{"id":108413,"date":"2024-04-08T21:30:00","date_gmt":"2024-04-09T05:30:00","guid":{"rendered":"https:\/\/www.juneauempire.com\/home\/alaska-lawmakers-ok-rules-for-subscription-style-basic-health-care\/"},"modified":"2024-04-08T21:30:00","modified_gmt":"2024-04-09T05:30:00","slug":"alaska-lawmakers-ok-rules-for-subscription-style-basic-health-care","status":"publish","type":"post","link":"https:\/\/www.juneauempire.com\/news\/alaska-lawmakers-ok-rules-for-subscription-style-basic-health-care\/","title":{"rendered":"Alaska lawmakers OK rules for subscription-style basic health care"},"content":{"rendered":"

The Alaska Legislature has voted to approve a health care approach likened to a gym membership.<\/p>\n

In a 28-12 vote on Monday, the state House voted to approve Senate Bill 45<\/a>, which authorizes direct health agreements in the state.<\/p>\n

SB 45 clarifies that direct care agreements — effectively a subscription for basic health care from a doctor’s office — aren’t insurance and can’t be regulated as such.<\/p>\n

“In Alaska, our insurance laws are drafted so broadly that the legality of these agreements is unclear,” said Rep. Kevin McCabe, R-Big Lake, who carried the bill on the House floor.<\/p>\n

Senators passed SB 45<\/a> in May 2023, and it’s just the fourth bill this year to gain approval from both House and Senate.<\/p>\n

Alaska has the highest health-care costs in the nation<\/a>, and there is a shortage of both specialty care and primary care. <\/p>\n

McCabe said the newly authorized agreements are intended to bypass insurance company markups, reducing costs. A patient can subscribe to their local doctor’s office and receive basic care as part of that subscription.<\/p>\n

Emergency care or specialty services might not be covered as part of the agreement.<\/p>\n

“Direct health care agreements work similarly to a gym membership or other subscription-based services,” McCabe said. “A gym membership can include certain things such as the use of machines, regular visits, but if you want to use tanning beds or attend a Pilates class, you pay an extra fee.”<\/p>\n

Rep. Genevieve Mina, D-Anchorage, said she grew up uninsured and sees direct health agreements as a way to meet the needs of people who were unable or unwilling to obtain insurance for basic care.<\/p>\n

But she also said she’s not sure that it will help Alaskans who need emergency care and are confronted with large bills as a result.<\/p>\n

“And so I wonder if this really is addressing cost issues that people are facing. And additionally, it doesn’t have the same insurance protections for the consumer,” she said.<\/p>\n

During debate on the House floor, lawmakers amended<\/a> SB 45 to say that any health care provider who offers a direct health agreement must have 20 percent of their patients be uninsured or on Medicare, the federal health insurance program for elderly Americans.<\/p>\n

Members of the House also added consumer protection language.<\/p>\n

But that didn’t satisfy all legislators, including Rep. Zack Fields, D-Anchorage and a cosponsor of some of the successful amendments.<\/p>\n

Fields said he’s worried that non-Alaskan private equity firms will buy clinics<\/a> and offer cut-rate services, making it impossible for Alaska-owned businesses to operate here.<\/p>\n

He unsuccessfully attempted to insert a provision into the bill that would have allowed only majority Alaska-owned businesses to offer direct care agreements.<\/p>\n

“If we don’t have proper consumer safeguards in place, frankly, it’s all too easy for these parasitic private equity companies to come in and get the revenue while really harming patients,” he said.<\/p>\n

Jared Kosin is president of the Alaska Hospital and Healthcare Association, which represents hospitals and existing clinics across the state. He said his organization wasn’t taking a stance on the bill.<\/p>\n

“We’ve been pretty strongly neutral on it. We don’t oppose it,” he said.<\/p>\n

Speaking before the final vote, McCabe said SB 45 should be viewed as a step forward, but not the final step in addressing the state’s health care problems.<\/p>\n

“This bill is not designed to fix all the problems in Alaskans’ healthcare, not by any means,” he said.<\/p>\n

SB 45 is being held in the House for a vote to confirm the House’s approval. If approved on reconsideration, the bill will return to the Senate, where lawmakers will be asked to approve the House’s changes.<\/p>\n

If adopted, SB 45 will go to Gov. Mike Dunleavy for final approval or veto. If senators don’t approve the changes, a select group of legislators will attempt to negotiate a compromise version.<\/p>\n

• James Brooks is a longtime Alaska reporter, having previously worked at the Anchorage Daily News, Juneau Empire, Kodiak Mirror and Fairbanks Daily News-Miner. This article<\/a> originally appeared online at alaskabeacon.com. Alaska Beacon, an affiliate of States Newsroom, is an independent, nonpartisan news organization focused on connecting Alaskans to their state government.<\/em><\/p>\n