HB 204-POSTSECONDARY MEDICAL EDUC. PROG. 9:18:55 AM CHAIR SEATON announced that the final order of business would be HOUSE BILL NO. 204, "An Act increasing the number of students pursuing a medical education who are provided postsecondary educational services and programs; and providing for an effective date." 9:19:19 AM CHAIR SEATON reminded the committee that pending before it is a motion to adopt CSHB 204, Version 26-LS0778\R, Mischel, 3/31/09, to which he had objected. 9:19:59 AM SAM DIX, Staff, Representative Nancy Dahlstrom, Alaska State Legislature, relayed that the [sponsor] has decided to [support] returning to the original version of HB 204, which would merely add four students to the Wyoming, Washington, Alaska, Montana, and Idaho (WWAMI) program. 9:20:25 AM CHAIR SEATON informed the committee that there have discussions within the legislature, the medical field, and the WWAMI program regarding eliminating the section of [Version R] that addresses medically underserved areas of the state because the definition of "area" wasn't a particular practice. The existing language could result in a situation in which there's a medically underserved area with a profitable practice. There was a proposal to remove the aforementioned section and the definition of "underserved area." There was also discussion of changing the definition of "qualified practice" to refer only to uninsured and Medicare because Medicaid and Denali Kid Care are profitable in some practices. The concern was that [the legislation] would dilute the incentive for doctors to take the three-year reimbursement. CHAIR SEATON explained that the motion to adopt Version R is before the committee and there is an objection to it. 9:23:18 AM REPRESENTATIVE WILSON withdrew her motion to adopt CSHB 204, Version 26-LS0778\R, Mischel, 3/31/09, as the working document. There being no objection, it was so ordered and before the committee was the original version, HB 204. 9:24:17 AM REPRESENTATIVE KELLER encouraged the committee to move the legislation out so that it can be considered in the House Finance Committee. From a policy perspective, he opined that the legislation shouldn't be passed in a vacuum and that the entire workforce shortage in the medical field should be considered. 9:25:53 AM CHAIR SEATON noted that Version R was discussed so that the policy questions incorporated in Version R were fully vetted. 9:26:22 AM REPRESENTATIVE GARDNER agreed with Representative Keller's comments, particularly since the real way to increase doctors in Alaska is to increase the residencies. Simply having more Alaskan students in a medical program doesn't necessarily mean those students will return to the state. 9:26:52 AM CHAIR SEATON stated his agreement, adding that he has learned much about the value of slots in medical schools. The slots are filled with the students from the states with medical schools, which is why WWAMI is so important. 9:27:35 AM REPRESENTATIVE WILSON inquired as to how the benefit works. 9:28:00 AM CHAIR SEATON explained that the state support amounts to about $56,000, half of which is converted into a loan and the student pays about $23,000. That $23,000 loan can be forgiven if the student returns to Alaska. A returning student who serves in rural Alaska receives a 33 1/3 percent per year reduction in their repayment obligation while those who serve in non-rural Alaska receive a 20 percent per year reduction in their repayment obligation. He recalled that about 50 percent of Alaska's WWAMI students return to the state and about another 38 percent of other WWAMI students come to Alaska. Therefore, Alaska receives about 88 percent of WWAMI students, although the state funds much less than that. Chair Seaton opined that the WWAMI program is successful at the current reimbursement rate. 9:29:45 AM REPRESENTATIVE GARDNER moved to report HB 204 out of committee with individual recommendations and the accompanying fiscal notes. There being no objection, it was so ordered.