Legislature(2001 - 2002)

04/11/2002 03:40 PM Senate STA

Audio Topic
* first hearing in first committee of referral
+ 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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