HJR 14-DELAY IMPLEMENTING AFFORDABLE CARE ACT  3:06:13 PM CHAIR HIGGINS announced that the first order of business would be HOUSE JOINT RESOLUTION NO. 14, Requesting the United States Congress and the Governor to take actions necessary to delay implementation of the Patient Protection and Affordable Care Act. REPRESENTATIVE BILL STOLTZE, Alaska State Legislature, stated that he had drafted this resolution out of concern for the implementation of the Patient Protection and Affordable Care Act, and offered his belief that this act was not well vetted. He suggested that the Supreme Court had identified the act as "a massive tax increase." He said that the crux of this proposed resolution was to seek delay for the implementation of the Patient Protection and Affordable Care Act. He stated that his goal was not to oppose it, but delay its implementation until Congress had examined all the employer costs and impacts on the private sector. He declared that he had contacted the National Federation of Independent Business (NFIB), which he deemed to be an advocacy group for "watching and protecting the interests of the mom and pops in small businesses" which "make up the fabric of our economy." He pointed out that the act did not take effect until 2014. He questioned how many jobs would be lost with the act. He offered his belief that this act was a tax policy, declaring that "taxes affect behavior." He surmised that the application of the act would affect employment and business. He opined that this was one of the largest tax increases in U.S. history. 3:11:41 PM The committee took a brief at-ease. 3:12:19 PM CHAIR HIGGINS brought the committee back to order, and opened public testimony. 3:12:38 PM MARK REGAN said that the State of Alaska, by not setting up a health exchange and not actively regulating health insurance in Alaska, had created a position whereby there was little the state could do to stop the Patient Protection and Affordable Care Act from going into effect. [indisc.] He suggested that the business community was not as nervous about the implementation of the act, as it had been earlier. He expressed his hope that the committee would delay consideration of this resolution until it had heard more balanced information. 3:14:21 PM KEN HELANDER, Associate Director for Advocacy, AARP, said that he was speaking on behalf of the 95,000 AARP members in Alaska, and that AARP strongly objected to HJR 14 and a delay to implementation of the Patient Protection and Affordable Care Act. He stated that HJR 14 did little to advance any meaningful purpose, pointing out that the act had been repeatedly upheld. He suggested that the legislature should look for ways to improve the opportunity for all Alaskans, instead of looking for ways to stand in the way. He declared that the act presented many opportunities for growth and economic stimulus in Alaska. He referenced the Northern Economic study which concluded that the Medicaid expansion would add an additional $15 in federal funds for every state dollar, would generate 4,000 new jobs by 2017, and would generate a cumulative economic benefit between 2014 and 2019 of $2.3 billion. [indisc.] He pointed out that Alaska had opted not to create its own health insurance exchange, which would bring federal involvement for a federally facilitated exchange. He emphasized that implementation of the act in Alaska would allow all Alaskans access to affordable, comprehensive health care coverage. He declared that AARP would act collaboratively with policy makers to ensure that a successful marketplace would be established, providing all Alaskans with health care coverage. 3:17:54 PM REPRESENTATIVE NAGEAK asked for the written comments to be sent to the committee. 3:18:39 PM PEGGYANN MCCONNOCHIE, Owner, Cycle Alaska, said that her company, Cycle Alaska, employed "just under the amount necessary for mandated health care." She said that her company wanted to grow. She declared support for proposed HJR 14. She reviewed that the annual [health care] premium for the average family would increase by $2100, while the IRS estimated that a family insurance plan in 2013 would be $20,000. She declared that her insurance cost had just increased by 13 percent. She referenced a report by the Congressional Budget Office (CBO) which estimated that 7 million people would lose employer based coverage, and she opined that this was due to employer penalties for lack of employee insurance. She suggested that employers would recommend for employees to purchase insurance through the various health exchanges. She reported that other business owners were not hiring, were dividing their companies into units of fewer than 50 employees, or were reducing hours from full time employment in order to avoid this requirement. Again referencing the CBO, she declared there were 1 trillion new taxes under the Patient Protection and Affordable Care Act. She declared that she did not "need or want any more taxes." She offered an anecdote about her pre-existing health condition, and stated that she had always had health care. She opined that the act would increase her health care costs, and would remove some of her current choices. She urged support for HJR 14. 3:21:30 PM CHAIR HIGGINS closed public testimony. 3:21:47 PM The committee took a brief at-ease. 3:22:35 PM CHAIR HIGGINS brought the committee back to order. [CHAIR HIGGINS passed the gavel to Vice Chair Keller.] CHAIR HIGGINS brought attention to proposed Amendment 1, labeled 28-LS0187\U.1, Bailey, 4/1/13, which read: Page 1, line 1: Delete "and the Governor" Insert ", the Governor, and the state's congressional delegation" Page 5, following line 12: Insert new material to read: "FURTHER RESOLVED that the Alaska State Legislature calls on the state's Congressional delegation to introduce, sponsor, support, and vote to pass legislation in both houses of the United States Congress that will delay the implementation of the Patient Protection and Affordable Care Act until a full analysis of the economic effect of the Act on Alaskans and Alaska can be clearly quantified; and be it" CHAIR HIGGINS explained that the proposed amendment added another whereas which would also urge the Alaska congressional delegation in Washington, D.C. to take action to delay implementation of the act. VICE CHAIR KELLER moved to adopt Amendment 1, labeled 28- LS0187\U.1, Bailey, 4/1/13. [Text included above] REPRESENTATIVE PRUITT objected for discussion. REPRESENTATIVE STOLTZE expressed appreciation for the proposed amendment which was consistent with his stated intent. VICE CHAIR KELLER explained that proposed Amendment 1 would delete "and the Governor" on page 1, line 1, and insert "the Governor, and the state's congressional delegation". He noted that, on page 5, line 12, a new "Further Resolved" would be added, and he read: further resolved that the Alaska State Legislature calls on the state's Congressional delegation to introduce, sponsor, support, and vote to pass legislation in both houses of the United States Congress that will delay the implementation of the Patient Protection and Affordable Care Act until a full analysis of the economic effect of the Act on Alaskans and Alaska can be clearly quantified; 3:24:44 PM REPRESENTATIVE PRUITT removed his objection. VICE CHAIR KELLER objected. REPRESENTATIVE NAGEAK asked if there would be further discussion on the proposed resolution. VICE CHAIR KELLER stated that there would be further discussion and he removed his objection. There being no further objection, Amendment 1 was approved. 3:25:13 PM The committee took a brief at-ease. [Vice Chair Keller returned the gavel to Chair Higgins] CHAIR HIGGINS brought the committee back to order. 3:25:41 PM REPRESENTATIVE NAGEAK questioned why there had not been any testimony from the rest of the state regarding proposed HJR 14. He pointed out that the committee had not heard anything from municipalities or tribal governments. He remarked that comments about a resolution of this magnitude should have been heard from the rest of the state. 3:26:56 PM REPRESENTATIVE KELLER declared that he supported the resolution. He said the resolution had been properly posted to allow the public to offer its comments. He offered his belief that the estimated costs to the act would increase. He noted that there were now more taxes, which created an unsustainable burden. 3:28:21 PM REPRESENTATIVE STOLTZE offered his belief that AARP "cut a deal" to market its insurance. He expressed his agreement with earlier testimony that things had changed in the previous six months, although, he opined, things had not "gotten rosier" as the public and private sector were simply more acquiescent toward the issues. He offered his belief that the stakes were elevating even higher, referencing some recent newspaper articles. He suggested that the public was "numbed." He offered his belief that the NFIB testimony represented the private sector and small businesses. He suggested to Representative Nageak that he "be careful about having a lot of trust in that long term; what the federal government gives, it can yank away, and does routinely." 3:31:44 PM REPRESENTATIVE KELLER commented that a tension from the Patient Protection and Affordable Care Act (PPACA) was that it "cuts huge amounts out of Medicare." He deemed that the provider had to pay the difference as Medicare was reduced. He opined that this would create a dependence on Medicaid, "a needs based program." He expressed his concern for seniors, and he suggested that a delay of the act would allow time for more thought. 3:33:17 PM REPRESENTATIVE STOLTZE concluded that he had focused his objections, and that "government can't give us anything unless they yank it away from someone else first." 3:33:58 PM REPRESENTATIVE NAGEAK acknowledged that he was not personally concerned as he had very good insurance, but he expressed his unease for those who could not afford insurance. 3:35:03 PM REPRESENTATIVE REINBOLD offered her belief that it was "important to look out for the fabric of America that's holding our economy together." She said "this is an unbelievable bill and I think it's really important that we slow this process down." 3:35:28 PM REPRESENTATIVE TARR, reporting on the history of the Patient Protection and Affordable Care Act, referenced the individual mandate discussions during the early 1990s. She opined that the individual mandate was the crux of this act and had been supported by the Alaska congressional delegation, as well as endorsed by the Heritage Foundation, which was a well-known pro- business, conservative organization. She declared that this history was important to remember. She remarked that the catalyst for change resulted from the rising health care costs, which were hurting businesses. She declared that "she wouldn't want us to kick the can down the road and not address the issue." She shared her interest in ensuring that "as many Alaskans as possible have health insurance, have access to affordable health insurance." She pointed out that the state with the most insured citizens was Massachusetts, under its health care program, known as "Romneycare." She directed attention to a table titled, "Health Care Model Comparison." [Included in members' packets] She declared that the Massachusetts model was similar to the PPACA, although more restrictive with regard to the employer mandate for required insurance coverage. 3:37:39 PM CHAIR HIGGINS stated that this discussion was not for a comparison of Massachusetts care to PPACA, and that Representative Tarr should "wrap this up." REPRESENTATIVE TARR replied that her comments were valid for the record, and that she did not appreciate her discussion time being shortened as this was a very important issue. She opined: "I don't think 35 minutes in committee over something that affects thousands and thousands of Alaskans is too much time." She pointed to the success of Massachusetts with insuring a high number of individuals, and suggested a look at the components of the Massachusetts plan, as they were important pieces of information for developing a plan to attain this goal of insuring more Alaskans. 3:38:39 PM CHAIR HIGGINS stated that he had previously heard arguments about the Massachusetts plan, which he deemed were "about Massachusetts only and not about any other state, so it's comparing apples to oranges, it's completely different, and that's why the numbers are different." 3:39:16 PM REPRESENTATIVE KELLER commented: "I really think we need to really go slow on this." He indicated a statistic from a 2010 Institute of Social and Economic Research (ISER) study which said that Alaskans spent $7.5 billion for health care, which was projected to double. He said that this was approximately half of the earnings of all Alaskans. He offered his belief that a change was forthcoming, and that it would affect the lives of the elderly and others in Alaska. REPRESENTATIVE KELLER moved to report HJR 14, Version 28- LS0187\U, [as amended], out of committee with individual recommendations and the accompanying zero fiscal notes. There being no objections, CSHJR 14(HSS) was moved from the House Health and Social Services Standing Committee.