HB 350 - INSURANCE COVERAGE FOR CONTRACEPTIVES Number 2110 CHAIRMAN BUNDE announced the next item on the agenda was HB 350, "An Act requiring that the cost of contraceptives and related health care services be included in health insurance coverage." He asked the sponsor, Representative Eric Croft to present his comments. Number 2116 REPRESENTATIVE ERIC CROFT, Alaska State Legislature, sponsor of HB 350, said he wanted to report back to the committee on a couple of issues that had been raised in the testimony at the last meeting on HB 350. With reference to Mr. Evans' testimony that he was not aware that most health insurance plans routinely covered abortions, Representative Croft said that is the factual situation in the nation. But more specifically relating to Alaska, according to the Division of Insurance, Blue Cross and Aetna do routinely cover abortions and sterilizations. There is no mandate by law, but both companies do it for their own reasons. Both companies publish a list of procedures that are not covered as part of their basic coverage and the lists do not include abortion. He noted that Principal Mutual Insurance Company, Alaska's third largest insurance company, may not routine cover abortions; it was somewhat unclear. Number 2166 REPRESENTATIVE CROFT said there had been some concerns expressed that HB 350 could have a wider application; i.e., that it might cover Medicare supplemental and/or dental. According to Katie Campbell, Division of Insurance and Mike Ford, bill drafter from Legislative Legal Services, the Medicare supplemental and/or dental would not be covered. Number 2192 REPRESENTATIVE CROFT referred to the philosophical discussion at the previous meeting regarding whether the provision of contraceptives causes promiscuity. He said there may be a correlation, but it seemed to him that it works the other way. For example, more promiscuous people might use contraceptives for the very obvious reason they're engaging in that activity, and less people might not, because they don't need to. He hasn't been able to find any evidence and has asked Mr. Heidersdorf for his sources, but as of this meeting, Representative Croft had not received any information from Mr. Heidersdorf. Number 2235 REPRESENTATIVE CROFT was of the opinion the legislation puts a tool in the hands of Alaskans that allows individuals to plan their families. Number 2243 CHAIRMAN BUNDE surmised that if HB 350 passes, insurance companies would offer this option, but people who belong to health plans would not necessarily have to subscribe to that option. REPRESENTATIVE CROFT replied that no one would have to use contraceptives if they didn't want to, but the option is there. CHAIRMAN BUNDE inquired if a person would have to pay for an insurance policy that provided that coverage. REPRESENTATIVE CROFT responded the individual wouldn't have to use contraceptives, but would be paying on an insurance policy that did provide the coverage to other people. Number 2276 CHAIRMAN BUNDE asked if there were further questions of the sponsor. Hearing none, he closed public testimony and asked the pleasure of the committee. Number 2329 REPRESENTATIVE DYSON said, "It seems to me that what we're doing here is not providing the devices, in a sense what we're doing is through the insurance company providing ... TAPE 98-11, SIDE B Number 0001 REPRESENTATIVE DYSON ... devices." He wondered if the argument was that people who have health insurance don't have enough disposable or marginal income to acquire the devices for themselves. It has been his experience that health insurance is so expensive that people who can afford health insurance or have a job that provides it, probably have some discretionary income. As he recalled, contraceptives are not prohibitively expensive. Number 0045 REPRESENTATIVE DYSON said he is not convinced that the reason people are not using birth control is because they don't have enough money because people who are able to afford insurance or have a job that provides it, would likely have the money. He said, "So then it seems to me if that's the case, then what we're doing is providing a mechanism for those who want to use their insurance company to buy it or just kind of providing a little discount for them because they can get someone else to help subsidize the cost of buying the birth control devices." Certainly, this issue can be argued from a safety standpoint in that there's less health risk if a person doesn't become pregnant and certainly with some birth control devices, there are less risks of sexually transmitted diseases. Is it then in an insurance company's or a person's best interest to avail themselves of these safety devices. In lots of cases it is. It appeared to him the insurance industry is in business to make money and if industry data indicated their clients were better off not getting pregnant, insurance companies would be offering incentives. He indicated he would not vote to pass this bill out of committee. Number 0132 CHAIRMAN BUNDE directed the committee's attention to a letter of intent in the packets. Number 0140 REPRESENTATIVE GREEN made a motion to adopt the letter of intent. There being no objection, the letter of intent was adopted. Number 0150 REPRESENTATIVE PORTER said after much personal debate, he had advised the sponsor the previous day that he would not be voting to pass HB 350 from committee. His concern was with the message that's being sent by asking that birth control devices be provided. It has been his experience that most children don't have an ideal home life and are guided by other outside influences, as well as what is legal and illegal, rather than by a set of principles instilled by the parents. REPRESENTATIVE PORTER recalled when marijuana was legal in Alaska for adults in their own home and said it was extremely difficult to conduct any drug prevention programs for children during that period of time, because it was technically legal. The public perception was that marijuana must be alright because it was legal. His concern is that kids will perceive that contraception is alright because it's being provided. This was not the message he wanted to pass on. Number 0268 REPRESENTATIVE BRICE said there were other aspects of society that needed to be looked at. For example, a tremendous amount of money is spent on drug and alcohol abuse and yet alcohol is legal. Tobacco is another example where funds are spent on educating young people, and yet it is still legal. In both cases, insurance companies cover the cost of the associated diseases. He viewed HB 350 as providing a certain amount of safety, not only for teenagers but for young married adults not wishing to start a family immediately, and don't have the disposable income available for contraception. He was of the opinion these types of programs should be covered through an insurance policy. REPRESENTATIVE BRICE said he was not necessarily enamored with the idea of mandating insurance coverage, but he thought that HB 350 had brought forth a very valid debate and he was going to vote to pass HB 350 from committee. Number 0398 REPRESENTATIVE KEMPLEN made a motion to move HB 350 with attached letter of intent and fiscal notes. CHAIRMAN BUNDE asked for a roll call vote. Representatives Brice, Kemplen, Green and Bunde voted in favor of moving the bill. Representatives Dyson and Porter voted against it. Representative Vezey was absent. Therefore, HB 350 moved from the House Health, Education and Social Services Standing Committee on a vote of 4-2.