HJR 17-FEDERAL ENSURING LASTING SMILES ACT  3:22:59 PM CHAIR MINA announced that the first order of business would be HOUSE JOINT RESOLUTION NO. 17, Urging the United States Congress to pass the Ensuring Lasting Smiles Act; and urging lawmakers to advocate for policies that guarantee equitable access to vital healthcare. 3:23:21 PM REPRESENTATIVE ALYSE GALVIN, Alaska State Legislature, as prime sponsor, presented HJR 17. She noted that the other body is currently considering the same resolution. She read the prepared sponsor statement [included in the committee file] for HJR 17, which read as follows [original punctuation provided]: House Joint Resolution 17 urges the United States Congress to pass the Ensuring Lasting Smiles Act (ELSA). Currently, individuals born with congenital anomalies, such as cleft lip, cleft palate, and other conditions, can be denied coverage by private medical insurance companies for treatment that is medically necessary. ELSA will close the federal loophole that allows insurance companies to deny coverage to individuals who are faced with a lifetime of surgeries, speech therapy, dental care, and other medical needs. Families in Alaska with children who have congenital dental anomalies are faced with an extraordinary cost burden. The financial costs can exceed $100,000 with care denied based on the misconception that the dental work is cosmetic. Dental health impacts overall health and well-being. Missing or malformed teeth, cleft lip and cleft palate, cause a myriad of health problems. Missing teeth can affect speech patterns and the ability to chew food, potentially resulting in nutritional deficiencies. Cleft lip and cleft palate can lead to difficulties with speech, feeding, and breathing. Congenital dental anomalies also carry a large psychological impact and my contribute to social isolation and negative self-perception. All individuals should be able to access necessary medical and dental care without the fear of an excessive financial burden. I ask for the Alaska State Legislature's support of HJR 17 and urge the Alaska Congressional Delegation to champion this legislation to close the federal loophole that denies essential dental treatment to individuals affected by congenital anomalies. REPRESENTATIVE GALVIN further noted that the Anchorage Assembly has passed a similar resolution to HJR 17 and that ELSA has also been reintroduced in the 119th Congress with bipartisan sponsorship in the House of Representatives and the U.S. Senate. 3:27:19 PM CHAIR MINA opened public testimony on HJR 17. 3:27:41 PM EMILY BRUBAKER, representing self, shared that she was diagnosed with hypohidrotic ectodermal dysplasia and she has been advocating for ELSA since she was six years old. She said that currently insurance companies classify medical procedures for cleft lips and cleft palates as cosmetic. She emphasized that ELSA would close a loophole that allows such procedures to be classified as cosmetic and unnecessary. She stated that the out-of-pocket costs for procedures that she would need to have in the future would cost over $100,000 without ELSA. Additionally, she stated there are other medical conditions for which ELSA would apply. 3:30:27 PM BRIAN BRUBAKER, representing self, stated that he is the father of Emily Brubaker and emphasized the extreme out-of-pocket costs his family has faced for her healthcare. He asserted that dentistry healthcare is not cosmetic. He thanked the committee for considering HJR 17. 3:31:44 PM LLANA KERSCHBAUM, representing self, testified in support of HJR 17. She stated she has a son with a rare medical condition called oligodontia. She stated that the medical treatments required for her son's condition would be very costly and would not be covered by health insurance. She stated that she was advised to find between $100,000 and $150,000 for her son's medically necessary procedures. Additionally, she noted that there were no specialists in Alaska at the time of her son's diagnosis. She described the extensive care that she has sought for her son outside of the state, as well as the many procedures to come. She noted that the affected population is a minority, but that other families like hers are currently being denied healthcare that is not optional. 3:35:30 PM REPRESENTATIVE PRAX asked for clarification about the insurance coverage that Ms. Kerschbaum received. MS. KERSCHBAUM replied that her family were insured through AETNA and her insurance as a teacher. She reiterated that private insurers consider all the treatments her son needs as cosmetic. MS. KERSCHBAUM, in response to a follow-up from Representative Prax, clarified that her son had coverage from birth and was dual insured. 3:38:58 PM CHAIR MINA, after ascertaining that there was no one else who wished to testify, closed public testimony on HJR 17. 3:39:20 PM REPRESENTATIVE RUFFRIDGE sought clarification that HJR 17 applied to private insurance. He asked if the goals of HJR 17 could be better accomplished by the legislature under Title 21, rather than a resolution. REPRESENTATIVE GALVIN replied that her constituent, Ms. Emily Brubaker, noted that there is a loophole at the federal level, allowing for private insurance companies to still not cover necessary dentistry care for patients. She said that she has not explored what could be done at the state level, through Title 21. REPRESENTATIVE RUFFRIDGE shared concern over the "piece-meal" insurance system and noted that dental and vision insurance typically does not cover enough. REPRESENTATIVE GALVIN reiterated testimony from Ms. Kerschbaum, providing the example that if her son had been in a car accident and required dental work, that would be considered medically necessary dental work. She added that ELSA affects thousands of individuals across the nation. She said that she would be happy to work offline with Representative Ruffridge to consider legislation at the state level. 3:43:31 PM REPRESENTATIVE GRAY offered agreement with Representative Ruffridge and considered making a motion to move HJR 17 from committee. 3:43:48 PM The committee took an at-ease from 3:43 p.m. to 3:44 p.m. 3:44:17 PM REPRESENTATIVE GRAY agreed that it is not a good idea to move HJR 17 from committee at this time. 3:44:36 PM REPRESENTATIVE PRAX stated that he was surprised because he believed, under state statute, congenital abnormalities and birth defects are supposed to be covered by insurance. He said that he previously worked for an insurance company that covered congenital abnormalities, including cleft palates. REPRESENTATIVE GALVIN noted that two separate insurance companies turned away the previous affected testifiers due to their recommended procedures being classified as cosmetic. 3:46:31 PM CHAIR MINA said that there may be a difference in state statutes regarding coverage for congenital defects at birth versus an ongoing medical condition. REPRESENTATIVE PRAX said that if HJR 17 is held over, it would be worth the committee's time to hear from the Division of Insurance to clear up concerns. REPRESENTATIVE GALVIN noted that, in some cases, the medical conditions were not evident at birth and that may have impacted insurance coverage. 3:48:17 PM CHAIR MINA announced that HJR 17 was held over.