Legislature(2001 - 2002)
04/11/2002 03:40 PM Senate STA
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* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
SB 15-INSURANCE COVERAGE FOR CONTRACEPTIVES SENATOR JOHNNY ELLIS, bill sponsor, described the bill as the Prescription Fairness Act of 2002. It would require health insurers in Alaska that cover prescription drugs to include coverage for all FDA approved prescription contraceptives. There is a companion bill in the House sponsored by a bi-partisan group of women legislators. To date, 24 states have a similar provision in law and pending legislation for the measure in 17 other states. A large impressive coalition of individuals and organizations from across the state support the bill. There are many good reasons to support this legislation and without this change in law it is clear that: · Women will continue to pay more and get less in health insurance in Alaska · Women will not receive equal health care treatment that they need and deserve · Alaskan law should be modified to avoid an expensive legal challenge that it would surely lose · Unintended pregnancies have enormous financial, personal and social costs and this legislation provides the opportunity to positively affect the numbers of unwanted births, abortions and child abuse cases in this state · Facts show that contraceptive coverage pays for itself SB 15 is fair, cost effective, respects the religious beliefs of employers, protects the state from legal action and is long overdue. ANN HARRISON from Fairbanks testified in support of SB 15. She was representing herself as a retired nurse practitioner with 30 years service in women's health care. CLAIRE NOLL testified from Anchorage in support of SB 15. Many women need contraceptives for reasons other than to protect from pregnancy. They should be available and affordable to all women. SIDE B 4:30 p.m. SHERRY JAEGER testified from Anchorage as a representative from the Young Women's Christian Association (YWCA) in support of SB 15. The bill addresses the current inequities in women's health care plans and would require equity in the workplace. It would affect 140,000 women of childbearing age in Alaska and would not burden insurance providers. DEATRICH SITCHLER testified from Anchorage in support of SB 15. Although all women deserve this coverage, she has a medical condition that makes it necessary for her to avoid pregnancy. Because it would be medically dangerous for her to become pregnant, she must take birth control pills whether insurance covers the cost or not. She then read a statement from Jennifer Rudinger in support of SB 15. Although most insurance plans cover prescription drugs they typically exclude prescription contraceptives and outpatient contraceptive services. This gap in coverage has a disproportionate impact on women. CINDY NORQUEST testified from Anchorage in support of SB 15. She said she was a concerned citizen representing the average woman in Alaska who is tired of being treated unfairly. Gender discrimination is the only explanation for this legislation not having already been passed. It is in both the public interest and the business interest to pass the legislation. PAULINE UTTER testified from Anchorage in support of SB 15. She presented a petition that was signed by 1,008 women that attended the last Woman's Political Caucus and stated women want equality. If prescription drugs such as Viagra are covered, then prescription contraceptives should be covered as well. ROBIN SMITH testified from Anchorage in support of SB 15. She said there might be religious beliefs that run counter to covering contraception. Although some religions don't believe that humans should receive blood products, it is unimaginable that insurance companies wouldn't cover that treatment. The Catholic Church doesn't believe in vasectomies and tubal ligations, but insurance companies cover them. Providence Hospital covers birth control pills for their employees yet the Catholic Church prohibits contraception. This is an issue that needs to be addressed because it is a health care issue. Women can become pregnant for 30 to 40 years of their lives so something must be done to prevent unintended pregnancies. She urged members to move SB 15 forward. REGINA MONTOUFEL testified from Anchorage in support of SB 15. She owns and operates a rooming house and has found fair insurance coverage for women and small business owners to be a huge problem. She works with many minimum wage individuals that have policies with huge deductibles and minimal coverage. To be treated unequally on prescription drug coverage is an injustice that low-income women shouldn't have to endure. JANE ANGVIK testified from Anchorage in support of SB 15. She was representing herself. The cost of unintended pregnancies is enormous. She said, "As the Legislature faces the challenge of dealing with the fiscal crisis, don't ignore the fact that one of the biggest challenges comes from assisting individuals whose births were unintended and or not wanted." There is a public cost and a personal cost to everyone and it is an issue that belongs to both men and women and impacts communities tremendously. Additionally, there is a basic civil rights question that deals with equity in providing equal access to men and women in prescription healthcare. KATHERINE DAVEY said she is a lifelong Alaskan and is speaking for herself. She testified from Anchorage and was pleased to add her voice in support of SB 15. This is an equity issue that should be addressed. The ability to plan pregnancies is basic to health care and should not be overlooked any longer. She echoed Ms. Angvik's testimony regarding the cost of unintended and unwanted pregnancies. Forty two percent of births in Alaska are unwanted or untimed. 4:45 p.m. BOB LOHR testified that the Alaska Division of Insurance supports SB 15. It is a different stance than the division has taken in the past, but in December 2000 the U.S. Equal Employment Opportunity Commission made a key ruling reinforced by a federal district court decision in the state of Washington. That ruling told employers they need to offer this coverage if they offer prescription coverage or they would be in violation of anti- discrimination statutes. The division recommended the following technical amendment: Page 3, lines 7 - 13 should be deleted. That reference is unnecessary because health care insurance plans already exclude these types of products as defined in AS 21.54. Deletion wouldn't change the meaning of the bill. Traditionally the division expresses concern about health insurance mandates because they may have the potential to increase the cost of health insurance. However, in the case of this type of mandate, the overall benefits to society are such that they are so far in excess of the additional cost on the policy that the change makes good policy sense. Other states have successfully included coverage and it has not been disruptive to the insurance plan involved. SHERRY GOLL testified from Haines as an Alaskan woman in support of SB 15. The legislation offers the Legislature an opportunity to do something important to end gender discrimination by reforming the state's insurance laws. DR. COLLEEN MURPHY, a board certified obstetrician and gynecologist practicing in Alaska since 1987, testified in support of SB 15. During her career in Alaska, she has worked in the tribal health care system, in a large practice group and is now in private practice. Each exposed her to different insurance realities. The average American family now has 2.1 children and America women are of reproductive age for approximately 39 years. Having two children during that 39 year period requires women to contracept for 37 of those years so the need for contraception is enormous during the majority of a woman's life. Current national statistics indicate that 50 percent of all pregnancies in the United States are unintended. Half will result in a termination of the pregnancy and many of the other half will become live born. These pregnancies are quite high risk with poor social and family outcomes. Alaska statistics are similar to the national average. When she talks to her patients about the most effective method of family planning, she must warn them that their insurance company may not cover the cost. The reaction to this news is consistent; the women are incredulous and they overwhelmingly say, "You mean they'll pay for a normal pregnancy but they won't pay for my birth control?" Unfortunately, the answer is yes; they won't pay for birth control. She urged the committee to look closely at the medical and social affects of unintended pregnancy in Alaska and the real costs to the individual and society. DEBRA WILLIAMS testified from Anchorage in support of SB 15. Alaska has a proud history of being progressive on women's issues. Unfortunately, the failure to address prescription equity is not in keeping with this proud heritage. There are thousands of compelling stories by women who need this basic medical prescription coverage. On behalf of all those women she urged the Legislature to pass SB 15. GUY BELL, Director of the Division of Retirement and Benefits, said they administer the select benefits plan for about 4,700 state employees in the retirement and benefit plan. The select benefit plan does include coverage for prescription contraceptives so the bill would have no cost impact to the state health plan if enacted. The retiree plan does not include prescription contraceptives at this time, but that fiscal impact would be modest. CHAIRMAN THERRIAULT asked whether the decision to add coverage in the state plan was a policy call or was driven by recent litigation. GUY BELL replied it was a policy call but they were aware of the litigation. KAREN PEARSON, Director of Public Health, described SB 15 as good public health policy. Approximately one half of the live births in Alaska are unintended each year and about half of those women were not using a contraceptive at the time of conception for reasons such as lack of access or expense. Every child should be wanted and children should be planned. The inability to access contraceptives through health coverage puts choice in grave danger. It costs about $1.43 per month to offer contraceptive services, which is a very small cost for insurance companies to make the kind of contribution they can to the quality of life of the women they serve. Caren Robinson, Representative from the Alaska Women's Lobby, said they want to go on record in strong support of SB 15. They believe that the decision to exclude contraception from the prescription drug coverage imposes an undue financial burden on women. On December 20, 2001 the Equal Employment Opportunity Commission ruled and June 2001 the federal district court decision declared the exclusion of contraception to be discriminatory. 5:10 p.m. LILO IVES testified from Anchorage in support of SB 15. It is a matter of common sense to include prescription contraceptives in health care coverage. CHAIRMAN THERRIAULT closed public testimony on SB 15 and announced the bill would be held in committee. He told Senator Ellis he would like to discuss the advisability of dropping paragraph (1), subsection (e), Section 3 on page 3 and he would like review the recent Washington court case.
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