Legislature(2015 - 2016)BILL RAY CENTER 230

06/02/2016 01:30 PM Senate FINANCE

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Audio Topic
01:36:27 PM Start
01:37:00 PM HB374
01:57:08 PM Adjourn
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
Moved SCS CSHB 374(FIN) Out of Committee
Bills Previously Heard/Scheduled
CS FOR HOUSE BILL NO. 374(FIN)                                                                                                
     "An Act relating to coverage under a state plan                                                                            
     provided by the Comprehensive Health Insurance                                                                             
     Association;  establishing   the  Alaska  comprehensive                                                                    
     health  insurance  fund;   relating  to  a  reinsurance                                                                    
     program; relating  to the definition of  'residents who                                                                    
     are  high  risks'; relating  to  an  application for  a                                                                    
     waiver for state innovation  for health care insurance;                                                                    
     and providing for an effective date."                                                                                      
1:37:00 PM                                                                                                                    
Vice-Chair   Micciche  MOVED   to   ADOPT  proposed   Senate                                                                    
committee  substitute  for  CSHB 374(FIN),  Work  Draft  29-                                                                    
GH2126\I (Glover/Wallace, 6/2/16).                                                                                              
Co-Chair MacKinnon OBJECTED for discussion.                                                                                     
1:37:44 PM                                                                                                                    
AT EASE                                                                                                                         
1:37:59 PM                                                                                                                    
LAURA    CRAMER,    STAFF,     SENATOR    ANNA    MACKINNON,                                                                    
communicated that there were two  changes to consider in the                                                                    
committee  substitute.  She  looked  at  page  3,  line  29,                                                                    
Section 6, which  was a sunset for  the Alaska Comprehensive                                                                    
Health Insurance Fund.  She pointed to page 2,  lines 11 and                                                                    
12,  Section  2,  which   originally  read,  "and  specified                                                                    
covered    conditions   eligible    for   payment    through                                                                    
appropriations   from   the  Alaska   Comprehensive   Health                                                                    
Insurance  Fund", and  cited  the  statute establishing  the                                                                    
fund. She explained  that by repealing the  fund, there were                                                                    
complications in  the specification. She looked  at line 12,                                                                    
which  stated   that  it  would   be  payment   through  the                                                                    
reinsurance program.                                                                                                            
Vice-Chair  Micciche queried  the  repeal  date. Ms.  Cramer                                                                    
specified that the repeal would be on June 30, 2018.                                                                            
Senator Dunleavy surmised that  the diverted stream would go                                                                    
to the general fund.  Ms. Cramer agreed.                                                                                        
Vice-Chair Micciche wondered if  the committee could discuss                                                                    
the logic of the sunset provision for the public.                                                                               
Co-Chair MacKinnon  WITHDREW her  OBJECTION. There  being NO                                                                    
further OBJECTION, it was so ordered.                                                                                           
Co-Chair  MacKinnon   shared  that  the  intention   of  the                                                                    
committee  substitute  was  to  provide  an  opportunity  to                                                                    
establish a  finance working group  to bring in  health care                                                                    
providers  within the  legislative  body to  examine how  to                                                                    
sustain the fund and program  in the long term. She believed                                                                    
that  the $55  million would  require the  administration to                                                                    
cut  $55  million  before the  beginning  of  the  following                                                                    
legislative  session. She  queried comments  related to  the                                                                    
two-year sunset.                                                                                                                
FRED  PARADY, DEPUTY  COMMISSIONER, DEPARTMENT  OF COMMERCE,                                                                    
COMMUNITY, AND  ECONOMIC DEVELOPMENT,  agreed that  the work                                                                    
during the  interim was valuable to  determine the financing                                                                    
mechanisms in support of the sunset.                                                                                            
Co-Chair MacKinnon  shared that  there had  been discussions                                                                    
about a  5-year sunset. She  noted that there  were multiple                                                                    
committee  members  who  had expressed  concern,  because  5                                                                    
years  was too  much  time. She  felt  that the  legislation                                                                    
provided an opportunity to ensure care for Alaskans.                                                                            
1:44:11 PM                                                                                                                    
Mr.   Parady  shared   that  he   had  conversed   with  the                                                                    
commissioner  about   the  collaborative   approach  without                                                                    
imbedding the  task force,  and shared that  it was  also an                                                                    
attractive approach.                                                                                                            
Co-Chair  MacKinnon   queried  comments  on   the  committee                                                                    
LORI   WING-HEIER,   DIRECTOR,    DIVISION   OF   INSURANCE,                                                                    
DEPARTMENT OF COMMERCE,  COMMUNITY AND ECONOMIC DEVELOPMENT,                                                                    
concurred with  Mr. Parady, and welcomed  the opportunity to                                                                    
sunset after two year.                                                                                                          
Co-Chair MacKinnon asked about  participation in the working                                                                    
group,  to utilize  the expertise  from the  administration.                                                                    
She hoped  to for  a representative  from the  Department of                                                                    
Health  and Social  Services (DHSS).  She remarked  that the                                                                    
state did not want to get  in the way of a medical practice,                                                                    
but wanted  to manage  emergency room costs.  Ms. Wing-Heier                                                                    
replied   that  she   would  welcome   the  opportunity   to                                                                    
participate in the working group.                                                                                               
Vice-Chair  Micciche  felt that  the  CS  was an  unintended                                                                    
impact  of the  Affordable Care  Act. He  felt that  the two                                                                    
years provided  the potential for some  congressional action                                                                    
to  improve the  outcome of  the regional  or national  high                                                                    
risk  pool. He  also felt  that  the two  year provided  for                                                                    
other potential state solutions,  for considering a regional                                                                    
or national state  insurance co-op option. He  felt that the                                                                    
state must find an  appropriate role in providing incentives                                                                    
to  reduce the  costs, or  the state  would continue  to add                                                                    
dollars for other health care coverage.                                                                                         
Mr. Parady echoed Vice-Chair  Micciche's comments. He stated                                                                    
that  the   two-year  timeline  was  an   intense  pressured                                                                    
timeline, because of the slowness of the 1332 waiver.                                                                           
Co-Chair MacKinnon  hoped to make  an accomplishment  in the                                                                    
first  year.  She noted  that  year  two would  not  provide                                                                    
enough notice  for the health  care providers to be  part of                                                                    
the solution. Therefore, there would  be nearly $170 million                                                                    
in year three.                                                                                                                  
Mr. Parady acknowledged that the  two year deadline, and the                                                                    
interior deadline was the following legislative session.                                                                        
Co-Chair MacKinnon  relayed that the committee  had received                                                                    
information about the Medicaid  (copies on file). She stated                                                                    
that the  department was not  the holder of  the demographic                                                                    
information of the high risk  pool. She remarked that the CS                                                                    
did not go  further in detail, because there was  no data to                                                                    
shape a  conversation about the  waiver in the  bill, rather                                                                    
it was up to the "department's good judgment."                                                                                  
1:49:39 PM                                                                                                                    
AT EASE                                                                                                                         
1:52:26 PM                                                                                                                    
Vice-Chair  Micciche MOVED  to REPORT  SCS CSHB  374 out  of                                                                    
committee with the accompanying  fiscal note. There being NO                                                                    
OBJECTION, it was so ordered.                                                                                                   
SCS CSHB  374(FIN) was  REPORTED out  of committee  with "no                                                                    
recommendation"  and with  one  previously published  fiscal                                                                    
impact note: FN 3(CED).                                                                                                         
1:53:30 PM                                                                                                                    
AT EASE                                                                                                                         
1:56:41 PM                                                                                                                    
Co-Chair MacKinnon discussed housekeeping.                                                                                      

Document Name Date/Time Subjects
HB 374 Follow up Senate Finance 6 2 16.pdf SFIN 6/2/2016 1:30:00 PM
HB 374
HB 374 Provider Tax Fact Sheet May 2016.pdf SFIN 6/2/2016 1:30:00 PM
HB 374
HB 374 SCS CSHB 374 work draft version I.pdf SFIN 6/2/2016 1:30:00 PM
HB 374