Legislature(2017 - 2018)HOUSE FINANCE 519
04/17/2017 01:30 PM House FINANCE
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| Audio | Topic |
|---|---|
| Start | |
| HB91 | |
| HB124 | |
| HB25 | |
| Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
| + | HB 124 | TELECONFERENCED | |
| + | HB 91 | TELECONFERENCED | |
| + | HB 25 | TELECONFERENCED | |
| + | SB 88 | TELECONFERENCED | |
| + | TELECONFERENCED |
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."
3:31:21 PM
REPRESENTATIVE MATT CLAMAN, SPONSOR, read a prepared
statement:
Good afternoon members of the Committee, for the
record, my name is Matt Claman, and I am the State
Representative for House District 21 in West
Anchorage. First off, I would like to thank you all
for hearing House Bill 25 this afternoon.
All across Alaska, women do not always have ready
access to women's health services. Women living and
working in rural areas, the tourism industry, the
military, and on the North Slope face additional
barriers, geographical and otherwise, to obtaining
greater access to family planning options.
Currently, women who use hormonal contraceptives must
return to the pharmacy every month to three months to
refill their prescriptions. House Bill 25 requires
health insurers to offer consumers the option to
receive a 12-month supply of hormonal contraception at
a time. The women in my family support House Bill 25,
and that tells me a lot. They support it not only
because it is often time consuming and inconvenient to
obtain a prescription contraceptive every 3 months or,
in some cases, every month, but they support it
because they know that improved access to
contraceptives means huge reductions in unintended
pregnancies.
Unintended pregnancy has a profound effect on the
overall well-being of Alaskan families. Unintended
pregnancy is associated with adverse maternal and
child health outcomes. Along with health concerns,
unintended pregnancy is a dramatic cost driver to
public health programs. I believe, and I hope the
members of the committee will agree, that with
Alaska's financial challenges, we should look for ways
to reduce costs in the short-term and long-term, and
this bill does exactly that.
House Bill 25 makes sense for Alaskan women and
families. With that, I will turn it over to my staff,
Lizzie Kubitz, to explain the details of the bill.
LIZZIE KUBITZ, STAFF, REPRESENTATIVE MATT CLAMAN, read from
a prepared statement:
Thank you members of the committee, for the record, my
name is Lizzie Kubitz and I am staff to Representative
Claman. Thank you all for hearing House Bill 25 today.
House Bill 25 would require health insurance companies
to, at the request of the consumer, provide coverage
for a 12-month supply of contraceptives at one time
and provide reimbursement to a health care provider or
dispensing entity. In the bill, prescriptive
contraceptives include hormonal contraceptives, namely
oral contraceptives, commonly known as "the pill."
Section 1 of the bill lays this out. Section 1 also
gives health care insurers the ability to enact
reasonable cost containment measures. In subsection
(d), cost containment is defined as incentivizing the
use of generic or lower cost medications or the use of
health care providers or pharmacies that offer
services or prescriptions at a lower rate.
The inclusion of this language gives insurers the
ability to steer towards generics as a cost
containment strategy-a provision that the Department
of Administration has advocated for as it could
substantially reduce their costs in covering a 12-
month supply of birth control.
However, subsection (e) states if the covered
therapeutically equivalent version of a prescription
contraceptive is not available or is considered
medically inadvisable by the health care provider of
the insured, a health care provider shall provide
coverage without cost sharing for an alternative
therapeutically equivalent version of the prescription
contraceptive that is prescribed for the insured.
The inclusion of this language makes it clear that
even though insurers will be allowed to steer towards
generics, if a particular generic or brand is
determined medically inappropriate by the health care
provider, then the insurer must accommodate the
insured.
3:35:55 PM
Ms. Kubitz continued to read a prepared statement:
Finally, Section 1 also includes a religious
exemption, so health plans sponsored by certain exempt
religious employers are not subject to the
requirements of Section 1.
Section 2 amends AS 39.30.090(a), which relates to
policies of group insurance covering state employees-
by adding a new subsection (13) to capture group
health insurance policies covering employees of a
participating governmental unit.
Section 3 amends AS 39.30.091, which relates to self-
insurance and excess loss insurance-by adding language
to capture a self-insured group medical plan covering
active state employees.
Sections 2 and 3 clarify that the requirements of
Section 1 apply to active state employees. I will note
for the record that Michele Michaud from the
Department of Administration is present to answer
questions relating to Title 39.
Section 4 directs the Department of Health and Social
Services to cover the 12-month supply of prescription
contraceptives for eligible recipients of medical
assistance.
Section 5 directs the Department of Health and Social
Services to amend and submit for federal approval a
state plan for medical assistance coverage consistent
with Section 4.
Section 6 is a conditional effect of Section 4 of the
bill, and
Sections 7 and 8 pertain to effective dates.
One major premise behind House Bill 25 is that when
women have greater access and availability to
contraceptives, unintended pregnancies are reduced.
Reductions in unintended pregnancies have a direct
cost savings to the state, which is reflected in the
fiscal notes from the Department of Health and Social
Services. And I will note for the record that Margaret
Brodie from the Department is online and available to
answer questions about the department fiscal notes.
According to a study, which I believe is in your bill
packets, in 2010, 48% of all pregnancies in Alaska
were unintended. Additionally, the study estimates
that 64.3% of the unintended pregnancies in 2010 were
publicly funded. As a State, Alaska spent $113.7
million on unintended pregnancies. Of that, $70.8
million was paid for by the federal government and
$42.9 million was paid by the state.
An additional study, included in your packet, looks at
84,000 women in California who were given various
supplies-1 month, 3 months, and yearlong-of oral
contraceptives . The researchers of that study
observed a 30% reduction in the odds of conceiving an
unintended pregnancy when given the yearlong supply of
oral contraceptives. That study also showed that over
the course of the year, California's family planning
program paid $99 more annually for women who received
3 cycles, and $44 more for women who received one
cycle, than it did for women who received a yearlong
supply all at once. This was mostly due to the costs
of associated visits and the higher use of pregnancy
tests among women who received fewer cycles. Women who
received 3 cycles were almost twice as likely as women
who received the 12-month supply to visit a clinic to
get a pregnancy test.
It is important to note that this bill does not change
who is eligible for coverage. What the bill does is
allow women, who already receive coverage for
prescription contraceptives, to receive, if she so
chooses, 12 months of that prescription at one time.
I wanted to take a moment to address some concerns we
have received from the Alaska National Federation of
Independent Business (NFIB) and America's Health
Insurance Plan (AHIP).
The NFIB has brought forward concerns about whether
this bill would apply to the state employee programs.
We have addressed that concern with the inclusion of
language found in Sections 2 and 3 of the bill.
An additional concern from the NFIB is the cost burden
of supplying 12 months of contraception at one time.
In response to that concern, multiple studies over the
past two decades have found that contraceptive
coverage does not raise insurance premiums and that
employers providing such coverage can, in fact, save
money by avoiding costs associated with unintended
pregnancy. The average commercial insurer payment for
all maternal and newborn care ranges from $18,000 to
$28,000. The average hormonal birth control costs
range from $100 to $600 a year. By preventing just one
unintended pregnancy, an insurer can save a minimum of
$17,000. That is enough savings to pay for 29
additional years of contraception.
AHIP also brought forward concerns.
Their initial concern is that a 12-month supply of
contraceptives could compromise patient safety, due to
potential decreased visits to a prescribing physician,
and efficacy, due to potential improper storage of a
12-month supply of birth control.
To address the concern of safety-research shows that
birth control pills can be safely prescribed based on
a careful review of your medical history and blood
pressure measurement. For most women, no further exams
are necessary. A Centers for Disease Control and World
Health Organization study in 2013 recommended
dispensing a year's supply of contraception and
advising women to return at any time to discuss side
effects, other problems, or changing the method being
used, but that no routine follow-up is required.
3:41:21 PM
To address the concern of efficacy-according to the
Centers for Disease Control and Prevention, oral
contraceptives have a shelf life of three to five
years, depending on the manufacturer. This timeframe
can be diminished depending on things like temperature
and moisture, but we trust that women who would opt
for a 12-month supply (women who are regular users of
hormonal contraception) know how to properly store
their medication.
Additional concerns from AHIP include waste, fraud,
and abuse.
To address the concern of waste-in the study included
in your bill packets, researchers in California found
that women who were dispensed a yearlong supply on
average "wasted" about one cycle of prescription
contraceptives. Wasting one cycle of pills is fairly
insignificant in comparison to the cost savings, such
as fewer total clinician and pharmacy visits, the
costs associated with pregnancy, and so on.
Overall, House Bill 25 would have huge advantages for
Alaskan women. From eliminating the inconvenience of
refilling their prescription every 1 or 3 months at a
time, to the real inability for some Alaskan women to
make it to the clinic, hospital, or pharmacy to refill
that prescription at all. Fisherwomen sometimes spend
3 to 4 months out on a boat at one time. Women who are
attending college often have busy schedules balancing
school and a job. Women in rural Alaska often have
trouble making it to the clinic or hospital due to
lack of transportation and limited operating hours.
This bill ensures the freedom for Alaskan women to
make decisions about their health and their futures.
Ms. Kubitz offered to answer any committee questions.
3:43:50 PM
Representative Wilson asked for the definition of
unintended pregnancy. Ms. Kubitz replied that the pregnancy
was not planned or desired by the individual.
Representative Wilson countered that it was necessary to
know which definition applied - unplanned or undesired. She
spoke to concern about the fiscal note. She spoke to
statistics and the distinction between unplanned and
unwanted. She believed that not all unplanned pregnancies
were unwanted.
Co-Chair Seaton asked Representative Wilson for
clarification. He provided the scenario where a woman
misses taking the pill due to a one month or three month
prescription and wondered what distinction she inquired
about. Representative Wilson referred to analysis in the
fiscal note and expected savings regarding the number of
unintended pregnancies due to the twelve month
prescription. She deduced that the "whole premise behind
the savings in the fiscal notes" was based on unintended
pregnancies. She relayed from personal experience that it
was not a problem to obtain contraceptives for an extended
period. She believed the distinction between unplanned and
"unwanted" was germane to the fiscal notes.
3:46:13 PM
Ms. Kubitz replied that the statistics only applied to the
rates of unintended pregnancies. She cited the study
["Increased Contraceptive Supply linked to Fewer Unintended
Pregnancies" University of California San Francisco (copy
on file)] statistics that reported a 30 percent reduction
in the odds of a pregnancy and a 46 percent decrease in the
odds of an abortion for women given a one-year supply of
birth control. She noted that the "whole point" of the bill
was for women to receive the entire supply of the
contraceptive prescription for a 12-month period. She
stated that if women had access they were more likely to
use it which limited the chance of pregnancy.
Representative Wilson reiterated her belief that women had
access to contraceptives. She asked whether the bill made
contraceptives available for men as well.
Representative Claman replied that "sadly" hormonal
prescription contraceptives were not available for men.
Representative Wilson opined that condoms could be provided
for men. She remarked that women must remember to take the
pill on a scheduled basis or they risk pregnancy. The issue
did not apply to condom use. She believed the legislation
placed the burden and fault on women. Ms. Kubitz discerned
that adding condoms would erode the cost savings in the
fiscal note. The cost savings in the fiscal note was
predicated on the amount of unintended pregnancies avoided
when women were prescribed a twelve month supply of
contraceptives. Representative Wilson wondered whether
current statute prohibited a twelve month prescription.
MARGARET BRODIE, DIRECTOR, DIVISION OF HEALTH CARE
SERVICES, DEPARTMENT OF HEALTH AND SOCIAL SERVICES,
responded that currently all prescriptions were available
for the maximum of 90 days. Representative Wilson asked
where she could find the provision in statute. Ms. Brodie
was uncertain and offered to provide the information later.
Representative Wilson referred to Page 1, line 11 of the
bill concerning voluntary sterilization procedures and
wondered whether the provision applied to both men and
women. Ms. Kubitz thought the provision applied to both
sexes. She stated that the provision was added to ensure
sterilization was a covered service.
Ms. Brodie conveyed that sterilization was covered for both
sexes.
3:52:24 PM
Representative Neuman understood that contraceptive pills
were also used for other purposes such as migraines. He
inquired whether other uses were covered. Ms. Kubitz
answered in the affirmative. Representative Neuman asked
Representative Claman about facts in the sponsor statement.
He referred to the $42.9 million cost to the state for
unintended pregnancies and asked for a breakdown of costs.
Ms. Kubitz reported that the number was based on a study
included in members bill packets from the Guttmacher
Institute titled, "State Facts About Unintended Pregnancy"
(copy on file). She informed the committee that the data
was from 2010 and was the most recent available. In Alaska,
the state and federal governments spent $113.7 million for
unintended pregnancies broken down to $70.8 million or 52
percent was spent by the federal government and $42.9
million was spent by the state.
Co-Chair Seaton verified that the cost savings resulted in
the avoidance of the unintended pregnancies. Ms. Kubitz
nodded affirmatively.
Representative Neuman maintained that he wanted a better
understanding of the costs associated with the savings. Ms.
Kubitz deferred to Ms. Brodie to clarify the numbers.
3:57:10 PM
Ms. Brodie relayed that the cost savings to the Medicaid
program was $1.355 million that represented the cost of 420
unintended pregnancies for the cost of delivery, medical
services, and prenatal doctor visits. Representative Neuman
was "trying to add validity" to the statements provided.
Representative Grenn quoted the following from the
Guttmacher Institute document:
In 2010, 3000 or 64.3% of unplanned births in Alaska
were publically funded…
Representative Grenn calculated from the $43 million figure
that the cost was roughly $14.3 thousand per unintended
pregnancy. He deduced that the amount was approximate to
the cost per delivery from his personal experience. He
deemed that the facts provided in the sponsor statement
were accurate. He thought that complicated births were
factored into the calculations. Ms. Brodie answered in the
affirmative.
Co-Chair Seaton wondered whether the fiscal note reflected
the cost of the contraceptives or savings from avoided
births. Ms. Brodie explained that the fiscal note reflected
the savings from unintended pregnancies. The state
currently paid for the cost of the contraceptives four
times a year along with dispensing fees each time
therefore; no additional funding for the contraceptives
were necessary. She added that the costs for contraceptives
would likely decrease due to fewer dispensing fees.
Representative Grenn suggested that the intent of the bill
was to provide access. He wondered whether the intent of HB
25 was providing access or cost savings. Representative
Claman responded that the intent was both, a cost savings
to the state and better access.
4:02:02 PM
Representative Kawasaki agreed with the underlying bill. He
had personally obtained a 90-day prescription for the
legislative session and had to go to Fred Meyer to have it
refilled. He wondered whether a physician typically
prescribed for twelve months or did length of prescriptions
correspond with refills. Ms. Kubitz understood that length
of prescription was dependent on what the insurance
companies covered. Representative Kawasaki wondered whether
there might be some situations where a physician would not
want to prescribe a 12-month prescription for birth
control. Ms. Kubitz responded that the purpose of the bill
allowed a woman to opt for a 12-month prescription but
ultimately the decision belonged to the doctor.
Representative Kawasaki inquired whether the choice was
ultimately up to the patient if the 12-month prescription
was advisable. Ms. Kubitz responded that a twelve month
supply was an option rather than mandatory.
Representative Guttenberg relayed information from personal
experience about the difficulty of obtaining the refills
for his personal prescriptions that was prescribed every 30
and 90 days. He suggested that the way pharmaceuticals were
prescribed was part of the inherent problem of escalating
costs. He thought that the way drugs were prescribed by
statute was burdensome and expensive for the state. He
remarked that Alaska was doing health care by statute. He
asked for clarification. Ms. Brodie responded that
prescribing had to be addressed in statute so the insurance
company would know coverage was possible for the entire
period of time.
4:07:44 PM
Vice-Chair Gara appreciated and supported the bill.
Representative Wilson asked whether Alaska Care prohibited
a woman from receiving a 12-month prescription for
contraceptives.
MICHELE MICHAUD, CHIEF HEALTH OFFICIAL, DIVISION OF
RETIREMENTS AND BENEFITS, DEPARTMENT OF ADMINISTRATION,
replied that currently the plan allowed for 90 days but the
plan administrator who was the Commissioner of the
Department of Administration could change the amount of
coverage. Representative Wilson asked whether a
contraceptive prescription could be extended before the 90
day period ran out through a phone call. Ms. Michaud
responded in the affirmative and added that Alaska Care
allowed for vacation overrides. Representative Wilson asked
whether any type of contraceptive coverage was available
for men. Ms. Michaud responded in the negative and
elucidated that condoms were not covered under the plan.
Representative Wilson asked whether she was aware of other
provider's practices regarding contraceptive extensions.
Ms. Michaud responded that she was uncertain of how other
providers handled the situation. She assumed other insurers
had similar provisions. Representative Wilson requested
more information identifying the problem and wondered what
the bill was "trying to fix."
Representative Guttenberg asked for a definition of a
vacation override. Ms. Michaud explained that the vacation
override was variable and was based on the individual's
circumstances and needs. She elaborated that the override
had to be requested each time it was necessary, even if
work travel was routine and overrides were needed for each
90-day prescription.
Vice-Chair Gara also mentioned problems when getting his
personal prescriptions refilled. He wondered whether a
person's doctor had to be contacted when a contraceptive
prescription needed to be refilled. Ms. Kubitz responded
that it depended on whether refills were part of the
prescription. She reminded the committee that the point of
the bill was access to a twelve month supply all at once.
She pointed out that other circumstances interfered with
women getting to a pharmacy and/or obtaining refills every
90 days.
4:13:41 PM
Representative Pruitt asked what percentage of insurance
plans were separate from Alaska Care in the state. Ms.
Kubitz responded that the bill encompassed Alaska Care,
Medicaid recipients, and private health insurers. She did
not know actual percentages.
Representative Pruitt asserted that the state was unable to
regulate all private insurers. He wondered what percentage
of private insurances the bill affected. Representative
Claman responded that the bill applied to private sector
insurers and underwriters who covered employees in the
state.
ANNA LATHAM DEPUTY DIRECTOR, INSURANCE DIVISION,
DEPARTMENT OF COMMERCE COMMUNITY AND ECONOMIC DEVELOPEMNT,
replied that roughly 50 percent of the plans were captured
under the bill. She detailed that the Employee Retirement
Income Security Act (ERISA) plans and the self-insured were
exempt but large and small group plans and State of Alaska
plans were covered under the legislation. Representative
Pruitt asked that if Alaska Care and Medicaid recipients
were carved out what percentage of covered plans were left.
He felt the legislation's mandate affected small "mom and
pop" companies.
4:17:30 PM
SARAH BAILEY INSURANCE SPECIALIST III - INSURANCE
DIVISION, DEPARTMENT OF COMMERCE, responded that the
division regulated approximately 20 percent of the health
care market in Alaska including, individual, small and
large employer.
Representative Pruitt asked whether there was anything that
prevented private insurers from implementing the twelve
month contraceptive coverage. Ms. Bailey responded in the
negative.
Representative Pruitt determined that the bill mandated 12-
month contraceptive coverage to 20 percent of the insurance
market in the state. He wondered whether his statement was
accurate. Ms. Latham answered in the affirmative.
Representative Pruitt asked about the religious exemption
in the bill. He read the following [page 3, lines 1 through
10]:
the state a health care insurance plan in the group
market 1 to a religious employer is exempt from the
requirements of this section with respect to the
health care insurance plan of the religious employer
if the religious employer opposes the coverage
required under this section and is an
(1) organization that meets the criteria set out in
26 U.S.C. 6033(a)(3)(A)(i) or (iii) (Internal
Revenue Code of 1986), as amended; or
(2) eligible organization that has self-certified in
the form and manner specified by the United States
Secretary of Labor or has provided notice to the
United States Secretary of Health and Human Services,
under the requirements set out in 45 C.F.R.
147.131(b)(1) - (3).
Representative Pruitt commented that there were employers
that had legitimate religious concerns. He wondered what
protections the legislation provided to employers with
religious affiliations. Ms. Latham responded that based on
her assessment religious groups were exempt.
Ms. Kubitz pointed out that the bill was tailored to match
provisions in the Affordable Care Act (ACA) regarding
religious employers and organizations exemptions. She
believed that the 12-month contraceptive mandate did not
apply to the religiously exempt group.
Representative Pruitt remarked that ACA could be repealed.
He asked whether religious entities would be able to
maintain their exemptions. Ms. Latham responded that if the
ACA was repealed so would the contraception mandate and
religious organizations and would "probably need an
exemption." Representative Pruitt suggested that the bill
created a mandate regardless of the ACA. He disagreed and
asserted that HB 25 was based on the ACA as a guideline to
some of the provisions in the bill. Representative Claman
was unsure how a court would handle the situation. He
predicted that the department and courts would provide
exceptions. The intent in the bill provided for religious
exemptions and he thought that a court would interpret the
exemption to apply even if the ACA was repealed or altered.
4:24:41 PM
Representative Pruitt remembered that years ago a previous
proposed constitutional amendment meant to protect the
Permanent Fund Dividend referenced an existing statute. A
legal opinion regarding the amendment determined that
attaching it to existing statute that was possible to alter
was tenuous. He believed that the same argument applied to
the religious exemption provision in HB 25. Representative
Claman thought that the number of hypothetical arguments
were limitless and maintained that he answered the question
to the best of his ability.
Vice-Chair Gara recommended adding a date to the statues
that referenced the ACA provisions and noted that there was
precedent for that type of clarification. He exemplified
the language, "as existed on January 1, 2017" and suggested
that the language could be added later by amending HB 25.
Representative Claman agreed to examine the issue.
Co-Chair Seaton surmised that Section 1 contained the
language, "the health care insurer that offers" and
interpreted that if the ACA was repealed the provisions
would not apply. If the insurer no longer offered
contraceptive coverage due to the repeal the statute no
longer applied to those insurers. He thought that the
scenario was "frustrating." Healthcare was driving much of
the budget and economy of the state. He believed that the
discussion should focus on passing bills that help control
costs and improve efficiency in the health care system.
4:28:32 PM
Representative Wilson shared her concern that Alaska Care
and Medicaid could change the policy on its own and if so,
why it wasn't changed. She wondered if the legislation
would force a doctor to prescribe a 12 month prescription.
She stated that some doctors wanted to see patients every
three months. Ms. Kubitz replied that the bill did not
place a mandate on the doctors. Most doctors who prescribed
contraceptives would not think that numerous checkups were
necessary. Representative Wilson inquired whether any
insurance company could provide information regarding the
necessity of the legislation and what if anything prevented
them from covering a 12 month supply of contraceptives.
Vice-Chair Gara was given the gavel to temporarily chair
the meeting.
Vice-Chair Gara OPENED Public Testimony.
ALYSON CURREY LEGISLATIVE LIAISON, PLANNED PARENTHOOD
VOTES NORTHWEST AND HAWAII, read a prepared statement:
Thank you, Mr. Chair and members of the committee for
the opportunity to testify today. My name is Alyson
Currey. I am a resident of Juneau and I represent
Planned Parenthood Votes Northwest & Hawaii.
Planned Parenthood has provided birth control and
other high-quality health care across the nation for
more than 100 years and we strongly support HB 25. In
Alaska, we currently serve more than 7,700 patients,
which includes providing birth control to nearly 3,000
women. There are many different kinds of birth
control, and no one method will work for every person
at every stage of their life. Women who are not
satisfied with their contraceptive method, are less
likely to use it consistently. Therefore, every person
should have full access to the birth control method
that works best for them, without barriers based on
cost and regardless of their insurance plan, in order
to increase consistent use. House Bill 25 would
remove such barriers.
Family planning is a basic economic issue for women
and families. Unintended pregnancies put women at
greater risk of homelessness, family hunger, poor
birth outcomes, and long-term dependence on publicly
funded programs. Family planning also creates costs
savings for public and private insurance plans.
Allowing women to access a full range of FDA-approved
contraceptives and providing a year's supply of birth
control instead of limiting dispensing to one or three
cycles lowers direct costs on follow-up visits,
pregnancy tests, and long-term costs associated with
unintended pregnancies.
Eight other states have passed legislation similar to
HB 25, including Washington, Virginia and California.
In an analysis of California's bill, the California
Health Benefits Review Program found that the
reduction in unintended pregnancies and doctor visits
would result in about $42.8 million in savings for the
state in its first year of existence. AK's cost-
savings analysis of HB 25 shows a higher savings per
capita.
By taking steps to decrease unintended pregnancies,
the state will decrease its long-term social service
spending and save money. Please support comprehensive
birth control access for all women and vote yes on HB
25.
4:35:23 PM
ELIZABETH FIGUS, SELF, SITKA, spoke in favor of HB 25. She
shared that she was a doctoral student at the University of
Alaska in Fairbanks and Juneau resident and in the summer
months she skippered a troll fishery tender. She felt that
the bill was a "no brainer" in a state where so many people
worked in remote locations seasonally. She spoke about the
unnecessary expense and difficulty in finding any time for
doctor's appointments or pharmacy visits during her busy
fishing season. She believed the bill was only about
streamlining prescription pick-ups. She was certain that
the committee "understood the importance of economic
efficiency for all Alaska residents." She urged members to
vote "yes" on the bill.
4:37:04 PM
ELIZABETH EILERS, SELF, JUNEAU, spoke in favor of HB 25.
She stated that "politicians cannot grow the economy and
simultaneously limit access to birth control" and thought
that the "state's economic health and women's reproductive
health were linked." She indicated that she paid a high
amount for birth control and believed that created numerous
challenges to access. She spoke of the high costs of all
types of birth control in out-of-pocket expenses. She
thought meaningful access to a variety of methods was
"critical" and a women's right. She maintained that without
insurance coverage the cost of birth control was
unattainable. She urged members to support HB 25 and "not
leave women behind."
4:38:58 PM
ALICA CARGILL, POLICY SPECIALIST, ALASKA NETWORK ON
DOMESTIC VIOLENCE AND SEXUAL ASSAULT, supported the
legislation. She spoke to "contraceptive coercion," access,
and equity. She relayed that in FY16 her agency served over
6,300 women and was "heavily invested in reproductive
health, access, and equity." She explained that "power and
control was the overall basis of domestic violence and
sexual assault." She stated that "a victim's autonomy was
fundamental in both preventing and responding to violent
acts. One critical element of this autonomy was access to
both affordable and consistent reproductive healthcare."
She felt that the bill enabled a women's autonomy. She
explained that contraceptive coercion was when an abuser
controlled a woman's ability to contraceptive access and
use. She explained that the bill expanded coverage for
long-acting reversible contraceptives such as intrauterine
devices and implants and assisted the woman living as
safely as possible in the short-term. She felt that
unintended pregnancies could occur without the long-acting
reversible contraceptives. She noted the correlation
between unintended pregnancies and domestic violence that
imposed "an even greater vulnerability for the victim." She
added that the bill increased women's access in underserved
rural populations.
4:41:25 PM
Representative Wilson asked whether she was concerned
because the bill only applied to insurers who already
covered contraceptives and some might choose to halt
coverage due to increased costs related to the bill. She
wondered if she was concerned with the possibility of less
coverage. Ms. Cargill responded that she had not considered
the scenario and would like to do further research. She
guessed that her agency would still support the bill.
Representative Wilson was concerned about any unintended
consequences.
4:42:53 PM
PAMELA SAMASH SELF, RIGHT TO LIFE, NENANA, opposed HB 25.
She expressed concern over the discussion regarding cost
savings from unintended pregnancies in rural populations
and equated it to a discussion about "rural population
control." She talked about doctors wanting to have routine
follow-ups as a way to prevent serious side effects. She
believed that unintended pregnancies were called
"miracles." She said children were the "future" and not
"dollar signs." She restated her opposition to HB 25. She
did not believe in giving women 12 months of birth control
and did not want to pay for emergency contraceptives.
4:45:56 PM
PAIGE HOGSON, SELF, ANCHORAGE, spoke in support of HB 25.
She offered that a lot of research existed that supported
the benefits of the legislation; for women, their families,
cost saving for the state, and society. She related that
the access delayed child bearing until planned. She thought
Alaska needed to be proactive. She urged members to support
the bill.
4:47:04 PM
ROBIN SMITH, SELF, ANCHORAGE, indicated that she was
driving and would prefer to testify the following morning.
Vice-Chair Gara agreed to the request.
4:47:38 PM
JUSTINE WEBB, SELF, FAIRBANKS, spoke in favor of HB 25 She
shared that she was a social work student at the University
of Alaska in Fairbanks and grew up in Sitka. She relayed
from personal experience the issues and difficulties
regarding her limited access to contraceptives receiving
only a 30 day supply at a time. She had missed classes and
experienced other inconveniences accessing contraception.
She conveyed that she was not able to refill her
prescription with only 2 days of pills left. She could not
imagine the added difficulties of accessing birth control
in remote areas of the state in light of her experiences
living in urban areas. She asked members to support the
legislation.
4:50:04 PM
VHEMIA PETERSON, SELF, ANCHORAGE, supported the
legislation. She relayed that she graduated from the
University of Alaska in Anchorage and currently worked two
jobs and volunteered and participated in the community. She
felt that her access to a long term supply of birth control
contributed to her success. She noted the high sexual
assault and abuse rate for women as well as a wide wage gap
between men and women. She urged members to support the
bill.
4:51:38 PM
Vice-Chair Gara indicated the meeting would recess until
April 18, 2017 at 9:45 a.m. He relayed the agenda for the
afternoon meeting.
^RECESSED UNTIL TUESDAY, APRIL 18, 2017 AT 9:45 A.M.