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.