Legislature(2005 - 2006)BELTZ 211

03/09/2006 01:30 PM Senate LABOR & COMMERCE

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01:32:55 PM Start
01:38:29 PM HB274
01:50:33 PM SB307
02:05:07 PM HB393
02:27:02 PM Confirmation Hearings:
02:28:45 PM Adjourn
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
Heard & Held
Heard & Held
+ Confirmation Hearing: TELECONFERENCED
Alcohol Beverage Control Board -
Billy G. Andrews and Gail M. Niemi
State Board of Registration for
Architects, Engineers & Land Surveyors -
Charles A. Leet
Board of Veterinary Examiners -
Steve Torrence
+ Bills Previously Heard/Scheduled TELECONFERENCED
Including But Not Limited to:
Moved CSSSHB 274(FIN) Out of Committee
    CSHB 393(HES)-INSURANCE FOR COLORECTAL CANCER SCREENING                                                                 
CHAIR   CON  BUNDE   announced  CSHB   393(HES)  to   be  up   for                                                              
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                                                              
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                                                              
2:18:02 PM                                                                                                                    
SENATOR  SEEKINS  asked him  to  explain the  virtual  colonoscopy                                                              
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                                                              
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                                                              
CHAIR BUNDE said he would set this aside for a future date.                                                                     

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