Legislature(2023 - 2024)BARNES 124
03/04/2024 03:15 PM House LABOR & COMMERCE
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| Audio | Topic |
|---|---|
| Start | |
| HB289 | |
| SB89 | |
| HB285 | |
| HB203 | |
| HB290 | |
| Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
| += | HB 203 | TELECONFERENCED | |
| + | SB 89 | TELECONFERENCED | |
| + | TELECONFERENCED | ||
| += | HB 290 | TELECONFERENCED | |
| += | HB 289 | TELECONFERENCED | |
| *+ | HB 285 | TELECONFERENCED | |
HB 285-MAMMOGRAMS: INSURANCE COVERAGE
3:53:17 PM
CHAIR SUMNER announced that the next order of business would be
HOUSE BILL NO. 285 "An Act relating to insurance; relating to
mammograms; and providing for an effective date."
3:53:38 PM
REPRESENTATIVE FIELDS, as prime sponsor, presented HB 285. He
said the bill would eliminate financial barriers necessary for
diagnostic breast imaging to detect and treat early-stage breast
cancer. He defined "screening mammograms" as routinely
performed to detect breast cancer in patients without symptoms
and designed to be unform throughout the country for consistent
standards of treatment. He paraphrased the sponsor statement
[included in the committee packet], which read as follows
[original punctuation provided]:
Breast cancer is both the most frequently diagnosed
and the second deadliest cancer among women in Alaska.
One in eight women will be diagnosed with breast
cancer in their lifetime, but when detected early,
breast cancer can be successfully treated. Screening
mammograms are covered under the Affordable Care Act
(ACA) as a preventative procedure, but diagnostic
imaging to help diagnose cancer is subject to cost
sharing (co-pay and deductible), costing patients
hundreds to thousands of dollars.
A study published by the Radiology Society of North
America found that these costs excluded some 21% of
patients who need supplemental testing following an
abnormal mammogram. Excluding patients from testing
increases the likelihood that cancers are not treated
early, risking harm to Alaskans, at higher costs for
employer-sponsored plans. This cost sharing
requirement exacerbates healthcare access disparities
in lower- and middle-income patients, who may be
insured, but are unable to afford additional testing.
Early detection of breast cancer is crucial for
survivability. This legislation would provide greater
access to care, ensure prompt diagnosis of breast
cancer, and reduce the overall cost to the patient and
the health care system.
3:56:51 PM
COURTNEY OWENS, Staff, Representative Zack Fields, Alaska State
Legislature, on behalf of Representative Fields, prime sponsor,
presented the sectional analysis for HB 285 [included in the
committee packet], which read as follows [original punctuation
provided]:
Section 1: Amends AS 21.42.375(e) to define
"diagnostic breast examination" and "supplemental
breast examination" and offers guidelines for the
basis of additional testing.
Section 2: Adds a new subsection to AS 21.42.375
guaranteeing that mammography screening, diagnostic
breast examinations, and supplemental breast
examinations are covered by applicable insurance
plans, with the exception of high deductible health
plans that are eligible for a health savings account
tax deduction.
Section 3: Amends the law of the State of Alaska by
applying Sec. 1 and Sec. 2 to an insurance policy or
contract on or after the effective date of the law.
Section 4: Amends the law of the State of Alaska to
allow the Division of Insurance to adopt regulations
necessary to implement this act under AS 44.62.
Section 5: Section 4 take effect immediately under AS
01.10.070(c).
Section 6: This Act takes effect January 1, 2025.
3:58:15 PM
REPRESENTATIVE SUMNER opened invited testimony on HB 285.
3:58:28 PM
KRISTEN SMITH, Regional State Policy & Advocacy Manager,
Northwest, Susan G. Komen Breast Cancer Foundation, gave invited
testimony in support of HB 285 and explained how the bill would
interact with the state's current healthcare system. She said
HB 285 would impact people with commercial health insurance
regulated by the state. It would not require coverage but
prohibits cost sharing for existing coverage. She explained
that women and men skip diagnostic tests for breast cancer
because they can't afford them even with insurance. She
reported that late diagnoses lead to higher costs and worse
health outcomes. Breast cancer diagnosed at stage 1 has a 99
percent survivability rate, whereas stage 4 breast cancer can be
treated, but is almost always eventually terminal. Getting
patients diagnosed earlier would bridge the gap, she said.
Today, who survives breast cancer too often depends on a
person's income, location, and race. HB 285 posits that all
patients should benefit from testing and early diagnosis. She
acknowledged that the bill would raise premiums; however, she
shared her belief that mammograms save more in long-term
healthcare costs than they cost in the short term.
4:02:47 PM
REPRESENTATIVE PRAX asked why the insurance companies are not
engaging in this voluntarily.
4:03:20 PM
LORI WING-HEIER, Director, Division of Insurance, Department of
Revenue (DOR), said under current statutes, insurers must cover
entry mammograms; however, further testing is not included
without copays.
REPRESENTATIVE FIELDS estimated that roughly 1,500 individuals
are unable to get diagnostic screenings due to the cost
prohibitive nature of mammograms.
REPRESENTATIVE PRAX said he does not dispute the statistics;
however, maintained his confusion as to why the state has to
enforce this if it's a known cost saving measure in the long
run.
REPRESENTATIVE FIELDs said he did not know the answer.
4:05:38 PM
REPRESENTATIVE SADDLER sought to confirm that currently, private
insurers must cover mammography and the patient is responsible
for the copay.
MS. WING-HEIER answered yes. In response to a series of
questions from Representative Saddler, she confirmed that the
state does not require insurance companies to provide coverage
for supplemental exams. She defined "other factors" that may
increase the risk of breast cancer as lifestyle aspects, such as
smoking, and genetic traits.
REPRESENTATIVE SADDLER suggested scoping the bill more finely to
define "other factors."
MS. SMITH said "other factors" is not defined. Generally,
"supplemental" is composed of three factors: first degree
relative with breast cancer; genetic tie to breast cancer; or a
previous breast cancer survivor.
4:09:13 PM
REPRESENTATIVE PRAX restated his question, asking why insurance
companies haven't done this voluntarily if it would save costs
in the long term.
MS. SMITH said insurance companies don't dispute that this
treatment would help with diagnosis and treatment; however, they
have concerns about the "slippery slope" that may arise if they
are asked to repeat this process for other diseases.
4:10:23 PM
REPRESENTATIVE SADDLER asked how many Alaskans are covered by
private insurance versus public.
MS. WING-HEIER estimated that no more than 15 percent of
Alaska's population are covered by private insurance.
REPRESENTATIVE SADDLER asked whether public insurance programs
cover the supplemental and diagnostic breast examinations as
defined in HB 285.
MS. WING-HEIER shared her understanding that the bill does not
extend beyond the regulated plans under Title 21.
REPRESENTATIVE SADDLER sought to confirm that the bill excludes
85 percent of Alaskans.
REPRESENTATIVE FIELDS said he would welcome bringing in Emily
Ricci to discuss the state plan.
4:12:35 PM
CHAIR SUMNER announced that HB 285 would be held over.