HB 367-MEDICAL ASSISTANCE PROGRAM COVERAGE CHAIR DYSON announced that the committee would take testimony on HOUSE BILL NO. 367, "An Act relating to coverage of children and pregnant women under the medical assistance program; and providing for an effective date." [Although the hearing on HB 367 had been officially postponed, Chair Dyson accommodated the following out-of-town witness by allowing him to testify.] Number 0754 CHRIS DEVLIN, Executive Director, Eastern Aleutian Tribes, thanked Chair Dyson for the opportunity to testify. He stated that HB 367's provision to lower the poverty level from 200 percent to 150 percent is a mistake. He characterized the 200- percent level as a safety boat; the 150-percent level would throw people overboard. This causes problems beyond the people directly affected; he explained that a ripple effect occurs. Eastern Aleutian Tribes is the first tribal health organization in the state to apply for community health center funding. He referenced health centers in Fairbanks and Anchorage. These community health centers operate very close to the break-even point; they need the Medicaid funding to continue to provide service to those who "fall outside the boat," he said. MR. DEVLIN encouraged members to involve community health centers in the discussion of the bill, which will have a direct impact on the centers' ability to provide care. He said, "If you wanted to work on some creative measures to try to bring some revenue in, maybe the place to consider would be between the 200 and the 250 or the 200 and the 300 percent. That's where some other states have set their target." He offered that people with incomes of $35,000 to $40,000 are unable to afford $1,000 a month for health insurance. He advised, "We have to be very careful when we start lowering that safety net that was provided, because ... they're going to end up costing the system more in the long run." Number 0854 CHAIR DYSON asked Mr. Devlin about his other work experience. MR. DEVLIN said he had worked in Barrow and Bethel, but this is his first job as the boss. CHAIR DYSON asked about a pattern of children's health problems. MR. DEVLIN replied that care for children is the logical place to invest funds; keeping children healthy will pay off in the future. Currently, oral health care is a big concern. He stated that the children in the Aleutians region are "loaded with cavities." Denali KidCare has allowed Eastern Aleutian Tribes to send more people in for dental treatment. He said the health issues with children are significant. He noted that lower-middle-class and working poor people are not going to pay for preventive health care; they will wait until the problem becomes serious. He indicated Denali KidCare's passage made a big change in getting more children in for care. He suggested finding of a different way to save the little that would be saved by lowering the eligibility percentage. It will cost the state more in the long run, he concluded. CHAIR DYSON inquired where children are sent for dental care. MR. DEVLIN replied that they are sent to Anchorage with a thousand-dollar airfare bill. He said the Aleutian region probably has some of the highest airfares. In some instances when preventative care is not given, the health problem results in a Medivac, he reported. Adults in his region have been sent recently via Medivac for dental purposes, which he pointed out is extremely expensive. [End of testimony on HB 367.]