SENATE HEALTH, EDUCATION AND SOCIAL SERVICES COMMITTEE March 28, 1994 1:37 p.m. MEMBERS PRESENT Senator Steve Rieger, Chairman Senator Bert Sharp, Vice-Chairman Senator Loren Leman Senator Mike Miller Senator Jim Duncan Senator Judy Salo MEMBERS ABSENT Senator Johnny Ellis COMMITTEE CALENDAR SENATE BILL NO. 367 "An Act relating to health care and insurance for health care; to review and approval of health insurance rates and rating factors; relating to certain civil actions against health care providers; to coordination of insurance benefits and to determination and disclosure of fees paid to an insured or health care provider; to the rate of interest on certain judgments and decrees; to excise taxes on cigarettes; amending Alaska Rules of Civil Procedure 26, 27, 68, 79, and 82 and Alaska Rules of Evidence 802, 803, and 804; repealing Alaska Rule of Civil Procedure 72.1; and providing for an effective date." PREVIOUS SENATE COMMITTEE ACTION SB 367 - No previous action to record. WITNESS REGISTER Nancy Usera, Commissioner Department of Administration P.O. Box 110200 Juneau, Alaska 99811-0200 POSITION STATEMENT: Expressed concerns with SB 367. Jay Livey, Deputy Commissioner Department of Health and Social Services P.O. Box 110601 Juneau, Alaska 99811-0601 POSITION STATEMENT: Suggested including an excise tax on alcohol. . ACTION NARRATIVE TAPE 94-23, SIDE A Number 005 CHAIRMAN RIEGER called the Senate Health, Education and Social Services (HESS) Committee to order at 1:37 p.m. He introduced SB 367 (HEALTH CARE REFORM COMMITTEES) as the only business before e the committee. He gave an overview of SB 367 through the sectional summary provided in the committee packets. He noted his previous amendment which strengthened the arbitration provision when indicating that it may be useful in sections 1 and 2 of SB 367. Chairman Rieger indicated that the language of section 4 was simpler language than earlier recommended to the committee which may or may not be appropriate. He explained that commercial enterprises would need a high enough rate of interest on judgements so as not to induce a delay of settlement. On the other hand, when not dealing with a commercial settlement, the penalty should not increase at a punitively high rate. The settlement should be relatively equal to the adjusted value of the damage when the damage occurred. He suggested that the committee review that language. Chairman Rieger pointed out that section 6 provides a $300 per day fee as opposed to the previous $150 per day fee. This may still be too low. He noted that section 12 changes the excise tax on cigarettes to 17 mills which differs from the Governor's proposal. He emphasized that the most significant changes in SB 367 are encompassed in sections 16 and 17. Section 16 establishes a committee with a more specific direction than that of SB 270; this section provides a mechanism for implementing a catastrophic universal plan and a major medical plan. Section 17 attempts to pursue the idea of practice parameters. He pointed out that the Health Care Plan Advisory Committee and the Medical Practice Advisory Committee are repealed under section 23 which eliminates the lengthy sunset process. Number 185 NANCY USERA, Commissioner of the Department of Administration, stated support for SB 270. She said that in some areas SB 367 goes farther than SB 270 and in others it does not. SB 367 would advance the cause of the health care system in Alaska. She supported the concept of discovering a financing mechanism and a financing source for the data collection; however, she expressed that the 1996 repealor of the advisory boards would leave a void for dealing with this issue in the long term. She stated that the things that SB 367 would do for the health care system are helpful. CHAIRMAN RIEGER explained that the repealer of the two committees is in response to the difficulty to sunset organizations. He said that language could be added to extend the existence of the committees, if they prove useful or if more information was needed by the state. NANCY USERA expressed concern that any long term changes to the health care system have adequate planning and management so that health care is reviewed in a comprehensive manner for Alaska. CHAIRMAN RIEGER asked if Ms. Usera had any specific areas that she wanted addressed in SB 367. NANCY USERA said no. CHAIRMAN RIEGER said that SB 367 would be open to suggestions. NANCY USERA said that she would review SB 367. JAY LIVEY, Deputy Commissioner of the Department of Health and Social Services, commended the inclusion of an excise tax on cigarettes in SB 367. He informed the committee that if someone can reach the age of eighteen without smoking, then they are not likely to start smoking. The higher price of cigarettes would be price sensitive to young smokers; hopefully, leading to a decrease in the number of young smokers. He suggested that an alcohol excise tax would be good for the same reasons as discussed regarding the cigarette excise tax. He noted SB 269 which includes an excise tax on cigarettes and alcohol. He offered to provide the committee with more information regarding an alcohol excise tax. CHAIRMAN RIEGER asked if anyone else would like to testify on SB 267. A brief at ease was taken in order to allow the listen only teleconference sites to testify. No one desired to testify by teleconference. Chairman Rieger held SB 367 until Wednesday's meeting. There being no further business before the committee, the meeting was adjourned at 2:00 p.m.