04/23/2024 03:30 PM Senate HEALTH & SOCIAL SERVICES

        HB  17-CONTRACEPTIVES COVERAGE:INSURE;MED ASSIST                                                                    
                                                                                                                                
3:32:29 PM                                                                                                                    
CHAIR WILSON  announced the  consideration of  CS FOR  HOUSE BILL                                                               
NO. 17(HSS)  am(efd fld) "An  Act relating to  insurance coverage                                                               
for contraceptives and related services;  and relating to medical                                                               
assistance coverage for contraceptives and related services."                                                                   
                                                                                                                                
CHAIR  WILSON  stated  that  on March  12,  2024,  the  committee                                                               
adopted  SCS CSHB  17,  work order  33-LS0222\U,  as the  working                                                               
document.                                                                                                                       
                                                                                                                                
3:33:11 PM                                                                                                                    
REPRESENTATIVE   ASHLEY  CARRICK,   District  35,   Alaska  State                                                               
Legislature,  Juneau,  Alaska,  explained   that  HB  17  reduces                                                               
barriers  to  contraceptive  access   by  extending  the  current                                                               
coverage duration from one to three months up to 12 months.                                                                     
                                                                                                                                
3:33:53 PM                                                                                                                    
CHAIR WILSON solicited a motion.                                                                                                
                                                                                                                                
3:33:56 PM                                                                                                                    
SENATOR  TOBIN  moved  to  adopt  Amendment  1,  work  order  33-                                                               
LS0222\U.1, to SCS CSHB 17.                                                                                                     
                                                                                                                                
                                                 33-LS0222\U.1                                                                  
                                                      Wallace                                                                   
                                                      4/22/24                                                                   
                                                                                                                                
                          AMENDMENT 1                                                                                       
                                                                                                                                
                                                                                                                                
     OFFERED IN THE SENATE                                                                                                      
          TO:  SCS CSHB 17(HSS), Draft Version "U"                                                                              
                                                                                                                                
     Page 1, line 1:                                                                                                            
          Delete the second occurrence of "and"                                                                               
                                                                                                                                
     Page 1, line 2, following "services":                                                                                    
         Insert "; and providing for an effective date"                                                                       
                                                                                                                                
     Page 2, lines 7 - 9:                                                                                                       
          Delete all material and insert:                                                                                       
          "(c)  Except as provided in (d) of this section,                                                                      
     a health care insurer may  not require cost sharing for                                                                    
     contraceptives or  services covered  under (a)  of this                                                                    
     section when  provided by  a participating  health care                                                                    
     provider or dispensing entity."                                                                                            
                                                                                                                                
     Page 2, lines 14 - 23:                                                                                                     
          Delete all material and insert:                                                                                       
          "(e)  A health care insurer that applies medical                                                                      
     management techniques, including  step therapy or prior                                                                    
     authorization, must provide without  delay a simple and                                                                    
     easy to  understand exception  procedure for  a covered                                                                    
     person to  access contraceptives  covered under  (a) of                                                                    
     this section."                                                                                                             
                                                                                                                                
     Page 2, line 28, following "prescribed":                                                                                   
          Insert "by a participating health care provider"                                                                      
                                                                                                                                
     Page 3, lines 6 - 13:                                                                                                      
          Delete "A religious employer that opposes                                                                             
     coverage under this subsection shall  provide a list of                                                                    
     the  contraceptives or  services  described  in (a)  of                                                                    
     this section  for which the religious  employer opposes                                                                    
     coverage                                                                                                                   
               (1)  to each prospective enrollee in the                                                                         
     religious employer's health  care insurance plan before                                                                    
     the enrollee's enrollment in the plan; and                                                                                 
               (2)  annually to all insureds enrolled in                                                                        
     the religious employer's health care insurance plan."                                                                      
                                                                                                                                
     Page 7, following line 31:                                                                                                 
          Insert a new bill section to read:                                                                                    
     "*  Sec.  9.  Section  1   of  this  Act  takes  effect                                                                  
     January 1, 2025."                                                                                                          
                                                                                                                                
                                                                                                                                
3:34:00 PM                                                                                                                    
CHAIR WILSON objected for purposes of discussion.                                                                               
                                                                                                                                
3:34:03 PM                                                                                                                    
CHAIR TOBIN said  that she wanted to  ensure accurate information                                                               
was placed  on the  public record regarding  Amendment 1  and may                                                               
seek  assistance from  Ms. Wing-Heier  to  answer questions.  She                                                               
explained   that  Amendment   1  aligns   HB  17   with  Medicaid                                                               
regulations and  highlighted that  the substantive  changes begin                                                               
on  page  2,  lines  7-9,  as  recommended  by  the  Division  of                                                               
Insurance.  These  changes  help   create  a  zero  fiscal  note,                                                               
eliminating  any fiscal  impact related  to HB  17's intersection                                                               
with  Medicaid. She  also pointed  out  that changes  to page  2,                                                               
lines   14-23  would   remove  the   indeterminate  fiscal   note                                                               
previously attached to  HB 17. Lastly, she  stated that Amendment                                                               
1  would  require  religious  employers  to  provide  a  list  of                                                               
contraceptives or  services they  oppose to  healthcare enrollees                                                               
before enrollment  and annually  thereafter, as outlined  on page                                                               
3, lines 6-13.                                                                                                                  
                                                                                                                                
3:37:25 PM                                                                                                                    
LORI WING-HEIER,  Director, Division of Insurance,  Department of                                                               
Commerce, Community and  Economic Development (DCCED), Anchorage,                                                               
Alaska,   explained  the   division's   recommended  changes   in                                                               
Amendment 1 (U.1).  She referred to HB 17, page  2, lines 7-9 and                                                               
14-23,  explaining that  under the  Affordable  Care Act,  states                                                               
adopted essential health benefits, and adding to these benefits                                                                 
such as  proposed in  HB 17requires  the  state to  defray costs.                                                               
She noted that an indeterminate  fiscal note was attached because                                                               
the  Centers  for  Medicare and  Medicaid  Services  (CMS)  might                                                               
require  the  state to  cover  these  costs.  She noted  that  in                                                               
previous  legislative sessions  there were  extensive discussions                                                               
to  this point.  Regarding changes  for religious  employers, she                                                               
stated that the  division does not oppose the  language but lacks                                                               
statutory authority  to regulate  religious employers  or mandate                                                               
them  to  provide  lists  of  covered  contraceptive  options  to                                                               
employees. She  emphasized that the division  regulates insurance                                                               
companies,  not employers,  and  these  limitations informed  the                                                               
recommended changes.                                                                                                            
                                                                                                                                
                                                                                                                                
3:39:04 PM                                                                                                                    
REPRESENTATIVE  CARRICK  stated  she   supports  the  changes  in                                                               
Amendment  1  (U.1).  She  said the  changes  are  technical  but                                                               
substantive and allow  Hb 17 to take effect.  She emphasized that                                                               
HB 17 was not intended to  generate a fiscal note, and the change                                                               
in language will help it advance.                                                                                               
                                                                                                                                
CHAIR WILSON  removed his objection,  found no  further objection                                                               
and Amendment 1 (U.1) was adopted.                                                                                              
                                                                                                                                
3:40:15 PM                                                                                                                    
CHAIR WILSON solicited the will of the committee.                                                                               
                                                                                                                                
3:40:19 PM                                                                                                                    
SENATOR  KAUFMAN moved  to report  SCS  CSHB 17,  work order  33-                                                               
LS0222\U,   as   amended,    from   committee   with   individual                                                               
recommendations and attached fiscal note(s).                                                                                    
                                                                                                                                
3:40:34 PM                                                                                                                    
CHAIR  WILSON  found  no  objection  and  SCS  CSHB  17(HSS)  was                                                               
reported  from the  Senate Health  and  Social Services  Standing                                                               
Committee.