CSHB 195(L&C)am-STATE HEALTH INSURANCE PLAN  SENATOR SEEKINS announced CSHB 195(L&C)am to be up for consideration. MS. HEATHER NOBREGA, staff to Representative Rokeberg, explained that CSHB 195(L&C)am deals with two distinct areas. Section 1 attempts to give individual health care insurance seekers the option of providing a bare bones insurance policy that doesn't include the state mandates listed in statute. This is intended to be in addition to the normal individual plan that would include all the mandates that are required. The proposed CS includes clarifying language on this issue on page 2, lines 2 - 4, that the bare bones coverage is "in addition to" the mandatory coverages listed in statute. The Division of Insurance requested the second portion of the bill. The federal government has adopted the Trade Adjustment Assistance Act, which provides a 65% health care tax credit on an insurance premium for people, like timber and oil workers, who have lost their jobs due to the effects of international trade acts. Sections 2 through 9 make conforming amendments to the Alaska Comprehensive Health Insurance Association (ACHIA) statutes so that those individuals who do qualify under the Federal Trade Adjustment Assistance Act can actually get 65% of their ACHIA premiums paid by the federal government. SENATOR DAVIS arrived at 3:22 p.m. SENATOR SEEKINS moved to adopt SCS CSHB 195(L&C), version U, as the working document. There were no objections and it was so ordered. SENATOR SEEKINS asked Ms. Nobrega to explain the numbers on the handout, which she did briefly. SENATOR SEEKINS asked what the impetus was to provide this kind of policy. MS. NOBREGA replied that this was Representative Rokeberg's idea. He wanted to help provide cheaper health care insurance for people who don't want all the coverage but would like some form of health care insurance. MS. MICHELLE CASSANO, Executive Director, American Diabetes Association, wanted to clarify the mandate in AS 06.42.390 is for coverage of diabetes treatment including medication, equipment and education. She indicated: HB 195 will eliminate the requirement that state regulated individual health insurance plans cover diabetes supplies, equipment and self-management education. It will eliminate a similar requirement to many other health benefits. The business community claims mandates-free policies provide affordable health insurance through [indisc.] consumer choice, but, in fact, they only provide employers and consumers with the choice of a health insurance plan that does not cover basic, necessary services. HB 195 will allow diabetes coverage to be offered rather than required in individual health insurance plans. [Indisc.] option coverage, but it doesn't work... She said that they wouldn't support HB 195 unless section 1 was eliminated. Approximately 39,000 Alaskans are affected by diabetes. SENATOR STEVENS asked if the changes in the bill would remove the mandate that insurance policies cover preventative treatment of diabetes and whether that would let the insurance companies off the hook for all of the debilitating aspects of diabetes as it progresses. MS. CASSANO replied that it is scientific fact that preventative care and good control of diabetes can limit complications in the aggregate by 68% in both Type 1 and Type 2 diabetes. MS. LOIS HILDEBRAND, Volunteer, American Cancer Society, said: This bill sets up a dangerous precedent for Alaskans for not getting life-saving cancer screening tests. Furthermore, it contains inconsistencies that undermine the stated intent of the legislation. Over the last decade, state legislatures have increasingly become aware of the importance of requiring insurance coverage for cancer screening. Early detection of cancer is the key to survival.... She said that all attempts made to reduce required insurance coverage in Washington State failed. MR. BILL MOORE, Manager, Legislative Policy, [indisc.], said his group likes legislation that responds to consumer concerns about rising costs of health insurance premiums and offers a choice in the health insurance marketplace. He stated, "We think HB 195 advances all of these principles." MS. JANEL WRIGHT, Anchorage resident, said she has had diabetes for over 27 years and urged the committee to not pass HB 195 or at least to eliminate section 1. She pointed out, "Access to and reimbursement providing supplies and equipment and self management education is cost effective." She said managing diabetes is expensive, but the cost to treat the complications of unmanaged diabetes is even more expensive. MS. LINDA HALL, Director of the Division of Insurance, said she thought there was a misunderstanding about this particular bill and the adopted CS. There is no intention on the part of the sponsor of the bill, which has the support of the division, to remove mandates for coverage. This was an attempt to make an option available should anyone choose to do so, requires a very clear disclosure of the lesser coverage provided by this particular option so that it might make a small dent in the number of uninsured people. We have a problem with health insurance costs; we have a problem with health care costs.... MS. HALL said the CS specifically maintains those mandates for individuals who choose to buy individual health care policies. This does not affect group policies or employer provided policies at all. She explained: The Division of Insurance did ask for the balance of this bill to be added. There will be federal money available in August for individuals whose jobs are replaced through various international trade assistant acts. This money is coming from the federal government and will be administered by the Department of Labor. Again, this is a small step in helping alleviate our uninsured population. The estimate right now is that there probably would have been 200 people this year affected by this. The estimates we were given by the Alaska Department of Labor indicated up to as many as 2,000 could have been affected in some prior years. We're very much encouraging you to pass this bill so that our citizens will be eligible for this care in August when the money is available. CHAIR BUNDE thanked her and said they would hear the bill again and Ms. Hall would be available, but he wanted to take public testimony with the remaining time. MS. BETSY TURNER-BOGGREN, Ester resident, asked the committee to not support HB 195 as it is written. Three years ago, she and her son, Max, traveled to Juneau and testified in front of this committee in support of HB 298 and SB 276, which required insurers in our state to reimburse for costs related to diabetes management. It became law and had overwhelming support. She told members, "HB 195 would not create a new type of health insurance policy. Instead, it would recreate the old type of policies that did not work well for the people of Alaska." CHAIR BUNDE responded that testimony from the Division of Insurance said that this bill does not remove any requirement for coverage. MS. BOGGREN replied that she didn't think that the language stated that very clearly, especially in section 1, which says: A health care insurer may offer a health care insurance plan issued to the individual market that does not include health coverage required under... CHAIR BUNDE said he would get further clarification of that section. MS. KARIN BRAUN, Nurse Midwife, opposed HB 195, especially section 1. She was concerned that if the legislature creates this precedent for individuals, group insurance will follow. MS. CARLA WILLIAMS, Alaska Breast Cancer Advocacy Partners, opposed HB 195 and said that she had submitted written testimony. MS. CAMILLE SOLEIL, Alaska Nurses Association (ANA), said the ANA opposes section 1 of HB 195. The ANA's concern is that this type of insurance would discriminate against midwives. CHAIR BUNDE apologized for rushing the testimony, but members were late for another meeting. He said he would hold the bill for further work and testimony.