HOUSE LABOR AND COMMERCE STANDING COMMITTEE March 22, 2000 3:20 p.m. MEMBERS PRESENT Representative Norman Rokeberg, Chairman Representative Andrew Halcro, Vice Chairman Representative Lisa Murkowski Representative John Harris Representative Tom Brice Representative Sharon Cissna MEMBERS ABSENT Representative Jerry Sanders COMMITTEE CALENDAR HOUSE BILL NO. 298 "An Act requiring that health care insurers provide coverage for treatment of diabetes." - MOVED CSHB 298(L&C) OUT OF COMMITTEE HOUSE BILL NO. 303 "An Act relating to the method of payment of fees and adoption of regulations under AS 21; relating to orders under AS 21 regarding risk based capital instructions; relating to accounting standards for insurance companies; amending the definitions of 'creditable coverage' and 'late enrollees' in AS 21.54; relating to requirements for small employer insurers; relating to requirements for issuance of new voting securities by an insurance company; requiring health care insurance coverage for reconstructive surgery following mastectomy; requiring guaranteed renewability of and certification of coverage regarding certain individual health insurance policies; and providing for an effective date." - MOVED HB 303 OUT OF COMMITTEE PREVIOUS ACTION BILL: HB 298 SHORT TITLE: REQUIRE HEALTH INS COVERAGE FOR DIABETES Jrn-Date Jrn-Page Action 1/21/00 1961 (H) READ THE FIRST TIME - REFERRALS 1/21/00 1961 (H) HES, L&C, FIN 1/24/00 1996 (H) COSPONSOR(S): PHILLIPS 2/22/00 (H) HES AT 3:00 PM CAPITOL 106 2/22/00 (H) Moved CSHB 298(HES) Out of Committee 2/22/00 (H) MINUTE(HES) 2/25/00 2315 (H) COSPONSOR(S): CISSNA 2/28/00 2327 (H) HES RPT CS(HES) 6DP 1DNP 2/28/00 2328 (H) DP: GREEN, MORGAN, DYSON, WHITAKER, 2/28/00 2328 (H) KEMPLEN, BRICE; DNP: COGHILL 2/28/00 2328 (H) ZERO FISCAL NOTE (DCED) 2/28/00 2328 (H) REFERRED TO LABOR & COMMERCE 3/17/00 (H) L&C AT 3:15 PM CAPITOL 17 3/17/00 (H) Heard & Held 3/17/00 (H) MINUTE(L&C) 3/20/00 2620 (H) COSPONSOR(S): KERTTULA 3/22/00 (H) L&C AT 3:15 PM CAPITOL 17 BILL: HB 303 SHORT TITLE: MISC. INSURANCE PROVISIONS Jrn-Date Jrn-Page Action 1/21/00 1967 (H) READ THE FIRST TIME - REFERRALS 1/21/00 1967 (H) L&C, HES 1/21/00 1967 (H) ZERO FISCAL NOTE (DCED) 1/21/00 1967 (H) GOVERNOR'S TRANSMITTAL LETTER 3/20/00 (H) L&C AT 3:15 PM CAPITOL 17 3/20/00 (H) Heard & Held 3/20/00 (H) MINUTE(L&C) 3/22/00 (H) L&C AT 3:15 PM CAPITOL 17 ACTION NARRATIVE TAPE 00-33, SIDE A Number 0001 CHAIRMAN NORMAN ROKEBERG called the House Labor and Commerce Standing Committee meeting to order at 3:20 p.m. Members present at the call to order were Representatives Rokeberg, Halcro, Murkowski, Harris and Brice. Representative Cissna arrived as the meeting was in progress. [For minutes on the overview regarding industry involvement in workforce development, see minutes for portion of meeting begun this date at 3:32 p.m.] HB 298-REQUIRE HEALTH INS COVERAGE FOR DIABETES CHAIRMAN ROKEBERG announced the first order of business would be HOUSE BILL NO. 298, "An Act requiring that health care insurers provide coverage for treatment of diabetes." [Before the committee was CSHB 298(HES), as amended (Amendment 1) at the hearing on 3/17/00. There also had been a motion to adopt Amendment 2.] CHAIRMAN ROKEBERG made a motion to withdraw Amendment 2. There being no objection, Amendment 2 was withdrawn. Number 0112 REPRESENTATIVE HALCRO made a motion to adopt Amendment 3, which read [original punctuation provided]: Page 2, Line 1, insert new subsection (b) to read: (b) The amount of coverage for the cost of diabetes outpatient self management training or education is limited to $1,500.00 per person per year. Re-letter following subsection. Page 2, Line 6, add new Sec. 2 to read: *Sec. 2. AS 21.42.390(b) is repealed January 1, 2003. CHAIRMAN ROKEBERG objected. REPRESENTATIVE MURKOWSKI explained that a cap was discussed at the previous meeting. She said: The discussion that we had heard was that education is a real key component to diabetes care, and they had agreed to a cap, that they would like to see the cap higher to make it a more realistic cap. And so we are presenting to the committee a cap of $1,500 per person per year, ... with the repealer January 1, 2003, for the cap, giving the insurance companies hopefully some time to make sure that this works, run their numbers, do what it is that they feel that they have to do. We feel that this is a workable compromise. I will, for the record, state that Mr. Evans' [Gordon Evans, who had proposed Amendment 2] clients aren't entirely satisfied with it; and I think some are looking at this as that this may be the lesser of the evils, because otherwise ... there's a possibility that this would go forward without a cap at all. But I think that it is a fair compromise at this point, and I would encourage the members to support it. CHAIRMAN ROKEBERG stated: I would prefer the entire amendment at a lower amount, because I think in the spectrum of the public costs and with the sunset provision, they will be given the opportunity to review and see if that was adequate, inadequate, and also, with the testimony we had, I believe the rough estimates - as I recall the testimony - were between, say, $3,000 and $6,000 a year, depending on the severity of the disease. And what has to be provided to the patient does vary, of course, but this is only a component of the total benefits that would be mandated. REPRESENTATIVE HALCRO referred to previous testimony by Young Shin, Registered Dietician, who had stated that the cost for management training and education would be anywhere between $500 to $2,000. He wondered if the amendment only pertained to management training and education. REPRESENTATIVE MURKOWSKI clarified that the cap specifically refers to management training and education. REPRESENTATIVE HALCRO explained that he did not support the cap at the previous hearing on HB 298 because he thinks training and education is the foundation of treating diabetes. He noted that he will support the [present] amendment. CHAIRMAN ROKEBERG withdrew his objection to Amendment 3. Number 0536 REPRESENTATIVE HALCRO made a motion to move HB 298 [CSHB 298(HES)], as amended, out of committee with individual recommendations and the attached zero fiscal notes. There being no objection, CSHB 298 (L&C) moved out of the House Labor and Commerce Standing Committee. HB 303-MISC. INSURANCE PROVISIONS CHAIRMAN ROKEBERG announced the next order of business would be HOUSE BILL NO. 303, "An Act relating to the method of payment of fees and adoption of regulations under AS 21; relating to orders under AS 21 regarding risk based capital instructions; relating to accounting standards for insurance companies; amending the definitions of 'creditable coverage' and 'late enrollees' in AS 21.54; relating to requirements for small employer insurers; relating to requirements for issuance of new voting securities by an insurance company; requiring health care insurance coverage for reconstructive surgery following mastectomy; requiring guaranteed renewability of and certification of coverage regarding certain individual health insurance policies; and providing for an effective date." CHAIRMAN ROKEBERG explained that this bill makes some technical corrections including the federally mandated reconstructive surgery following a mastectomy. He commented that it is important to make these technical corrections to state statute in order to retain primacy of the Division of Insurance on the health insurance in Alaska with respect to affordability. Number 0647 REPRESENTATIVE HALCRO made a motion to move HB 303 out of committee with individual recommendations and the attached zero fiscal note. There being no objection, HB 303 moved out of the House Labor and Commerce Standing Committee. CHAIRMAN ROKEBERG called an at-ease to prepare for the overview regarding industry involvement in workforce development. [For that portion of the meeting, see minutes for this date, 3:32 p.m.]