Committee continues family planning Medicaid discussion, sets House Bill 185 aside for future consideration

The House Health and Social Services Committee continued consideration of House Bill 185 on May 15, 2025. The bill would create a family planning state plan amendment (SPA) that converts a temporary 1115 waiver into a permanent Medicaid SPA and expands family planning coverage to people with incomes up to 225% of the federal poverty level. Committee members discussed scope, definitions and whether the proposal would fund abortion services; the committee set the bill aside for future consideration.

"House Bill 185 would create a family planning state plan amendment that would expand Medicaid coverage to provide family planning services to Alaskans," sponsor Representative Carolyn Hall said in her opening remarks. Hall said the SPA would increase the number of Alaskans eligible for family planning services to 225% of the federal poverty level and noted the committee had received written answers to several outstanding questions.

JJ Jackson, staff to Representative Hall, read answers provided to the committee and summarized the state regulatory definition of family planning services. "Alaska Administrative Code or AAC 110.230(f) defines family planning services as services and materials provided with the purpose of postponing, avoiding, or terminating pregnancy," Jackson said. He told the committee that while the regulatory definition can include abortion, "In the case of the family planning SPA, HB 185 would not include abortion services. As stated on page 2, lines 10 and 11 of the bill, these services would be for individuals of childbearing age who are not pregnant."

Committee members raised questions about congenital syphilis and whether the SPA would affect prenatal care or coverage for pregnant people. Jackson and other presenters said the SPA is focused on non-pregnant individuals; speakers noted expanded family planning coverage could help prevent some pregnancy-related health problems by increasing access to contraception and preconception care. Jackson cited research and public health materials in the packet, including a 2025 study from the University of Alaska Anchorage Institute of Circumpolar Health and a State of Alaska epidemiology bulletin on congenital syphilis.

Kristen Delfino, division operations manager with the Division of Health Care Services, answered a procedural question about existing programs for eligibility determinations. "I'm not aware of any specific programs where an individual that has congenital disabilities can come into a facility and gain eligibility through that avenue. We do have programs where, if they need hospitalization services, the hospital can presumptively determine eligibility for a period of time," Delfino said. The division staff said they would verify eligibility processes with the Division of Public Assistance if needed.

Representative Prax asked to confirm that the bill does not provide Medicaid funding for abortions. Jackson explained the federal Hyde Amendment prohibits use of most federal funds for abortions, and told the committee, "Therefore, for Medicaid to include abortion services or fund abortion services, it would be illegal." Committee members clarified the bill's scope and discussed access gaps in rural and remote areas.

There was no public testimony at the hearing. After discussion, Chair Rep. Mina said she would set House Bill 185 aside for future consideration. "At this time, I am setting House Bill 185 aside for future consideration," Mina said; no committee vote on the bill was taken that day.

The committee adjourned its last meeting of the session later that afternoon.