Alaska Senate Advances Bill to Establish Subscription-Based Healthcare

The Alaska Senate on Wednesday passed a bill that would legalize subscription-based access to health care providers to combat rising health insurance costs.

Direct medical contracts are a method used in some states where patients pay a monthly subscription fee to access specific medical care, such as primary care providers or dental care, rather than a per-service fee. can do. It is described as an alternative to traditional health insurance and a service that can improve access to healthcare for those who have insurance plans with high deductibles or who have difficulty accessing certain healthcare services through insurance. It has been.

Proponents of the policy, including conservative advocacy groups Alaska Policy Forum and Americans for Prosperity, argue that eliminating the need for bureaucratic insurance companies will reduce health care costs. ing.

“Although these agreements do not protect patients from high and dramatic medical costs, they can bridge the gap between expensive deductible health insurance plans and actual routine care.” Wasilla Republican Senator David Wilson, who proposed the bill, said. .

Skeptics say the plans are often out of reach and do nothing to solve the challenges that hinder access for low-income and Medicaid and Medicare-dependent people, while potentially exacerbating them. , says it will lead to improved access to healthcare for those who can afford the service. .

Fairbanks Democrat Sen. Scott Kawasaki, who voted against the bill, said health care providers could discriminate against patients suffering from serious medical conditions by only serving relatively healthy people. He said he had “serious concerns”.

The bill stipulates that patients cannot be excluded from plans for pre-existing conditions. But Kawasaki said providers could raise prices for sicker patients “so high that patients can’t afford them”, thereby “selecting the healthiest patients who can afford the system”. said.

“I see it working both ways. It means that people will not receive care because they have to be there,” Kawasaki said.

The bill passed the Senate by an 18-2 vote against only two Democrats. However, several legislators who voted in favor of the measure expressed concern about how new health care options would be for low-income Alaskans who already struggled to find providers who would accept public insurance options. expressed concern about the impact

Anchorage Republican Senate Majority Leader Kathy Giesel said before the vote, “I doubt this bill will increase access to care, or reduce the cost of care at all. There’s really nothing in this bill that guarantees that.” It’s because there isn’t,” he said. support the bill.

The bill followed the House, and the bill is sponsored by Big Lake Republican Rep. Kevin McCabe. Their swift action could get the bill passed before parliament’s scheduled session on Wednesday.

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Current state law does not allow direct medical contracts. However, some providers already offer such contracts and have been doing so for several years. If the state does not legalize them, the state could initiate action against these providers for misconduct, said insurance director Lori Wing-Hire.

“At this point, they are considered insurance and we intend to take all available measures for insurance products against them,” Winghire said. “We don’t want to do that, but it’s our way.”

Without this bill, a direct care contract would be considered an insurance plan, even though the health care provider is not licensed to offer insurance. The bill would explicitly define contracts as “not insurance,” meaning the department would not be responsible for auditing or reviewing contracts.

Winghire said if direct care contracts were legalized, families with high deductible insurance plans could rely on them to supplement their insurance coverage.

“There are so many people who can’t get insurance unless it’s a fatal disease or something. They pay premiums and they have pretty high deductibles and they never get insurance.” Winghire said. “I knew from talking to them that a lot of Alaskans wanted to see this.”

Before the bill passed, legislators amended the bill to allow clinics with direct medical contracts to also accept low-income patients who are dependent on public health insurance, or who are uninsured or enrolled in Medicare. mandated to set a quota of at least 20% of Or be eligible for Medicaid.

“I know many of my voters in East Anchorage, and many Alaskans across the state, who would not be able to afford this payment,” said the amendment proponent Anchorage. Democratic Senator Bill Willechowski said. He said part of the motivation for introducing the amendment is to ensure the bill doesn’t exacerbate the existing shortage of providers who accept Medicare patients.

Wade Erickson, a physician at Capstone family medicine in Wasilla, told a legislative committee earlier in the session that he could not afford to provide health insurance to employees, but was interested in providing health insurance directly to employees. He said he was approached by a small business owner. some medical services.

“This inspired me to spend time, effort and money trying to get this into the state,” Erickson said.

But some of the bill’s main supporters are not Alaska residents. Doctors in Florida and Kansas were called to committee hearings to support the bill, but public testimony about the move was minimal.

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