Legislature(2017 - 2018)HOUSE FINANCE 519
05/12/2017 01:30 PM House FINANCE
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| Audio | Topic |
|---|---|
| Start | |
| HB25 | |
| SB28 | |
| SB6 | |
| Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
| += | SB 6 | TELECONFERENCED | |
| += | SB 28 | TELECONFERENCED | |
| += | SB 107 | TELECONFERENCED | |
| + | TELECONFERENCED | ||
| *+ | HJR 23 | TELECONFERENCED | |
| += | HB 25 | TELECONFERENCED | |
HOUSE BILL NO. 25
"An Act relating to insurance coverage for
contraceptives and related services; relating to
medical assistance coverage for contraceptives and
related services; and providing for an effective
date."
1:36:32 PM
LIZZIE KUBITZ, STAFF TO REPRESENTATIVE MATT CLAMAN,
ANCHORAGE (via teleconference), relayed that she was
available for questions regarding the amendments.
1:38:35 PM
Representative Kawasaki MOVED to ADOPT Amendment 1, 30-
LS0261\0.1 (Wallace, 4/18/17) (copy on file):
Page 3, following line 13:
Insert new bill sections to read:
"*Sec. 2. AS 29.10.200 is amended by adding a new
paragraph to read:
(66) AS 29.20.420 (health care insurance plans).
*Sec. 3. AS 29.20 is amended by adding a new section
to article 5 to read:
Sec. 29.20.420. Health care insurance plans. (a) If a
municipality offers a group health care insurance plan
covering municipal employees, including by means of
self-insurance, the municipal health care insurance
plan is subject to the requirements of AS 21.42.427.
(b) This section applies to home rule and general law
municipalities.
(c) In this section, "health care insurance plan" has
the meaning given in 12 AS 21.54.500."
Renumber the following bill sections accordingly.
Page 6, line 30:
Delete "sec. 4"
Insert "sec. 6"
Page 7, line 1:
Delete "sec. 4
Insert "sec. 6"
Page 7, line 4:
Delete "sec. 4"
Insert "sec. 6"
Page 7, line 7:
Delete "sec. 4"
Insert "sec. 6"
Page 7, line 9:
Delete "sec. 5"
Insert "sec. 7"
Page 7, line 10:
Delete "sec. 4"
Insert "sec. 6"
Page 7, line 12:
Delete "sec. 4"
Insert "sec. 6"
Page 7, line 14:
Delete "sees. 5 and 6"
Insert "sees. 7 and 8"
Page 7, line 15:
Delete "sec. 7"
Insert "sec. 9
Representative Wilson OBJECTED.
Representative Kawasaki explained the amendment. The
amendment safeguarded that municipalities who self-insured
were also covered within the twelve month period. He shared
that he contacted the "top three" municipalities and was
informed that they already had a similar provision. He did
not feel the legislation impacted municipalities.
Representative Wilson did not support the amendment without
knowing how the bill impacted municipalities. She stated
that how the legislation impacted municipalities was
unknown. The bill mandated insurance coverage for
contraceptives; it was not merely about extending the
prescription to 12 months.
A roll call vote was taken on the motion.
IN FAVOR: Guttenberg, Kawasaki, Ortiz, Gara, Grenn, Foster,
Seaton
OPPOSED: Pruitt, Neuman, Tilton, Wilson
The MOTION to Adopt Amendment 1 PASSED (7/4).
1:40:49 PM
Representative Wilson MOVED to ADOPT Amendment 2, 30-
LS0261\0.4 (Wallace, 4/18/17):
Page 1, line 8, following "market":
Insert "that provides coverage for prescription
contraceptives"
Co-Chair Seaton OBJECTED.
Representative Wilson explained the amendment. She was
concerned that the bill mandated coverage for
contraceptives. She felt that some people purchased health
insurance policies based on their needs and that the
mandate would increase premium costs to individuals that
did not need contraceptives. The amendment clarified that
the bill only applied to insurers who already provided
coverage for contraceptives.
Co-Chair Seaton asked whether the bill sponsor wanted to
speak to the amendment.
REPRESENTATIVE MATT CLAMAN, SPONSOR, did not support the
amendment. He commented that the amendment was contrary to
the point of the bill.
Representative Kawasaki asked whether there were health
insurance policies and "individual market plans" that did
not currently cover contraceptives.
Representative Wilson responded that she did not know,
which characterized the point of her amendment. She spoke
to her understanding of the bill. She reiterated that the
bill required every plan to provide the coverage even if it
currently did not. Ms. Kubitz replied that HB 25 was about
expanding access to contraceptives. She pointed out that
the amendment would not allow the expansion of coverage.
She believed coverage for contraceptives was a "standard of
care" Alaskan women were entitled to unless an employer
upheld a religious exemption.
1:45:39 PM
Representative Ortiz asked whether the sponsor's intent was
to force insurers to provide contraceptives as part of
their plan. Representative Claman believed that the only
plans that did not allow coverage were policies with
religious exemptions. He did not believe HB 25 created a
mandate and that contraceptive coverage was required under
the Affordable Care Act (ACA).
Representative Wilson believed the amendment would not harm
existing practices. She maintained that the amendment
clarified that the bill did not create a mandate that had
unintended negative consequences.
Representative Neuman asked how the 12 month requirement
pertained to the amendment. Representative Wilson answered
that the 12 month language was in the bill. She explained
that the bill dealt with other contraceptive methods but
extending prescriptions for pills was a major provision to
prevent the inconvenience for women having to obtain the
prescription from a pharmacy multiple times each year. She
restated that her amendment ensured that contraceptive
coverage was already included in the policy before the rest
of the bill's provisions were applied.
Representative Guttenberg asked whether there would be any
other impacts from the bill and if the sponsor had heard
from anyone who was concerned by the mandate.
Representative Claman replied that he had not heard from
anyone whose policies did not provide coverage and were
apprehensive over the requirement.
Co-Chair Seaton asked whether Representative Wilson's
intention was to provide contraceptive coverage in Alaska
regardless of whether or not the ACA mandated the coverage
or was repealed.
1:51:33 PM
Representative Wilson answered that was not her intent. She
cited a letter from the National Federation of Independent
Business (NFIB) (copy on file) that opposed the mandate.
She offered that every time more mandates were placed on
private companies to cover conditions their costs
increased. She reiterated the intent of the amendment.
1:53:26 PM
Representative Wilson provided final comments regarding the
intent of the amendment.
Co-Chair Seaton MAINTAINED his OBJECTION.
A roll call vote was taken on the motion.
IN FAVOR: Ortiz, Pruitt, Neuman, Tilton, Wilson
OPPOSED: Kawasaki, Gara, Grenn, Guttenberg, Seaton, Foster
The MOTION to adopt Amendment 2 FAILED (5/6).
Representative Wilson WITHDREW Amendment 3, 30-LS0261\0.2
(Wallace, 4/18/17) (copy on file).
1:55:21 PM
Vice-Chair Gara reviewed the fiscal notes: FN 1 (CED) zero
from the Department of Commerce, Community and Economic
Development, one new zero fiscal note from the Department
of Administration, and FN 3 (DHS) showing fiscal impact
from the Department of Health and Social Services, Medicaid
Services that reported an anticipated cost savings of $678
thousand in FY 18 and $1.3 million in the out years through
the reduction in unintended pregnancies.
Representative Wilson was trying to determine how the
savings was derived. She wondered how many women were not
currently "taking the pill that should be." She understood
that the department already could provide the prescription
for twelve months but do not because a women might not be
eligible for Medicaid for the entire twelve month period.
She was uncertain the bill would allow the department to
change its prescribing practices.
1:57:55 PM
MARGARET BRODIE, DIVISION DIRECTOR HEALTH CARE SERVICES,
ANCHORAGE (via teleconference), answered that based on
national studies there was a 6 percent contraceptive
failure rate utilizing a twelve month prescription period
as opposed to a 9 percent failure rate based on 3 month
prescriptions. She added that the department chose a 7
percent failure rate. The fiscal note was based on the
difference between the lower and higher failure rate.
Representative Wilson countered that the department had
testified that it could have been prescribing
contraceptives for 12 months without the legislation. She
wondered why the extended prescriptions had not been
implemented. Ms. Brodie answered that the Medicaid program
was "under constant pressure to contain costs" and often
the contraceptive prescriptions were not issued at all.
She related that the contraceptive failure rate study was
new. In addition, savings would be realized from reduced
dispensing fees the department was required to pay for
prescriptions. Representative Wilson cited the $1.4 million
in savings and wondered how many individuals the figure
represented. She asked why DHSS used national figures
versus Alaskan numbers because the state's Medicaid
standards were much higher than the federal poverty rate.
Ms. Brodie responded that the national averages were
employed to determine the contraceptive failure rate but
Alaskan data was used to determine the number of unintended
pregnancies (120). Representative Wilson asked what
happened if a woman became ineligible within the year but
was issued a 12 month prescription. Ms. Brodie answered
that initially the situation was factored into the
analysis. However, after further research, DHSS discovered
that the state did not have to repay the ineligible portion
as long as the individual was eligible for Medicaid at the
time of dispensing the medication. Representative Wilson
still believed the numbers in the DHSS fiscal note were
"skewed" but did not have access to data to prove her
assumption.
Vice-Chair Gara remarked that the all of the data discussed
was located on page 2 of the DHSS fiscal note analysis. He
relayed the following:
A report by Foster et. al. (2011) projects a decrease
in failure rate of approximately 30 percent when oral
contraceptives are dispensed in 12month quantities,
which would result in an oral contraceptive failure
rate of 6 percent.
… Applying this differential, we estimate that
approximately 5.28 of the avoided 120 unintended
pregnancies would have been complicated births …
Vice-Chair Gara noted that the data was the basis for the
projected savings. He wanted to help prevent unintended
pregnancies.
Co-Chair Seaton addressed the question of whether the
state's Medicaid program currently had the ability to
provide 12 month prescriptions. He related that the bill
contained conditional language that was not effective
unless the federal Medicaid program approved the state's
plan amendment adopting the 12 month requirement.
2:04:38 PM
Representative Wilson asked whether Ms. Brodie's previous
testimony regarding the issue had been incorrect. Ms.
Brodie responded that regulations allowed it, but the state
had to file a state plan amendment that required approval
from the federal government. Representative Wilson asked
whether legislation was required to amend the state plan.
Ms. Brodie answered that the commissioner of DHSS could
make the determination and request the federal government's
approval.
2:05:54 PM
Co-Chair Seaton MOVED to REPORT CSHB 25(FIN) out of
committee with individual recommendations and the
accompanying fiscal notes.
Representative Wilson OBJECTED. She remarked on the usage
of the words "unintended and unwanted" in a negative
context. She reasoned that "everything in life was not
always intended" but could be welcomed. She expressed
concern that the bill carried a mandate in addition to the
12-month coverage. She opposed additional mandates and the
problems she felt they created for small businesses. She
appreciated that Co-Chair Seaton mentioned issues due to
Medicaid expansion. She did not know what the overall costs
to the state were due to the uncertainty of ACA and
Medicaid expansion. She reiterated her opposition to
mandates because of the "pressure" they placed on small
businesses.
2:08:22 PM
A roll call vote was taken on the motion.
IN FAVOR: Ortiz, Gara, Grenn, Guttenberg, Kawasaki, Foster,
Seaton
OPPOSED: Pruitt, Neuman, Tilton, Wilson
The MOTION PASSED (7/4).
There being NO further OBJECTION, CSHB 25(FIN) was REPORTED
out of committee with a "do pass" recommendation and with
one new zero fiscal note from the Department of
Administration; one previously published zero fiscal note:
FN1 (CED); and one previously published fiscal impact note:
FN3 (DHS).
| Document Name | Date/Time | Subjects |
|---|---|---|
| SB 28 LOS Petersburg Economic Development Council 1.26.17.pdf |
HFIN 5/12/2017 1:30:00 PM |
SB 28 |
| HJR23 Additional Documents-Ak Perm Fund financial history and projections 5.9.17.pdf |
HFIN 5/12/2017 1:30:00 PM |
HJR 23 |
| HJR23 Additional Documents-Presentation AK Perm Fund Corp 5.9.17.pdf |
HFIN 5/12/2017 1:30:00 PM |
HJR 23 |
| HJR23 Sponsor Statement.pdf |
HFIN 5/12/2017 1:30:00 PM |
HJR 23 |
| HJR23 Supporting Document-APRN - PFD cuts 5.9.17.pdf |
HFIN 5/12/2017 1:30:00 PM |
HJR 23 |
| HJR23 Supporting Document-ISER How PFDs reduce poverty 5.9.17.pdf |
HFIN 5/12/2017 1:30:00 PM |
HJR 23 |
| HJR23 Supporting Document-Leg Research Effect of PFD Reductions 5.9.17.pdf |
HFIN 5/12/2017 1:30:00 PM |
HJR 23 |
| SB 6 - Amendment 5.12.17.pdf |
HFIN 5/12/2017 1:30:00 PM |
SB 6 |
| SB6_Support_051217.pdf |
HFIN 5/12/2017 1:30:00 PM |
SB 6 |
| HB25_Support_051217.pdf |
HFIN 5/12/2017 1:30:00 PM |
HB 25 |