Legislature(2005 - 2006)BELTZ 211
03/09/2006 01:30 PM Senate LABOR & COMMERCE
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CSHB 393(HES)-INSURANCE FOR COLORECTAL CANCER SCREENING CHAIR CON BUNDE announced CSHB 393(HES) to be up for consideration. SENATOR JOHNNY ELLIS said he had concerns with the fiscal note. CHAIR BUNDE responded that is one of the reasons he is going to hold the bill for further explanation. CRYSTAL NOVOTNY, staff to Representative Tom Anderson, sponsor, read the sponsor statement to HB 393. Current Alaska state law requires that health insurance policies cover screenings for breast, cervical and prostate cancer. Colon cancer is the only cancer with a recommended screening test available that is not on this list. Colorectal cancer is the second-leading cause of death in Alaska and across the nation. An estimated 57,000 Americans died from colon cancer in 2005. Alaska Natives have the highest rate of colorectal cancer in the nation. Cancers that are caught through colorectal screening have a 90 percent five-year survival rate. The five-year survival rate is only 10 percent if the cancer is not caught until symptoms appear. A colonoscopy is over 90 percent effective at detecting colon cancer and can remove precancerous colon polyps, which prevents cancer from ever developing. Screening is cost effective. National studies confirm the cost of these screenings spread across the insured population is minimal and covering screenings also has the potential for long- term savings by avoiding treatment costs. Colonoscopies are required only once every 10 years starting at the age of 50. Medicare picks up coverage for the full range of screenings including colonoscopies when a person becomes Medicare-eligible. This underscores the cost effectiveness covering for what most people will be only two colonoscopies between the ages of 50 and 65. The Institute of Medicine reports that the death rate from colon cancer could drop by up to 80 percent if a majority of Americans were regularly screened. Eighteen other states including Texas, Missouri and Nevada have already adopted similar legislation requiring screening coverage. 2:05:07 PM MARIE DARLIN, Capitol City Task Force, AARP, supported HB 393 saying it would save lives and health care costs. 2:05:55 PM EMILY NENON, American Cancer Society, supported HB 393. She related that this legislation would not get everyone in the state covered, but it is a significant piece as the state regulates about 25 percent of all insurance policies. The American Cancer Society is working on the other pieces as well and has gotten 70 percent of all the federal employee health benefit plans and Medicare to include this coverage. 2:07:19 PM MS. NENON discussed the cost of colon cancer screening and how it reduces costs by actually preventing cancer. Treatment for colon cancer costs $250,000 per year just for the drug, so colonoscopies save money as well as lives. 2:10:53 PM CHAIR BUNDE asked the cost of an uninsured colonoscopy. MS. NENON replied about $2,500 in Anchorage. SENATOR ELLIS asked if she had seen the fiscal notes for HB 393. MS. NENON replied that she was concerned with the assumptions that were made. When you look at the cost of adding the benefit, you also have to look at the treatment savings, for instance. 2:12:24 PM MIKE FORD, Alaska Native Health Board, supported HB 393. Alaska Natives have the highest rate of colon cancer from other racial groups. "So, whenever we can chip away at the problem, we would like to do so." He also commented that he wasn't certain the fiscal note reflected the true fiscal effect of the bill. The current active state employee plan covers colon screening, but it is different for retirees. 2:13:29 PM RICK URION, cancer survivor, said he is still undergoing treatment. He is in the group of people who have a high rate of survival because he had an early detection colonoscopy. The screening that detected the cancer was within one year of the previous colonoscopy. 2:14:47 PM DR. FRANK SACCO, General Surgeon, Alaska Native Medical Center, voiced support for HB 393. He remarked how colon cancer has tremendous emotional and economic costs affects on a person who develops it. He emphasized that this cancer can be decreased and cured, unlike a lot of other cancers. It's frustrating for him to see folks die needlessly. 2:16:35 PM SENATOR SEEKINS asked what kind of screening Alaska Native Medical Center provides for people. DR. SACCO replied it provides two things - flexible sigmoidoscopies for people of average risk and colonoscopies for high-risk folks. Its screening rates are below the national average. 2:18:02 PM SENATOR SEEKINS asked him to explain the virtual colonoscopy program. DR. SACCO replied that it may be a way to get more folks screened, but unfortunately it still requires a full bowel preparation for the patient who would still get a tube inserted that gets inflated with air. About 30 to 40 percent of the patients will have something that warrants a colonoscopy. It's not recommended for general screening. 2:19:22 PM CHAIR BUNDE asked if this bill would impact his clients. DR. SACCO replied that it would help. About 40 percent of his patients have other some sort of coverage or private insurance. He noted that over half his hospital's budget comes from what it collects, not from the federal government. Collecting more means it can provide more services. CHAIR BUNDE asked why colon cancer is more prevalent in native cultures. DR. SACCO speculated diet, genetic and lifestyle issues. The gene is more prevalent in Natives and their traditional diets are low in fiber. Screening is the only proven way to detect cancer and remove polyps that would prevent it from developing. 2:22:40 PM CARE TUKS, Wasilla, related that she has survived 10 separate bouts with cancer. She testified that screening and early detection works. If it's detected early, thousands of lives could be saved as well as thousands of dollars in prolonged treatment. CHAIR BUNDE said he would set this aside for a future date.