The second regular session of Alaska’s 33rd legislature began on Jan. 16th, and a variety of health-related bills have been introduced or carried over from last year.
Within health policy, lawmakers are focusing on many issues including workforce, health coverage, and prescription medicine therapy. Below are some key healthcare-related bills to keep an eye on as the session progresses.
The workforce shortage
Rep. Mike Prax (R-North Pole) filed two bills that aim to combat the healthcare workforce shortage, House Bill 237 and HB 149.
HB 237 would allow nurses to obtain a temporary license while they wait for their renewal application for a lapsed license to be processed.
“[The bill] will enable these nurses to go to work while their renewable application is being processed,” Prax told State of Reform. “This poses minimal risk to public health, because it applies to nurses who’ve previously held a license and are therefore familiar to Alaska’s nursing board.”
HB 149 would allow Alaska to join the multi-state Nursing Licensure Compact (NLC). Nurses with licenses in compact states can easily practice in other compact states without having to get a new license. Currently, 41 states are part of the NLC.
There are other bills in the legislature that would allow Alaska to enter similar compacts. Senate Bill 74, sponsored by Sen. David Wilson (R-Wasilla), and HB 137, sponsored by Rep. Stanley Wright (R-Anchorage), look to have Alaska join the Physical Therapy Compact.
SB 75, sponsored by Wilson, and HB 138, sponsored by Wright, would have Alaska join the Audiology and Speech-Language Pathology Interstate Compact.
Sen. Forrest Dunbar (D-Anchorage), a member of the Senate Health and Social Services Committee, told State of Reform that he supported SB 74 and SB 75, which both passed the Senate in 2023.
He said physical therapists and audiologists came to the lawmakers in support of joining the compacts, but that the nurses union asked lawmakers not to enter the nursing licensure compact.
“If a profession comes to us and says, ‘Do not do this. We don’t want to do this,’ then I’m a little more resistant,” Dunbar said.
He emphasized that no one bill will be a silver bullet when tackling the workforce shortage, and that the state needs to look at a variety of factors to tackle the problem.
Health coverage expansion
HB 17, sponsored by Rep. Ashley Carrick (D-Fairbanks), would require insurance companies to cover 12 months of contraceptive prescriptions at a time. Cherie Bowman, Carrick’s aide who is helping to carry this legislation, told State of Reform this bill would allow people to have continuous access, which would ultimately improve overall health.
“That helps to prevent unintended pregnancies. It is shown to reduce the amount of abortions people seek, and it improves the health and welfare of women throughout the state,” Bowman said.
For people living in rural areas, Alaska’s road system can be a major barrier to getting consistent medication.
“It’s even more important in a place like Alaska that you can have your prescription for just more than 30 days at a time,” said the bill’s co-sponsor, Rep. Jennie Armstrong (D-Anchorage), in an interview with State of Reform.
Bowman noted that some Alaskans work up on the North Slope in remote places for weeks at a time, and when they come back down from the slope, they may not be able to get into a doctors office due to their schedule.
“So [this bill] would make sure they have that uninterrupted access,” she said.
The bill was introduced in early 2023 and was returned to the House Rules Committee at the beginning of this year.
Rep. Andy Josephson (D-Anchorage) recently introduced HB 239, which would expand the parameters of workers compensation coverage for firefighters and police.
Josephson explained that there are ways some professions are able to receive compensation after they have left the job if the illness or injury is directly related to what they used to do at work.
“What happens is, some people get a cancer diagnosis, particularly firefighters, long after they’ve quit their jobs,” Josephson told State of Reform. “ … Our law allows, where there has been an independent medical exam, for them to assert continuing workers comp benefits after they’ve already separated from their work.”
He said that the bill would add a section on compensability for post-traumatic stress disorder (PTSD) diagnosed in policemen and firefighters.
HB 100 is another bill that could expand health coverage. Armstrong, who sponsors the bill, explained what it would do.
“It takes our existing Alaska family and medical leave act and takes it from 18 weeks of unpaid leave for state employees to 18 weeks of paid leave through the state paying an insurance premium,” she said.
Armstrong highlighted the impact it could have on maternal health outcomes, saying it would allow for mothers to spend more time with their newborns and their families after birth without worrying about losing income during that time. It would also benefit anyone who needs to take leave for other medical reasons.
Prescription medicine
Armstrong and Dunbar are both sponsoring bills that would establish a mental health and psychedelic medicine task force in the state. HB 228 and SB 166 aim to prepare Alaska in the event that the US Food and Drug Administration (FDA) legalizes certain psychedelic medicines for therapeutic use.
The bill does not take a position on the legalization or medicalization of psychedelics, however Armstrong said she wants the state to be ready to immediately begin using the medication for therapy if and when that happens.
“We essentially rank worst when it comes to mental health, and we have a lot of folks like veterans and victims of domestic violence and sexual assault who have a high likelihood of mental health disorders including PTSD,” Armstrong said.
“So when you hear about something like these psychedelic substances that could be coming online, being medicalized, that is life-changing for people to have that access.”
Dunbar, who is a part of the Alaska Army National Guard, said his interest in establishing the task force comes from his military experience and how psychedelic therapies can treat PTSD, which many veterans struggle with.
“We have these really acute problems with addiction and with trauma and PTSD, in our general population, but also within our first responder community and our veterans community,” Dunbar said.
He said that if the drug is legalized for medicinal purposes, people who are no longer active members of the military may be able to benefit from the therapies that could be offered.
Psychedelic healing has been historically used by indigenous people, which Dunbar wanted to keep in mind when creating the task force.
“One of the critiques of how it was done in Colorado and Oregon is that there weren’t enough indigenous voices at the table when decisions around these substances were being made, despite the fact that there are traditional healers that have been using these kinds of substances, some of them, for thousands of years. So we tried to structure the task force in a way that traditional healers and the native health board were directly involved.”
—Dunbar
The task force would focus on two major components: licensing and insurance. Armstrong wants to let the task force figure out who will become licensed to use psychedelic medicine for therapy, and she wants the task force to work out coverage with insurance so that all people have access, not just people with lots of money.
“My personal goal, and it will be the will of the task force to decide what they think is best, but I wanted to ensure equitable access and I wanted to ensure that we were following the best practices possible within the parameters of what the FDA sets forward,” Armstrong said.