2014 legislative update: Anti-ACA bill clears Alabama Senate committee

A bill that purports to nullify parts of the Affordable Care Act (ACA) sailed through an Alabama Senate committee Wednesday with few questions. The bill now goes to the full Senate for consideration.

SB 220’s sponsor, Sen. Jerry Fielding, R-Sylacauga, told members of the Senate Judiciary Committee that he needed to pass the bill out of the committee Wednesday but said there would be a chance to make changes. “I have some changes myself,” Fielding said. “There will be opportunity for adjustments.”

The bill cites the Tenth Amendment to the U.S. Constitution in seeking to refuse to enforce sections of the ACA that “exceed the authority of Congress.” The measure does not specify all the parts of the ACA that are believed to exceed that authority. The U.S. Supreme Court upheld the ACA’s constitutionality in 2012.

Depending on how state officials would interpret the broadly worded SB 220 if it became law, enforcement might halt Alabama’s compliance with numerous technical provisions of the ACA, including new Medicaid eligibility requirements, information system upgrades and interagency data sharing. Disrupting such activities could jeopardize current federal Medicaid funding, ACPP policy director Jim Carnes said.

SB 220 would authorize the attorney general to file lawsuits on behalf of certain individuals or businesses “being harmed by implementation” of the ACA. The measure also would prohibit Alabama or any of its cities or counties from establishing a health insurance exchange under the ACA.

In addition, the bill would forbid state agencies and employees from conducting “involuntary” home visits under certain maternal, infant and early childhood programs referenced in the ACA. The ACA already requires that all such visits be voluntary. If SB 220 bars all in-home visits under that section of the ACA, the Department of Children’s Affairs could lose $6.3 million a year in federal grants, according to the Legislative Fiscal Office.

Committee member Sen. Phil Williams, R-Rainbow City, asked whether the bill’s passage could void certain insurance contracts already in force. Fielding said he would welcome a floor amendment to address that concern.

Identical legislation – HB 147, sponsored by Rep. Barry Moore, R-Enterprise – awaits action in the House Health Committee. The Legislature will return Thursday for the 16th of 30 allowable meeting days during the 2014 regular session, which is expected to last until early April.

By M.J. Ellington, health policy analyst. Posted Feb. 19, 2014.

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