alaska.                                                                                               
                                                                                                                                
REPRESENTATIVE  KELLER  moved  to  report  HJR  14,  Version  28-                                                               
LS0187\U,  [as   amended],  out  of  committee   with  individual                                                               
recommendations and  the accompanying  zero fiscal notes.   There                                                               
being  no objections,  CSHJR  14(HSS) was  moved  from the  House                                                               
Health and Social Services Standing Committee.                                                                                  

Document Name Date/Time Subjects
HJR14 Sponsor Statement.pdf HHSS 4/2/2013 3:00:00 PM
HJR 14
HJR 14 Proposed Amendment Ver U.1.pdf HHSS 4/2/2013 3:00:00 PM
HJR 14
HJR14.pdf HHSS 4/2/2013 3:00:00 PM
HJR 14
HJR14 Summary.pdf HHSS 4/2/2013 3:00:00 PM
HJR 14
HJR14 Resolution Sources.pdf HHSS 4/2/2013 3:00:00 PM
HJR 14
HJR14 Supporting Documents - ADN Article.pdf HHSS 4/2/2013 3:00:00 PM
HJR 14
HJR14 Supporting Documents - Alaska Dispatch Article.pdf HHSS 4/2/2013 3:00:00 PM
HJR 14
HJR Supporting Documents - NFIB.pdf HHSS 4/2/2013 3:00:00 PM
HJR 14
ACS Capsis.pdf HHSS 4/2/2013 3:00:00 PM
ACS Presentation
ACS distance based delivery system.pdf HHSS 4/2/2013 3:00:00 PM
ACS Presentation
Overview -20130402.pdf HHSS 4/2/2013 3:00:00 PM
ACS Presentation
ANTHC ACS Letter 1.pdf HHSS 4/2/2013 3:00:00 PM
ACS Presentation
HB054 Research - House HSS information from 4-2-13.pdf HHSS 4/2/2013 3:00:00 PM
HB 54