HB 209-INSURANCE COVERAGE FOR TOBACCO CESSATION  3:23:34 PM CHAIR KELLER announced that the next order of business would be HOUSE BILL NO. 209, "An Act requiring a health care insurer to provide coverage for tobacco cessation treatment." JANE ANN BOER, Intern, Representative Bob Herron, Alaska State Legislature, paraphrased the sponsor statement for HB 209: Tobacco dependence is a chronic and lasting condition that negatively affects the health, productivity, and overall well being of Alaskans and their loved ones. Statistics show that tobacco is a leading cause of death in Alaska. Tobacco addiction kills more Alaskans each year than suicide, motor vehicle crashes, chronic liver disease and cirrhosis, homicide, and HIV/AIDS combined. In 2007, tobacco use cost Alaskans $314 million in direct medical expenditures and an additional $177 million in lost productivity due to tobacco-related deaths. This bill gives Alaskans the resources and support they need to end tobacco addiction. It requires insurance companies to provide smoking cessation programs to aid those who wish to be free from tobacco addiction. With the implementation of House Bill 209, insurance companies would provide coverage for a minimum of two courses of treatment during each year. Two courses allow for multiple attempts for those smokers who continue to work towards ending addiction. Coverage provides for not less than four counseling sessions in each course as well as over the counter or proscribed medication approved by the USFDA. While coverage includes both counseling and medication, counseling is not a precondition for medication so that treatment is flexible to personal preferences. Data show that programs where participants may tailor treatment to personal preferences and needs are the most effective. This bill provides the assistance many Alaskans need to end tobacco addiction and live healthy, long, productive lives. The long term effects of House Bill 209 will be cost savings in medical expenditures, increased productivity in the work place, lower long- term insurance costs for insurance providers, and healthier, happier Alaskans. 3:27:15 PM MS. BOER opined that a lack of mandates could increase costs for insurers, as conditions not covered by insurance often go unchecked, and cost more in the long term. She stated that HB 209 was an inexpensive, preventative measure for the extremely expensive long term addiction to tobacco. 3:28:32 PM REPRESENTATIVE HERRON asked if any other states had these programs. MS. BOER replied that, of the five other states with these programs, Oregon had shown the greatest success, with a decrease of 26 percent. 3:29:29 PM CHAIR KELLER asked how much it would cost to quit smoking. MS. BOER replied that the cost could range from $0.66 to $1.20 per year. CHAIR KELLER asked specifically about the treatments and those costs. 3:30:10 PM MS. BOER explained some of the treatments, which included gum, patches, inhalers, nasal sprays, and lozenges. 3:31:05 PM REPRESENTATIVE DICK asked about the rates of success. MS. BOER, in response to Representative Dick, said that she would supply those statistics. She reported that the bill allowed for two courses, which included four counseling sessions, to attempt to quit. 3:31:47 PM CHAIR KELLER asked who would be covered by this bill. He pointed out that legislation had no jurisdiction over the Employee Retirement Income Security Act (ERISA), Medicaid, or Medicare. 3:32:29 PM MS. BOER reported that about 15 percent of state insured and 34 percent of self insured populations were smokers, but she did not know if all the individual plans would be required to comply. She shared that ERISA insurance already included tobacco cessation treatment. She noted that HB 209 provided further details to the programs. 3:33:06 PM REPRESENTATIVE SEATON asked if the bill would include the state insurance and the retiree insurance policies. MS. BOER replied that both plans were included. 3:34:03 PM EMILY NENON, Alaska Government Relations Director, American Cancer Society Cancer Action Network (ACSCAN), stated that ACSCAN supported HB 209, and she directed attention to its letter of support. [Included in members' packets] She shared that each additional piece of support for tobacco cessation increased the chances for success. She pointed out the difficulty to quit smoking, noting that it took an average of seven attempts to quit permanently. 3:35:49 PM CHAIR KELLER asked where in HB 209 coverage was declared by the State of Alaska insurance plan. He asked to clarify that the Legislature had the jurisdiction over all health care plans. 3:36:21 PM MS. BOER, in response, said that she would supply that information. 3:37:09 PM REPRESENTATIVE SEATON, referring to page 2, lines 2-4, asked for the purpose of the provision. MS. BOER replied that this provision guaranteed that everyone could receive the treatment, as pre-authorization could result in some exclusions. REPRESENTATIVE SEATON, referring to page 2, lines 9-11, opined that pre-authorization was for the knowledge of the cost of co- payments and deductibles. He asked for more specific information on the necessity for pre-authorization. 3:39:13 PM REPRESENTATIVE KERTTULA, pointing to page 1, lines 9-11, and to page 2, lines 7-8, asked about the conflicting statements that coverage must include the cost of counseling sessions, but then later in the bill it stated that it was not required. She asked about the program in other states, and if there were any statistics for the success of each approach. MS. BOER replied that the programs varied throughout the other five states, and that in the model legislation used by HB 209, there was the choice for either treatment. [HB 209 was held over.]