SJR 3-MEDICARE RATES IN ALASKA 4:09:12 PM CHAIR WILSON announced that the next order of business would be SENATE JOINT RESOLUTION NO. 3, Relating to the effect of Medicare rates on senior citizens' access to healthcare; and urging the United States Congress to increase Medicare rates for Alaska. 4:09:36 PM SENATOR BILL WIELECHOWSKI, Alaska State Legislature, presented SJR 3, as prime sponsor, paraphrasing from the sponsor statement, which read as follows [original punctuation provided]: Approximately 55,000 Alaskans rely on the federal Medicare Program to meet their health care needs. As you know, Medicare serves senior citizens age 65 and older, certain Alaskans with disabilities, and those with end-stage kidney disease. This is the largest health insurance program in the country, and one that is of key importance to all Alaskans. Once any of us turns 65, Medicare provides our primary insurance coverage, regardless of whether we have other health insurance. Unfortunately this program is increasingly letting down some of Alaska's most vulnerable citizens, and that should be of concern to all of us Many Alaska physicians say that Medicare pays less than 50% of what it costs them to treat their patients. As a result, an alarming number are refusing to accept new Medicare patients, and many are terminating existing patients. This is leaving a growing number of senior and disabled Alaskans without access to medical care, including those with life-threatening illnesses. We have all read reports of seniors calling dozens and dozens of doctors before finding one that will see them. Projections show the problem will only get worse. Baby boomers begin turning 65 in 2011, four years from now. The number of Alaskans on Medicare is expected to double in the next 25 years. The American Medical Association calls the Medicare reimbursement formula "broken beyond repair." A national survey of doctors conducted by the AMA found that nearly half will be forced to decrease or stop accepting new Medicare patients if reimbursement rates get any lower. The United State Medicare Payment Advisory Commission concurs that rate cuts will only worsen patient access to medical doctors. Likewise, the Military Officers Association of America says Medicare reimbursement rates are hurting military beneficiaries' access to care since military health insurance is linked to Medicare reimbursement rates. Unfortunately we are told by the Congressional Budget Office that in 2008 Alaska will lose $8 million in federal payments to doctors as a result of cuts in Medicare reimbursement rates. The CBO projects a loss of $240 million between 2008 and 2015 as a result of planned rate cuts of nearly 40%. The problem in Alaska appears to be worse than in other states because of the higher cost of providing medical care in Alaska and a funding formula that does not take this into account. Alaska is the only state in which Medicare reimbursement rates are even lower than those for Medicaid. SJR 3 calls on Congress and the U.S. Department of Health and Human Services to address this crisis by rewriting the formulas used to develop Medicare reimbursement rates for Alaska. It also urges Congress to address inequities in physician reimbursement that are leading to the collapse of the primary care system and limiting seniors' access to those physicians best qualified to coordinate their care. I urge you to join me in supporting SJR 3 and helping to ensure that senior and disabled Alaskans get the medical care they need and have been promised. 4:12:04 PM REPRESENTATIVE GARDNER asked why the problem is worse in Alaska than in other states. SENATOR WIELECHOWSKI answered that it is worse here due to the higher costs of medical procedures, the shortage of doctors, and the cost of pharmaceuticals. He noted that the Legislative Health Caucus reported that rates for medical procedures in Alaska are 30 percent to 40 percent higher than in Washington or Oregon. Furthermore, the shortage of doctors means that there is no competition to keep costs lower or to encourage doctors to see Medicare patients. 4:13:36 PM REPRESENTATIVE SEATON offered to make an amendment that provides for the electronic transmittal of the resolution. SENATOR WIELECHOWSKI said he had no objection. 4:15:18 PM REPRESENTATIVE SEATON offered Amendment 1 to insert on page 2 line 29 after the word "sent", "by electronic transmission and by mail." 4:15:44 PM REPRESENTATIVE GARDNER objected and said that as the resolution is written it is not precluded from being transmitted electronically. She advised that amending the resolution will result in a delay as it is returned to the senate for concurrence. REPRESENTATIVE SEATON explained that documents are sent by mail unless specified for electronic transmission. 4:16:38 PM REPRESENTATIVE CISSNA suggested supporting the resolution as it is and offering this amendment on the floor. 4:17:17 PM REPRESENTATIVE SEATON offered to withdraw the amendment. 4:17:37 PM SENATOR WIELECHOWSKI stated he would have his office send the resolution by electronic mail. REPRESENTATIVE SEATON withdrew Amendment 1. 4:17:55 PM REPRESENTATIVE NEUMAN opined that amendments should be offered in committee. CHAIR WILSON expressed her understanding of Senator Wielechowski's concern about delaying the passage of the resolution. REPRESENTATIVE ROSES pointed out that if the Medicare payment level is raised it may help with a portion of Alaska's unfunded liability that is in the medical obligation of the Alaska Public Employees Retirement System and Teachers Retirement System (PERS/TRS). 4:19:10 PM REPRESENTATIVE NEUMAN asked whether stronger legislation than a resolution can be written SENATOR WIELECHOWSKI informed the committee that this problem is with the federal system, which limits the state's influence. He expressed his hope that the Washington, Alaska, Montana, and Idaho Family Practice Residency Program (WAMI) bill will bring more doctors into the state in the long run. Furthermore, the legislature has state universal health care legislation to consider during this session. Nevertheless, SJR 3 asks for a remedy on the federal level. 4:20:39 PM REPRESENTATIVE CISSNA advised that a representative of the congressional delegation has stated that it is important to hear from the state about these issues. She opined that this resolution is appropriate. 4:22:01 PM REPRESENTATIVE SEATON moved to report SJR 3 out of committee with individual recommendations. There being no objection, SJR 3 was reported from the House Health, Education and Social Services Standing Committee.