SB 74-MEDICAID REFORM/PFD/HSAS/ER USE/STUDIES  2:05:10 PM CHAIR STEDMAN announced the consideration of SB 74. He opened public testimony. ROSS BEILING, CEO, Medical Bidline, LLC, testified on SB 74. He provided information about his business. He discussed reform efforts in light of the economic situation. He listed what services his company provides. He suggested looking at cost reforms in health care. He said there has not been competition in health care and it has led to expensive equipment. He said we cannot afford not to get Medicaid expansion right. 2:10:33 PM CHAIR STEDMAN asked Mr. Beiling if he is requesting the state to lower its costs by using used or reconditioned equipment. He asked what his bottom line is. MR. BEILING stated that the state should engage in competitive bidding because it levels the playing field. CHAIR STEDMAN asked for clarification. MR. BEILING said it should be for new and used medical equipment. 2:13:03 PM BECKY HULTBERG, President/CEO, Alaska State Hospital and Nursing Home Association (ASHNHA), testified in favor of reform and expansion concepts in SB 78. She said ASHNHA supports many of the reform concepts in both bills. She opined that expansion is necessary as part of improving Medicaid. She pointed out that hospitals support Medicaid expansion due to the potential for reduction in costs of uncompensated care and to provide fiscal and economic benefits. Reforms are also necessary to improve the Medicaid system. 2:15:05 PM MS. HULTBERG pointed out that the department has already been involved in reform. She stressed the importance of "paying for value." She gave two examples of payment reform, one in Ketchikan and the other in Central Peninsula Hospital. She disagreed with the idea that reform should come before expansion. Reform is an on-going process. She maintained that Medicaid must evolve at the same pace as reform. She disagreed that innovation and change require resources. Providers are going to have to take risk and innovate to create new models of care. She suggested capital for change can come from reduction in uncompensated care. She concluded that reform is achievable and expansion is key to achieving reform. 2:19:04 PM SENATOR STOLTZE requested Ms. Hultberg to comment on the previous speaker's ideas. MS. HULTBERG said she is not familiar with the details of Mr. Beiling's proposals. She agreed competition is a positive principle. SENATOR STOLTZE questioned the role of competition in hospitals. 2:20:33 PM JEFF JESSEE, CEO, Alaska Mental Health Trust Authority (AMHTA), testified in favor of Medicaid reform and expansion in SB 78. He explained that the reform elements in both bills are vital in order to protect AMHTA beneficiaries in the long run. He stated that expansion is critically important to beneficiaries because there are many beneficiaries that do not have any health care. Reform ideas in both bills would go a long way to stabilize Medicaid and would be a positive fiscal move. He said expansion should be looked at because other parts of the state budget could also be brought under the same kind of cost control. He used Corrections as an example of a department in need of sustainability. Recidivism is prevented by providing support for recovery and health care. There is now an opportunity to have 90 percent coverage by the federal government of support for recovery in the Corrections population. He stressed that when the Corrections budget is controlled, then other departments' budgets are affected; Public Defender, Department of Law, Court System, the troopers and the police. He concluded that the Trust is supportive of reform efforts in both bills, and the expansion in SB 78. 2:26:38 PM FRANK MCQUERY, representing himself, testified in opposition to the expansion of Medicaid. He said the bigger the system, the more difficult it is to be controlled. He gave an example of a problem with checking financial eligibility for Medicaid. He said reform is needed before expansion. He maintained that the system will not work for the neediest beneficiaries. He did not believe expansion would work. 2:31:10 PM JEREMY PRICE, State Director, Americans for Prosperity, testified against further implementation of the Affordable Care Act in Alaska. He noted a portion of Alaska's financial report, noting defects in Medicaid's accounting system. He said he agrees with the reform ideas in SB 74. 2:35:11 PM SENATOR STOLTZE asked Mr. Price what outreach he has received from DHSS. MR. PRICE said none. SB 74 was held in committee.