Alaska Health Policy Review  comprehensive, authoritative, nonpartisan
August, 2007- Vol 1, Issue 1
Click Title To Read Article
Interview with Hollis French
Policy Analysis: Denali KidCare
Interview with Representative Peggy Wilson
Health Legislation Passed During The Last Session
Health Policy Calendar
Quick Links
From The Editor  


Dear Colleagues:

I am pleased to send you a complimentary copy of the first issue of Alaska Health Policy Review, a new publication from the Alaska Center for Public Policy.  The Review is a comprehensive, authoritative, nonpartisan source for health policy matters in the State of Alaska. It features: 

  • analysis of key health policy legislation
  • tracking of health-related bills through committees
  • interviews with influential legislators, regulators, advocates, and lobbyists
  • monitoring and reporting on Alaska health policy research
  • access to an electronic reference library of Alaska health policy documents
  • a calendar of health policy hearings and events
  • and much more...

We are a nonprofit organization.  Our purpose is to provide the most useful health policy information for you that we can.  Thank you in advance for reading this issue of the Review and for sending me your frank and constructive suggestions regarding content and format.  Your feedback will help us better serve your needs in the future. Thanks also to Elizabeth Agi and Jacqui Yeagle, who helped produce this issue.

The Review is issued electronically weekly during the regular legislative session and monthly the rest of the year. A 12-month subscription to Alaska Health Policy Review is available for $850. Please inquire about discounts for multiple issues for the same organization, and for smaller nonprofit organizations. Don't miss an issue! Send orders, comments, and inquiries to Lawrence D. Weiss at [email protected], or call (907) 276-2277.

Lawrence D. Weiss Ph.D., M.S.
Editor, Alaska Health Policy Review

Interview With Senator Hollis French

 Hollis French
 AHPR: Why did you want to become a legislator?
 
Senator French: I have always been attracted to the idea of being in politics, I sort of liked that idea, and I had an opportunity to do that. I tried and failed once against Loren Lehman, and then tried again against Dave Donnelly with a better district and succeeded. I am really glad I did that. I enjoy both the politics and the policy, so I like doing both.
 
AHPR: Why are you interested in health reform legislation?
 
Senator French: It just strikes me as one of the great unsolved policy problems of not only our state, but of our nation--getting health coverage out to every single citizen.
 
AHPR: Would you please summarize what SB 160 proposes to do?
 
Senator French: SB 160 is designed to bring affordable health insurance to every single Alaskan citizen through a market-based Alaskan solution to the problem. We have used other states as the basic template, but we are really trying to craft a solution that works in our state for our population of uninsured that relies not on a single-payer model, but on a market-driven solution that continues to use private health insurance policies, uses the benefits of their competing against one another for customers, and yet also includes subsidies and other mechanisms that help get individuals into a plan they can afford.
 
AHPR: Why, of all the approaches to health reform, did you go down this particular road?
 
Senator French: There are a lot of ways to solve that problem. If you go see Michael Moore's Sicko, you see that other governments have chosen other solutions. But what we were looking for was something that could actually pass, actually come into being in the political landscape in which we find ourselves. Neither the people of the State of Alaska, nor the people of the United States are ready for a single-payer system. You will not overcome the resistance you get from the business community if you take that approach.
 
When I saw Mitt Romney and the Massachusetts Legislature work together--those are unlikely allies just to begin with--but when I saw them craft a solution that got the blessing of Ted Kennedy, I said to myself, "There is a way to do this, there is a way to thread the needle," if you will, that uses the tools we have in place in our political world and still get coverage out to every single person, and it looks like it's something along the lines of what they adopted. You keep private insurance in place, you simply make it affordable and you also define what it is they have to cover so that each person who is buying a policy knows they are getting something that is worth having.
 


"I think it is hard to argue against a single-payer system at some level. Ultimately, you eliminate the problems of the overhead and the marketing and the triage expenses that all take place in the churn of private insurance companies, but to me that is not politically viable."



AHPR: Would another formulation be better, but less politically viable?
 
Senator French: I think it is hard to argue against a single-payer system at some level. Ultimately, you eliminate the problems of the overhead and the marketing and the triage expenses that all take place in the churn of private insurance companies, but to me that is not politically viable. Yes, it is a nice idea, but I want something that works.
 
AHPR: Do you have any evidence or research that gives you the idea that your proposal will work? In other words, is it fact-based or evidence-based in any way?
 
Senator French: It has been instituted in Massachusetts. It is being looked at in probably 20 other states. We know for example that there is at least 15% of the health insurance premiums that I and every other Alaskan pay, [that] go to covering the uninsured, so there's at least 15% of a premium out there that we can siphon off and cover those individuals with if we can just figure out how to do that. So there's good evidence that suggests not only that it can be done but that it can be done without enormous expense.
 
AHPR: Is there any part of your proposal that monitors the insurers in order to make sure that the savings are passed on?
 
Senator French: The idea is that you set up this health care board that does two things. It defines essential health care services so it says these are the things a policy has to have in order to qualify under the plan, and then, two, it certifies those plans and helps match people up with them. That's not exactly the question you asked but that's more of a Division of Insurance function, and it's something we're looking at as far as specifying in the bill how tightly you tighten the screws on the industry to make certain that when everybody does get covered, that 15% premium goes away, that is, it should be realized--I agree. We don't address it in the bill right now, but it is certainly an item of interest to me.
 
AHPR: Please tell us what happened to SB 160 in the first session of the 25th Legislature.
 
Senator French: Mainly what happened was [Legislative Aide] Andy Moderow worked on it and got it drafted. That was probably 80% of the work that took place in the first session. I was busy with my day-to-day legislative activities. When the bipartisan majority coalition happened I got an extra staffer. I hired Andy Moderow. One of his main tasks, besides answering the telephone and looking after all the other things he had to do at the front desk, was his big legislative assignment--work on health care. We talked a lot about how we wanted to go about that in general terms, but I turned him loose, and he did a huge amount of research, and he worked with Legislative Drafting and produced a bill that got filed late in the session.
 
AHPR: Anything you care to say about committee assignments?
 
Senator French: I got what I consider to be good committee assignments. It went to the HESS committee chaired by Senator Bettye Davis, and then to the Labor and Commerce Committee chaired by Senator Johnny Ellis, and then it goes to Senate Finance, where I expect to have the most difficulty, but I have two sort of warm-up committees to work my way through and practice my act before I get up to the Senate Finance Committee where things are more difficult.
 
Your readers should also know that a companion bill, an identical bill, was filed in the House of Representatives by a Republican, Gabrielle LeDoux of Kodiak, so the bill is alive in both bodies.
 
AHPR: [asking a rhetorical question] Is appreciation of Senate Bill 160 split strictly along party lines, or not?
 
Senator French: Obviously the answer is no. We've got a Republican prime sponsor in the other body, and really there is the more global question which is, how is the world going to look at this bill? Are they going to look at it as a sort of left-wing Democratic proposal, or is it sort of a moderate solution, or is it even a right-wing proposal. Really, it is a moderate to right-wing answer to the health care crisis. This is a business-friendly solution; this does not make a lot of people on the left very happy, but the fact is that the left has not produced universal health care in this country and they don't look like they are anywhere close to getting there. My object is to get the job done and then as we can make more reforms in the system in the distant future, fine, but let's get everybody a health insurance policy, first things first. And if that means I make peace with the insurance industry and work with business, that's great as far as I'm concerned. So that's kind of the political spectrum analysis.
 
AHPR: I forgot to ask this question at the beginning of the interview, but what is your position with ARCO?
 
Senator French: I worked in the oil industry for a dozen years. I was a blue-collar worker up on a platform in Cook Inlet. On the North Slope I was a production operator. Those are the guys that actually run the facilities that produce the oil that fill the pipeline full of that black gold. I quit that job in 1992, went to law school, and have been in the legal world and the political world since then.
 
AHPR: You are a member of the Alaska Senate Bipartisan Working Group. How would you characterize how this group views or acts on health reform issues?
 
Senator French: Well, here's a good example. We were able to, on Denali KidCare, reverse a four-year slide in eligibility this year through a floor amendment, which is almost unheard of. Bill Wielechowski brought a floor amendment to attach his Denali KidCare "fix", if you will, to the Senior Care bill, I believe, it went over to the other House, and did so via a floor amendment. That is astonishing, really. It is hard for me to convey to your readers just how astonishing that is, both procedurally and politically, to have our group leading on a reform to Denali KidCare. So, I think that on at least some subjects our bipartisan group is progressive on health care reform.
 
AHPR: Well, that's good to hear.
 
Senator French: I guess it remains to be seen. Tomorrow there is a hearing on Les Gara's universal kid health care coverage, and we'll have hearings next session on my universal health care bill and of course those are quantum leaps ahead of something as simple as Denali KidCare, but it's all of a piece. I think it shows that there's room in the middle to work on the problem.
 
AHPR: In SB 160, who would be covered by health insurance who is not already covered?
 
Senator French: The first thing to know is if you have health insurance now, the bill doesn't affect you at all except to lower your premiums once we get everybody insured. If you have health insurance now, this bill doesn't touch you. What it does do is it reaches out to the 15% of our population, about 100,000 people in this state who don't have health insurance, and it would find a way to get them covered through a variety of steps.
 
AHPR: What does it cover, and what does it not cover, for example long-term care, prescription drugs, at-home care, drug rehabilitation, behavioral health, etc.?
 
Senator French: Those are specifics that are to be developed as we bring out other iterations of the bill. The idea is to turn to a series of experts who would be on the health care board appointed by the governor and have them define essential health care services. Instead of having a production operator writing what the appropriate health care services ought to be, let's get the experts to do it. The bill sets up this framework under which they would define essential health care services. Clearly, you could spell those all out individually in the bill, or you could just say, by regulation, give them the power to do so by regulation. I'm sure that's a policy they will have because a lot of that affects the cost of the plan--the more inclusive the more costly, the less inclusive the less costly.
 
AHPR: Then would a package come out to be bid on by insurance companies?
 
Senator French: Once you get this definition in place, this is the list of things that a health insurance policy must offer in order to qualify as one of these policies that citizens are going to be required to buy, once you have that in place, then four or five, six, seven insurance companies you assume will want this business. There's going to be a profit for them in it. That's what keeps the insurance industry interested. They craft plans to match what the board has defined, and then put them over here in this clearinghouse where people go to buy them.
 
AHPR: How does the connection get made between an interested insurer and the insurer selling the plans?
 
Senator French: Through this thing called the Clearinghouse. The bill says that everyone has to have a health insurance policy. A guy driving a truck for himself says, "Oh my God, I've got a requirement, just like I have to have a policy covering my truck, I now have to have a policy cover me. Where do I go for help?" You put out the word that you need to contact this group called the Health Care Clearinghouse. He goes there and the people at the clearinghouse say, "OK, how much money do you make? This much money...Oh, you're down here. You are going to get a voucher which lets you walk over here and pick your policy. There are five policies here and you can compare them and decide which one you want," but they all comply with basic state law as far as what is an allowable health insurance policy.
 
AHPR: And each is sold by a different private insurance company?
 
Senator French: Exactly, [for example] State Farm, Allstate, all those individuals would be offering health insurance, Blue Cross, Premera, etc.
 

"Anyone who has coverage through the VA, anyone who has coverage through a Native Corporation, anyone who has coverage through Medicaid, they're taken care of. They've already got a policy and the law shouldn't directly affect them. "



AHPR: Alaska has some very unique health care system profiles. For example, the whole Native health care system, there is a major presence of the VA and other military health care systems, Community Health Centers are very big in Alaska, so how does SB 160 interact with these other systems? What is the interface or is there any particular need for an interface?
 
Senator French: The short answer is, not directly. Anyone who has coverage through the VA, anyone who has coverage through a Native Corporation, anyone who has coverage through Medicaid, they're taken care of. They've already got a policy and the law shouldn't directly affect them. But as wide a net as those entities cast, they're leaving 100,000 people uninsured, so there's clearly a need for something else.
 
AHPR: The Massachusetts plan is just starting, so we don't really know too much about it in terms of how it's going to be in practice, but I have heard it criticized as having a punitive element for low-income people who really can't afford these additional expenses. I wonder to what extent you have considered that issue, or if that is an issue at all?
 
Senator French: Keep in mind that, and I guess it depends on how you define "low income," but if you are below 100% FPL [federal poverty level] you are essentially going to get a voucher for an insurance policy. A lot of these folks are already covered by Medicaid anyway, but if they are not, they would get a voucher at essentially low or no cost. The essential policy has to be to provide affordable health insurance. If you are forcing somebody who makes $30,000 a year to buy a policy, and you are going to try to charge them $800 a month, that is obviously absurd, and you are never going to get there. You've got to keep the price down to something closer to your cable bill or a bill that you are already accustomed to paying--$100 or $200 a month kind of thing. At that rate, it becomes economically obvious that you should be getting a health policy so that you can do the preventive care, the checkups, the maintenance that saves you the huge expenses down the road. But affordability is key. You can't force people to buy something that doesn't make sense for them. You'll get a revolt and you'll never get there.
 
AHPR: The latest data I've seen on this is a couple years old, but there appears to be a monopoly by Blue Cross Blue Shield of health insurance in this state. My recollection is they have about 85% of the market.
 
Senator French: The private market?
 
AHPR: Yes.
 
Senator French: I didn't know that.
 
AHPR: In terms of the private market, they really seem to have a monopoly. It makes me wonder when the time comes for health insurers to bid on packages, or to connect with packages, however the details are going to be worked out, it makes me think that Blue Cross Blue Shield may have an inordinate amount of power to do whatever deal they want because you're not really talking about a competitive market here.
 
Senator French: I guess that remains to be seen. They've got to be competitive. They won't be setting the price. The price will be set by the degree to which the pots of money which you collect, either through appropriations or through federal money that's being directed to the uninsured now. The price you charge individuals will be set by the degree to which you can subsidize the cost of what they are providing. I'm not sure that quite answers the question about competition, but my belief is that if you define the parameters correctly and allow for the companies to make a profit, there will be competition.
 
AHPR: I hope that's true given the current situation.
 
Senator French: It is a side inquiry, but it is an important inquiry. Why is it that they are so dominant? Why is it that they have that size of a market share? Are they that good or are they predatory?
 
AHPR: I think it is because the pool in Alaska is so small, the catchment area is so small.
 
Senator French: That has always been part of the problem. We have that same problem in Unemployment [Insurance] and Workers Comp [Insurance]. We just don't have a huge market for folks to come fishing.
 
AHPR: You sort of addressed this issue before, but I would like to ask it again: in light of known administrative overhead in the private health insurance industry of at least 25%--in other words, for every dollar that goes in, only about 75 cents goes out to actually pay for health care. I contrast that with, for example the Social Security Administration which only has a three to five percent administrative overhead. So, in light of that, why would you focus on a health insurance solution rather than a solution that focuses on access to health care. For example, I am thinking of things like we have a statewide system of Community Health Centers. Why not directly contract with them for some care, completely skipping the health insurance industry? Private companies, for example, contract directly in some cases. So, I'm curious why you would not consider that as part of the mix?
 
Senator French: We haven't written the final version of this bill. Just yesterday we were talking about the article that called for Medicare for all. Why not just expand Medicare and get everybody under that one single tent, and that way you avoid the overhead problems you're talking about. I think when you total up the cost of that Medicare for all, you will recoil and think there's got to be a better way. Again, it boils down to political viability. What is possible? What can we actually pass? What will get 21 votes in the House of Representatives and 11 votes in the Senate and become law that winds up covering everybody? It may be that we end up paying a little more because of that political viability, but it gets there.
 

"...there's a cost of not insuring the uninsured. There's not only the higher cost of going to the emergency room instead of seeing a preventive care nurse, but there's also the loss in productivity, there's the harm to business. "



AHPR: Have any reports or studies or projections been prepared, or are going to be prepared, for this bill in terms of its viability, its cost effectiveness, those kinds of issues.
 
Senator French: We've gotten letters of support from Al Parish at Providence and from James Shill at North Star, so we've got the interest of major medical institutions. We also will get what is known as a fiscal note prepared at some point which will estimate the cost of implementing the plan, and that will probably be more on point to your question. What is this going to cost, and even if it does save us 15%, what's the price tag for giving everybody another 10? I'd be guessing if I said a number...But keep in mind as you think about that, that there's a cost of not insuring the uninsured. There's not only the higher cost of going to the emergency room instead of seeing a preventive care nurse, but there's also the loss in productivity, there's the harm to business. Probably the biggest shift that's happened in the last four or five years is that the business community has figured out that this is hurting their bottom line. That's the paradigm shift that's taking place in the Lower 48 and in Alaska right now. When you've got folks from Commonwealth North coming to you and saying, "We've got to fix this problem," that's what opens the hole, if you will, through which you can drive a universal health care bill, the recognition that we are losing out from the business perspective because of the costs we are incurring in paying for medical care for people without health insurance policies.
 
AHPR: Will you re-introduce this bill in the next session and, if so, do you plan any changes?
 
Senator French: The bill doesn't need to be re-introduced because it is still alive from the first session, but we are planning an enormous list of changes. Essentially, what we filed was a 12-page overview of what the system will look like. Now, Andy is back at work preparing an enormous list of specific questions you have to answer that will absorb a huge amount of energy because every one of them is riven with a hundred little policy decisions and begin to pit one sort of group against another group. You've got to flesh it out. We are trying to get someone from the Heritage Foundation to analyze the bill. We want to be able to give this person some meat to chew on and not sort of a shell of a bill, and yet they are very interested. You've got extremely conservative groups like that buying into the idea that you can cover every single individual with a market-based approach. That's the meeting of the left and the right in these new approaches.
 
AHPR: That's very interesting to have a national organization look at it. Are there any others that aren't quite so conservative that will be reviewing it?
 
Senator French: I have no doubt that that's true. We tend to be focused on them right now because it's the most conservative that seems to be the most interested, but you can find all kinds of groups in the middle that have been pushing this thing for a long time--AARP, and groups like that.
 
AHPR: Can you say anything about your prospects for the next session in terms of passage?
 
Senator French: It's hard to get any bill through the Legislature. Every bill is a struggle. There's probably one or two bills a year that seem to fly through the system, but with everything else you've got to reach a consensus and you've got to compete for the attention of the committees and the members, and it's always an uphill push to get any bill through. I am optimistic about this bill's chances with the Senate. I think we've got the structure in place for a group that will at least give it serious thought. My hope is to get it to the floor of the Senate for a vote this year and passed over to the House, and see what happens. This is not an easy thing to swallow; it takes a long time to get familiar with. It takes a long time to get a basic understanding of how it works. You are a health care professional and I'm not, but it has taken me months to get up to speed to where I can discuss the components of the bill comfortably. To make that happen in the committee process requires a little bit of magic. I am optimistic; I am an optimistic person by nature, but this is not going to be an easy trick.
 

"It's got to cover everybody. That is the one point I won't give in on. If you come back with a solution and say, "Well, we can get halfway there," I'm just not that interested. "



AHPR: What are your non-negotiable points in the bill?
 
Senator French: It's got to cover everybody. That is the one point I won't give in on. If you come back with a solution and say, "Well, we can get halfway there," I'm just not that interested. There are plenty of models across the face of the globe where governments are able to figure out a way to cover every single one of their citizens with health insurance, and you can obviously do that and not sort of crumble economically. It is time for us to do that. I am open to any solution. If you don't like SB 160, fine! Toss it out and we'll start working on a different one, but I want something that can actually pass and that covers everybody.
 
AHPR: Is there any evidence of popular support for your bill?
 
Senator French: Probably one of the frustrations up-to-date has been getting a wide press on the bill. It is not a sexy subject. We have tried [various] ways of getting press coverage, but we haven't gotten the big break yet. We are still working on ways to make that happen. I'll speak to just about any group that will have me, but it takes a while to build momentum. It will happen, but it hasn't happened yet.
 
AHPR: Please talk about your web site (http://www.healthyalaskans.com/) a little bit. I am assuming it is part of an educational effort. Are there any other plans for a broader media/educational campaign?
 
Senator French: I'm going to let Andy answer that question. He constructed and designed the web site and I'm going to let him tell you about it.
 
Andy Moderow: I think the web site has been a great resource. We've had a lot of comments coming in from people. When they ask a question, they can go to the interactive calculator and find out how, if they lived in Massachusetts, a similar effort would affect them. I think the sky's the limit on what technology can provide us. The Senator and I will be discussing options there, and we will use it as an effective resource to give information out about the bill.
 
AHPR: It sounds like you had one media roll-out. Are you planning more?
 
Senator French: We are. We are trying to get a joint Labor and Commerce and Senate HESS Committee meeting to discuss the bill just to get some of the committee members up to speed before the session actually starts, and to use that as an opportunity to bring in an expert, like someone from the Heritage Foundation, to talk about why this can work, and what it can do for business, and why it can lower everybody's costs. I think that's a bit of a striking idea--an institution whose perspective comes from the right on the political spectrum is interested in universal health care. That is newsworthy, so we are trying to coordinate all that.
 
AHPR: I have a list of the bills in which you are prime sponsor, and quite a few of them deal with public health issues, not just health care issues. They cover everything from workers compensation, medical assistance, violence, assault, and Medicare rates. Please talk about your general interest in these public health and health care issues, and focus on any of these that may be of particular importance.
 
Senator French: Generally you can see that it's one of those areas that just seems ripe for reform. It's an area that's a little bit difficult for folks to work on, but it is something important for policymakers to get involved in. I guess I come to it with an overarching philosophy. I see problems, and my job as a legislator is to try to fix things where government isn't performing right, so that's the most general statement I can make on the topic. I certainly didn't start this year thinking I've got to fix a bunch of health care problems, but it just seemed like once SB 160 started to take shape, your interest and your awareness expands, and other things come along and you say, "Yeah, I'll jump on that."
 
AHPR: Are there other legislators you work with because they have an interest in health issues?
 
Senator French: Probably number one is Senator Johnny Ellis. He and (at the time) Senator Duncan proposed universal health care 15 years ago. God bless them, they worked their tails off and it just fell under the same political problems that Hillary Clinton fell into. You just got demonized by the insurance industry, the right, and you couldn't push a bill through in that climate. It caused everybody to pull back, to leave the situation alone for a decade, and slowly the business community has come around to the idea that we were right, that there's a good reason, not just a moral and humanistic reason to cover everybody, but also a business reason.
 
AHPR: Is there anything else at all that you would like to tell the readership of the Review?
 
Senator French: Write a letter to the editor demanding that their legislator take action on this bill now. It is one of these things that's going to take a huge amount of individual work, and every little bit helps. Call in to talk radio and say, "How come we're not talking about health care instead of some cheesy little affair or that little escapade? Why aren't we talking about the big picture stuff?" Letters to the editors certainly help. Letters to your legislators help. E-mails to your legislators help. Everything matters. It is a small state and every single person that reads this article can make a difference. You are selling this obviously to policymakers, but everyone should be shaking the tree a little bit and saying, "Let's get moving now!"

END

Policy Analysis: Denali KidCare
 
Denali KidCare is the program in Alaska that provides health insurance coverage to children and pregnant women whose family incomes are too high to qualify for Medicaid, but are too low to afford private insurance. It provides for a full range of preventive and treatment options, including physical and mental health. The program also includes coverage for prescription drug costs and lab testing. Currently, Denali KidCare covers over 7,000 children under age 19. Pregnant women of any age may also apply using a Denali KidCare application. Despite these successes, there are 21,197 children without health insurance, approximately two-thirds of whom would qualify for either Medicaid or Denali KidCare.
 
Denali KidCare gets its funding from several sources; the most notable source of federal funding is the State Child Health Insurance Program (SCHIP). Federal Medical Assistance Percentages (FMAPs) determine the amount of federal matching funds for state expenditures for assistance payments for certain social services and for state medical and medical insurance expenditures. For qualifying expenditures, states receive an enhanced federal matching rate. SCHIP's current enhanced FMAP provides 70 cents in federal money for every dollar the state spends on health care for its residents. Once the federal allotment has been spent, the FMAP reverts to the non-enhanced Title XIX (Social Security Act) FMAP of approximately 58 cents per federal dollar.
      
SB 27 Medical Assistance Eligibility

On May 15, 2006, the final version of SB 27 Medical Assistance Eligibility was approved by both chambers of the Alaska Legislature and submitted to the governor for signature. SB 27 is a partial reversal of the 2003 legislation that established eligibility guidelines for medical assistance provided by the state. The new legislation was effective back to July 1, 2007. Prior to 2003, the eligibility level was at 200% of the federal poverty guidelines (FPG). Legislation enacted by then-Governor Murkowski, however, lowered the eligibility guidelines to 175%. The legislation also froze eligibility relative to the 2003 federal poverty guideline standard, making the absolute level actually lower each year as inflation and the cost of medical coverage rose. This resulted in the eligibility guideline prior to July 1, 2007, falling to 154% FPG. Because of this change, between 2003 and 2006, 2,553 children and 436 pregnant women lost health care coverage. SB 27 raises the eligibility guideline up to 175% FPG and removes the frozen 2003 standard. While this is still lower than the pre-2003 level, it is nonetheless a significant expansion from the current levels of enrollment.
      
A second significant change, though not a direct result of the 2003 legislation, was the elimination of five Denali KidCare outreach specialists from the program's budget. Once a part of DHSS's Division of Public Health, they were responsible for the training of local recruiters and the marketing of Denali KidCare. This consisted of traveling to communities and villages to train and assist clients in filling out applications for Denali KidCare. The positions were eliminated early in the Murkowski administration due to budget constraints. Initially the Outreach Specialist budget was transferred to the Division of Public Assistance, then it was simply removed from the FY 2003 budget altogether. Since then, there have been no outreach specialists for Denali KidCare.
 
SB 27's main focus is to reverse the eligibility guidelines for Denali Kid Care. In doing so, the bill also lays out clear categories of people who the state may choose to cover in the program and of criteria they must meet. These guidelines distinguish between certain groups of children under the age of 21 and groups of certain adults as optional groups for whom the state may claim federal financial participation for medical assistance.
      
The key factor of SB 27 is its reversal of the previous eligibility cut-off of 154% FPG. To calculate the funds necessary per fiscal year from 2008 to 2013, DHSS made certain assumptions about the projected growth rates of the population and about medical costs within the state, as well as projected re-enrollment to Denali KidCare during FY 2008. To arrive at the cost projections for SB 27, an annual growth rate for Alaska's population of 8.6% was used. Additionally, an annual inflation in the cost of medical care of 5% was used. DHSS assumed that the number of children and pregnant women who enroll in Denali KidCare during FY 2008 will be approximately equal to half the number from each group who were dropped from the program between 2003 and 2006. This amounts to 1,277 and 218 new enrollees in Denali KidCare in each category, respectively. Assumptions about the number of children and pregnant women covered are based on the current best-guesses about population growth and medical cost inflation, and so are subject to significant change in future years. Ultimately, the number of new enrollees during the next five years will be affected most directly by the amount of funding available. Exact estimates for population growth and medical cost inflation rates remain estimates.
      
The State Child Health Insurance Program (SCHIP)
      
It is important to note the relationship between the funding proposed in SB 27 and the federal programs from which much of the money comes. The State Child Health Insurance Program (SCHIP) provides the most significant source of federal dollars to Denali KidCare. SCHIP is currently facing reauthorization in the US House and Senate. Both bills seek to address the current shortfalls in many states that have resulted in even more people being dropped during FY 2006. The House proposal would dramatically increase the number of children covered. However, pregnant women in Alaska who are covered by Denali KidCare are funded by the Title XIX FMAP. Consequently, they will be affected differently than children regardless of what the final SCHIP bill looks like.
 
According to a 2007 study conducted by FamiliesUSA, the proposed $50 billion increase would give Alaska roughly $230 million in additional federal funding over the next five years, enough to cover between 8,000 and 9,000 additional uninsured children by the end of FY 2008. The differences between this number and the projected FY 2008 enrollment using the current SCHIP funding levels are staggering: based on the FY 2008 projections at the current funding levels, Denali KidCare would increase coverage to approximately 1,200 children, or roughly the same number as were dropped from the program following the 2003 eligibility cuts. This leaves thousands of Alaskan children uninsured, and underscores the benefits Alaska stands to gain with increased federal funding.
  
The FamiliesUSA study takes the examination of what the state would gain a step further than the Department of Health and Social Services' (the agency responsible for SB 27's fiscal notes) analysis, and looks at more general state-wide impacts of the funding. According to the study, the $230 million would result in over $82 million in increased business activity, over $30 million in increased wages, and 843 new jobs in Alaska.
 
Advocates had hoped that SCHIP would be reauthorized with the proposed $50 billion funding increase. This would have meant an even greater increase in the number of children Denali KidCare could cover. As of August 13, 2007, the Senate had approved HR 976 EAS (Engrossed Amendment as Agreed to by the Senate), a bill with $35 billion in new SCHIP funding, and the House had approved HR 3162, an $86 billion bill with $47 billion in new SCHIP funding. A final SCHIP reauthorization bill won't be decided on until after both chambers of Congress conference on the issue, but it is likely that the final result will be somewhere in-between these two figures. While anything less than the hoped-for $50 billion will seem like a significant shortfall, it still represents a marked increase in both children covered and in larger economic growth for the state. Even with 30% less funding than anticipated (should the final bill remain at the Senate's proposed $35 billion funding level), Alaska would still gain tens of millions more per year for uninsured children than it currently has (or it would have received from President Bush's proposed increase of $5 billion over five years increase). 
      
DHSS's current projection model forecasts a total of $2,691,500 in Denali KidCare expenditures during FY 2008, increasing each year to a total of $4,081,000 in FY 2013. The overall cost projection is divided between three departments within Denali KidCare, each of which warranted its own fiscal analysis by DHSS. Over 80% of the projected cost of SB 27 in FY 2008 goes toward the operating expenditures of the Medical Services division, with the remaining costs divided between the Public Assistance Field Services and the Behavioral Health Medicaid Services divisions. Important to note is that the Public Assistance Field Service's budget includes funds for the creation of one full-time position dedicated to overseeing the eligibility screening process; the position includes full-time pay and benefits for the half-year of FY 2008--the time when the funding would become available--and then year-round through FY 2013.
      
Denali KidCare, SCHIP, and the new eligibility guidelines established in SB 27 all form a net to catch the most at-risk children, those who do not have the economic means of purchasing private health insurance coverage. And what, after all, is more important than the health of the children?

Sources:

This analysis was last updated August 13, 2007.

END

Interview With Representative Peggy Wilson

Peggy Wilson AHPR:  You are a central figure on the HESS (Health, Education and Social Services) committee, and with your personal background it's kind of an interesting confluence.

Rep. Wilson: A little bit of background. I also have been at one time on welfare, and because of that, you go through the humiliation--and this has been a long time ago, 30 some years ago--but you really have empathy for other people in certain situations and what they're looking at. I was married for 8 � years and there were three children when I ended up on welfare--I wasn't an unwed mother. Especially with the uninsured, I am amazed at how [some] say, "Oh, if you are over 300% of the poverty level, you can afford your own insurance." We had insurance and didn't use it because we could not afford the deductibles. There's a lot of people out there like that.

AHPR: I am really glad you brought that up because this is not an issue that is being studied that much. Being insured is not the same as real access for a number of reasons.

Rep. Wilson: I think that's very, very important because I have experienced a lot of different things. I have been on the Social Services Board when I was in North Carolina, I've been on the Mental Health Board when I was in Tok, so I feel like I've got a pretty good background. I was a nurse for 30 years before I became a legislator. And then when I lived in Tok, I worked in a clinic and was also a member of the ambulance squad. So I have really been in a lot of different areas to see first-hand what kinds of situations people are in and how they're dealing with it. And I was a school nurse for 9 1/2 years. So all that together really does help me think about questions and what to think about.

AHPR: Why did you want to become a legislator?

Rep. Wilson: Actually, education was my stepping stone because of the unfair funding in education for rural versus urban in this state, and I feel we're starting to make progress finally. Because of that, that's when I really started, and then I found it really wasn't much different than what I was doing as a nurse. I was helping people in one way when I was a nurse in the hospital and now I'm helping people in a different way as a legislator, but I'm still helping people. It fits pretty good with my personality, I guess.

AHPR: How have your education and experience as an EMT and a registered nurse and these other occupations that you've mentioned, influenced your thinking about health care reform in Alaska?

Rep. Wilson: It has made me realize that there is not just one answer. Just saying "Oh well, we'll give everybody insurance," doesn't necessarily answer it. If we had all the money in the world maybe we could do everything, but we don't and our health care dollars are limited. We have to look at what can we sustain, and I think we have already seen in this state what happens when you give people something and then have to take it away, and we sure don't want to do that, so I think we have to be very careful what we do and really think about, "Can we sustain this?" When our population and the demographics change, which our research has showed us that they're going to, when they change, and all the things that we're doing for our elderly population now, once that grows by leaps and bounds, will we be able to continue doing what we're doing? So if we can't sustain what we have, then we have to think, "How can we spend our health care dollars more wisely?" That means we really have to think hard about what we're doing, and what the ramifications are, and how we can do it to get the most people covered. I think we are going to have to spend more money, but there is a limit to the "more money", so we have to make sure that we are doing it wisely.


"It's very interesting because everybody that is on Finance--and I won't pick anybody out at all individually--but overall, they could care less about the people that we are not reaching. They're thinking money. That is all they're thinking."


AHPR: As chair of House HESS, what role do you think you and your committee can play in terms of health policy for the State of Alaska?

Rep. Wilson: This is my seventh year as a legislator here in Alaska. I found that the first five years I was always on the Finance Subcommittee for Health and Social Services, but you can still give your ideas and recommendations, but that doesn't mean it's going to fly. The last two years I've decided we have to use the HESS committee as a committee that has got some teeth and that is going to be listened to, and if we're going to be listened to, we are going to have to work more than just during the time we are in session. So last year we worked on it, and this year we're going to continue to work on it, and I am hoping by the end of this interim, before next session, that we will have some kind of a bill or some kind of a recommendation of some better ideas of what we can do to help the access, to help coverage for people, and to make a difference. We have to make a difference!

We have many people in our legislature that say, "We're not going to start any new programs because we can't afford to start any new programs!" But what this legislature has done in the past is we constantly throw the money down here at the wrong end--we throw it down here with the problems, and they keep growing. We have got to start putting some money up front, and start doing prevention things, and all the research is telling us that also, and even insurance companies are starting to realize that. But we haven't made very many changes at all in the Legislature.

It's very interesting because everybody that is on Finance--and I won't pick anybody out at all individually--but overall, they could care less about the people that we are not reaching. They're thinking money. That is all they're thinking. And when you just think money, you've got to think a little bit with some empathy for what's going on in Alaska, and how we can make changes. Usually the changes are very, very slow to come about. But we have to start to make a difference, and I want to make a difference! When I am out of here, I want to know that I really did make a difference and that I just didn't take up a chair and say, "I'm not going to spend money." As a Republican, that's kind of a tendency people do, to say "We're just not going to spend more money. We're going to cut government," and all that. That's easy to say, and it's not necessarily that hard to do, but what are the outcomes? Are we really making a difference? We've got real people--blood and sweat people--that are hurting out here, you know, and we have to make a difference.

AHPR: Under your leadership during the first session of this legislature, House HESS sponsored four pieces of legislation. Please tell us why these pieces of legislation were important to the committee, and also please tell us a little bit about the internal committee process that came up with this legislation.

Rep. Wilson: [Referring to the House HESS Committee Working Group, "Using Health Care Dollars Wisely," which met several times during the last half of 2006.] Last year during the interim, we had committee hearings very similar [to the one we held today], and we came up with recommendations for the legislators in funding health care issues. We came up with eight recommendations and some of [these pieces of legislation] meet some of those recommendations a little bit.

We went through a lot of research. We went through all of the long-term care-there were seven different studies done for Alaska. We went through all that and condensed it, and looked at the things that were the same, saw what we had changed, which ones we had never even done anything about. It all started from a conference that ten people from Alaska went to in Denver, Colorado. It was with seven other states, and they charged us and got us started about what to look for, and sent all of the states out to continue. Well we were the only state that followed through and really came up with some recommendations for our legislature.

Last year we worked very hard as a committee to come up with that information [we mentioned earlier]. We had several meetings; I think there were five different meetings that we held. Then we got everybody's recommendations, everybody on the committee, and there were ten people involved altogether because we had a joint committee. Only two of them were from my committee, so we included those 10 people plus the committee to do this. Everybody on the committee and those ten people gave us recommendations, and then we would discuss the recommendations and decided which ones we were going to keep and which ones we weren't going to keep. Then we came back; we narrowed it down to eight recommendations.

It was very, very involved with those recommendations because we were going to recommend those to the Legislature as a whole. So we made sure that every legislator had it, and especially the people on the Finance Committee, and especially the Finance Subcommittee on Health and Social Services. So that's what it is when it's a full blown something that we are really working on. And that's the bill that we are going to come out with this time. It is going to be done that same way. These were things that had come up during the year, during debate on other bills or something that we thought we needed to work on.

Also, our committee as a whole has wanted for the last two years, to see what we could really do to make a difference with health care in this state. So what process you go through depends on the situation. Any time it's not going to be a bill, but a bill that is recommended by the committee, then it will say that. These bills, themselves, were not a big force by the committee, but what we are doing now will be. There is a difference. It depends on the situation and how far you're going. These are just very individualized type things. When we get done, this is going to be pretty comprehensive yet very specific.

AHPR: When you say, "When it will get done," will it take the form of a finished piece of legislation?

Rep. Wilson: I hope so, but I don't even know how it's going to turn out yet. So it is kind of hard to say. I hope that we do have that. I have carried these bills, but my thoughts ahead of time are that different members of the committee helped carry the bill, so that when it's in one of their committees, let them do it, and not just me. It will be all of us together doing something. So I am hoping that we will be able to show the rest of them that it's not just me, but it's the group as a whole has made this decision--bipartisan--and we'll see what we come up with. I think we have to do it because I've just been here too long with not enough happening, so I think we really need to do something.

AHPR: There are quite a few health related bills currently in House HESS. Which of these are likely to pass out of your committee?

Rep. Wilson: All this [a list of bills currently in house HESS] shows is the bills that have been assigned to my committee. However, there is a big process you go through before a bill is heard. And the first thing that happens, you have to ask for the bill to be heard, and about half of these people have not asked for the bill to be heard. You have to realize many people put in a bill so that they can say, "Well, I put it in, but they never heard it." They all know that they have to give me a packet with all the information before I can schedule a meeting, and they have to write a formal request to have the bill heard. And many times they have no intention of having their bill heard. And then in the next campaign they can say, "I put it in, but they never heard it."

I am very careful to hear every single bill that is requested. I don't play favorites. I think that's very important, that if it's a bill that somebody wants to have heard, I hear it. Any bills that haven't been heard, it is because they haven't asked. That is not just with my committee--that's with every committee--everybody knows that. Unfortunately, the public doesn't know that.


"You will have a better chance of passing your bill if you will have people that testify and stand up for you. Some of them need some help in that area, and sometimes it gets to the point that by the time they're ready, we have run out of time."


AHPR: How does the bill get from "heard" to "passed out of committee?"

Rep. Wilson: Sometimes there are not the votes to pass it out of committee. Some people know that to begin with and they say, "I just want it to get to be heard so the issue gets out and is talked about." And they know that the votes aren't there...so I'll do that. Sometimes they hope that they can convince the people that there's enough votes. Usually I don't want to embarrass anybody by having a vote and it gets turned down, so rarely do we do that. Sometimes I'm going to say, "I am going to hold this bill until next time," or something like that and it's usually because there are not the votes to have it pass.

So it depends on the bill, it depends on whether the person has asked for the bill to be heard, and some people say, "I know it's going to take several years for this bill to be thought of in a good light so all I want to do this year is get it introduced."

There have been people who have asked to have their bill heard three times, but they still haven't given me the packet, and they have to have the packet...I try to have the information two days before my meeting and then my staff aide goes and delivers it to all the members' offices so they've got two days to read it before we have it in committee.

I always hear everybody's bill that I can and not all legislators do that. Some legislators will not hear certain legislators' bills. Those are just the facts. I can't do that. Even if it's a bill I don't like, I still will have it heard and discussed because sometimes we can make some changes to make it a better bill. We might have to pull it into a subcommittee and say, "You know, we're going to work on this for a year, because this isn't a bill that's ready for the floor yet." And then we'll make changes for next year and by the next year we'll come up with something.

Lots of times people will come to me with the bill but they don't have any support for it. And I will say [for example], "You might want to get the dentists behind you on this, and maybe the dental hygienists." If they are new, I might suggest to them, "The more support you have, the more people you could bring in to testify," and some of them just don't have anyone to testify. You will have a better chance of passing your bill if you will have people that testify and stand up for you. Some of them need some help in that area, and sometimes it gets to the point that by the time they're ready, we have run out of time.

I just can't imagine what we are going to do next year with only 90 days. I can't imagine.

AHPR: You are a prime sponsor of HB 207. Please tell us about your interest in HB 207, which changes the parental consent requirements for surveys in schools from active to passive for anonymous surveys. What issues did you have to overcome with fellow legislators? What is the status of the bill now?

Rep. Wilson: The bill got through three committees and is now in Rules. It got through the HESS Committee, the Judiciary Committee, and the Finance Committee. It is in Rules ready to be heard, but John Coghill does not like it and he is the chairman of that committee. I have had an interest in that in years past and it was kind of a carryover, but it was definitely one of the specific things we talked about in our "Spending Health Care Dollars Wisely", because nonprofits can get grants from the federal government or from other organizations if they have proof that what they do works. And they don't have proof because of the active parent consent. When you send things home, we all know that they get lost in the shuffle.

The biggest problem is that there are a certain number of parents who are Christian oriented--I'm a strong Christian--but I just think you can't shelter your kids from all kinds of things. They actually object to the questions that are answered, "Well, if it says 'have you had sex in the last month', they're going to think about having it." And I think there's only two sexual questions on that survey, but they just get hung up on it. There are a very few who don't like it because of questions like, "Does anyone in your family use drugs." But these are totally anonymous. There are no names on these whatsoever. I feel real strong about that because we could get more help to our kids if they could go in and do this, but without this survey, they can't. So, I want the survey. Our committee as a whole was very strong on getting this survey changed this year, so now John Coghill's got it because he doesn't like it, but I do think I'll be able to get it out of him this year by just having a bunch of people sign a paper saying "We want it," and if there's more than half the group, I think he will because he didn't do that this year with the Senior Care and he's feeling the ramifications of that. I talked to him and I said, "John, I told you you needed to take that out," but he says, "Well, very few people asked me, and there were several that said just hang on, stick to your guns."

A lot of politics makes a difference in a lot of these things, and there's  lots of times there are things that should get passed that don't get passed just because of the politics. Sometimes, and I've had it happen, where somebody is holding one of my bills--and I let a bill go this year that I really hated, the Ophthalmologist Bill--they put it in after it got out of my committee about the injections, and I don't think that [ophthalmologists are] qualified to give the injections and they shouldn't be giving injections. The governor hasn't signed the Bill yet. I would love it if she would veto it. The rest of the bill is fine, but nobody should be giving injections in the eye except an M.D.--nobody else. We really did get a lot of things changed in that bill because of my feelings on it.

The optometrists wanted to issue all drugs and I said, "no, there are certain drugs that are habit forming drugs that you don't have to have...So that class of drugs, the Vicodin, the Percocet, those type of things they are selling on the streets, there's no reason for them because if people are having that much eye pain, then they need to be seen by a real doctor. So that changed, the extra training changed, there was a lot of things that got changed that made that a better bill. And so we finally got it through. That was a fight every single year I've been here but this is the first year they've been willing to give on some of these things.

AHPR: Did those changes occur within your committee?

Rep. Wilson: Actually they didn't, because the lobbyist came and talked with me, they had hired a different lobbyist, and he came to me and he said, "What's the deal? How come [you are holding it up]?" And I said to him, "I can tell you 'how come.' It's because of this and this and this and this..." and he goes, "Oh. The reasons you've given me kind of make sense." So he went back to his people and said, "Why not give in on these issues?" And so they were willing to give on the issues, and we came to some agreements. But they weren't willing to make any changes for five years, and that is one bill that I held in committee, and because of that, the sponsor of the bill held some of my bills in his committee. Those things you have to weigh. I just don't like to give up my principles because of something that someone's going to do to my bill.

AHPR: How can someone who cares about some particular public policy know that it's being held up for these reasons? Because it is something so personal between legislators it's not likely to become public information.

Rep. Wilson: Lots of times it's not. But if somebody comes to me and says, "What's the deal? How come the bill is not moving?" I'll say, "It's because of this."

But it does happen, and it has happened the last two years more than ever before. You get a new bunch of people who aren't used to the normal give and take of legislators. This year we didn't have very many caucuses and because we didn't have many caucuses, we didn't get to know each other very well. When we don't get to know each other very well, you don't have those connections. Once we get here, we are so busy, we are just so busy. I'm on five committees plus three subcommittees. And that just really keeps you going.


"I talked with Workers Compensation Division and they said, 'Oh, would you please put a bill in. We are having such a terrible time with this same company. It's an ambulance chasing company.' "


AHPR: You are a prime sponsor of House Bill 121 relating to Workers Compensation records. Please tell us a bit about that bill, your interest in it.

Rep. Wilson: That bill is a bill I brought about because of a request from one of my constituents. She and her husband were working on the Aleutian Chain and she got hurt. It got taken care of, but all at once she started getting letters from a law firm in Michigan wanting to know if they could take her case on about her getting hurt, and they had her name and her address and her telephone number. She was really upset and called [her employer] and said, "What are you doing giving people my information?" And they said, "We didn't give people your information."

I talked with Workers Compensation Division and they said, "Oh, would you please put a bill in. We are having such a terrible time with this same company. It's an ambulance chasing company." So they helped frame the bill, the department worked with me on it. Think about it, though, if it was a policeman and now everybody knows where he lives, or what about a childcare worker who went to somebody's house and took their kids? That bill is all the way through the House and the Senate, and it's in Senate Finance, and they told me that they thought they would pass it, but we just ran out of time this year.

And not only that, but they could get their Social Security numbers! Every single department of state government had to comply with the new federal regulations on that information because of personal privacy and there was that loophole in that one department that can still do that and they have to give it according to our statutes. Until we can get this passed, they can still do it. The day it hit the first committee, that company in Michigan solicited information from 17 different companies so that they would have all that information. They've got all that information on people and they're writing them, and calling them, and sending them information.

AHPR: Are there any other bills you sponsored or co-sponsored relating to medical care or broader public health that you would like to discuss with us?

Rep. Wilson: House Bill 4, which is the Certificate of Need, is coming up next month sometime. The HESS committee in the House, and the HESS Committee in the Senate are holding hearings on CONs because there is so much controversy on this, and it does make a difference in health care costs, and the verdict is still out whether it helps or hurts. We are going to do much more research on this because several states that got rid of it that are now putting it back into place and we need to really know why. Do we need to change some of the regulations, or what can we do? That is something that is pretty important for this state that we need to look at. [Senator] Bettye Davis is working on that and she's going to be the lead person on that, but we are meeting together on that.

AHPR: Who does the research to answer those kinds of questions?

Rep. Wilson: The National Conference of State Legislators has lots of people who do nothing but research on the different states and what's going on, so that is one area you can go as a resource. They are bipartisan, they try to look at different states and what different states are doing with insurance, CON, education... they are a big think tank that really tries to look at how can they help states to spend less money yet give as many services as possible. Sometimes you just call somebody. I myself might call the HESS chairman in another state, and say "Why did you guys change that?" and find out from the horse's mouth. There are some experts nationwide. Actually, the two people that we are having next time are pretty well-known in this specialty. It is pretty unusual to go into a bill that somebody else has but that's all we have right now to work with. So we need to see what do we have, and what's before us. Is that good? Are there other options? It is very important for us to get everything on the table so we know what we're dealing with.

AHPR: I'm so glad to hear you talk about having to look at the research first before you turn to public policy because I feel that among many legislators that is almost irrelevant.

Rep. Wilson: We can't afford not to do that anymore. On our committee, "Spending Health Care Dollars Wisely", one of the criteria was that we don't start any new programs unless we make sure that they are scientifically based and we know they work. We really went into a lot of detail to try to come up with some wise decisions. One of them was, maybe we should try to do some pilot programs in Alaska.

AHPR: Were there any other bills that you especially wanted to mention or discuss?

Rep. Wilson: The air ambulance services. That's a good bill, but it's not going anywhere in committee right now. Because we have to have so much service all over the state, medevacs everywhere. There is one company that is saying, "if you pay $100 a year, no matter what the medevac costs... it's not like insurance and many other states are doing this, but the other air ambulance services are throwing an absolute fit about it. Will the [Division of Insurance] say that that is insurance coverage or not? Because there is such a need in this state, and because there is such devastation if you do get medevaced out...sometimes it is $25,000. How long is it going to take some poor family to pay that? Maybe they will have to go into bankruptcy. I used to live in Tok and we medevaced people out all the time. It was either a four-hour drive to Fairbanks, or an eight-hour drive to Anchorage. So I see how important the need for that is, but the other companies were just crazy, so I held that in committee. I said, "We need to work on this some more...these darn other companies, it makes me so irritated, because what they want to do is gouge these people, and they can write it off anyway if they don't get anything from people. It's a business expense. So I think we are going to come up with something and I think we will be able to do this. Their concern [the other medevac companies] is that, "Well, what if he's busy somewhere else and can't come, and we have to go?" I think we are going to say, "If you do it, then he has to pay you." We had two different committee meetings on this and they went way into the evening, so I just pulled it. This is a bill that I think is important and it will help the people of this state, but it is not ready yet.

AHPR: Is there anything else you would like to tell the readership of Alaska Health Policy Review?

Rep. Wilson: Don't be afraid to call my office and ask questions if they have them. We are very good at trying to keep the public informed if we can. If they want to testify on any bills, make sure they contact us and we will see if we can make that happen.

END

Health Legislation Passed During The Last Session

This list of health-related legislation passed during the last session was determined using the Alaska Legislature's BASIS website. A list of all health and social services-related bills (regardless of final legislative status) was developed, followed by a list of all legislation passed during the most recent session. These two lists were then indexed together, and all non-health policy bills were removed. The remaining bills were individually reviewed from the perspective of a broad definition of "health policy legislation."

Bills relating to issues such as alcohol use, mental health, and insurance were all included, as were general budget appropriations bills that directed funds to the Department of Health and Social Services. The resulting list contains a broad spectrum of issues relating to the physical, mental, and social well-being of Alaskan residents.  Note that all the bill numbers are live links in the "BILL" column, and will take you to the appropriate "Bill History/Action for 25th Legislature" page. 

BILL

SHORT

TITLE

PRIME

SPONSOR(s)

CURRENT

STATUS

HB 18

POSTSECONDARY MEDICAL & OTHER EDUC. PROG.

MEYER

SIGNED INTO LAW 3/28/07

EFFECTIVE

6/26/07

HB 35

EXTEND BOARD OF MIDWIVES

KAWASAKI, WILSON

SIGNED INTO LAW 5/11/07

EFFECTIVE

5/12/07

 

HB 90

CRIMES/ALCOHOL/DRIVERS LICENSES

SAMUELS, STOLTZE

SIGNED INTO LAW 6/25/07

EFFECTIVE 6/27/07

HB 95

APPROP: OPERATING BUDGET/LOANS

/FUNDS

RLS BY REQUEST OF THE GOVERNOR

SIGNED INTO LAW 6/29/07

EFFECTIVE 7/2/07

HB 96

APPROP: MENTAL HEALTH BUDGET

RLS BY REQUEST OF THE GOVERNOR

SIGNED INTO LAW 6/29/07

EFFECTIVE 7/1/07

HB 113

OPTOMETRISTS' USE OF PHARMA-

CEUTICALS

SAMUELS

AWAIT TRANSMIT GOV

HB 118

PROHIBIT ALLOWING MINORS TO HAVE ALCOHOL

MEYER

SIGNED INTO LAW 6/25/07

EFFECTIVE 9/23/07

HB 120

EXTENDING COUNCIL ON DOMESTIC VIOLENCE

FAIRCLOUGH

SIGNED INTO LAW 3/15/07

EFFECTIVE 3/16/07

HB 155

EXTEND ALCOHOLIC BEVERAGE CONTROL BOARD

LABOR & COMMERCE

SIGNED INTO LAW 7/3/07

EFFECTIVE 7/4/07

HB 170

INSURANCE

LABOR & COMMERCE

SIGNED INTO LAW 7/3/07

EFFECTIVE 7/3/07

HB 213

CRIMES : DOMESTIC VIOLENCE SHELTERS

DOLL

SIGNED INTO LAW 7/3/07

EFFECTIVE 10/1/07

HB 215

TASK FORCE RE: COUNCIL ON DOM. VIOL.

FAIRCLOUGH

SIGNED INTO LAW 7/3/07

EFFECTIVE 10/1/07

HB 228

WORKERS' COMP. MEDICAL TREATMENT FEES

KELLY

SIGNED INTO LAW 7/3/07

EFFECTIVE 7/6/07

HCR 3

SEXUAL ASSAULT AWARENESS MONTH

MEYER

PERMANENTLY FILED

4/13/07

SB 27

MEDICAL ASSISTANCE ELIGIBILITY

DAVIS

SIGNED INTO LAW 7/9/07

EFFECTIVE  7/10/07

SB 53

BUDGET: CAPITAL, SUPP. & OTHER APPROPS

RLS BY REQUEST OF THE GOVERNOR

PARTIAL VETO BY GOVERNOR - 7/3/07

EFFECTIVE 7/3/07

SB 61

SUPPLEMENTAL APPROPRIATIONS/EDUC FUNDING

RLS BY REQUEST OF THE GOVERNOR

SIGNED INTO LAW 5/11/07

EFFECTIVE 5/12/07

SB 84

TOBACCO SALES/

CIGARETTE TESTS & PACKAGING

OLSON

SIGNED INTO LAW 7/18/07

EFFECTIVE 7/20/07

SB 85

EXTEND STATE MEDICAL BOARD

DAVIS

SIGNED INTO LAW 7/9/07

EFFECTIVE 7/10/07

SB 93

PROFESSIONAL COUNSELORS

DAVIS

SIGNED INTO LAW 5/31/07

EFFECTIVE 8/29/07

SB 100

SUBSTANCE ABUSE/MENTAL HEALTH PROGRAMS

ELLIS

SIGNED INTO LAW 7/17/07

EFFECTIVE 10/15/07

SB 123

RETIREM'T/ BENEFITS:PUB EMPLYEES/TEACHERS

RLS BY REQUEST OF THE GOVERNOR

SIGNED INTO LAW 6/6/07

EFFECTIVE 6/20/07

SB 128

ALCOHOL LOCAL OPTION PROVISIONS

OLSON

SIGNED INTO LAW 6/25/07

EFFECTIVE 6/26/07

SCR 2

BRAIN INJURY AWARENESS MONTH: MARCH 2007

MCGUIRE

PERMANENTLY FILED

3/19/07

SCR 4

PUBLIC HEALTH AND HEALTH COMPACT

HEALTH, EDUCATION & SOCIAL SERVICES

LEGIS RESOLVE 24

6/20/07

SJR 1

MEDICAL ASSISTANCE FOR CHILDREN

DAVIS

LEGIS RESOLVE 4

4/27/07

SJR 3

MEDICARE RATES IN ALASKA

WIELECHOWSKI

LEGIS RESOLVE 10

6/20/07

 END

Health Policy Calendar
 

Meeting

Date/Time

Place

Comments

Alaska Public Health Association (ALPHA) Summit

Summit: Dec. 3-5, 2007

Post-summit: Dec. 6-7, 2007

Sheraton Hotel, Anchorage

(907) 276-8700

Summit title:"Making Alaska Healthy: Individuals, Communities, Policies and Environment"

Governor's Health Strategies Council

Aug. 27, Sept. 17, Oct. 15, Nov. 12, Dec. 3; 1-5 PM

8/27, 9/17, 10/15, 11/12 - ANTHC Office Building

12/3 - Sheraton Anchorage Hotel, Anchorage

Call-in: 1-800-315-6338 Code: 7800

House Health, Education, and Social Services Committee

Aug. 28; 10-3:30

Anchorage Legislative Information Office, Room 220

Meeting topics: "Health Care Reform Across the US"; "Rethinking Insurance"; "Changing the Health Care System"

END

 
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