SENATE BILL NO. 13 "An Act relating to eligibility requirements for medical assistance for certain children and pregnant women; and providing for an effective date." SENATOR BETTYE DAVIS, SPONSOR, introduced the bill and her staff member. LYNNE KORAL, INTERN, SENATOR BETTYE DAVIS, discussed the legislation, which increases eligibility limits for Denali Kid Care (DKC) from 175 to 200 percent of the federal poverty level (FPL). She explained that SB 13 restores the original level of the qualifying income eligibility standard for the DKC program to 200 percent of the FPL. She explained that DKC is considered an enhanced reimbursement program with up to 70 percent matching funds from the federal government's State Children's Health Insurance Program (SCHIP), created in 1997. Ms. Koral stated that uninsured children with a medical need are four times more likely to use emergency rooms at a much higher cost because they tend not to receive care from a regular care provider. Alaska is one of five states who fund its SCHIP program below 200 percent of the FPL. Private health care coverage for children has declined over 30 percent in the last 10 years and the deepening recession is pulling more children and families into the uninsured ranks. SB 13 makes insurance eligibility accessible to an estimated 1,277 additional children and 225 additional pregnant women in Alaska. 9:36:34 AM Co-Chair Hoffman commented that the administration does support CSSB 116. Senator Huggins asked if the administration supports SB 13. Senator Bettye Davis stated that she had not been informed about a lack of support from the administration. The department stated that they indeed support an increase in eligibility limits to 200 percent of the FPL in the last Senate Finance Committee meeting of 2/25/09. 9:38:06 AM JON SHERWOOD, DIRECTOR, OFFICE OF PROGRAM REVIEW, DEPARTMENT OF HEALTH AND SOCIAL SERVICES (DHSS), explained that the Governor publically supported expanding income eligibility levels to 200 percent of the FPL. The Governor expressed interest in provisions such as premiums. He stated that the administration does not have a position in opposition to SB 13. Senator Huggins asked for the contrast between a similar bill addressing the increase of eligibility limits for DKC. Mr. Sherwood answered that there were four different proposals on the table to expand the DKC program. Two of the bills expand beyond 200 percent of the FPL with some degree of cost sharing in the form of premiums and or co-pays. One bill expands from 175 to 250 percent of the FPL with cost sharing in the form of premiums beginning at 175 percent of the FPL and expanding for children only. Senator Huggins assumed that the specialists in the department favor one bill that best supports children and remains cost effective. 9:40:43 AM Mr. Sherwood stated that he had disclosed all of the information that was available to him. He did not feel that he could answer the question further. Senator Huggins encouraged an effective means of helping Alaskans with healthcare costs and he asked the administration to come forward with a position. Senator Bettye Davis stated that the cost of the various bills remains the same, however, SB 13 allows children to obtain coverage as soon as possible. She emphasized that the proper action was to bring as many children onto DKC as soon as possible. She maintained that cost sharing was still a possibility with another bill. She stressed that the solitary goal of SB 13 was raising income eligibility limits to 200 percent of the FPL. Senator Huggins stated that he preferred an omnibus bill that combines the best methods within the available means. 9:43:33 AM Senator Bettye Davis stated that SB 13 could pass while work occurs with the other bills providing the accomplishment of many good ideas. Co-Chair Stedman asked if additional employees were necessary to process the paperwork. Mr. Sherwood answered that the program's caseload will increase by 1500 additional individuals. He informed that given the current caseload averages, two additional employees are necessary. Co-Chair Stedman asked if the positions were eliminated when eligibility was reduced in 2003. 9:45:43 AM ELLIE FITZJARRALD, DIRECTOR, DIVISION OF PUBLIC ASSISTANCE, DEPARTMENT OF HEALTH AND SOCIAL SERVICES, commented on the elimination of positions with eligibility reductions. The two positions requested for SB 13 are due to changes in Medicaid requirements surrounding citizenship verification and the emphasis on payment accuracy to ensure that applicants are eligible for the program. When income scales are increased, more time is needed to ensure eligibility. The request for additional employees serves the increased number of applicants. 9:47:58 AM Co-Chair Stedman spoke to the three fiscal notes increasing the general fund spending $861,000 in FY09 and $940,000 in FY10. Senator Bettye Davis stated that she wished for the bill to pass out during the current hearing. Co-Chair Hoffman MOVED to report SB 13 out of Committee with individual recommendations and the accompanying fiscal notes. There being NO OBJECTION, it was so ordered. SB 13 was REPORTED out of Committee with "no recommendation" and with a new fiscal impact note by the Department of Health and Social Services and with two previously published fiscal impact notes: FN1 (DHS) and FN2 (DHS).