HB 285-MAMMOGRAMS: INSURANCE COVERAGE  3:06:22 PM CHAIR PRAX announced that the first order of business would be HOUSE BILL NO. 285, "An Act relating to insurance; relating to mammograms; and providing for an effective date." 3:06:43 PM REPRESENTATIVE ZACK FIELDS, Alaska State Legislature, as prime sponsor, introduced HB 285. He noted that the bill came as a suggestion from Susan G. Komen, the organization that did the research on the bill. He stressed that of the different types of mammograms, many Alaskan women cannot afford diagnostic imaging exams. He said that the Affordable Care Act (ACA) does not cover diagnostic screenings; therefore, high risk women who are not wealthy struggle to pay for these mammograms. He said that when cancer is detected early, it is less expensive to treat; the bill would require an up-front cost which pales in comparison to the cost of delaying detection. He went through the number of detections in Alaska as well as the rest of the U.S. He further related impacts in detection in regard to a woman's race. He drew attention to a slide [hard copy included in the committee packet], which went over cost comparisons. He noted many states have enacted this type of legislation and he welcomed questions from committee members. 3:12:05 PM COURTNEY OWENS, Staff, Representative Zack Fields, Alaska State Legislature, on behalf of Representative Fields, prime sponsor, gave the sectional analysis for HB 285 [included in the committee packet], which read as follows [original punctuation provided]: Section 1: Amends AS 21.42.375(e) to define "diagnostic breast examination" and "supplemental breast examination" and offers guidelines for the basis of additional testing. Section 2: Adds a new subsection to AS 21.42.375 guaranteeing that mammography screening, diagnostic breast examinations, and supplemental breast examinations are covered by applicable insurance plans, with the exception of high deductible health plans that are eligible for a health savings account tax deduction. Section 3: Amends the law of the State of Alaska by applying Sec. 1 and Sec. 2 to an insurance policy or contract on or after the effective date of the law. Section 4: Amends the law of the State of Alaska to allow the Division of Insurance to adopt regulations necessary to implement this act under AS 44.62. Section 5: Section 4 take effect immediately under AS 01.10.070(c). Section 6: This Act takes effect January 1, 2025. 3:13:08 PM REPRESENTATIVE MINA asked what the average cost share of diagnostic imaging was. REPRESENTATIVE FIELDS answered that he heard in public testimony there was a range of rates including hundreds of dollars, but he did not know if that was the average. 3:13:54 PM REPRESENTATIVE PRAX offered his belief that diagnostic screening followed the regular screening. REPRESENTATIVE FIELDS confirmed that was correct. For the high- risk group, which he noted in Alaska is 12,000 people, it was recommended by doctors that they have the diagnostic screening. REPRESENTATIVE PRAX questioned whether the diagnostic screening would need pre-authorization and why the insurance company wouldn't pay it. REPRESENTATIVE FIELDS answered that the issue is that ACA required no cost share for a standard mammogram, but the diagnostic would need a co-pay. He went over scenarios where people may not be able to pay the costs. 3:16:08 PM REPRESENTATIVE RUFFRIDGE asked for clarity whether high deductible plans would be exempt under the proposed legislation. REPRESENTATIVE FIELDS explained the differences between deductibles and delays in care. REPRESENTATIVE RUFFRIDGE sought confirmation that the bill would cover people covered under private insurance and would not affect Medicaid or Medicare. Further, he inquired whether a person with a high deductible plan would not be mandated to cost-share under the bill. REPRESENTATIVE FIELDS responded that's correct. 3:17:47 PM REPRESENTATIVE PRAX welcomed invited testifiers. 3:17:59 PM REBECCA BIRCH, Director, State Policy & Advocacy, Susan G. Komen, said she strongly supported HB 285 and shared a story about a patient who was "barely making ends meet" who had to take out a loan to take the diagnostic test and the costs that ensued because of late detection. She commented about a study on cost averages and said high deductible plans are eliminated with the health savings accounts. 3:21:29 PM REPRESENTATIVE PRAX opened public testimony on HB 285. 3:22:11 PM BEVERLY WOOLEY, representing self, testified in support of HB 285. She described her history with breast cancer and how her ultrasound finally found a tumor. She said she was an example of how the cost savings can be realized through early detection, and the bill would provide an increase to much needed access. She noted because of delayed diagnosis, 20 years out she was still paying for follow-up care. She opined that HB 285 would save lives and encouraged the committee to pass it without delay. 3:25:13 PM LISA PEABODY, FORCE - Facing Our Risk of Cancer Empowered, Inc., said she represented a high-risk community and testified in support of HB 285. She further discussed high risk individuals with a predisposition that the average person does not have. This high-risk community, according to national guidelines, needed their mammograms to start at age 25. In addition to mammograms, this group may also need a breast ultrasound or MRI every year, even when it costs hundreds of dollars, and she opined that the proposed bill would close the gap for the high- risk individuals. 3:27:57 PM KELLEY MARRE, representing self, testified in support of HB 285 and shared that she was an oncology social worker. She offered statistics on annual diagnoses and noted that men also get breast cancer. She discussed costs and delays in diagnosis due to the lack of affordability. She stressed that no one should have to choose between basic needs or health care and asked the committee to pass HB 285 so individuals would not be charged for high-risk screening and diagnostic imaging. 3:29:53 PM EMILY NENON, Alaska Government Relations Director, American Cancer Society Cancer Action Network, testified in support of HB 285 and gave a history of coverage for cancer screenings. She spoke to state-regulated plans and how they set the precedence for what other plans do and opined that the bill would be about setting precedence for every plan offered in the state. She shared a story of a woman who needed follow up treatment, who had to set aside money each month for over a year to be able to afford the treatment, and she said the bill would help people like her. She offered to address deductibles and [health] savings accounts, the latter which are specific kinds of accounts that have federal law issues. She said she looked forward to progressing and that she was available for questions. 3:33:43 PM REPRESENTATIVE PRAX, after ascertaining that no one else wished to testify, closed public testimony on HB 285. 3:34:29 PM REPRESENTATIVE RUFFRIDGE moved to report HB 285 out of committee with individual recommendations and the accompanying fiscal notes. There being no objection, HB 285 was reported out of the House Health and Social Services Standing Committee.