Legislature(2023 - 2024)BARNES 124
03/27/2023 03:15 PM House LABOR & COMMERCE
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| Audio | Topic |
|---|---|
| Start | |
| HB17 | |
| HB99 | |
| Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
| + | HB 17 | TELECONFERENCED | |
| + | TELECONFERENCED | ||
| += | HB 99 | TELECONFERENCED | |
HB 17-CONTRACEPTIVES COVERAGE:INSURE;MED ASSIST
3:16:15 PM
CHAIR SUMNER announced that the first 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."
3:16:35 PM
REPRESENTATIVE CARRICK introduced HB 17. 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 federal Affordable
Care Act. Furthermore, 22 states and the District of Columbia
ensure women can receive at one time a 12-month extended supply
of contraception. She stated that HB 17 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.
REPRESENTATIVE CARRICK stated that studies show that 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. She argued that
the proposed legislation would also save the state money and
pointed out a prior fiscal note had estimated an annual savings
of $1.35 million because of the reduction in unplanned
pregnancies. She pointed out the three, zero fiscal notes
attached to the bill.
REPRESENTATIVE CARRICK pointed out 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. She advised that the emergency
contraception language has been removed from the bill.
3:20:54 PM
CHERIE BOWMAN, Staff, Representative Ashley Carrick, Alaska
State Legislature, on behalf of Representative Carrick, prime
sponsor, paraphrased the sectional analysis of HB 17 [copy
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; (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.
MS. BOWMAN added that subsection (d) [in paragraph (B)] would
set out cost containment incentives, promoting the use of
generic, low-cost medication and health care providers who offer
services at a lower rate. As a cost containment strategy, she
said that this gives insurers the ability to direct patients
towards generics. She stated that when the lower cost
contraception is not available, subsection (f) would allow an
alternative or equivalent version of the contraceptive be given
to the insured, and subsection (h) would allow a religious
exemption.
MS. BOWMAN continued paraphrasing the sectional analysis, which
read as follows [original punctuation provided]:
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.
3:23:19 PM
MS. BOWMAN continued paraphrasing the sectional analysis, which
read as follows [original punctuation provided]:
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.
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.
3:25:08 PM
REPRESENTATIVE PRAX questioned whether this would not prevent
insurers from including the cost of compliance in their general
insurance rates.
REPRESENTATIVE CARRICK expressed the understanding that this is
correct. She deferred the question to the Division of
Insurance.
3:26:12 PM
SARAH BAILEY, Insurance Specialist, Division of Insurance,
Department of Commerce, Community, and Economic Development,
expressed the understanding that the proposed legislation would
not allow insurers to adjust cost shares, such as deductibles
and copayments; therefore, the expectation is it would be
applied to the premium, with some cost bidding. She notified
the committee that under federal law currently insurers cannot
apply deductibles or cost sharing on contraceptives.
REPRESENTATIVE PRAX, with a follow up for clarification,
expressed the opinion that Section 5 of the proposed legislation
would not affect any additional insurance coverage.
MS. BAILEY expressed agreement that this would be highly
unlikely.
REPRESENTATIVE CARRICK concurred.
3:29:23 PM
REPRESENTATIVE SADDLER, concerning remote work, questioned
whether individuals seeking contraception would be away [from a
doctor or pharmacist] for this extensive amount of time.
REPRESENTATIVE CARRICK responded that one of the major
challenges the legislation seeks to address for Alaskan women is
that prescription pick-up time is limited. There is also the
challenge of having a doctor's appointment or making a visit to
a pharmacist within short timeframes. She pointed out that this
would be considering the time for travel back and forth to work,
especially when women do not have access to a pharmacy on a
regular basis. She expressed the opinion that this access
should be as smooth as possible.
REPRESENTATIVE SADDLER questioned whether women in rural Alaska
would have to travel to pick up any prescription drugs.
REPRESENTATIVE CARRICK responded that before receiving any
prescription drugs, women would need access to a provider. She
stated that some prescriptions can be delivered in the mail;
however, in rural Alaska mail service is known to be unreliable.
In response to a follow-up question concerning the justification
for a prescription for a full year's worth of contraception, she
expressed the opinion that a year is a reasonable amount of time
and deferred to a pharmacist to confirm that the contraceptives
would be safe in this dosage. She added that Alaskan women have
requested this. In response to a follow-up question, she
answered that a prescription of three months or six months would
be better than the current situation; however, unless there is a
strong medical reason, she suggested that there should not be a
limitation.
3:33:52 PM
REPRESENTATIVE CARRICK, in response to a question from
Representative Wright, stated that the proposed legislation
would address women who come and go from rural areas of the
state. She added that women in urban parts of the state also
need these prescriptions to help control medical conditions,
such as endometriosis.
3:35:46 PM
CHAIR SUMNER announced that HB 17 was held over.