Legislature(2015 - 2016)BUTROVICH 205
02/24/2016 01:30 PM Senate HEALTH & SOCIAL SERVICES
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| Audio | Topic |
|---|---|
| Start | |
| SB113 | |
| SB156 | |
| Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
| *+ | SB 113 | TELECONFERENCED | |
| *+ | SB 156 | TELECONFERENCED | |
| + | TELECONFERENCED |
SB 156-INSURANCE COVERAGE FOR CONTRACEPTIVES
2:07:48 PM
CHAIR STEDMAN announced the consideration of SB 156.
2:08:02 PM
SENATOR BERTA GARDNER, Alaska State Legislature, sponsor SB 156,
introduced the bill. She explained that it is difficult to draft
a bill that is perfect and she recognizes that it needs some
changes. The bill attempts to make it easier for people who are
using self-administered birth control to get it for a longer
term than currently they can. If a person has insurance, they
should be able to get it for 12 months. It is particularly
important in Alaska, but it is a part of a national movement.
The bill does not speak to copays or prices. It is a cost to the
patient and to the medical system to only be allowed to get
birth control monthly or for three months. She emphasized that
the bill is not trying to change insurance policies or co-pays.
2:10:32 PM
KATIE BRUGGEMAN, Staff, Alaska State Legislature, presented
information on SB 156. She said the bill would mandate insurance
companies to provide a 12-month supply of hormonal, self-
administered contraception at one time, should the recipient
chose that option.
She read from the sponsor statement:
All across Alaska, women working in rural areas, in the tourism
industry, in the military, and on the North Slope, do not always
have ready access to women's health services, thereby posing
limitations on their ability to control whether and when they
conceive children. This bill, SB 156, mandates insurance
companies to pay both private and Medicaid claims and reimburse
health care providers for an initial 3 month supply (to gauge
adverse reactions), which is then followed by a 12 month supply
of contraceptives, including, but not limited to, birth control
pills and hormonal contraceptive patches. The bill makes no
changes to insurance plans or coverage. The goal of the bill is
quite narrow. If a woman is already covered by insurance, and if
she already receives birth control prescriptions, she should be
able to receive a 12-month supply at one time.
She pointed out that the current version of SB 156 does include
problems that have come to light in the past few days, but with
the help of departments, stakeholders, and the legislative legal
team and the committee, the sponsor's aim is to address them in
development of a new version of the bill. She noted that they
have heard from many Alaska women who have had difficulty in
obtaining a consistent supply of hormonal contraception. Some of
those are limited clinic hours, privacy concerns, and long
stretches of time spent in remote areas. The bill is meant to
address a real problem for Alaskans.
2:13:22 PM
MS. BRUGGEMAN shared facts about unintended pregnancies, both in
Alaska and nationwide. She said unintended pregnancy has a
profound effect on the economic opportunities and overall well-
being of Alaskans statewide. According the Centers for Disease
Control and Prevention, an unintended pregnancy is a pregnancy
that is reported to have been either unwanted (the pregnancy
occurred when no children, or no more children, were desired) or
mistimed (the pregnancy occurred earlier than desired).
Unintended pregnancy is a core concept that is used to better
understand the fertility of populations and the unmet need for
contraception and family planning.
Unintended pregnancy mainly results from not using
contraception, or inconsistent or incorrect use of effective
contraceptive methods. Unintended pregnancy is associated with
an increased risk of problems for both the mother and baby: if a
pregnancy is not planned before conception, a woman may not be
in optimal health for childbearing, and might make poor prenatal
choices due to a lack of resources or a family support system,
unaddressed issues with drug and alcohol dependence, and an
absence of nutritional knowledge that might otherwise keep both
mother and child healthy through the prenatal experience.
Along with these health concerns, unintended pregnancy is an
economic issue for Alaskan families, as well as the state
Department of Health and Social Services. Nationally, 51% of all
US births in 2010 were paid for by public insurance through
Medicaid, the Children's Health Insurance Program (CHIP), and
the Indian Health Service. Public insurance programs paid for
68% of the 1.5 million unplanned births that year, compared with
38% of planned births. Two million births were publicly funded
in 2010; of those, about half were unplanned. Alaska data is
consistent with national trends.
Nationally, a publicly funded birth in 2010 cost an average of
$12,770 in prenatal care, labor and delivery, postpartum care
and 12 months of infant care; when 60 months of care are
included, the cost per birth increases to $20,716. Government
expenditures on the births, abortions, and miscarriages
resulting from unintended pregnancies nationwide totaled $21.0
billion in 2010; that amounts to 51% of the $40.8 billion spent
for all publicly funded pregnancies that year. To put these
figures into perspective, in 2010, the federal and state
governments together spent an average of $336 on unintended
pregnancies for every women aged 15 - 44 in the country.
In Alaska, where health care sometimes costs more than 30%
higher than national averages and Medicaid spending is one of
the primary cost drivers of the state budget, these costs become
even more problematic. Amid an unprecedented state budget
deficit, and the fact that most Alaskan women cherish economic
and professional freedoms, now is the time to allow greater
access to family planning options. SB 156 will help us reach
that goal.
2:16:53 PM
MS. BRUGGEMAN noted that concerns by opponents are being
considered. She concluded that the sponsor believes in the core
concept of the bill and the positive impact that it might make
in the lives of Alaskan families.
2:17:32 PM
CHAIR STEDMAN noted it is the first hearing of the bill.
SENATOR STOLTZE asked who is opposed to the bill.
MS. BRUGGEMAN said Dr. Carolyn Brown was opposed to over-the-
counter contraceptives, which will be removed from the bill.
Also, the National Federation of Independent Business (NFIB)
voiced concern about costs to small business, which will also be
removed from the bill. The sponsor intends to keep the co-pay
requirements the employee is responsible for. NFIB also
discussed a hypothetical situation of an employee starting a
job, working for a month and receiving a 12-month supply of
contraceptives, and then quitting.
2:19:53 PM
SENATOR STOLTZE inquired if the Division of Insurance is opposed
to the mandate.
2:20:37 PM
CHAIR STEDMAN opened public testimony.
2:21:09 PM
LORI WING-HEIER, Director, Division of Insurance, Department of
Commerce, Community and Economic Development (DCCED), testified
on SB 156. She said DCCED has been working with the sponsor on
the bill and several issues have been resolved. The bill is in
process and a new version will be out soon. She talked about the
issue of mandates under the ACA.
SENATOR STOLTZE commented on mandates.
MS. WING-HEIER said the majority of the bill is under the ACA
already. The issues of co-pay and deductible were concerns, have
been considered, and would address the costs borne by the state
as a mandate.
2:23:47 PM
AL TAMAGNI, Leadership Chair, National Federation of Independent
Business (NFIB), testified in opposition to several provisions
in SB 156. He opined that small employers are going to be
affected. The biggest question is why small business is the only
one that has to pay.
2:26:08 PM
DIANA KRISTELLER, Nurse Midwife, testified in support of SB 156.
She believed women should have access to 12 months of birth
control. She pointed out that women are on birth control for
reasons other than birth control. The pharmacy currently fills
three months' supply at a time, which is a burden to women.
There are limits in place for cost overruns regarding
prescriptions. She stressed that unintended pregnancies are
frequent and real occurrences.
2:29:01 PM
AMMIE TREWHLY, representing herself, testified in support of SB
156. She said she is a nurse educator who works with young women
in the School of Nursing at UAA. She stated the bill will reduce
many hurdles for women.
2:30:27 PM
ROBIN SMITH, representing herself, testified in support of SB
156. She spoke as a small business owner who did not agree with
NFIB's concerns because small businesses are covered by ACA. She
shared situations where women find it difficult to get birth
control pills monthly. She referred to the Center for Disease
Control regarding birth control distribution. Dispensing for one
year would decrease the unintended birth rate by 30 percent. It
would also reduce costs. She urged the committee to look at this
as a way to empower people.
2:34:39 PM
CATRIONA REYNOLDS, Clinic Manager, Kachemak Bay Family Planning
Clinic, testified in support of SB 156. She shared information
about the struggles of obtaining birth control in rural areas.
She said many of her clients are on Medicaid and some are on a
sliding scale for which the clinic has been distributing 12
months' worth for some time. She shared a study for the Oregon
Health Authority regarding pill distribution.
2:39:25 PM
KEN LANDFIELD, representing himself, testified in support of SB
156. He said the bill could prevent the need for abortion and
unwanted pregnancies.
2:40:38 PM
JUDY ANDREE, Member, League of Women Voters, testified in
support of SB 156. She said birth control contributes to healthy
families, healthy babies, less unintended pregnancies and saves
costs. The bill would decrease financial dependence helping to
encourage planned pregnancies, and save money. She concluded
that it makes sense for the government to do all it can to
increase family health and financial stability and save money.
2:43:07 PM
MAXINE DOOGAN, Member, Community United for Safety, testified in
support of SB 156. She says her organization deals with current
and former sex workers, sex trafficking victims, and allies. It
works toward seeking protection for all people in the sex trade.
Expanding access to women's health care is in the best interest
to all Alaskans.
2:44:13 PM
SAMANTHA SAVAGE, representing herself, testified in support of
SB 156. She shared a personal story and concluded that
increasing access to contraception is good.
2:45:21 PM
TERRA BURNS, representing herself, testified in support of SB
156. She shared her experience living in rural Alaska and the
difficulty in obtaining birth control.
2:46:33 PM
ROBYN STEVENS, representing herself, testified in support of SB
156. She shared a personal story of difficulty in getting birth
control only every 25 days. She said she will have to take time
off from work in order to get birth control.
2:47:48 PM
ALICIA NORTON, representing herself, testified in support of SB
156. She shared stories about two friends who did not have time
to get birth control and had to drop out of school to have
children.
2:49:02 PM
ALYSON CURREY, Member, Planned Parenthood Votes Northwest,
testified in support of SB 156. She said Planned Parenthood (PP)
has long supported sincere efforts to expand access to birth
control. For 100 years PP has provided birth control and other
high quality health care across the nation. Every woman should
have access to the method of birth control of her choice without
barrier to cost. The bill would build on the gains women have
made over the past 50 years. She pointed out that the bill would
reduce unintended pregnancy by 30 percent and produce a 46
percent drop in the chance of needing an abortion. She concluded
that it is a common sense bill that would lower barriers and
save the state money.
2:50:56 PM
ELIZABTHE FIGUS, representing herself, testified in support of
SB 156. She said in the summer she captains a trawl tender
vessel based out of Sitka and cannot get to a place to pick up
pre-approved birth control. She said so many residents in Alaska
spend significant portions of the year in remote locations. She
concluded that SB 156 is the fiscally responsible choice for
women's healthcare in Alaska.
CHAIR STEDMAN asked if there were any final comments.
MS. BRUGGEMAN thanked the committee.
CHAIR STEDMAN held SB 156 in committee.