Legislature(2005 - 2006)HOUSE FINANCE 519

01/21/2005 01:30 PM House FINANCE


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Audio Topic
01:37:49 PM Start
03:24:42 PM Adjourn
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
Overviews: Revenue Projections,
Dept. of Revenue
Proposed Sr. Health Care Program DHSS
<Postponed>
Proposed Changes in Medicaid
Reimbursement, DHSS
                   HOUSE FINANCE COMMITTEE                                                                                      
                      January 21, 2005                                                                                          
                         1:37:49 PM                                                                                           
                                                                                                                                
                                                                                                                                
 CALL TO ORDER                                                                                                                
                                                                                                                                
 Co-Chair Chenault called the House Finance Committee meeting                                                                   
 to order at 1:37:49 PM.                                                                                                      
                                                                                                                                
                                                                                                                                
 MEMBERS PRESENT                                                                                                              
                                                                                                                                
 Representative Mike Chenault, Co-Chair                                                                                         
 Representative Kevin Meyer, Co-Chair                                                                                           
 Representative Bill Stoltze, Vice-Chair                                                                                        
 Representative Richard Foster                                                                                                  
 Representative Mike Hawker                                                                                                     
 Representative Reggie Joule                                                                                                    
 Representative Mike Kelly                                                                                                      
                                                                                                                                
                                                                                                                                
 MEMBERS ABSENT                                                                                                               
                                                                                                                                
 Representative Eric Croft                                                                                                      
 Representative Jim Holm                                                                                                        
 Representative Carl Moses                                                                                                      
 Representative Bruce Weyhrauch                                                                                                 
                                                                                                                                
                                                                                                                                
 ALSO PRESENT                                                                                                                 
 Joel Gilbertson, Commissioner, Department of Health & Social                                                                   
 Services;  William  Corbus,  Commissioner,   Department  of                                                                    
 Revenue; Tom  Boutin,  Deputy  Commissioner, Department  of                                                                    
 Revenue; Brett Fried, Economist, Tax Division, Department of                                                                   
 Revenue; Janet Clarke, Director, Division of Administrative                                                                    
 Services, Department of Health and Social Services                                                                             
                                                                                                                                
                                                                                                                                
 PRESENT VIA TELECONFERENCE                                                                                                   
                                                                                                                                
 Michael Williams, Chief Petroleum Economist,  Department of                                                                    
 Revenue, Anchorage; Dan Dickinson, Director,  Tax Division,                                                                    
 Department of Revenue, Anchorage                                                                                               
                                                                                                                                
                                                                                                                                
 GENERAL SUBJECT(S):                                                                                                          
                                                                                                                                
     OVERVIEWS:REVENUE PROJECTIONS, DEPARTMENT OF REVENUE                                                                     
         PROPOSED CHANGES IN MEDICAID REIMBURSEMENT /                                                                         
           DEPARTMENT OF HEALTH & SOCIAL SERVICES                                                                             
                                                                                                                                
The following overview was taken in log note format.  Tapes                                                                     
and handouts will be on file with the House Finance                                                                             
Committee through the 24th Legislative Session, contact 465-                                                                    
6814. After the 24th Legislative Session they will be                                                                           
available through the Legislative Library at 465-3808.                                                                          
                                                                                                                              
                                                                                                                                
 TIME        SPEAKER         DISCUSSION                                                                                     
 1:38:14 PM Co-Chair         Convened the House Finance Committee                                                             
             Chenault        meeting to take up discussion on the                                                               
                             Department of Revenue, Revenue                                                                     
                             Projections and the Department of                                                                  
                             Health & Social Services, proposed                                                                 
                             changes in the Medicaid reimbursement.                                                           
                                                                                                                                
                             DEPARTMENT OF REVENUE                                                                            
                             REVENUE PROJECTIONS                                                                            
 1:39:03 PM WILLIAM          Provided members with handouts                                                                   
             CORBUS,         outlining the revenue forecast for the                                                             
             COMMISSIONER,   upcoming year.  (Copy on File).                                                                    
             DEPARTMENT OF   He introduced his staff, Tom Boutin,                                                               
             REVENUE         Deputy Commissioner, Department of                                                                 
                             Revenue; Brett Fried, Economist, Tax                                                               
                             Division, Department of Revenue; and                                                               
                             teleconferenced Michael Williams, Chief                                                            
                             Petroleum Economist, Department of                                                                 
                             Revenue and Dan Dickinson, Director,                                                               
                             Tax Division, Department of Revenue in                                                             
                            Anchorage.                                                                                        
 1:40:39 PM Commissioner     Stated that revenue forecasting is                                                               
             Corbus          important work and that many                                                                       
                             governmental decisions are based on                                                                
                             that forecast.  Much work goes into                                                                
                             preparing it.  He referenced Attachment                                                            
                             #1. (Copy on File).                                                                              
 1:42:14 PM Commissioner     Referenced the Table of Contents, Page                                                           
             Corbus          3, stating that it was the best, "quick                                                            
                             and dirty" source book for State                                                                   
                             finances.  He pointed out that Alaska                                                              
                             National Wildlife Refuge (ANWR) was the                                                            
                             example used throughout the handout.                                                             
 1:43:59 PM Commissioner     Noted tables on the next six pages,                                                              
             Corbus          while highlighting the Fall forecast.                                                              
                             The price projections listed on Table                                                              
                             2-4, Page 10:  The price per barrel of                                                             
                             oil on 1/20/05 was $49.71.                                                                         
                             Commissioner Corbus pointed out price                                                              
                             projections for the next several years:                                                            
                                · FY05 - $43.61 versus $28.30 last                                                              
                                  spring                                                                                        
                                · FY06 - $34.50 versus $25.85 last                                                              
                                  spring                                                                                        
                                · FY07 - $30.95 versus $22 last                                                                 
                                  spring                                                                                        
                                · FY08 - FY15 was $25.50, up $3.50                                                            
                                  from last spring.                                                                             
                             The Organization for Petroleum                                                                     
                             Exporting Countries (OPEC) Price Goal                                                              
                             is $22-$28 dollars per barrel which                                                                
                             compares to the $28.30 projected from                                                              
                            last year.                                                                                        
 1:46:23 PM Commissioner     Reiterated that OPEC has indicated that                                                          
             Corbus          oil will be at between $22 and $28                                                                 
                             dollars per barrel.                                                                              
 1:47:01 PM Commissioner     The State is not certain that OPEC will                                                          
             Corbus          maintain market discipline in that                                                                 
                             range.                                                                                           
 1:47:32 PM Commissioner     Addressed the "wild ride" price                                                                  
             Corbus          volatility oil has moved through this                                                              
                             past year.  Last year, he compared the                                                             
                             $15 dollar drop in 48 days; there was                                                              
                             then a rise caused by the anticipated                                                              
                             Iraqi war.  He remembered a $15 dollar                                                             
                             drop in 37 days in 1991.  The price                                                                
                             today is approximately $41 dollars, $7                                                             
                             dollars higher than a week ago.  He                                                                
                             acknowledged that projecting prices is                                                             
                             difficult and there is great                                                                       
                             volatility.  There has been a change in                                                            
                             relationships between prices of oil.                                                               
                             When the Department provides a                                                                     
                             forecast, they use the West Texan                                                                  
                             Institute (WTI) intermediate code.                                                                 
                             Alaska sells its oil to the west coast                                                             
                             with a differential in that price.                                                                 
                             Historically, there has been a constant                                                            
                             relationship between prices.  That                                                                 
                             relationship does not hold as strong as                                                            
                             it had in the past.                                                                              
 1:50:53 PM Commissioner     Addressed production and referenced                                                              
             Corbus          Table 2-6 - By FY2011, new oil                                                                     
                             developments will be 48.1% of the total                                                            
                             production.                                                                                      
 1:52:31 PM Commissioner     Commented on Table 2-2, highlighting                                                             
             Corbus          the unrestricted general-purpose                                                                   
                             revenue conversion years, 2004 through                                                             
                             2006, compared to the $2.36 billion                                                                
                             dollars for FY04.  Spring, FY04, is                                                                
                             estimated at $1.96 billion dollars.                                                                
                             The higher numbers for FY05 reflect                                                                
                             higher oil prices.  The total for FY06                                                             
                             is projected at $2.3 billion dollars.                                                              
                             Based on the fall revenue forecast, a                                                              
                             surplus of $653 million dollars is                                                                 
                             projected given the average price of                                                               
                             $43.51 dollars per barrel.                                                                       
 1:54:23 PM Commissioner     Continued, Page 4, Table 2-9 indicates                                                           
             Corbus          the Capital Budget Reserve (CBR) draw,                                                           
                             lasting until February 2011, assuming                                                              
                             the price and production information                                                               
                             presented and the $2.3 billion dollar                                                              
                             budget.  Commissioner Corbus referenced                                                            
                             Table 2-8, looking into the future,                                                                
                             understanding that the State still has                                                             
                             a long run structural financial problem                                                            
                             that needs to be addressed in matching                                                             
                             reoccurring revenues with reoccurring                                                              
                            expenses.                                                                                         
 1:58:44 PM Commissioner     Addressed the actual year to date,                                                               
             Corbus          futures for the remainder time.  He                                                                
                             pointed out that the futures for FY06                                                              
                             are significantly higher than $34.50.                                                              
                             The next update for the Department will                                                            
                             be April, 2005.                                                                                  
 2:00:01 PM Representative Questioned the idea of "not trusting"                                                              
             Joule           OPEC projections.                                                                                
 2:01:26 PM Commissioner     Commented that OPEC has stated that                                                              
             Corbus          they are considering reevaluating the                                                              
                             proposed price range.  The Department                                                              
                             anticipates that change.                                                                         
 2:01:57 PM Representative Referenced Page 2, & asked when that                                                               
             Joule           information would be factored into the                                                             
                             projection.  Commissioner Corbus                                                                   
                             responded that ANWR was not included in                                                            
                             that table.  The full impact of ANWR                                                               
                             will not be felt until after 2020.                                                               
 2:02:44 PM DAN DICKINSON, Explained the process of preparing a                                                               
             DIRECTOR,       forecast every six months.  He                                                                     
             (TESTIFIED VIA acknowledged that it is usually wrong.                                                              
             TELECONFERENCEThe Department does attempt to provide                                                               
             ), TAX          a reasonable model for determining                                                                 
             DIVISION,       price formation in the specified time                                                              
             DEPARTMENT OF   period.  An average is created using a                                                             
             REVENUE,        "best guess" scenario.  A similar                                                                  
             ANCHORAGE       process is used for a long-term                                                                    
                             forecast.  It is important not to                                                                  
                             change the long-term numbers resulting                                                             
                             from recent news.  He emphasized that                                                              
                             there is a tendency to be overly                                                                   
                             optimistic or pessimistic during ups                                                               
                            and downs.                                                                                        
 2:06:28 PM Mr. Dickinson    Referenced Page 10 and how Alaska North                                                          
                             Slope (ANS) is priced relative to West                                                             
                             Texas Intermediate (WTI) prices.  In                                                               
                             the last six months, the differential                                                              
                             has moved up about $6 dollars, which is                                                            
                             extraordinary.  That information causes                                                            
                             concern when determining a forecast.                                                               
                             He referenced Attachment #3.  (Copy on                                                             
                             File).  The graph indicates the                                                                    
                             absolute percentage error in                                                                     
                             forecasting oil prices for the next                                                                
                             year's budget cycle. The graph                                                                     
                             indicates a new price relationship                                                                 
                             between WTI and ANS.                                                                             
 2:09:31 PM Mr. Dickinson    Acknowledged that there are questions                                                            
                             regarding the historical norms for the                                                             
                             forecast.  It is important to note the                                                             
                             volume indicated on Page 12.  The graph                                                            
                             indicates about 30 different producing                                                             
                             areas, which added together provides                                                               
                             the information.  Production is divided                                                            
                             into three categories:                                                                             
                                · Producing fields at this time;                                                                
                                · Production coming from current                                                                
                                  development; and                                                                              
                                · Items under evaluation.                                                                     
 2:12:51 PM Mr. Dickinson    Spoke to the bizarre period occurring                                                            
                             in early January in the North Slope                                                                
                             with warmer temperatures, resulting in                                                             
                             not getting as much oil out of the                                                                 
                             ground at 12,000 barrels per day, a                                                                
                             small number.  He outlined the four                                                                
                             areas of revenue:                                                                                  
                             *Federal numbers provided by Office of                                                             
                             Management and Budget (OMB;                                                                        
                             *Investment numbers; and                                                                           
                             *Other revenues.                                                                                 
 2:14:31 PM BRETT FRIED,     Page 37, Table 5-1, listed the other                                                             
             ECONOMIST, TAX revenues except for the federal and                                                                 
             DIVISION,       investment listings.  The unrestricted                                                             
             DEPARTMENT OF   revenues are broken into different                                                                 
             REVENUE         categories.  He referenced Table 5-2,                                                              
                             the other tax, pointing out the actual                                                             
                             FY04 and projected FY05-FY06 figures.                                                              
                             Page 41, Table 5-2, referencing the                                                                
                             alcohol beverage tax, $16.3 million                                                                
                             dollars projected.  From there, the                                                                
                             column drops down to restricted taxes.                                                             
                             50% of the tax from the alcohol                                                                    
                             beverage tax goes into the prevention                                                              
                             treatment fund.                                                                                    
                             The cigarette column indicates                                                                     
                             projected numbers also into FY07.  The                                                             
                             reason for the increase in cigarette                                                               
                             tax revenue, is that the tax was                                                                   
                                                               st                                                               
                             increased to $1.60 as of January 1.                                                                
                             The corporate income tax changed with                                                              
                             the creation of the Job Assistance Act,                                                            
                             which changed how long taxpayers could                                                             
                             claim their losses, from five to two                                                               
                             years.  He identified fish taxes.                                                                
 2:19:32 PM Mr. Fried        Explained the "other tax" category.                                                              
 2:20:06 PM Vice-Chair       Asked about the drop in motor fuel tax.                                                          
             Stoltze                                                                                                            
 2:20:33 PM Mr. Fried        Stated that FY04 number was high                                                                 
                             resulting from assessments from                                                                    
                             previous years.  There were big                                                                    
                             assessments in those years resulting in                                                            
                             a higher amount.                                                                                 
 2:21:01 PM Representative Referenced the tobacco taxes and asked                                                             
             Hawker          if that had been factored into the                                                                 
                             proposed numbers.  Mr. Fried responded                                                             
                             that it was not factored into the                                                                  
                             forecasts.  There was more revenue in                                                              
                             FY04 when it went into effect.  The                                                                
                             Department is not sure of what the                                                                 
                             source is of the additional revenue.                                                               
                             The future could indicate more revenue                                                             
                             with the increase in the tax rate.                                                               
 2:22:36 PM MICHAEL          Provided an overview of his personal                                                             
             WILLIAMS, DR,   background qualifications, earning a                                                               
             TESTIFIED VIA   doctorate in economics from a                                                                      
             TELECONFERENC, university in Colorado.  He stressed                                                                
             CHIEF           that he has been involved in the energy                                                            
             PETROLEUM       field since his graduation in the early                                                            
             ECONOMIST,      '80's.                                                                                           
             DEPARTMENT OF                                                                                                      
             REVENUE,                                                                                                           
             ANCHORAGE                                                                                                          
 2:25:29 PM Dr. Williams     Spoke to the expansion of crude oil                                                              
                             production within the world market. He                                                             
                             reiterated that OPEC has been                                                                      
                             discussing raising the price ceiling.                                                              
                             He emphasized that there is a growing                                                              
                             oil demand.  Currently, there is a                                                                 
                             "sellers market".                                                                                
 2:27:04 PM Dr. Williams     Touched upon the differential concern.                                                           
                             He mentioned the hurricanes that                                                                   
                             happened in the Gulf of Mexico,                                                                    
                             knocking our many production platforms.                                                            
                             That produced a "sweet" crude oil and                                                              
                             the market needed additional crude oil.                                                            
                             The heavier crude oils were brought                                                                
                             from oils in the middle East, causing                                                              
                             the differential to expand.  He spoke                                                              
                             to price volatility.  He pointed out                                                               
                             that there has been a 5% change per day                                                            
                             since early January and offered to                                                                 
                             address that change.                                                                               
                             He commented on the absolute changes.                                                              
                             The daily changes in January have                                                                  
                             averaged about 1.9%.  On average, the                                                              
                             price change averaged 77 cents per                                                                 
                             barrel per day.  He pointed out that                                                               
                             this months volatility was similar to                                                            
                             that occurring in past years and                                                                   
                             results from people's perspective of                                                               
                             the future.                                                                                      
 2:30:43 PM Dr. Williams     U.S. Energy reported a rise in the                                                               
                             crude oil stock prices.  The world oil                                                             
                             system is affected by production                                                                   
                             capacity and how that relates to a                                                                 
                             stable system.  He added that there is                                                             
                             little spare crude oil capacity but at                                                             
                             the same time, the international                                                                   
                             projection is an increased demand which                                                            
                             is stressing the international system.                                                             
                             He stated that there is political                                                                  
                             volatility in a number of world                                                                    
                             situations.  He predicted that the                                                                 
                             crude oil prices would remain volatile.                                                          
 2:33:11 PM Commissioner     Stated that would complete the                                                                   
             Corbus          presentation from the Department of                                                                
                             Revenue.                                                                                         
 2:33:34 PM Co-Chair Meyer Asked if $500 million dollars was a                                                                
                             safe windfall prediction.  Commissioner                                                            
                             Corbus explained that he was reluctant                                                             
                             to say a "revised projection".  It is                                                              
                             anticipated at this time, and would be                                                             
                             approximately $150 million below.                                                                
 2:34:30 PM Co-Chair Meyer  Asked about any new revenue measures                                                              
                             being considered by the Department.                                                              
 2:35:07 PM Commissioner     Replied that the Office of the Governor                                                          
             Corbus          is evaluating alcohol taxes.  He added                                                             
                             that the Percent of Market Value                                                                   
                             (POMV), the Administration supported it                                                            
                             last session.  Currently, the                                                                      
                             Administration still considers it to be                                                            
                             "On the Table" with other proposals to                                                             
                             take advantage of the Permanent Fund,                                                              
                             addressing long-term fiscal problem.                                                             
 2:36:44 PM Co-Chair Meyer Mentioned the Amerada-Hess dividends                                                               
                             being a separate consideration.  He                                                                
                             applauded the work provided by the                                                                 
                             Department in determining the oil                                                                  
                             forecasting. He stated that the State                                                              
                             could control the oil production and                                                               
                             how that is increased statewide.  He                                                               
                             inquired about dissatisfaction of the                                                              
                             oil companies with the administrative                                                              
                             order to change the tax cut and asked                                                              
                             how it could impact future production.                                                           
 2:37:58 PM Commissioner     Replied that the Administration has                                                              
             Corbus          been "heavily supportive" of the oil                                                               
                             industry to increase production.  He                                                               
                             noted line items, which have boosted                                                               
                             that industry.  The Administration                                                                 
                             stated that the situation at Prudhoe                                                             
                             Bay was unique.                                                                                  
 2:41:12 PM Mr. Dickinson    Interjected, that there was a tax                                                                
                             credit available for exploration.                                                                  
                             There are five companies that are                                                                  
                             looking at that credit at this time.                                                               
                             He added, that the companies want to                                                               
                             know what their tax will be before they                                                            
                             invest. They can apply for an advanced                                                             
                             ruling before they invest through                                                                  
                             regulation.  He stressed that option is                                                            
                             available before making a major                                                                    
                             investment and added that the biggest                                                              
                             consideration is the price to the oil                                                              
                             companies in order that it is                                                                      
                             attractive.  There are concerns that                                                               
                             can be controlled and will be through                                                              
                             advanced rulings.                                                                                
 2:43:51 PM Co-Chair Meyer  Understood that the ruling would be                                                               
                             retroactive and asked if heavy oil                                                                 
                             would then be excluded.  Co-Chair Meyer                                                            
                             voiced his concern with that.                                                                    
 2:44:35 PM Commissioner     Understood the concern with the "heavy                                                           
             Corbus          oil" issue and that the Department was                                                             
                             available to meet with the owners of                                                               
                             those fields to discuss their concerns.                                                            
                             He pointed out that there are                                                                      
                             administrative remedies.                                                                         
 2:45:11 PM Co-Chair Meyer Asked when the additional revenue would                                                            
                             be available.  Commissioner Corbus                                                                 
                             thought that revenue would be available                                                            
                                                      st                                                                        
                             immediately by February 1.  Mr.                                                                    
                             Dickenson interjected that the actual                                                              
                             payment would be one month delayed and                                                             
                             would start the last day of March.                                                               
 2:46:13 PM Co-Chair Meyer  Recommended the State's need to                                                                   
                             diversify in planning long-range fiscal                                                            
                             issues.  He spoke to the Percent of                                                                
                             Market Value and other reasonable                                                                  
                             revenue generating measures.                                                                     
 2:46:56 PM Vice-Chair       Referenced the section addressing                                                                
             Stoltze         business licenses and asked if that had                                                            
                             met the expectation for increased                                                                  
                             revenue.                                                                                         
 2:47:48 PM Mr. Fried        Pointed out that information was                                                                 
                             included in the Charge for Services                                                                
                             section.  Mr. Dickinson interjected                                                                
                             that was listed on Page 42, footnote                                                               
                             #2.                                                                                              
 2:48:16 PM Mr. Fried        Stated that he would get back to the                                                             
                             Committee regarding if the increase                                                                
                             would meet the expectations.  Vice-                                                                
                             Chair Stoltze noted that he had voted                                                              
                             for that concern and now was "upset"                                                             
                             that he had.  He requested more                                                                    
                             information.                                                                                     
 2:49:20 PM Representative Questioned if it was the intent that                                                               
             Hawker          the Percent of Market Value proposal                                                               
                             would raise revenues.  He recalled that                                                            
                             was not the purpose of that proposal                                                               
                             but rather to protect the Permanent                                                                
                             Fund.  He requested clarification.                                                                 
                             Commissioner Corbus acknowledged that                                                              
                             the Percent of Market Value is for the                                                             
                             protection of the fund, however, it                                                                
                             could open up opportunities to make                                                                
                             funds available to fund government.                                                              
 2:50:24 PM Representative Asked if it would make more                                                                        
             Hawker          opportunities than currently available.                                                            
                             Commissioner Corbus responded that the                                                             
                             Legislature has the authority to access                                                            
                             the Permanent Fund, but historically                                                               
                             has chosen not to do that.                                                                       
 2:51:06 PM Representative Understood those comments to mean that                                                             
             Hawker          the Legislature does in fact have the                                                              
                             authority to access the earnings                                                                   
                             reserve and that had not been changed                                                              
                             in any way.  Commissioner Corbus                                                                   
                             agreed.                                                                                          
 2:51:27 PM Representative Asked about the Internal Revenue                                                                   
             Kelly           Service's (IRS) letter regarding                                                                   
                             drilling and if it could be changed by                                                             
                             the Governor or the Legislature.                                                                 
 2:51:53 PM Mr. Dickinson    Replied that there are conditions under                                                          
                             which that letter could be changed but                                                             
                             there would have to be good reason to.                                                             
                             In response to concerns voiced by Vice                                                             
                             Chair Stoltze, he stated that the                                                                  
                             letter establishes conditions to be                                                                
                             met.  In FY03, the revenues generated                                                              
                             were $2.1 million from business                                                                    
                            licenses.                                                                                         
 2:53:00 PM Co-Chair         Noted that would conclude the                                                                    
             Chenault        presentation from the Department of                                                                
                             Revenue.                                                                                         
                                                                                                                                
                             Department of Health & Social Services                                                           
                             Proposed Changes in Medicaid                                                                     
                             Reimbursement                                                                                  
 2:54:59 PM JOEL             Provided the Committee with a handout,                                                           
             GILBERTSON,     Attachment #5.  (Copy on File).  He                                                                
             COMMISSIONER,   introduced Janet Clarke, Director,                                                                 
             DEPARTMENT OF   Division of Administrative Services,                                                               
             HEALTH &        Department of Health and Social                                                                    
             SOCIAL          Services.                                                                                        
             SERVICES,                                                                                                          
 2:56:59 PM Commissioner     Medicaid currently insures about 128                                                             
             Gilbertson      thousand Alaskans.  That budget exceeds                                                          
                             $1 billion dollars in total federal                                                                
                             funding in FY06.  There is some                                                                    
                             volatility in the State's match rate.                                                              
                             Federal Medical Assistance Percentage                                                              
                             Program (FMAP) was calculated annually,                                                            
                             using a three-year average of per                                                                  
                             capita income, to determine if the                                                                 
                             State is a wealthier or poorer state,                                                              
                             which then determines the amount paid                                                              
                             by the federal government.  Alaska                                                                 
                             historically has been a 50/50 state.                                                               
                             There are some services paid by                                                                    
                             Medicaid that are "enhanced" Medicaid                                                              
                             services.  Examples of that are the                                                                
                             State's children's health insurance                                                                
                             program and the breast and cervical                                                                
                             cancer services.  He added that 100%                                                               
                             reimbursement is received for the                                                                  
                             Alaska Natives.                                                                                  
 3:00:13 PM Commissioner     Pointed out that up until 1997, the                                                              
             Gilbertson      Medicaid match rate for Alaska has been                                                            
                             50% federal and 50% State.  In 1997,                                                               
                             Senator Frank Murkowski argued for the                                                             
                             core formula to enhance Alaska's                                                                   
                             Medicaid match rate for three years.                                                               
                             That provided a 9.8% increase for three                                                            
                             years.   Costs for providing care in                                                               
                             Alaska are much higher than other                                                                  
                             states.  When that sunset, the formula                                                             
                             continued to be flawed.  In 2001,                                                                  
                             another piece of legislation won                                                                   
                             passage, again by Senator Murkowski,                                                               
                             which adjusted the formula for a period                                                            
                             of five years.  The result is an                                                                   
                             enhanced match rate for the State of                                                               
                                                               st                                                               
                             Alaska.  That sunsets on October 1,                                                                
                             2005 and reverts back to the underlying                                                            
                             formula calculation for the State.  It                                                             
                             will result in a drop of 7.5 points,                                                               
                             caused by the 5-year sunset and the                                                                
                             fact that the per capita income has                                                                
                             increased statewide.                                                                             
 3:03:52 PM Commissioner     Stated that a major change will occur                                                            
                                      st                                                                                        
             Gilbertson      October 1, 2005, and includes a change                                                             
                             to the manner in which per capita                                                                  
                             income is determined for the nation.                                                               
                             It will include employer contributions                                                             
                             to employee retirement plans.  Such an                                                             
                             adjustment means $53 million dollars                                                               
                             for per capita income.  The State                                                                  
                             Administration has an obligation to fix                                                            
                             this problem in statute.  For FY06, the                                                            
                             Administration has chosen not to fund                                                            
                             that gap and is waiting for the U.S.                                                               
                             Congress to fix it.  The Administration                                                            
                             has been working with the U.S.                                                                     
                             Congressional delegation to fix the                                                                
                             concern before the end of this year's                                                              
                             budget cycle.                                                                                    
 3:06:49 PM Representative Asked about the loss and whether Alaska                                                            
             Hawker          was the only state affected.                                                                       
                             Commissioner Gilbertson responded that                                                             
                             every year, there are changes in the                                                               
                             Medicaid match rates.  Some states go                                                              
                             up and some down.  Alaska experiences                                                              
                             the changes the most and Wyoming is the                                                            
                             state next affected by a three-point                                                               
                             drop.  Representative Hawker commented                                                             
                             that there are other states in this                                                                
                             predicament and that Alaska does not                                                               
                             stand-alone.  Commission Gilbertson                                                                
                             agreed that other states do have an                                                                
                             interest in preventing this reduction.                                                             
                             He reiterated that Alaska is the most                                                              
                             expensive State regarding delivery of                                                              
                             health care services.                                                                            
 3:09:40 PM Representative Requested a definition of FMAP, fair                                                               
             Hawker          share and pro share issues.                                                                        
                             Commissioner Gilbertson explained that                                                             
                             the FMAP is the Federal Medicaid                                                                   
                             Assistance Program and deals solely                                                                
                             with determining the ratio of Medicaid                                                             
                             costs bore by the State and the federal                                                            
                             government.  It is determined by a                                                                 
                             three-year average of the State's per                                                              
                             capita income as compared to the                                                                   
                             national per capita income.                                                                        
                             Fair share is a plan developed in the                                                              
                             State of Alaska in FY01, to oversee                                                                
                             Medicare and Medicaid to allow for                                                                 
                             permissive transfer for funds through                                                              
                             enhanced Medicaid payments to tribal                                                               
                             operated facilities.  That plan went                                                               
                             through a denial and currently is being                                                            
                             litigated by the State of Alaska.                                                                  
                             Pro share deals with permissive                                                                    
                             intergovernmental transfers used to pay                                                            
                             State's share of the Medicaid match.                                                               
                             Private pro share is an approved State                                                             
                             plan amendment, submitted by the State                                                             
                             of Alaska, in which, the State does                                                                
                             make enhanced payments to the private                                                              
                             health care system.                                                                              
 3:13:31 PM Co-Chair Meyer Questioned if the Department's budget                                                              
                             would reflect the reduction to the                                                                 
                             FMAP.  Commissioner Gilbertson                                                                   
                             responded that the Governor's FY06                                                                 
                             budget does not include funding for the                                                            
                             withdrawal from the federal budget for                                                             
                             that amount.  It is intended that the                                                              
                             U.S. Congressional delegation will be                                                              
                             able to "fix" the Medicaid reduction                                                               
                             through legislation.                                                                             
 3:14:54 PM Co-Chair Meyer  Commented that $53 million dollars is a                                                           
                             large risk.  Commissioner Gilbertson                                                               
                             reiterated the he thought there would                                                              
                             be a supplemental requested and                                                                    
                             granted.                                                                                         
 3:15:27 PM Co-Chair Meyer Asked how Alaska compared to other                                                                 
                             states in providing the Medicaid                                                                   
                             program.                                                                                           
                             Commissioner Gilbertson responded that                                                             
                             the Medicaid rates and the amount                                                                  
                             provided to the provider are fairly                                                                
                             high.  Facilities are paid based on                                                                
                             costs.  Alaska rates that go out to the                                                            
                             providers are high.                                                                                
                             He pointed out the eligibility                                                                     
                             standards and the areas within the                                                                 
                             State which have authority over its'                                                               
                             Medicaid program:                                                                                  
                             *Optional services;                                                                                
                             *Optional eligible categories; and                                                                 
                             *Rates                                                                                           
 3:17:23 PM Commissioner     Reiterated that the State has generous                                                           
             Gilbertson      programs.  He commented on capping                                                                 
                             benefit services.                                                                                
 3:18:13 PM Co-Chair Meyer Asked for an explanation of the Senior                                                             
                             Care Program proposed by the Governor.                                                           
 3:18:44 PM Commissioner     Responded that the Senior Care Program,                                                          
             Gilbertson      which provides supplemental funding for                                                            
                             seniors for prescriptive drugs, was                                                                
                             passed in the last legislative session                                                             
                                                              st                                                                
                             and is due to expire on January 1,                                                                 
                             2006.  The Governor intends to propose                                                             
                             legislation this session to enhance                                                                
                             that program.  He listed the criteria                                                              
                             for the program, highlighting "Part D"                                                             
                             for the prescription drugs.  That                                                                  
                             section has its' own premium for those                                                             
                             seniors who are 300% below the poverty                                                             
                             line.                                                                                              
                             He added that there is currently                                                                   
                             proposed legislation in cooperation                                                                
                             with the Mental Health Trust, which                                                                
                             will provide preventative dental                                                                   
                             services for seniors.                                                                            
 3:21:57 PM Co-Chair Meyer  requested more in-depth overview of the                                                           
                             proposed program at a future date.                                                               
 3:22:22 PM Representative Asked if there were guidelines being                                                               
             Kelly           considered to help people move off and                                                             
                             out of the system.                                                                                 
                             Commissioner Gilbertson responded that                                                             
                             the Department works aggressively to                                                               
                             help promote self-sufficiency through                                                              
                             job training skills and other means.                                                               
                             For some people, they will never become                                                            
                             "self sufficient".  This Administration                                                            
                             supports maintaining a strong safety                                                               
                             net.                                                                                               
                             Commissioner Gilbertson acknowledged                                                               
                             that some rural concerns address access                                                            
                             and under-serviced issues.  Those                                                                  
                             concerns differ from various sections                                                              
                             of the State.  He stressed the                                                                     
                             Department's success rate in moving                                                                
                             people out of the program.  It has                                                                 
                             dropped 58%.                                                                                     
 3:24:42 PM Co-Chair         ADJOURNMENT                                                                                    
             Chenault                                                                                                           
                             The meeting was adjourned at 3:25 P.M.                                                           
                                                                                                                                
                                                                                                                                

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