03/21/1994 01:45 PM Senate HES

 VICE CHAIRMAN SHARP introduced  SB 313  (HEALTH INS. FOR HIGH RISK            
 RESIDENTS) as the final order of business before the committee.               
                                                                               
 CAROL CARROL, staff to Senator Kerttula, explained that SB 313                
 would amend the Health Insurance Association set up 1992 for high-            
 risk health insurance.  She reviewed the amendments to SB 313 which           
 are present in the committee's packets.                                       
                                                                               
 SENATOR LEMAN asked for a description of the " other managed care            
 arrangements " which can be found on page 1, line 10.  CAROL CARROL     L    
 said that a provider type arrangement, a preferred provider                   
 arrangement would be an example.                                              
                                                                               
 BOB NIEBRUGGE, Consumer Representative of the Comprehensive Health            
 Insurance Association, agreed with the preferred provider                     
 arrangement example which Providence Hospital may be able to                  
 fulfill.  He said that HMO's may be able to offer care at a cheaper           
 rate in the future.  SB 313 provides language to offer health care            
 insurance at a cheaper rate to the insurers and make it as                    
 accessible as possible.                                                       
                                                                               
 SENATOR ELLIS asked why Senator Kerttula's original legislation had           
 five insurance representatives and two consumer representatives on            
 the board.                                                                    
                                                                               
 BOB NIEBRUGGE stated that the five insurance representatives were             
 beneficial with the technical tasks to create the legislation.  The           
 composition of the board has been successful.                                 
                                                                               
 SENATOR ELLIS inquired as to Mr. Niebrugge's background.  BOB                 
 NIEBRUGGE explained that he was a self-employed diabetic, a pre-              
 existing condition.  Eventually, he did discover Communicating for            
 Agriculture, which had created a high risk pool.  Under                       
 Communicating for Agriculture, insurance was available at an                  
 elevated premium without any subsidies.                                       
                                                                               
 SENATOR ELLIS asked if Mr. Niebrugge had any suggestions for those            
 individuals who cannot afford the elevated premium.  BOB NIEBRUGGE            
 said not in the context of this legislation.  SENATOR ELLIS said              
 that was the point.                                                           
                                                                               
 SENATOR ELLIS noted that SB 313 references HMO's and previous                 
 legislation from Senator Kerttula attempting to help HMO's to do              
 business in Alaska.  Still, HMO's are not coming to Alaska.  He               
 asked if there was hope for HMO's in Alaska.  BOB NIEBRUGGE said              
 no, this is an attempt to clean up the language in this                       
 legislation.                                                                  
                                                                               
 SENATOR ELLIS inquired of the background of the other consumer                
 representative on the Association.  BOB NIEBRUGGE explained that              
 Elaine Hurley was the other consumer representative who has a                 
 daughter with a pre-existing health condition.                                
                                                                               
 Number 416                                                                    
                                                                               
 SENATOR DUNCAN asked Mr. Niebrugge if he had insurance through the            
 high risk pool.  BOB NIEBRUGGE said no, he has a group plan.  In              
 response to Senator Duncan, Mr. Niebrugge stated that they had                
 approximately seventy-some applications for the high risk pool.               
                                                                               
 SENATOR DUNCAN asked Mr. Niebrugge to clarify the number of                   
 individuals who actually received insurance.  BOB NIEBRUGGE said              
 that seventy-two individuals were actually insured.  Mr. Niebrugge            
 suspected that very few individuals would be declined, due to their           
 initial information when applying.                                            
                                                                               
 SENATOR DUNCAN stated that these changes seemed to make sense, but            
 would SB 313 change the number of individuals joining the high-risk           
 pool.  BOB NIEBRUGGE explained that the original legislation only             
 provided three levels of deductibles; most individuals opt for the            
 higher deductible because it has the lowest premium.  Mr. Niebrugge           
 indicated that if these changes occur in SB 313, a higher                     
 deductible similar to a catastrophic plan would be offered.  This             
 type plan would substantially decrease premiums which would help              
 enrollment.                                                                   
                                                                               
 SENATOR DUNCAN inquired as to other states' deductible under a                
 high-risk pool.  BOB NIEBRUGGE noted that there are a variety of              
 programs, but they generally lean toward the higher deductible.               
 Mr. Niebrugge offered to provide the committee with a publication             
 of other states' programs.                                                    
                                                                               
 SENATOR DUNCAN asked Mr. Niebrugge about his group policy.  BOB               
 NIEBRUGGE explained that his group policy was with a company that             
 had opened their enrollment to high-risk individuals for a short              
 time.  SENATOR DUNCAN inquired as to the status of his premium.               
 BOB NIEBRUGGE stated that his premiums have gradually increased.              
                                                                               
 SENATOR MILLER moved SB 313 out of committee with individual                  
 recommendations.  Hearing no objections, it was so ordered.