Legislature(2009 - 2010)CAPITOL 120

04/12/2010 01:00 PM JUDICIARY


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* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ SB 244 GOVERNOR'S DUTY STATION/TRAVEL ALLOWANCES TELECONFERENCED
Moved HCS SB 244(JUD) Out of Committee
+ SB 239 IGNITION INTERLOCK DEVICES/DUI/CHEM. TEST TELECONFERENCED
Moved HCS CSSB 239(JUD) Out of Committee
+ HB 423 POLICY FOR SECURING HEALTH CARE SERVICES TELECONFERENCED
Moved CSHB 423(HSS) Out of Committee
+ Bills Previously Heard/Scheduled TELECONFERENCED
+= SB 284 CAMPAIGN EXPENDITURES TELECONFERENCED
Moved HCS CSSB 284(JUD) Out of Committee
<Bill Held Over from 4/11/10>
       HB 423 - POLICY FOR SECURING HEALTH CARE SERVICES                                                                    
                                                                                                                                
1:23:19 PM                                                                                                                    
                                                                                                                                
CHAIR RAMRAS announced  that the next order of  business would be                                                               
HOUSE BILL NO.  423, "An Act stating a public  policy that allows                                                               
a person  to choose or decline  any mode of securing  health care                                                               
services, and  providing for  enforcement of  that policy  by the                                                               
attorney general."  [Before the committee was CSHB 423(HSS).]                                                                   
                                                                                                                                
CHAIR  RAMRAS noted  that members'  packets include  a memorandum                                                               
from  Legislative  Legal and  Research  Services  dated April  9,                                                               
2010, that addresses constitutional issues raised by HB 423.                                                                    
                                                                                                                                
REPRESENTATIVE GATTO presented  HB 423 on behalf  of the sponsor,                                                               
the House  Judiciary Standing  Committee.  He  said HB  423 would                                                               
specify in statute  that the State of Alaska has  a policy that a                                                               
person has the  right to choose or decline any  mode of obtaining                                                               
health  care  services,  and,  if   passed,  would  be  known  in                                                               
uncodified law  as the Alaska  Health Freedom Act.   He indicated                                                               
that HB 423  was introduced in response to the  recent passage of                                                               
federal healthcare  reform legislation  - the  Patient Protection                                                               
and Affordable Care  Act (PPACA).  He ventured that  if the PPACA                                                               
does get  challenged, the  court might  decide that  those states                                                               
that already  have a  specific policy  in place  - such  as would                                                               
occur with the  passage of HB 423 - need  not follow federal law.                                                               
In response to  a question, he indicated that a  prior version of                                                               
the bill directed  the attorney general to  take certain actions,                                                               
but that language  is no longer contained in the  bill because it                                                               
is already  the job  of the  attorney general  to look  after the                                                               
State's legal rights.                                                                                                           
                                                                                                                                
1:29:05 PM                                                                                                                    
                                                                                                                                
DAVID  JONES,   Senior  Assistant  Attorney   General,  Opinions,                                                               
Appeals, & Ethics, Civil Division  (Anchorage), Department of Law                                                               
(DOL), in  response to  questions, relayed that  he is  unable to                                                               
say with  certainty whether passage  of HB 423 would  either help                                                               
or  hinder  any forthcoming  action  the  attorney general  might                                                               
choose to take regarding the federal PPACA.                                                                                     
                                                                                                                                
CHAIR  RAMRAS  expressed  favor  with HB  423,  opining  that  it                                                               
reflects the  offense taken by  some over passage of  the federal                                                               
PPACA.                                                                                                                          
                                                                                                                                
REPRESENTATIVE  GATTO, in  response to  comments and  a question,                                                               
acknowledged that  CSHB 423(HSS)  is now  simply making  a policy                                                               
statement  that will  have no  value  if the  U.S. Supreme  Court                                                               
should eventually rule that the PPACA is constitutional.                                                                        
                                                                                                                                
REPRESENTATIVE  GRUENBERG  asked why  the  DOL  has submitted  an                                                               
indeterminate fiscal note for HB 423.                                                                                           
                                                                                                                                
MR. JONES said it's because the  DOL doesn't know what impact the                                                               
bill would have on the DOL's fiscal operations.                                                                                 
                                                                                                                                
1:41:57 PM                                                                                                                    
                                                                                                                                
THOMAS  REIKER, Staff,  Representative Carl  Gatto, Alaska  State                                                               
Legislature,  on behalf  of Representative  Gatto, added  that he                                                               
and  Representative  Gatto,  too,  had concerns  with  the  DOL's                                                               
analysis of the bill's potential  fiscal impact, considering that                                                               
analysis to  be unclear, and  so the DOL  has agreed to  submit a                                                               
revised fiscal note  for the bill's next committee  of referral -                                                               
the House Finance Committee.                                                                                                    
                                                                                                                                
REPRESENTATIVE GATTO  went on to  explain that because  all State                                                               
of Alaska  employees are  required to  have health  insurance and                                                               
because  sometimes the  courts  can order  a  person to  purchase                                                               
health  insurance,  CSHB  423(HSS) now  contains  language  which                                                               
specifies that the  policy outlined in the bill  doesn't apply to                                                               
health  care  services  provided  or required  by  the  state,  a                                                               
political subdivision of the state, or a court of the state.                                                                    
                                                                                                                                
MR. REIKER  indicated that a forthcoming  amendment would further                                                               
clarify that exemption.                                                                                                         
                                                                                                                                
1:47:29 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE GATTO  made a motion  to adopt Amendment  1, which                                                               
read [original punctuation provided]:                                                                                           
                                                                                                                                
     Page 1, line 9:                                                                                                            
     Delete "and may choose or"                                                                                                 
                                                                                                                                
     Page 1, line 13:                                                                                                           
     Delete "provided or"                                                                                                       
                                                                                                                                
REPRESENTATIVE HOLMES objected for the purpose of discussion.                                                                   
                                                                                                                                
REPRESENTATIVE GATTO,  in response to a  question, indicated that                                                               
Amendment 1 is  a technical amendment, and that he  is seeking to                                                               
simplify the language currently in CSHB 423(HSS).                                                                               
                                                                                                                                
REPRESENTATIVE GRUENBERG indicated disfavor with Amendment 1.                                                                   
                                                                                                                                
REPRESENTATIVE  GATTO   observed  that   with  the   adoption  of                                                               
Amendment 1's proposed change to page  1, line 9, the language of                                                               
the bill  would then in  part read:  "a  person has the  right to                                                               
decline any mode of obtaining health care services".                                                                            
                                                                                                                                
MR. REIKER,  in response  to comments, said  the concern  is that                                                               
the federal  PPACA might  take away a  person's right  to decline                                                               
health insurance  he/she doesn't  want.   He then  explained that                                                               
with regard to Amendment 1's proposed  change to page 1, line 13,                                                               
the concern  with the  current language  of the  bill is  that it                                                               
might be  used to  force the  State of  Alaska to  provide health                                                               
care services  to someone who  would otherwise be  ineligible for                                                               
those services.                                                                                                                 
                                                                                                                                
REPRESENTATIVE  HOLMES offered  her understanding,  however, that                                                               
Amendment 1's  proposed  change to  page  1,  line 13,  would  be                                                               
deleting  language  that  was  suggested by  the  DOL,  and  that                                                               
without  that  language,  the  exemption  outlined  in  the  bill                                                               
wouldn't function as desired.                                                                                                   
                                                                                                                                
REPRESENTATIVE GRUENBERG  suggested that  Amendment 1  be divided                                                               
such that  its proposed change to  page 1, line 9,  be considered                                                               
Amendment 1a,  and its  proposed change  to page  1, line  13, be                                                               
considered Amendment 1b.                                                                                                        
                                                                                                                                
REPRESENTATIVE GATTO instead withdrew Amendment 1.                                                                              
                                                                                                                                
1:51:56 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE GATTO  made a motion  to adopt Amendment  2, which                                                               
read [original punctuation provided]:                                                                                           
                                                                                                                                
     Page 1, line 8, after (a), insert:                                                                                         
     Pursuant to the Ninth and Tenth Amendments of the U.S.                                                                 
     Constitution,                                                                                                          
                                                                                                                                
REPRESENTATIVE HOLMES objected for the purpose of discussion.                                                                   
                                                                                                                                
REPRESENTATIVE GRUENBERG  pointed out  that although  Amendment 2                                                               
has  some   merit,  it   might  be   too  specific   and  thereby                                                               
unnecessarily  limit  the  situations   under  which  the  policy                                                               
outlined in the bill would apply.                                                                                               
                                                                                                                                
REPRESENTATIVE  GATTO  acknowledged   that  point,  and  withdrew                                                               
Amendment 2.                                                                                                                    
                                                                                                                                
1:53:58 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE HOLMES  referred to the  aforementioned memorandum                                                               
from Legislative Legal  and Research Services, and  noted that it                                                               
says   in  part   [original  punctuation,   although  with   some                                                               
formatting changes, provided]:                                                                                                  
                                                                                                                                
     to  the   extent  that  the  recently   signed  Patient                                                                    
     Protection  and Affordable  Care  Act ...  specifically                                                                    
     regulates  state  insurance  by requiring  everyone  to                                                                    
     obtain  health care  insurance, the  federal law  would                                                                    
     likely be  found to preempt  state law on  the subject.                                                                    
     ...  if  a  power  is  delegated  to  Congress  by  the                                                                    
     Constitution, the Tenth Amendment  does not protect the                                                                    
     states from  the exercise of  that federal power.   The                                                                    
     federal  Constitution  gives   Congress  the  power  to                                                                    
     control commerce.   In light  of the ruling in  U.S. v.                                                                  
     South-Eastern  Underwriters  Assn.,   supra,  that  the                                                                  
     business of  insurance is part of  interstate commerce,                                                                    
     it  is  reasonable  to  conclude   that  the  power  to                                                                    
     regulate commerce and thus  regulate insurance has been                                                                    
     delegated  to   the  United  States  Congress   by  the                                                                    
     Constitution.   Therefore,  it  seems  unlikely that  a                                                                    
     court  would  hold  that   the  Tenth  Amendment  would                                                                    
     prevent  the  federal  government from  implementing  a                                                                    
     bill specifically regulating insurance.                                                                                    
                                                                                                                                
REPRESENTATIVE HOLMES said  she reads that language  to mean that                                                               
the  bill  isn't  going  to  accomplish its  stated  goal.    She                                                               
explained  that   her  main  concern   is  that  no   one  really                                                               
understands  what  effects the  bill  will  have, either  on  any                                                               
future actions  the DOL might decide  to take with regard  to the                                                               
federal  PPACA,  or  on  the  Department  of  Health  and  Social                                                               
Services (DHSS) and the DOL, or on other federal programs.                                                                      
                                                                                                                                
CHAIR  RAMRAS  said  he shares  Representative  Gatto's  concerns                                                               
about the PPACA, and opined that  passage of HB 423 would be good                                                               
for Alaskans.                                                                                                                   
                                                                                                                                
REPRESENTATIVE  GATTO,  after  reading  excerpts  from  something                                                               
pertaining to the  PPACA, opined that it would  be beneficial for                                                               
Alaska to  have - via  passage of HB 423  - a specific  policy on                                                               
the issue  of health  care services already  in place,  but again                                                               
acknowledged that the  bill would be rendered  meaningless if the                                                               
U.  S. Supreme  Court should  eventually rule  that the  PPACA is                                                               
constitutional.                                                                                                                 
                                                                                                                                
REPRESENTATIVE HERRON  pointed out,  though, that the  bill makes                                                               
no reference to the federal  PPACA, and opined that the committee                                                               
should  instead  focus solely  on  the  constitutionality of  the                                                               
proposed state policy regarding obtaining health care services.                                                                 
                                                                                                                                
REPRESENTATIVE GRUENBERG added that  he would be more comfortable                                                               
with  the bill  if  it weren't  being used  as  a political  tool                                                               
against  as-yet unfinished  federal  legislation,  a tool  that's                                                               
going  to  draw  the  state into  litigation.    Expressing  some                                                               
disfavor with  the title  of HB  423, he  acknowledged that  as a                                                               
generic statement,  the language  in the  bill is  fairly benign.                                                               
He asked  whether there was  any way around  using the bill  as a                                                               
means of drawing the state into a political battle.                                                                             
                                                                                                                                
REPRESENTATIVE  GATTO  acknowledged  that if  the  federal  PPACA                                                               
hadn't passed, HB  423 would "almost be laughable."   The bill is                                                               
about  people's  rights,  he  remarked,  both  the  right  to  do                                                               
something and the right to not have to do something.                                                                            
                                                                                                                                
REPRESENTATIVE   GRUENBERG  said   that   the  policy   statement                                                               
encompassed in  the bill  has its  own merits,  and he  likes the                                                               
idea behind it.                                                                                                                 
                                                                                                                                
2:07:03 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  DAHLSTROM moved  to report  CSHB 423(HSS)  out of                                                               
committee  with individual  recommendations and  the accompanying                                                               
indeterminate fiscal note.                                                                                                      
                                                                                                                                
REPRESENTATIVE HOLMES objected.                                                                                                 
                                                                                                                                
A roll  call vote  was taken.   Representatives  Lynn, Dahlstrom,                                                               
Herron, Gatto,  and Ramras voted  in favor of reporting  the bill                                                               
from  committee.    Representatives Gruenberg  and  Holmes  voted                                                               
against it.   Therefore,  CSHB 423(HSS) was  reported out  of the                                                               
House Judiciary Standing Committee by a vote of 5-2.                                                                            

Document Name Date/Time Subjects
01 SB239 Proposed CS version C.pdf HJUD 4/12/2010 1:00:00 PM
SB 239
02 SB239 Sponsor Statement.pdf HJUD 4/12/2010 1:00:00 PM
SB 239
03 SB239 LAW 0 fiscal note.pdf HJUD 4/12/2010 1:00:00 PM
SB 239
04 SB239 ADM 0 Fiscal note.pdf HJUD 4/12/2010 1:00:00 PM
SB 239
05 SB239 JUD CS version P.pdf HJUD 4/12/2010 1:00:00 PM
SB 239
06 SB239 legal opinion 3.12.10.pdf HJUD 4/12/2010 1:00:00 PM
SB 239
07 SB239 Back up.pdf HJUD 4/12/2010 1:00:00 PM
SB 239
01 SB 244 sponsor statement[1].pdf HJUD 4/12/2010 1:00:00 PM
SB 244
02 SB244 Bill STA CS version C.pdf HJUD 4/12/2010 1:00:00 PM
SB 244
03 SB0244-1-1-021210-GOV-N.pdf HJUD 4/12/2010 1:00:00 PM
SB 244
04 SB244 AAM - Travel[1].pdf HJUD 4/12/2010 1:00:00 PM
SB 244
01 HB 423 Sponsor Statement.pdf HJUD 4/12/2010 1:00:00 PM
HB 423
02 HB423 CS HB423(HSS) version E.pdf HJUD 4/12/2010 1:00:00 PM
HB 423
03 HB423 Explanation of Changes from HB 423 Version R to the HHSS CS.pdf HJUD 4/12/2010 1:00:00 PM
HB 423
HB423CS(HSS)-LAW-CIV-04-10-10.pdf HJUD 4/12/2010 1:00:00 PM
HB 423
05 HB4234 Congressional Research Service Constitutional Questions.pdf HJUD 4/12/2010 1:00:00 PM
HB4234
06 HB423 Goldwater Institute Q-A.pdf HJUD 4/12/2010 1:00:00 PM
HB 423
07 HB423 13 AG Complaint in Fed Court.pdf HJUD 4/12/2010 1:00:00 PM
HB 423
08 HB423 public signatures.pdf HJUD 4/12/2010 1:00:00 PM
HB 423
09 HB423 MO Lt Governor Press Release.pdf HJUD 4/12/2010 1:00:00 PM
HB 423
10 HB423 Supreme Court Syllabus.pdf HJUD 4/12/2010 1:00:00 PM
HB 423
11 Hb423 news articles-Health Freedom Act.pdf HJUD 4/12/2010 1:00:00 PM
HB 423
12 HB423 VA lawsuit.pdf HJUD 4/12/2010 1:00:00 PM
HB 423
HB423 AMENDMENT 1 to CS HB 423 (HSS).pdf HJUD 4/12/2010 1:00:00 PM
HB 423
HB423 AMENDMENT 2 to CS HB 423 (HSS).pdf HJUD 4/12/2010 1:00:00 PM
HB 423