04/11/2017 03:00 PM House HEALTH & SOCIAL SERVICES

          HB 25-INSURANCE COVERAGE FOR CONTRACEPTIVES                                                                       
                                                                                                                                
3:19:04 PM                                                                                                                    
                                                                                                                                
CHAIR SPOHNHOLZ announced  that the next order  of business would                                                               
be 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."                                                                                               
                                                                                                                                
3:19:33 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  EDGMON  moved  to adopt  the  proposed  committee                                                               
substitute  (CS)   for  HB  25,  labeled   30-LS0261\J,  Wallace,                                                               
3/31/17, as the working draft.                                                                                                  
                                                                                                                                
3:19:41 PM                                                                                                                    
                                                                                                                                
CHAIR SPOHNHOLZ objected for discussion.                                                                                        
                                                                                                                                
3:19:55 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  MATT  CLAMAN,  Alaska State  Legislature,  stated                                                               
that proposed  HB 25 sought  to make  prescriptive contraceptives                                                               
more  easily available  by mandating  that  health care  insurers                                                               
provide coverage for  a 12-month supply of  contraceptives at one                                                               
time.   He reported that  his office had worked  with individuals                                                               
from the  Division of Insurance, (Department  of Administration),                                                               
and the Department of Law  to find language which captured active                                                               
state employee  programs and  allowed insurers  and the  state to                                                               
apply   reasonable  medical   management   techniques  and   cost                                                               
containment    strategies    when    providing    coverage    for                                                               
contraceptives.                                                                                                                 
                                                                                                                                
3:20:43 PM                                                                                                                    
                                                                                                                                
LIZZIE KUBBITZ,  Staff, Representative Matt Claman,  Alaska State                                                               
Legislature, paraphrased the changes  made to Version J [Included                                                               
in members' packets], which read:                                                                                               
                                                                                                                                
     "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."                                                                                                                     
                                                                                                                                
     Section 1   Amends AS  21.42.427(d) to give health care                                                                  
     insurers   the  ability   to   enact  reasonable   cost                                                                    
     containment measures and provides  a definition of cost                                                                    
     containment.  Adds a  new subsection  (e) which  states                                                                    
     that if the  covered therapeutically equivalent version                                                                    
     of a prescription contraceptive  is not available or is                                                                    
     considered   medically  inadvisable,   a  health   care                                                                    
     provider  shall provide  coverage without  cost sharing                                                                    
     for   an  alternative   version  of   the  prescription                                                                    
     contraceptive.                                                                                                             
                                                                                                                                
     Section  2    Amends AS  39.30.090(a) by  adding a  new                                                                  
     subsection (13)  to include: "a group  health insurance                                                                    
     policy   covering   employees    of   a   participating                                                                    
     governmental unit is subject  to the requirements of AS                                                                    
     21.42.427."                                                                                                                
                                                                                                                                
     Section 3    Amends AS  39.30.091 to include:  "a self-                                                                  
     insured  group medical  plan covering  active employees                                                                    
     provided  under   this  section   is  subject   to  the                                                                    
     requirements of 21.42.427."                                                                                                
                                                                                                                                
3:23:34 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  JOHNSTON asked  if  all  state employees,  except                                                               
retirees, as  well as other  public employees, would  be covered.                                                               
She asked  which programs would  not be covered by  this proposed                                                               
bill.                                                                                                                           
                                                                                                                                
MS.  KUBBITZ replied  that the  Department of  Administration had                                                               
advised  the sponsor  to  only attempt  to  capture active  state                                                               
employees.                                                                                                                      
                                                                                                                                
REPRESENTATIVE  JOHNSTON asked  if  this would  apply to  private                                                               
employer programs.                                                                                                              
                                                                                                                                
MS.  KUBBITZ  reiterated that  AS  39  would only  capture  state                                                               
employees;  however, other  portions of  the proposed  bill would                                                               
apply to Medicaid  and private employers.  She  said that Version                                                               
J would ensure that active state employees were included.                                                                       
                                                                                                                                
REPRESENTATIVE  JOHNSTON  asked  about  other  public  employees,                                                               
including the self-insured Municipality of Anchorage.                                                                           
                                                                                                                                
MS.  KUBBITZ said  that  she  would defer  that  question to  the                                                               
Department  of  Administration.    She offered  her  belief  that                                                               
municipal  employees had  not been  included in  any of  the bill                                                               
discussions.                                                                                                                    
                                                                                                                                
REPRESENTATIVE  JOHNSTON  expressed   her  concern  that  private                                                               
individuals and companies were  required to participate, although                                                               
state employees had been excluded.   She stated that "I am trying                                                               
to look for what is fair is fair."                                                                                              
                                                                                                                                
3:26:57 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  CLAMAN pointed  out that  the proposed  Version J                                                               
specifically addressed  earlier questions  for coverage  to state                                                               
employees.   He opined  that it would  get even  more complicated                                                               
for coverage  of municipalities, although many  of these programs                                                               
participated in state  programs, even though it  was not intended                                                               
to give them an out.                                                                                                            
                                                                                                                                
REPRESENTATIVE JOHNSTON  declared that it would  be necessary for                                                               
this to be addressed.                                                                                                           
                                                                                                                                
3:28:29 PM                                                                                                                    
                                                                                                                                
ANNA  LATHAM,   Deputy  Director,  Juneau  Office,   Division  of                                                               
Insurance,   Department  of   Commerce,   Community  &   Economic                                                               
Development  (DCCED), in  response to  earlier questions,  stated                                                               
that the  proposed bill did  not cover municipal  plans, although                                                               
other  vetted language  could  be  added to  include  them.   She                                                               
offered  her belief  that the  sponsor only  intended to  include                                                               
active state employees.                                                                                                         
                                                                                                                                
3:29:18 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE JOHNSTON directed attention to  page 5, lines 28 -                                                               
29, which  stated that a  group health  policy was subject  to AS                                                               
21.42.427 and asked if this would cover the municipalities.                                                                     
                                                                                                                                
3:30:05 PM                                                                                                                    
                                                                                                                                
MS. LATHAM opined  that this would not  cover municipalities, but                                                               
she deferred to the Department of Law.                                                                                          
                                                                                                                                
REPRESENTATIVE JOHNSTON  asked if  this would  also apply  to the                                                               
government bargaining units.                                                                                                    
                                                                                                                                
3:30:58 PM                                                                                                                    
                                                                                                                                
MICHELE MICHAUD, Chief Health  Official, Central Office, Division                                                               
of Retirement  and Benefits  (DRB), Department  of Administration                                                               
(DOA),  in response,  stated that  the Municipality  of Anchorage                                                               
was not currently  participating, although it could.   She stated                                                               
that there were union health  trusts which were not covered under                                                               
the Alaska Care  plan, as they were  exempted through regulation,                                                               
and these would also not be covered under the proposed bill.                                                                    
                                                                                                                                
3:32:02 PM                                                                                                                    
                                                                                                                                
The committee took a brief at ease.                                                                                             
                                                                                                                                
3:32:25 PM                                                                                                                    
                                                                                                                                
CHAIR SPOHNHOLZ  removed her objection.   There being  no further                                                               
objection, Version J was adopted as the working draft.                                                                          
                                                                                                                                
3:32:59 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  JOHNSTON   expressed  her  concern   that  moving                                                               
forward a certain  element of the population  would be segregated                                                               
out.   She said that  she would probably be  a no vote  and would                                                               
recommend an amendment.                                                                                                         
                                                                                                                                
3:33:28 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE SULLIVAN-LEONARD said that  she struggled with the                                                               
mandate aspect  of the proposed legislation  for certain coverage                                                               
of  contraceptives, and  she could  not conceptually  support the                                                               
legislation.                                                                                                                    
                                                                                                                                
3:34:29 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  EDGMON  moved  to  report CSHB  25,  Version  30-                                                               
LS0261\J,  Wallace, 3/31/17,  out  of  committee with  individual                                                               
recommendations and the accompanying fiscal notes.                                                                              
                                                                                                                                
3:34:41 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE EASTMAN objected.  He  said that much of the early                                                               
testimony  dealt  with  obtaining   prescriptions,  and  yet  the                                                               
proposed bill was much broader  based, directing attention to the                                                               
voluntary    sterilization    procedures,   the    consultations,                                                               
examinations, procedures,  and medical services.   He opined that                                                               
the State  of Alaska should  not require that  insurance coverage                                                               
be provided for these items.                                                                                                    
                                                                                                                                
3:35:41 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE EASTMAN maintained his objection.                                                                                
                                                                                                                                
3:35:46 PM                                                                                                                    
                                                                                                                                
A roll call  vote was taken.   Representatives Spohnholz, Edgmon,                                                               
Kito,  and Tarr  voted  in  favor of  CSHB  25.   Representatives                                                               
Sullivan-Leonard,  Eastman,   and  Johnston  voted   against  it.                                                               
Therefore, CSHB 25(HSS) was reported  out of the House Health and                                                               
Social Services Standing Committee by a vote of 4 yeas-3 nays.