Legislature(2023 - 2024)BARNES 124
03/16/2023 08:00 AM House COMMUNITY & REGIONAL AFFAIRS
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| Audio | Topic |
|---|---|
| Start | |
| HB61 | |
| HB17 | |
| HB78 | |
| Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
| *+ | HB 61 | TELECONFERENCED | |
| + | HB 17 | TELECONFERENCED | |
| += | HB 78 | TELECONFERENCED | |
| + | TELECONFERENCED | ||
HB 17-CONTRACEPTIVES COVERAGE:INSURE;MED ASSIST
8:46:55 AM
CHAIR MCCORMICK announced that the next order of business would
be HOUSE BILL NO. 17, "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." [Before the committee was CSHB
17 (HSS).]
8:47:12 AM
REPRESENTATIVE ASHLEY CARRICK, Alaska State Legislature, as
prime sponsor, presented CSHB 17 (HSS). She synopsized the bill
as per the sponsor statement, which read as follows [original
punctuation provided]:
Women in Alaska, especially rural Alaskans, face many
obstacles in accessing reproductive health care and
prescription contraceptives for a variety of reasons.
Travel limitations can create barriers regarding
consistent access to reproductive health care.
Additionally, a significant number of women in Alaska
work on fishing boats or on the North Slope, limiting
access to reproductive health care and prescription
contraceptives. Busy work schedules and family life
can also be problematic in traveling to healthcare
facilities or pharmacies necessary for providing these
services.
House Bill 17 mandates coverage by healthcare
insurers, including Medicaid, for prescription
contraceptives and related medical services, allowing
up to a 12-month supply of prescription
contraceptives. This bill is an important step in
preventing unintended pregnancies by eliminating
barriers associated with cost and availability.
Studies show that providing a one-year supply of
prescription contraceptives, including long-acting
reversible contraceptives (LARCs), reduces unintended
pregnancies by 30%. It also increases family planning
options while reducing costs related to unintended
pregnancies such as pregnancy tests, follow-up visits
and other associated long-term costs.
Furthermore, it empowers victims of domestic or
interpersonal violence whose abusers control access to
contraceptives. It reduces the number of abortions
performed. Women also use birth control to alleviate
symptoms from certain medical conditions such as
endometriosis and acne. With greater access and
increased options to reproductive health care, Alaskan
women will have the necessary support to improve
family planning while decreasing health care costs.
REPRESENTATIVE CARRICK also noted there are zero fiscal notes
attached to the bill.
8:51:59 AM
CHERIE BOWMAN, Staff, Representative Ashley Carrick, Alaska
State Legislature, on behalf of Representative Carrick, prime
sponsor, gave the sectional analysis on CSHB 17 (HSS) [included
in the committee packet], which read as follows [original
punctuation provided]:
Section 1
AS 21.42.427. Coverage for contraceptives. Amends AS
21.42 by adding a new section which (1) requires a
health care insurer to provide coverage for
prescription contraceptives and medical services
necessary for those products or devices (including
over-the-counter emergency contraception that was
obtained without a prescription); (2) requires
reimbursement to a health care provider or dispensing
entity for dispensing prescription contraceptives
intended to last for a 12-month period for subsequent
dispensing; (3) prevents an insurer from offsetting
the costs of compliance; (4) prevents an insurer from
restricting or delaying coverage for contraceptives;
(5) if the provider recommends a particular service or
FDA-approved item based on a determination of medical
necessity, the plan or issuer must cover that service
or item without cost sharing; and (6) exempts
religious employers if certain criteria are met.
Section 2
AS 29.10.200. Limitation of home rule powers. Amends
AS 29.10.200 by adding a provision applying to home
rule municipalities.
Section 3
AS 29.20.420. Health insurance policies. Amends AS
29.20 by adding a new section clarifying that
municipal health care insurance plans that are self-
insured are subject to the requirements of sec. 1.
Section 4
AS 39.30.090. Procurement of group insurance.
Clarifies that a group health insurance policy
covering employees of a participating governmental
unit is subject to the requirements of sec. 1.
Section 5
AS 39.30.091. Authorization for self-insurance and
excess loss insurance. Clarifies that a self-insured
group medical plan covering active state employees
provided under this section is subject to the
requirements of sec. 1.
Section 6
AS 47.07.065. Payment for prescribed drugs. Requires
the Department of Health to pay for prescription
contraceptives intended to last for a 12- month period
for subsequent dispensing for eligible recipients of
medical assistance, if prescribed to and requested by
the recipient, as well as medical services necessary
for those products or devices. Distributed by the
Office of Representative Ashley Carrick 1.25.2023 2
The Department of Health must also provide coverage
for over-the-counter emergency contraception that was
obtained without a prescription.
Section 7
Uncodified law - applicability Requires the Department
of Health to immediately amend and submit for federal
approval a state plan for medical assistance coverage
consistent with sec. 6 of this Act.
Section 8
Uncodified law - applicability Makes sec. 6 of the Act
conditional on the approval required under sec. 7 of
the Act.
Section 9
If, under sec. 8 of this Act, sec. 6 of this Act takes
effect, it takes effect on the day after the date the
revisor of statutes receives notice from the
commissioner of health under sec. 8 of this Act.
8:56:17 AM
REPRESENTATIVE MCCABE said women he knows have expressed concern
that if at 12 months, a birth control prescription will not be
as effective, or body chemistry may change to cause the
ineffectiveness.
REPRESENTATIVE CARRICK responded that the medical provider has
full control over what they believe to be the right prescription
for the individual. She stated most providers may prescribe
just a few months prescription then conduct a follow-up.
8:58:04 AM
REPRESENTATIVE MCCABE reiterated the concern that had been
relayed to him and asked Representative Ruffridge, who has a
background in pharmacy, to address it.
REPRESENTATIVE RUFFRIDGE explained that oral contraception is
never 100 percent effective, and low dose versions are rigid in
how you must take them. He confirmed there are very few
alterations to body chemistry that affect contraception in
general. He stated HB 17 can help cover some of the gaps
because in the pharmacy setting some of the more emergent refill
prescriptions are women who didn't realize they needed a refill,
and then possibly skip their low dose medication.
9:01:21 AM
REPRESENTATIVE MCKAY commented his understanding is that
currently, if a female goes to a doctor, explains she will be
gone several months, and asks for a 12-month dose, the issue is
that insurance won't pay for it.
REPRESENTATIVE CARRICK stated that is exactly the gap that would
be fixed through HB 17 - that extended prescriptions, as opposed
to one- to three-month prescriptions, will be covered under
insurance.
9:03:27 AM
REPRESENTATIVE MEARS commented on her own prescriptions and
having them filled before coming to Juneau for the duration of
the legislative session. Her perception of the bill is that it
brings contraceptives on par with other medications.
REPRESENTATIVE CARRICK replied that is correct.
9:04:40 AM
LORI WING-HEIER, Director, Division of Insurance, Department of
Commerce, Community & Economic Development, clarified that
insurance would not "get in the middle" of a provider and the
provider would not be stopped from having their responsibility
to a patient; the proposed legislation is stating that once a
contraceptive is provided, then the patient will have the right
or ability to get a 12-month supply. It is a convenience for
women to get their prescriptions for longer periods of time if
they will be away for extended periods due to work, travel, or
other reasons. She noted there had not been any rebuttal from
insurance companies over HB 17.
9:07:07 AM
REPRESENTATIVE HIMSCHOOT commented that the bill is decades
overdue, and it would help women, including, for example, the
women in Southeast Alaska who go out on extended fishing trips.
9:07:45 AM
REPRESENTATIVE MEARS echoed the sentiments of Representative
Himschoot.
9:08:03 AM
REPRESENTATIVE CARRICK commented that HB 17 is an insurance bill
at its core; it would not change contraception coverage or the
relationship with the provider, it would change what happens at
the pharmacy once a patient has a prescription. She explained
there had been some opposition submitted, and she encouraged
people to visit her office and speak with her and her staff to
communicate with those who may still feel opposition to help
illuminate the purpose of this legislation.
9:09:17 AM
CHAIR MCCORMICK announced that the amendment deadline for HB 17
is March 19 and public testimony will be on March 21.
[HB 17 was held over.]