Legislature(2001 - 2002)
04/11/2002 03:40 PM Senate STA
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* first hearing in first committee of referral
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= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
SB 15-INSURANCE COVERAGE FOR CONTRACEPTIVES
SENATOR JOHNNY ELLIS, bill sponsor, described the bill as the
Prescription Fairness Act of 2002. It would require health
insurers in Alaska that cover prescription drugs to include
coverage for all FDA approved prescription contraceptives. There
is a companion bill in the House sponsored by a bi-partisan group
of women legislators. To date, 24 states have a similar provision
in law and pending legislation for the measure in 17 other
states.
A large impressive coalition of individuals and organizations
from across the state support the bill. There are many good
reasons to support this legislation and without this change in
law it is clear that:
· Women will continue to pay more and get less in health
insurance in Alaska
· Women will not receive equal health care treatment that they
need and deserve
· Alaskan law should be modified to avoid an expensive legal
challenge that it would surely lose
· Unintended pregnancies have enormous financial, personal and
social costs and this legislation provides the opportunity
to positively affect the numbers of unwanted births,
abortions and child abuse cases in this state
· Facts show that contraceptive coverage pays for itself
SB 15 is fair, cost effective, respects the religious beliefs of
employers, protects the state from legal action and is long
overdue.
ANN HARRISON from Fairbanks testified in support of SB 15. She
was representing herself as a retired nurse practitioner with 30
years service in women's health care.
CLAIRE NOLL testified from Anchorage in support of SB 15. Many
women need contraceptives for reasons other than to protect from
pregnancy. They should be available and affordable to all women.
SIDE B 4:30 p.m.
SHERRY JAEGER testified from Anchorage as a representative from
the Young Women's Christian Association (YWCA) in support of SB
15. The bill addresses the current inequities in women's health
care plans and would require equity in the workplace. It would
affect 140,000 women of childbearing age in Alaska and would not
burden insurance providers.
DEATRICH SITCHLER testified from Anchorage in support of SB 15.
Although all women deserve this coverage, she has a medical
condition that makes it necessary for her to avoid pregnancy.
Because it would be medically dangerous for her to become
pregnant, she must take birth control pills whether insurance
covers the cost or not.
She then read a statement from Jennifer Rudinger in support of SB
15. Although most insurance plans cover prescription drugs they
typically exclude prescription contraceptives and outpatient
contraceptive services. This gap in coverage has a
disproportionate impact on women.
CINDY NORQUEST testified from Anchorage in support of SB 15. She
said she was a concerned citizen representing the average woman
in Alaska who is tired of being treated unfairly. Gender
discrimination is the only explanation for this legislation not
having already been passed. It is in both the public interest and
the business interest to pass the legislation.
PAULINE UTTER testified from Anchorage in support of SB 15. She
presented a petition that was signed by 1,008 women that attended
the last Woman's Political Caucus and stated women want equality.
If prescription drugs such as Viagra are covered, then
prescription contraceptives should be covered as well.
ROBIN SMITH testified from Anchorage in support of SB 15. She
said there might be religious beliefs that run counter to
covering contraception. Although some religions don't believe
that humans should receive blood products, it is unimaginable
that insurance companies wouldn't cover that treatment. The
Catholic Church doesn't believe in vasectomies and tubal
ligations, but insurance companies cover them. Providence
Hospital covers birth control pills for their employees yet the
Catholic Church prohibits contraception. This is an issue that
needs to be addressed because it is a health care issue. Women
can become pregnant for 30 to 40 years of their lives so
something must be done to prevent unintended pregnancies. She
urged members to move SB 15 forward.
REGINA MONTOUFEL testified from Anchorage in support of SB 15.
She owns and operates a rooming house and has found fair
insurance coverage for women and small business owners to be a
huge problem. She works with many minimum wage individuals that
have policies with huge deductibles and minimal coverage. To be
treated unequally on prescription drug coverage is an injustice
that low-income women shouldn't have to endure.
JANE ANGVIK testified from Anchorage in support of SB 15. She was
representing herself. The cost of unintended pregnancies is
enormous. She said, "As the Legislature faces the challenge of
dealing with the fiscal crisis, don't ignore the fact that one of
the biggest challenges comes from assisting individuals whose
births were unintended and or not wanted." There is a public cost
and a personal cost to everyone and it is an issue that belongs
to both men and women and impacts communities tremendously.
Additionally, there is a basic civil rights question that deals
with equity in providing equal access to men and women in
prescription healthcare.
KATHERINE DAVEY said she is a lifelong Alaskan and is speaking
for herself. She testified from Anchorage and was pleased to add
her voice in support of SB 15. This is an equity issue that
should be addressed. The ability to plan pregnancies is basic to
health care and should not be overlooked any longer. She echoed
Ms. Angvik's testimony regarding the cost of unintended and
unwanted pregnancies. Forty two percent of births in Alaska are
unwanted or untimed.
4:45 p.m.
BOB LOHR testified that the Alaska Division of Insurance supports
SB 15. It is a different stance than the division has taken in
the past, but in December 2000 the U.S. Equal Employment
Opportunity Commission made a key ruling reinforced by a federal
district court decision in the state of Washington. That ruling
told employers they need to offer this coverage if they offer
prescription coverage or they would be in violation of anti-
discrimination statutes.
The division recommended the following technical amendment: Page
3, lines 7 - 13 should be deleted. That reference is unnecessary
because health care insurance plans already exclude these types
of products as defined in AS 21.54. Deletion wouldn't change the
meaning of the bill.
Traditionally the division expresses concern about health
insurance mandates because they may have the potential to
increase the cost of health insurance. However, in the case of
this type of mandate, the overall benefits to society are such
that they are so far in excess of the additional cost on the
policy that the change makes good policy sense. Other states have
successfully included coverage and it has not been disruptive to
the insurance plan involved.
SHERRY GOLL testified from Haines as an Alaskan woman in support
of SB 15. The legislation offers the Legislature an opportunity
to do something important to end gender discrimination by
reforming the state's insurance laws.
DR. COLLEEN MURPHY, a board certified obstetrician and
gynecologist practicing in Alaska since 1987, testified in
support of SB 15. During her career in Alaska, she has worked in
the tribal health care system, in a large practice group and is
now in private practice. Each exposed her to different insurance
realities.
The average American family now has 2.1 children and America
women are of reproductive age for approximately 39 years. Having
two children during that 39 year period requires women to
contracept for 37 of those years so the need for contraception is
enormous during the majority of a woman's life.
Current national statistics indicate that 50 percent of all
pregnancies in the United States are unintended. Half will result
in a termination of the pregnancy and many of the other half will
become live born. These pregnancies are quite high risk with poor
social and family outcomes. Alaska statistics are similar to the
national average.
When she talks to her patients about the most effective method of
family planning, she must warn them that their insurance company
may not cover the cost. The reaction to this news is consistent;
the women are incredulous and they overwhelmingly say, "You mean
they'll pay for a normal pregnancy but they won't pay for my
birth control?" Unfortunately, the answer is yes; they won't pay
for birth control.
She urged the committee to look closely at the medical and social
affects of unintended pregnancy in Alaska and the real costs to
the individual and society.
DEBRA WILLIAMS testified from Anchorage in support of SB 15.
Alaska has a proud history of being progressive on women's
issues. Unfortunately, the failure to address prescription equity
is not in keeping with this proud heritage. There are thousands
of compelling stories by women who need this basic medical
prescription coverage. On behalf of all those women she urged the
Legislature to pass SB 15.
GUY BELL, Director of the Division of Retirement and Benefits,
said they administer the select benefits plan for about 4,700
state employees in the retirement and benefit plan. The select
benefit plan does include coverage for prescription
contraceptives so the bill would have no cost impact to the state
health plan if enacted. The retiree plan does not include
prescription contraceptives at this time, but that fiscal impact
would be modest.
CHAIRMAN THERRIAULT asked whether the decision to add coverage in
the state plan was a policy call or was driven by recent
litigation.
GUY BELL replied it was a policy call but they were aware of the
litigation.
KAREN PEARSON, Director of Public Health, described SB 15 as good
public health policy. Approximately one half of the live births
in Alaska are unintended each year and about half of those women
were not using a contraceptive at the time of conception for
reasons such as lack of access or expense. Every child should be
wanted and children should be planned. The inability to access
contraceptives through health coverage puts choice in grave
danger. It costs about $1.43 per month to offer contraceptive
services, which is a very small cost for insurance companies to
make the kind of contribution they can to the quality of life of
the women they serve.
Caren Robinson, Representative from the Alaska Women's Lobby,
said they want to go on record in strong support of SB 15. They
believe that the decision to exclude contraception from the
prescription drug coverage imposes an undue financial burden on
women.
On December 20, 2001 the Equal Employment Opportunity Commission
ruled and June 2001 the federal district court decision declared
the exclusion of contraception to be discriminatory.
5:10 p.m.
LILO IVES testified from Anchorage in support of SB 15. It is a
matter of common sense to include prescription contraceptives in
health care coverage.
CHAIRMAN THERRIAULT closed public testimony on SB 15 and
announced the bill would be held in committee. He told Senator
Ellis he would like to discuss the advisability of dropping
paragraph (1), subsection (e), Section 3 on page 3 and he would
like review the recent Washington court case.
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