Legislature(2025 - 2026)DAVIS 106
03/18/2025 03:15 PM House HEALTH & SOCIAL SERVICES
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| Audio | Topic |
|---|---|
| Start | |
| State Medical Board | |
| HJR9 | |
| HB14 | |
| SB60 | |
| Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
| + | TELECONFERENCED | ||
| *+ | HJR 9 | TELECONFERENCED | |
| += | HB 14 | TELECONFERENCED | |
| + | SB 60 | TELECONFERENCED | |
| + | TELECONFERENCED |
HJR 9-EXTEND AFFORDABLE CARE ACT TAX CREDITS
HJR 9-EXTEND AFFORDABLE CARE ACT TAX CREDITS
3:46:17 PM
REPRESENTATIVE MEARS announced that the next order of business
would be HOUSE JOINT RESOLUTION NO. 9, Urging the United States
Congress to extend enhanced tax credits for health insurance
premiums under the Affordable Care Act.
3:46:40 PM
CHAIR MINA, as prime sponsor, presented HJR 9 to the committee.
She said the goal of HJR 9 is to stabilize healthcare costs for
Alaskans on the individual marketplace. She provided a brief
background of the Affordable Care Act (ACA). She emphasized
that premium tax credits make premiums affordable for many
people. She provided a recent history of these premium tax
credits. She explained that if Congress does not expand the
extension of the enhanced ACA tax credits, premiums would
increase dramatically, forcing many people to be unable to
afford them.
3:53:09 PM
REPRESENTATIVE MEARS announced invited testimony.
3:53:21 PM
JARED KOSIN, President and CEO, Alaska Hospital and Healthcare
Association, explained that HJR 9 would make healthcare more
affordable and accessible for Alaskans who purchase coverage
through the federal marketplace. He emphasized how many people
would become uninsured if premiums were to increase. He
explained that lacking insurance funnels people towards
emergency rooms and hospitals for healthcare, where they cannot
be denied, which are the most expensive environments for care in
the entire healthcare system. He said that reducing access to
affordable healthcare services will ultimately increase the cost
of healthcare for all people in Alaska.
3:56:33 PM
REPRESENTATIVE PRAX asked how a tax credit could make the cost
of the insured go more than 100 percent.
MR. KOSIN responded that the numbers he sees are the amount the
premium would cost in the offset from the tax credit. He said
that if the tax credit goes away, there will be a destabilizing
effect on the market at large, doubling, or tripling premiums.
3:58:27 PM
LORI WING-HEIER, Director, Division of Insurance, Department of
Commerce, Community, and Economic Development, explained that
the tax credits are based on income and family size, and said
that these credits are reassessed when an individual files their
taxes.
REPRESENTATIVE PRAX asked if the tax credit could be more than
what an individual paid for the premium.
MS. WING-HEIER said that an individual would never receive more
in tax credits than what their total premium is.
REPRESENTATIVE PRAX provided an example to clarify how this tax
credit would work. He asked how an individual's premium could
go up more than 100 percent.
MS. WING-HEIER responded that a premium would not exceed 100
percent through the tax credits. She explained that if the
enhanced premium tax credits were not available, an individual
would receive less in a premium tax credit in 2026 than they did
in 2025.
REPRESENTATIVE PRAX asked if the enhanced tax credit would go to
the insurance provider or the insured individual.
MS. WING-HEIER responded that the tax credit would go to the
insurance company to pay the premium.
REPRESENTATIVE PRAX asked if the number of people purchasing
policies would decrease, causing the prices to increase.
MS. WING-HEIER responded that some people would have to pay
more, and that some would not be able to afford their insurance
even with a subsidy.
4:03:59 PM
REPRESENTATIVE RUFFRIDGE asked if the enhanced tax credits, with
a subsidy, have covered individuals who actually were above 400
percent of the federal poverty line.
MS. WING-HEIER responded that is correct.
REPRESENTATIVE RUFFRIDGE asked if individuals above 400 percent
of the federal poverty line would now have to pay for their
health insurance in full if it is not provided through some
other means.
MS. WING-HEIER responded that is correct.
REPRESENTATIVE RUFFRIDGE asked if the subsidy would remain for
individuals falling between 100 and 400 percent of the federal
poverty line.
MS. WING-HEIER confirmed that is correct.
4:05:53 PM
REPRESENTATIVE SCHWANKE asked if there is data to show what the
average savings on premiums per family was when these tax
credits went into place.
MS. WING-HEIER provided examples to show how families' premiums
would increase without the enhanced premium tax credits.
REPRESENTATIVE SCHWANKE asked what savings occurred prior to
these premium tax credits going into place. She said she does
not want to over generalize what the effect would be if these
tax credits go away.
4:09:37 PM
REPRESENTATIVE FIELDS asked about the income of people currently
benefiting from these tax credits. He asked if these
individuals would go without insurance if they were to lose the
tax credits.
MS. WING-HEIER responded that the recipients of these tax
credits are middle-income, and she is concerned about what would
happen to them without the tax credits.
REPRESENTATIVE FIELDS asked about premiums increasing for other
employers who now have a higher share of uncompensated care.
MS. WING-HEIER explained that hospitals will always see a
patient, regardless of their ability to pay. She said that if a
patient cannot afford to pay their hospital bill, that cost
affects "all of us," meaning that hospital prices must increase
to keep their doors open.
REPRESENTATIVE FIELDS asked about the conditions of rural
communities that have lost all hospital care, which he said
would happen if Medicaid expansion and enhanced premium tax
credits go away.
4:13:07 PM
MR. KOSIN responded that there would be a cost shift. He said
that there are such high insurance rates in Alaska because
healthcare costs have shifted onto private insurance companies.
He emphasized the importance of the premium tax credits.
4:14:58 PM
REPRESENTATIVE RUFFRIDGE said that there are 23,000 Alaskans
that are covered under some tax credit plan under the ACA. He
asked how many of those 23,000 fall above the 400 percent
federal poverty limit.
MS. WING-HEIER responded that she estimates there are 23,000
enrolled in the individual market. She said she would follow up
with how many of those qualify for premium tax credits, the
enhanced premium tax credits, or none at all because of their
income.
4:16:17 PM
AMBER LEE, Owner, Amber Lee Strategies, shared a personal story
of losing both her health insurance and her job at the same time
that she was diagnosed with cancer. She expressed her gratitude
that Alaska's Medicaid expansion insurance covered her and her
two children. She said she was able to enroll with marketplace
insurance under ACA because it prevents insurance companies from
denying people like her, who have preexisting conditions. She
emphasized the importance of small business owners in the
economic diversification of Alaska and said that losing these
tax credits would hurt their ability to continue owning their
businesses.
4:19:30 PM
The committee took an at-ease from 4:19 p.m. to 4:20 p.m.
[During the at-ease, Representative Mears handed the gavel back
to Chair Mina.]
4:20:09 PM
.
CHAIR MINA opened public testimony on HJR 9.
4:20:23 PM
TERI TIBBETT, Alaska Re-entry Partnership, explained that the
Alaska Re-entry Partnership supports HJR 9 because the tax
credits are currently helping people who are just re-entering
the workforce from incarceration. She explained that the
barriers that her clients face in achieving jobs with health
insurance.
4:22:26 PM
KATHARINA WOOFTER, Life and Health Insurance Agent, described
her experience connecting clients to individual marketplace
plans with subsidy, emphasizing the importance of these
subsidies. She provided examples of individuals' premiums with
and without these subsidies.
4:25:21 PM
TREVOR STORRS, President and CEO, Alaska Children's Trust, said
that the passage of ACA was pivotal in reducing the rate of
uninsured individuals in Alaska, including thousands of families
with children. He emphasized that when parents have health
insurance, their children will have it, and those children will
access care.
4:27:24 PM
ARIANE KELSEY, Senior Manager, AIDS Drug Assistance Program
(ADAP) and Quality Insurance, The Alaskan AIDS Assistance
Association (AAAA), explained that AAAA works with clients who
have no option for health insurance besides enrolling through
Alaska's health insurance marketplace with tax credits. She
emphasized that losing these tax credits would directly and
negatively affect ADAP in Alaskan.
4:29:10 PM
ELIZABETH NEWELL, representing self, shared a personal anecdote,
describing how she would need to drop her health insurance if
she lost her premium tax credits.
4:30:35 PM
SHELLIE GOODEN, representing self, emphasized the difficult
lifestyle choices that many would need to make if HJR 9 were not
passed.
4:32:42 PM
CHAIR MINA, after ascertaining that there was no one else who
wished to testify, closed public testimony on HJR 9.
4:32:50 PM
REPRESENTATIVE RUFFRIDGE asked about the total amount of tax
credit being paid out each year, by Alaska and the United
States. He said that with these tax credits, Americans are
essentially paying taxes to an insurance company. He asked if
that is an accurate analysis.
CHAIR MINA responded that Representative Ruffridge offered a
great way to think about this issue.
4:34:54 PM
MS. WING-HEIER responded that ACA helped individuals pay for
healthcare, but it did not address the cost of healthcare. She
said that in 2024, the premium tax credits for Alaska were
$385,000,000. She emphasized the viciousness of the cycle
regarding healthcare cost increasing, causing tax credits to
increase.
4:36:26 PM
REPRESENTATIVE RUFFRIDGE said that in 2024, individuals in
Alaska receiving tax credits received an average of $16,000 per
person. He asked about cost-shifting. He asked if cost-
shifting merely would allow the state to decide who makes that
money if the state is going to spend this money regardless.
MS. WING-HEIER responded that cost-shifting allows the state to
decide who makes and who spends this money. She provided an
example to emphasize the disproportionate amount of money that
patients are being charged for healthcare.
REPRESENTATIVE RUFFRIDGE said that he really struggles with this
resolution.