Lawmakers debate cancer coverage

Bills address how coverage would be extended for Medicaid recipients

Posted: Wednesday, February 26, 2003

Two plans to continue Medicaid coverage of breast and cervical cancer diagnoses and treatment were passed out of the House Health, Education and Social Services Committee on Tuesday.

Lawmakers, however, did not discuss the main difference between the two plans - how much the poor would have to pay for treatment.

The program, started in 2001, depends on 70 percent of its funding from the federal government and 30 percent from the state. The Legislature, however, placed a sunset clause on the bill authorizing the program, which is set to expire in June.

About 94 Alaska women have been treated under the program at a total cost of $1.1 million. About $330,000 of that has been paid by the state, according to the Alaska Department of Health and Social Services. Some 44 women are enrolled in the program now, officials said.

At Tuesday's hearing, the issue drew supportive and at some points emotional testimony from those who have experienced cancer.

Cheryl Mann, a professor of human services at the University of Alaska Anchorage, was diagnosed with breast cancer in December and started chemotherapy treatment in January. Although Mann is covered under the university health plan she implored the committee to continue providing coverage for those without health care.

"I am really fortunate because I'm getting my treatment," Mann said. "I really encourage you to level the playing field and make treatment accessible to all women."

Bills before the committee by Juneau Democratic Rep. Beth Kerttula and Anchorage Republican Rep. Nancy Dahlstrom propose to continue the program, but Dahlstrom's House Bill 107 would allow the state to charge small fees for the coverage.

The federal program prevents states from charging those who receive treatment, but Dahlstrom's staff said the state would ask for a waiver on the rule if HB 107 passes into law. Dahlstrom was unavailable for comment today.

Current cost-sharing limits in Alaska are $2 for prescriptions, $3 for doctor visits and $50 a day for inpatient hospitalization.

Kerttula's House Bill 21 would continue the coverage without any new charges.

The HESS committee heard both bills Tuesday, but chairwoman Peggy Wilson, a Wrangell Republican, instructed members not to discuss the financial aspects of the competing proposals.

"I know this is highly unusual that I'm handling these bills like I have, but I feel very strongly that there's really not that much difference in the bills as far as policy goes and that's what this committee is here for," Wilson said.

Wilson noted the House Finance Committee would consider the monetary aspects of the two bills.

Rep. Mary Kapsner, a Bethel Democrat, said after the hearing that lawmakers should have gotten the opportunity to discuss financial aspects of the two plans.

"There is a feeling in the Legislature now that only the finance committees should hear arguments on fiscal matters," Kapsner said.

Dahlstrom's bill has companion legislation in the Senate from Sen. Lyda Green, a Wasilla Republican.

Green opposed instituting the program in 2001 and was instrumental in putting the sunset clause on the bill. At the time, she argued the program unfairly provided treatment for certain diseases and not others.

"If we're going to start paying for Medicaid by diagnosis, let's do it for all our friends," Green said in 2001. "I don't think it's a good public-policy direction."

The Senate Health, Education and Social Services committee, headed then by Green, also amended the bill by calling for a report on how behavioral factors, such as promiscuity and smoking, might lead to breast and cervical cancer.

Green's Senate Bill 78 was to be heard at 1:30 p.m. today by the Senate Health, Education and Social Services Committee. Companion legislation to Kerttula's bill has been filed in the Senate by Sen. Bettye Davis, an Anchorage Democrat. Davis' Senate Bill 17, filed before the session began, has not been scheduled for a hearing.

• Timothy Inklebarger can be reached at

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