Legislature(2023 - 2024)BARNES 124

03/16/2023 08:00 AM House COMMUNITY & REGIONAL AFFAIRS

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* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
*+ HB 61 LIMITATIONS ON FIREARMS RESTRICTIONS TELECONFERENCED
Heard & Held
-- Testimony <Invitation Only> --
+ HB 17 CONTRACEPTIVES COVERAGE:INSURE;MED ASSIST TELECONFERENCED
Heard & Held
-- Testimony <Invitation Only> --
+= HB 78 AK COMMUNITY HEALTH AIDE APPRECIATION DAY TELECONFERENCED
Moved HB 78 Out of Committee
-- Public Testimony --
+ Bills Previously Heard/Scheduled TELECONFERENCED
**Streamed live on AKL.tv**
        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  stated  that                                                               
currently  there are  28 states  which  require health  insurance                                                               
plans regulated by the state  to cover contraceptive prescription                                                               
drugs and devises,  as laid out in the 2010  Affordable Care Act.                                                               
As recommended  by the Institute  of Medicine and defined  by the                                                               
U.S.  Health Resources  and Services  Administration, she  stated                                                               
that  women's preventative  services  include all  contraceptives                                                               
approved  by  the  Federal  Drug  Administration.    Preventative                                                               
services  also  include  patient  education  and  counseling,  as                                                               
prescribed by  a health care provider.   She stated that  this is                                                               
collectively  referred to  as contraceptive  services, which  are                                                               
required to be covered by health insurance by federal law.                                                                      
                                                                                                                                
REPRESENTATIVE  CARRICK stated  that furthermore,  22 states  and                                                               
the  District  of Columbia  allow  women  to receive  a  12-month                                                               
extended supply  of contraception at  one time.  She  stated that                                                               
the proposed  legislation would put  language into  statute which                                                               
aligns  with the  federal contraceptive  coverage guarantee.   It                                                               
also   allows   up  to   a   12-month   supply  of   prescription                                                               
contraceptives.   She explained  that this  would allow  women in                                                               
rural communities  and those who  work extended shifts  in remote                                                               
locations a continuous supply of  contraception.  She stated that                                                               
studies  show   providing  a  one-year  supply   of  prescription                                                               
contraceptives, compared to a  3-month supply, reduces unintended                                                               
pregnancies by  30 percent and  drops the likelihood  of abortion                                                               
by 46 percent.                                                                                                                  
                                                                                                                                
REPRESENTATIVE  CARRICK  argued  that  the  proposed  legislation                                                               
would  also save  the  state  money, pointing  out  that a  prior                                                               
fiscal  note had  estimated an  annual savings  of $1.35  million                                                               
because  of   the  reduction  in  unplanned   pregnancies.    She                                                               
continued  that currently  obtaining  contraception  can be  time                                                               
consuming;  however, she  maintained that  improved access  would                                                               
mean improved  health for  women and families.   She  stated that                                                               
the proposed legislation would take  away insurance coverage as a                                                               
barrier to  access.  She added  that the bill could  also protect                                                               
women  in  the  presence  of   domestic  violence,  in  terms  of                                                               
contraceptive   cohesion.      She   argued   the   benefits   of                                                               
contraception for  family and societal  health and  urged support                                                               
for 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 advised that women have expressed concerns                                                                
that during a 12-month prescription, birth control may become                                                                   
ineffective, as body chemistry could change.                                                                                    
                                                                                                                                
REPRESENTATIVE  CARRICK  responded  that medical  providers  have                                                               
full control over  what is believed to be  the right prescription                                                               
for  the  individual.    She  expressed  the  opinion  that  most                                                               
providers would  prescribe only a  few months and 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 this.                                                                                        
                                                                                                                                
REPRESENTATIVE  RUFFRIDGE explained  that  oral contraception  is                                                               
never 100 percent  effective, and low dose versions  are rigid in                                                               
how  they  must be  taken.    He  confirmed  there are  very  few                                                               
alterations to  body chemistry  which would  affect contraception                                                               
in general.   He advised that CSHB 17(HSS) could  help cover gaps                                                               
because,  in   the  pharmacy  setting,  some   of  the  emergency                                                               
prescriptions  are for  women who  did not  realize a  refill was                                                               
needed.   This could result in  the possibility of a  skip in the                                                               
low dose medication.                                                                                                            
                                                                                                                                
9:01:21 AM                                                                                                                    
                                                                                                                                
REPRESENTATIVE MCKAY  expressed the understanding  that currently                                                               
if a female  explains an extended absence to the  doctor, and she                                                               
requests a 12-month prescription, the  insurance will not pay for                                                               
it.                                                                                                                             
                                                                                                                                
REPRESENTATIVE  CARRICK  responded  that  this  is  the  gap  the                                                               
proposed legislation would fix.   Women would be allowed extended                                                               
prescriptions,  as  opposed  to shorter  prescriptions,  and  the                                                               
prescriptions would 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                                                               
would bring contraceptives on par with other medications.                                                                       
                                                                                                                                
REPRESENTATIVE CARRICK replied that this is correct.                                                                            
                                                                                                                                
9:04:40 AM                                                                                                                    
                                                                                                                                
LORI WING-HEIER,  Director, Division of Insurance,  Department of                                                               
Commerce,  Community, and  Economic  Development, clarified  that                                                               
insurance would  not "get in the  middle" of a provider,  and the                                                               
provider would  not be  stopped from  having responsibility  to a                                                               
patient.    She expressed  the  understanding  that the  proposed                                                               
legislation   would  allow   that,   once   a  contraceptive   is                                                               
prescribed, the patient would have  the ability to get a 12-month                                                               
supply.  She advised that it  would be a convenience for women to                                                               
get  prescriptions for  longer periods  in  relation to  extended                                                               
absences because  of work, travel,  or other reasons.   She noted                                                               
there have been  no rebuttals from insurance  companies over CSHB
17(HSS).                                                                                                                        
                                                                                                                                
9:07:07 AM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  HIMSCHOOT  commented  that the  bill  is  decades                                                               
overdue, and, for  example, it would help 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 described  CSHB 17(HSS)  as an  insurance                                                               
bill at its  core, as it would not  change contraception coverage                                                               
or the relationship  with the provider; however,  it would change                                                               
what happens at  the pharmacy once a patient  has a prescription.                                                               
She  alluded  to opposition  to  the  bill and  encouraged  these                                                               
people to  speak with her  and her staff  on the purpose  of this                                                               
legislation.                                                                                                                    
                                                                                                                                
9:09:17 AM                                                                                                                    
                                                                                                                                
[CSHB 17(HSS) was held over.]                                                                                                   

Document Name Date/Time Subjects
HB61vA-020923.pdf HCRA 3/16/2023 8:00:00 AM
HB 61
HB61vACRA-020923.pdf HCRA 3/16/2023 8:00:00 AM
HB 61
HB61vALegal-020923.pdf HCRA 3/16/2023 8:00:00 AM
HB 61
HB61vASectional-020923.pdf HCRA 3/16/2023 8:00:00 AM
HB 61
HB61vASponsor-020923.pdf HCRA 3/16/2023 8:00:00 AM
HB 61
HB 17 DOA Fiscal Note.pdf HCRA 3/16/2023 8:00:00 AM
HB 17
HB 17 DOH Fiscal Note.pdf HCRA 3/16/2023 8:00:00 AM
HB 17
HB 17 DCCED Fiscal Note.pdf HCRA 3/16/2023 8:00:00 AM
HB 17
HB 17 FDA Decisional Memorandum 12.23.2022.pdf HCRA 3/16/2023 8:00:00 AM
HB 17
HB 17 Letter of Support 2.23 ANDVSA.pdf HCRA 3/16/2023 8:00:00 AM
HB 17
HB 17 Letter of Support ALPHA Policy Comm 2-10-23.pdf HCRA 3/16/2023 8:00:00 AM
HB 17
HB 17 Research ACOGFactsAreImportantEC.pdf HCRA 3/16/2023 8:00:00 AM
HB 17
HB 17 Research Guttmacher Alaska Statistics 2016.pdf HCRA 3/16/2023 8:00:00 AM
HB 17
HB 17 Research HRSA Women's Preventive Services Guidelines.pdf HCRA 3/16/2023 8:00:00 AM
HB 17
HB 17 Research Insurance Coverage of Contraceptives 4.01.2021.pdf HCRA 3/16/2023 8:00:00 AM
HB 17
HB 17 Research Public Costs From Unintended Pregnancies February 2015.pdf HCRA 3/16/2023 8:00:00 AM
HB 17
HB 17 Research UCSF Study Newspaper Article 2.22.2011.pdf HCRA 3/16/2023 8:00:00 AM
HB 17
HB 17 Research Unintended Pregnancies Study March 2011.pdf HCRA 3/16/2023 8:00:00 AM
HB 17
HB 17 v. A Sectional Analysis.3.01.23.pdf HCRA 3/16/2023 8:00:00 AM
HB 17
HB 17 v. A Sponsor Statement.pdf HCRA 3/16/2023 8:00:00 AM
HB 17
HB0017A.pdf HCRA 3/16/2023 8:00:00 AM
HB 17
HB 17 DOA Fiscal Note Version B 3.9.23.pdf HCRA 3/16/2023 8:00:00 AM
HB 17
HB 17 DOH Fiscal Note Version B 3.9.23.pdf HCRA 3/16/2023 8:00:00 AM
HB 17
HB 61 LAW Fiscal Note 3.10.23.pdf HCRA 3/16/2023 8:00:00 AM
HB 61
HB0017B CS.pdf HCRA 3/16/2023 8:00:00 AM
HB 17
HB 61 Letters of Support as of 0800 3.15.23.pdf HCRA 3/16/2023 8:00:00 AM
HB 61
HB 61 Letters of Opposition as of 0800 3.15.23.pdf HCRA 3/16/2023 8:00:00 AM
HB 61
HB61vASponsor-031323.pdf HCRA 3/16/2023 8:00:00 AM
HB 61
HB61vASectional-031323.pdf HCRA 3/16/2023 8:00:00 AM
HB 61
HB61vA-031323.pdf HCRA 3/16/2023 8:00:00 AM
HB 61
HB61vA-020923- South_Dakota_2021.pdf HCRA 3/16/2023 8:00:00 AM
HB 61
HB61vA-020923- Georgia_2021.pdf HCRA 3/16/2023 8:00:00 AM
HB 61
HB61vA-020923 - West_Virginia_2021.pdf HCRA 3/16/2023 8:00:00 AM
HB 61
HB61vA-020923 - North_Dakota_2021.pdf HCRA 3/16/2023 8:00:00 AM
HB 61
HB 61 EO-03.pdf HCRA 3/16/2023 8:00:00 AM
HB 61
HB61vAPresentation-031323.pdf HCRA 3/16/2023 8:00:00 AM
HB 61
HB 17 Letters of Opposition Redacted as of 0800 3.15.23.pdf HCRA 3/16/2023 8:00:00 AM
HB 17
HB 17 Letters of Support Redacted as of 0800 3.15.23.pdf HCRA 3/16/2023 8:00:00 AM
HB 17
HB 17 v. B Summary of Changes.pdf HCRA 3/16/2023 8:00:00 AM
HB 17
HB 17 Letters of Support Redacted as of 1600 3.15.23.pdf HCRA 3/16/2023 8:00:00 AM
HB 17
HB 61 Letters of Opposition as of 1600 3.15.23.pdf HCRA 3/16/2023 8:00:00 AM
HB 61
HB78 ANHB to Rep. McCormick re HB 78 CHAP Appreciation Day 23.03.20.pdf HCRA 3/16/2023 8:00:00 AM
HB 78