SENATE BILL NO. 87 "An Act establishing a program in the Department of Commerce, Community, and Economic Development for payment of grants to health care providers for care of patients who are 65 years of age or older." 10:14:03 AM Senator French, Sponsor, explained the bill. He maintained that Alaska's Medicare system is not working well. Too many seniors cannot find a primary care doctor. Physicians who do accept Medicare patients are losing money with each visit, as the cost of providing care exceeds the federal reimbursement rate. We can't wait for the federal government to fix Medicare; instead, we need to act today. This legislation will immediately improve seniors' access to primary care services in Alaska. The bill establishes a grant fund for health care providers serving Alaskans who are sixty-five years of age or over. The grants will be paid to medical providers that increase primary care access to Alaska's seniors. All health care providers - including physicians, nurse practitioners, and physician assistants - would be eligible for grants. Access to primary care, as you know Mr. Chariman, improves health outcomes and reduces medical costs. Instead of waiting for small ailments to become major, primary care prevents expensive medical treatments. Instead of requiring an emergency room visit, primary care keeps our seniors healthy. Senator French observed that a new Medicare clinic opened in Alaska. The clinic hopes to serve five to six thousand citizens, which is only half of the 13,000 seniors on Medicare in Anchorage that do not have a primary care provider. While the Medicare clinic is a good step forward, Senator French did not feel that one solution could be relied on to solve the entire problem. He observed that the Institute of Social and Economic Research (ISER) estimates that Alaska will have 86,000 non-native Alaskans eligible for Medicare by 2020. Senator French estimated that the supplemental cost of one primary care visit for those that don't have a primary care doctor would cost the state $1.2 million. He stressed that costs would be reduced by the coverage of nurses and physician assistants. 10:17:51 AM In response to a question by Senator Olson, Senator French clarified that the Medicare clinic was put together by Providence Hospital. Senator Olson wondered if there were provisions to cover dental costs. Mr. Moderow agreed to provide that information. 10:18:24 AM Senator Olson stressed concern with high pharmaceutical costs. Senator French observed that Medicare Part D and the Affordable Care Act shrunk the "donut whole" that affected so many seniors that had to pick up costs of pharmaceuticals. The legislation primarily addresses primary care; pharmacy costs are not addressed. 10:19:23 AM Co-Chair Stedman wondered if there were some areas of the state that are underserved. Senator French stated that the south central region held the biggest issue. 10:20:43 AM JOHN SHERWOOD, DEPARTMENT OF HEALTH AND SOCIAL SERVICES, stated that the responsibility of the program would fall under the Department of Commerce, Community and Economic Development. Federal legislation allowing state grants without Medicare payment issues precludes the state's Medicare agency from operating the grant program. The Department of Health and Social Services is the state agency. Co-Chair Stedman queried the position of the administration. Mr. Sherwood replied that the administration had not taken a position. 10:22:04 AM Co-Chair Stedman highlighted the fiscal note: $234,100 GF from the Department of Commerce, Community and Economic Development for two new positions and supplies. The fiscal note does not make assumptions on the possible number of grants or provide grant funding. 10:22:38 AM PAT LUBY, AARP (via teleconference), testified in support of SB 87. The legislation would enable a grant program to help providers that see a significant number of Medicare patients. He pointed to access problems faced by many Medicare patients, primarily in urban areas. He stressed that older Alaskans will leave the state if they cannot find a health provider. 10:23:37 AM DENISE DANIELLO, EXECUTIVE DIRECTOR, ALASKA COMMISSION ON AGING, spoke in support of SB 87. Alaska continues to lead all states with the growth of its senior population. Currently, there are 53,200 Alaskans age 65 or older. Older Alaskans, growing in number and living longer, are experiencing chronic medical health conditions and physical disabilities. Alaska is, at the same time, experiencing a shortage of primary care providers. In recent years, seniors have been unable to access primary health care as doctors refuse them due to low Medicare reimbursement rates. A statewide survey by the Commission found that 16 percent of respondents had difficulty finding a doctor. In 2005, a similar survey found that 24 percent of seniors experienced a health care problem. Today 31 percent of seniors experience a health care problem. 10:26:23 AM BOB DOLL, PRESIDENT, RETIRED PUBLIC EMPLOYEES OF ALASKA, testified in support of SB 87. Medicare appears as the state sanctioned method for providing post-retirement age medical coverage that was part of employment for retirees. He observed that the retirees look to the plan creators (legislature) for remedy to problems. He maintained that that SB 87 provides a remedy and acknowledged the work of the Alaskan congressional delegation in making supplementary payments to Medicare providers legal. He maintained that thousands of Alaskan seniors pass through the Medicare window every year and some will find that their health care is jeopardized. 10:27:55 AM Co-Chair Hoffman wondered why there was a proposal to set up the program without recommendations for individual grants. Senator French replied that there was a recommendation of $1.2 million, which would satisfy the problem for a year. 10:28:46 AM SB 87 was HEARD and HELD in committee for further consideration.