Legislature(2001 - 2002)
03/19/2001 09:09 AM Senate FIN
Audio | Topic |
---|
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
SENATE CONCURRENT RESOLUTION NO. 7 Establishing a Health Care Cost Review Task Force. This was the first hearing for this resolution in the Senate Finance Committee. Senator Green announced that while the Department of Health and Social Services Budget Subcommittee was addressing that department's budget, the members were "surprised" at the growth of the Medicaid program. She emphasized the increasing costs and subsequent impacts to both the federal and state governments. She spoke of continued proposals for new matching fund programs, but stated that the question is how to continue to pay for existing Medicaid programs. Senator Green informed that the Medicaid program in Alaska expends approximately $10 million a week of combined state and federal funds. She calculated this equals about one-half billion dollars annually. She pointed out that Medicaid is the second largest state program behind education. She ascertained several state agency budgets could be combined and still cost less than the cost of a month of Medicaid expenses. Senator Green expressed the difficulties in examining the Medicaid expenses because there are "various layers" of service providers, vendors, agencies, departments, individuals and nonprofit groups that rely on Medicaid funds as a part of their on-going operations. Senator Green stated the intent of this resolution is to establish a group to investigate the reasons for the high costs and possibly identify cost containing alternatives. This, she said would include determining whether the state is participating in programs not mandated by the federal government, finding out if any programs could be restructured or privatized to have less impact on the state general fund and perhaps build a better program. Senator Green stressed there is no intent to "negatively impact the Medicaid budget." Co-Chair Kelly commented that any attempt to reduce the budget is beneficial. JIM BRADY, Kenai Peninsula Independent Living Center, testified via teleconference from Homer to request the Committee keep in mind the costs required to care for disabled people. He stressed that for many, Medicaid is the only method of health insurance. He noted that providing care at the early stages of a condition could save considerable money in the long run. He referenced the "buy-in" option that allows disabled individuals to pay for continued Medicaid coverage once they are employed. Co-Chair Kelly noted that the discussion at this time is to determine whether or not to form the task force. He stated there would be another opportunity to debate the issues before the task force. DAVID JACOBSON, Member, State Independent Living Council, testified via teleconference from Fairbanks in appreciation that the Committee was not yet setting the agenda for the task force. However, he emphasized that Medicaid is an essential program. He also spoke of the necessity of treating illnesses in their early stages rather then waiting for the condition to become more serious. He spoke of the savings to the state in allowing the elderly to remain in their community rather than an institution. He supported a proposed language change prepared by the Department of Health and Social Services. He explained this language addresses specific needs of the disabled and elderly and also gives recommendations on the membership of the task force to include consumers. He commented on the Long-Term Care Task Force, commending the representation by all factions of the community. TIM ANDERSON, Senior Service Provider and Director, Wasilla Area Seniors, testified via teleconference from Mat-Su about the various services provided to the elderly by Medicaid. He estimated that 30 percent of Medicaid costs in his community go to pay for senior services. RICHARD TUBBS, Executive Director, Palmer Senior Center, testified via teleconference from Mat-Su that he understood the reasons the state wishes to reduce costs, but emphasized the necessity of home community based senior services. He referenced a state conducted study that found that community based services cost much less than nursing home care. He urged that the task force include representation from the senior care community. JANE DEMMERT, Executive Director, Alaska Commission on Aging, testified in Juneau about the Long-Term Care Task Force. She stated that there were recommendations of this task force that remains unimplemented. She suggested the new task force consider the work and structure of the earlier task force. She stressed the lack of flexibility of insurance for elderly care. ROSEMARY HAGAVIG, Executive Director, Catholic Community Services, testified in Juneau to echo the remarks of the previous testifiers. She also noted that Alaska is one of only a few states that does not provide Medicaid for Alzheimer disease, which she stressed is a growing portion of elderly needs. She spoke of the benefits of providing care in the early stages of this disease. She hoped the task force would consider this. SUZANNE PRICE Executive Director, Fairbanks Community Mental Health Center and representative of Mental Health Providers Association of Alaska, testified in Juneau sharing the message that cost- containment has been included in the organization's practice for a number of years. She offered the groups input in the task force's efforts. She warned of the "domino effect" when a task force makes cost-containment decisions. She stressed, "Cost containment is a tricky issue." She said that the providers association has knowledge in this area and she requested they be allowed to participate in the task force. Senator Green noted that there would be a decrease in federal participation in Medicaid funding in the year 2002. She said it needed to be decided how the state's general funds would be prioritized. She ascertained that additional programs would be introduced, making the need to prioritize greater. RUTH L'HOMMIDIEU, Chair, State Independent Living Council, testified via teleconference from Fairbanks, to advise the Committee to proceed with caution in establishing the task force. She stated that Medicaid is the number one form of medical insurance for people with disabilities. She recommended expanding the Medicaid buy-in option. She listed the annual cost of nursing home treatment as $96,809 per person. She stressed the need to ensure people can remain in their own community, and return to work. She supported the Department of Health and Social Services' proposed language. RICHARD RAINERY, Acting Executive Director, Alaska Mental Health Board testified in Juneau to reiterate other points raised. He agreed that the proposed task force membership excludes several factions. He opined that health care users, payers and providers should be included in the primary membership instead of ad hoc members. He predicted that the task force would learn that Medicaid is a "very complex subject" and he was concerned that the timeframe allowed would be inadequate. He warned that the impacts on access to health care should be carefully considered, in the mental health field. He spoke of the reliance on Medicaid by many community mental health care providers and the limited ability to replace that funding from other sources. He pointed out that Alaska does not have a health insurance parody clause, so private insurance is not required to include mental health coverage. JAY LIVEY, Deputy Commissioner, Department of Health and Social Services, testified in Juneau to voice concerns about the resolution. He expressed that the task force is "narrowly charged" in that it is only directed to review cost containment. He emphasized the "interrelationships and complexity of health care" He stated that the department supports cost containment and he agreed that the cost of health care is rising. However, he said, "cost containment itself does not exist entirely in a vacuum." Mr. Lively shared there are three ways to reduce costs within a health care program. He listed them as reducing the number of participants, lowering the reimbursement rate and reducing the amount of services. He pointed out that each of these would have other ramifications on the health care system. He stressed that many elderly and disabled patients do not have other health insurance options, due to preexisting conditions, lack of income to purchase private insurance, and other factors. Mr. Lively spoke of the connection between publicly funded health care programs and local health care economies. He explained that in many smaller communities, there is a connection between Medicaid funding for long-term care and the economic viability of small rural hospitals. He stated that the Medicaid portion of long-term care funding keeps the hospitals operational. He also noted that Medicaid funding for disabled patients provides funding to maintain many mental health care programs. While he acknowledged that these programs do not serve Medicaid eligible patients exclusively, without the Medicaid funding, there would not be adequate private funding income to provide the services to any patients. Senator Green asked if the witness was addressing the impact of private insurance and subsidized Medicaid in providing lower rates to those individuals that pay for services without insurance. Mr. Livey agreed there is an interrelationship between Medicaid payments and the health care economy. He explained that if an individual does not have health care coverage, and must seek medical care, "somebody has to pay for that." He said that the "somebody" is "the rest of the public that pays the health care bill." Mr. Lively qualified that "the worst" would not necessarily happen, but stressed that because of the complexity of the issue, if the task force only addresses cost containment, "it is going to miss some of these connections. He was concerned that unless the scope of the task force is broadened to include access, the impact on other health care economies and other providers, unintended consequences could result. Mr. Livey concluded suggesting that the task force membership should include additional representation from recipients, families of recipients or advocates for recipients as well as additional membership for the Administration. Co-Chair Kelly ordered the bill HELD in Committee.
Document Name | Date/Time | Subjects |
---|