Legislature(2009 - 2010)CAPITOL 120
04/12/2010 01:00 PM JUDICIARY
Download Mp3. <- Right click and save file as
* first hearing in first committee of referral
= bill was previously heard/scheduled
= bill was previously heard/scheduled
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.