Legislature(2023 - 2024)BARNES 124
03/16/2023 08:00 AM House COMMUNITY & REGIONAL AFFAIRS
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| Audio | Topic |
|---|---|
| Start | |
| HB61 | |
| HB17 | |
| HB78 | |
| Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
| *+ | HB 61 | TELECONFERENCED | |
| + | HB 17 | TELECONFERENCED | |
| += | HB 78 | TELECONFERENCED | |
| + | TELECONFERENCED | ||
HB 17-CONTRACEPTIVES COVERAGE:INSURE;MED ASSIST
8:46:55 AM
CHAIR MCCORMICK announced that the next order of business would
be HOUSE BILL NO. 17, "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." [Before the committee was
CSHB 17(HSS).]
8:47:12 AM
REPRESENTATIVE ASHLEY CARRICK, Alaska State Legislature, as
prime sponsor, presented CSHB 17(HSS). She stated that
currently there are 28 states which require health insurance
plans regulated by the state to cover contraceptive prescription
drugs and devises, as laid out in the 2010 Affordable Care Act.
As recommended by the Institute of Medicine and defined by the
U.S. Health Resources and Services Administration, she stated
that women's preventative services include all contraceptives
approved by the Federal Drug Administration. Preventative
services also include patient education and counseling, as
prescribed by a health care provider. She stated that this is
collectively referred to as contraceptive services, which are
required to be covered by health insurance by federal law.
REPRESENTATIVE CARRICK stated that furthermore, 22 states and
the District of Columbia allow women to receive a 12-month
extended supply of contraception at one time. She stated that
the proposed legislation would put language into statute which
aligns with the federal contraceptive coverage guarantee. It
also allows up to a 12-month supply of prescription
contraceptives. She explained that this would allow women in
rural communities and those who work extended shifts in remote
locations a continuous supply of contraception. She stated that
studies show providing a one-year supply of prescription
contraceptives, compared to a 3-month supply, reduces unintended
pregnancies by 30 percent and drops the likelihood of abortion
by 46 percent.
REPRESENTATIVE CARRICK argued that the proposed legislation
would also save the state money, pointing out that a prior
fiscal note had estimated an annual savings of $1.35 million
because of the reduction in unplanned pregnancies. She
continued that currently obtaining contraception can be time
consuming; however, she maintained that improved access would
mean improved health for women and families. She stated that
the proposed legislation would take away insurance coverage as a
barrier to access. She added that the bill could also protect
women in the presence of domestic violence, in terms of
contraceptive cohesion. She argued the benefits of
contraception for family and societal health and urged support
for the bill.
8:51:59 AM
CHERIE BOWMAN, Staff, Representative Ashley Carrick, Alaska
State Legislature, on behalf of Representative Carrick, prime
sponsor, gave the sectional analysis on CSHB 17(HSS) [included
in the committee packet], which read as follows [original
punctuation provided]:
Section 1
AS 21.42.427. Coverage for contraceptives. Amends AS
21.42 by adding a new section which (1) requires a
health care insurer to provide coverage for
prescription contraceptives and medical services
necessary for those products or devices (including
over-the-counter emergency contraception that was
obtained without a prescription); (2) requires
reimbursement to a health care provider or dispensing
entity for dispensing prescription contraceptives
intended to last for a 12-month period for subsequent
dispensing; (3) prevents an insurer from offsetting
the costs of compliance; (4) prevents an insurer from
restricting or delaying coverage for contraceptives;
(5) if the provider recommends a particular service or
FDA-approved item based on a determination of medical
necessity, the plan or issuer must cover that service
or item without cost sharing; and (6) exempts
religious employers if certain criteria are met.
Section 2
AS 29.10.200. Limitation of home rule powers. Amends
AS 29.10.200 by adding a provision applying to home
rule municipalities.
Section 3
AS 29.20.420. Health insurance policies. Amends AS
29.20 by adding a new section clarifying that
municipal health care insurance plans that are self-
insured are subject to the requirements of sec. 1.
Section 4
AS 39.30.090. Procurement of group insurance.
Clarifies that a group health insurance policy
covering employees of a participating governmental
unit is subject to the requirements of sec. 1.
Section 5
AS 39.30.091. Authorization for self-insurance and
excess loss insurance. Clarifies that a self-insured
group medical plan covering active state employees
provided under this section is subject to the
requirements of sec. 1.
Section 6
AS 47.07.065. Payment for prescribed drugs. Requires
the Department of Health to pay for prescription
contraceptives intended to last for a 12- month period
for subsequent dispensing for eligible recipients of
medical assistance, if prescribed to and requested by
the recipient, as well as medical services necessary
for those products or devices. Distributed by the
Office of Representative Ashley Carrick 1.25.2023 2
The Department of Health must also provide coverage
for over-the-counter emergency contraception that was
obtained without a prescription.
Section 7
Uncodified law - applicability Requires the Department
of Health to immediately amend and submit for federal
approval a state plan for medical assistance coverage
consistent with sec. 6 of this Act.
Section 8
Uncodified law - applicability Makes sec. 6 of the Act
conditional on the approval required under sec. 7 of
the Act.
Section 9
If, under sec. 8 of this Act, sec. 6 of this Act takes
effect, it takes effect on the day after the date the
revisor of statutes receives notice from the
commissioner of health under sec. 8 of this Act.
8:56:17 AM
REPRESENTATIVE MCCABE advised that women have expressed concerns
that during a 12-month prescription, birth control may become
ineffective, as body chemistry could change.
REPRESENTATIVE CARRICK responded that medical providers have
full control over what is believed to be the right prescription
for the individual. She expressed the opinion that most
providers would prescribe only a few months and then conduct a
follow-up.
8:58:04 AM
REPRESENTATIVE MCCABE reiterated the concern that had been
relayed to him and asked Representative Ruffridge, who has a
background in pharmacy, to address this.
REPRESENTATIVE RUFFRIDGE explained that oral contraception is
never 100 percent effective, and low dose versions are rigid in
how they must be taken. He confirmed there are very few
alterations to body chemistry which would affect contraception
in general. He advised that CSHB 17(HSS) could help cover gaps
because, in the pharmacy setting, some of the emergency
prescriptions are for women who did not realize a refill was
needed. This could result in the possibility of a skip in the
low dose medication.
9:01:21 AM
REPRESENTATIVE MCKAY expressed the understanding that currently
if a female explains an extended absence to the doctor, and she
requests a 12-month prescription, the insurance will not pay for
it.
REPRESENTATIVE CARRICK responded that this is the gap the
proposed legislation would fix. Women would be allowed extended
prescriptions, as opposed to shorter prescriptions, and the
prescriptions would be covered under insurance.
9:03:27 AM
REPRESENTATIVE MEARS commented on her own prescriptions and
having them filled before coming to Juneau for the duration of
the legislative session. Her perception of the bill is that it
would bring contraceptives on par with other medications.
REPRESENTATIVE CARRICK replied that this is correct.
9:04:40 AM
LORI WING-HEIER, Director, Division of Insurance, Department of
Commerce, Community, and Economic Development, clarified that
insurance would not "get in the middle" of a provider, and the
provider would not be stopped from having responsibility to a
patient. She expressed the understanding that the proposed
legislation would allow that, once a contraceptive is
prescribed, the patient would have the ability to get a 12-month
supply. She advised that it would be a convenience for women to
get prescriptions for longer periods in relation to extended
absences because of work, travel, or other reasons. She noted
there have been no rebuttals from insurance companies over CSHB
17(HSS).
9:07:07 AM
REPRESENTATIVE HIMSCHOOT commented that the bill is decades
overdue, and, for example, it would help the women in Southeast
Alaska who go out on extended fishing trips.
9:07:45 AM
REPRESENTATIVE MEARS echoed the sentiments of Representative
Himschoot.
9:08:03 AM
REPRESENTATIVE CARRICK described CSHB 17(HSS) as an insurance
bill at its core, as it would not change contraception coverage
or the relationship with the provider; however, it would change
what happens at the pharmacy once a patient has a prescription.
She alluded to opposition to the bill and encouraged these
people to speak with her and her staff on the purpose of this
legislation.
9:09:17 AM
[CSHB 17(HSS) was held over.]