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House | June 28, 2016 | Chamber | House Insurance

Full MP3 Audio File

[SOUND]. I'd like to call this meeting of health insurance to order. I'd like to thank our sergeant-at-arms Mr Layton, Ms Cook, Mr Masprin, Mr Cherry and Mr Salzbery. We appreciate your endurance. I'd like to thank our Pages. [INAUDIBLE] Edward Malloy and McKenzie Silver thank you for being here and get back into it. [BLANK_AUDIO]. Ladies and Gentlemen, committee is about to take out house bill 1048, Representative [INAUDIBLE] please present your bill. And for information purposes Officers in the committee. We will be voting on this bill at 1:40. >> Why so early? >> No, Ma'am. Due to our rules we have to be out of this room in 15 minutes before the session begins. So we will be voting at 1:40. [SOUND]. >> Mr Chairman Members, thank you so much for the chance to stand before you today. If I could make just a few remarks and then I'll ask the chair to recognize a member of the public who wishes to comment on this matter. We discussed this bill the last time we met. So I'd like to make a few points different In addition to the points I made before. What does this bill, before you do? Insurance and step therapy programs are based on clinical guidelines that're developed by independent experts. It insures that an exceptions process for step therapy is transparent and An accessible to patients and healthcare providers. It establishes a basic framework for me it's medically appropriate to exempt patients from stem therapy. It establishes the health plans cannot place restrictions such as prior authorization on abuse deterrent [INAUDIBLE] that they also do not place upon non abuse deterrent opiloids and it ensures that if a physician writes a prescription specifically for an abuse deterrent opiloid, that a health plan cannot require the patient to first fail on the non-abuse deterrent opioid. Now let me tell you what this bill does not do. What this bill does not do, is that it does not prevent insurance from using step therapy or even limit the number of steps, it does not require insurers to develop a new exemptions process, it does not prevent insurance from requiring prior authorization before covering a drug. It does not prevent insurers from requiring patients to try a generic drug if it's equivalent to the prescribed brand. This legislation will not make a Not require a health plan to cover every abuse to turn a product that's on the market and it does not require the disposition prescribed in at all. This bill allows health plans to impose all of the traditional cost containment methods that're used everyday such as Co-pay, tears, quantity limits and Higher authorizations. Ladies and gentlemen, this issue is one that affects the people that we serve. And I have asked, I know the other the other bill sponsors wanna speak Miss Chairman but I have asked the Chair if, since we had We had four speakers the last time, if we could at least add one to the committee today and I've made that known to the Chairman in advance. [SOUND]. >> [INAUDIBLE] [BLANK_AUDIO]. [COUGH]. Thank you Mr. Chairman, ladies and gentlemen we did speak about this issue before I just have a few points in follow up. Sunday morning I usually like to get up early and take a long bicycle ride before church and I came home this past Sunday and the paper had been delivered and And I wanna share with you what the [UNKNOWN] article was in our paper and most likely articles just like this have been in all our papers. This is a tragic epidemic that is facing us. We can not stick our heads in the sand about this and tragically enough this article in part is about one of my One of my workers whose worked for me for 20 years her son 18 who died four months ago from an overdose. This is tragic, it is something that is happening in every community, it has no racial boundaries, it has no social economic boundaries has no boundaries otherwise this is happening in every facet of our community and we as our legislators need to address this. Also this weekend [COUGH] I spent a great deal of time because I

am a small business owner, going through different insurance policies because our policies are due on August the 1st and we have historically been with Blue Cross and Blue Shield. Has raised our rates every year for the last I can't tell you how many and so as a small business owner, I understand that cuz I have to kick in that money. That's money that I pay every year, increasing for each of my employees. But as a physician, I will tell you that in all the increases, over the last many years, I'm not so sure That despite healthcare cost going up, that we are seeing better medicine. I will tell you that this bill is better medicine. It is money well spent on the front end of an opiate abuse problem. It's been shown in communities, with this type of legislation is enacted, it saves hundreds hundreds of millions of dollars in medical costs for ED deserts and hospitalizations. So yes, it may increase costs slightly upfront in the flavor of prescriptions that are prescribed fro opioids. It saves a tremendous amount, of not only money but heartache and human loss and suffering in the end. Mr. Pendeleton brought up insurance mandate last time, I have reached out to Blue Cross, Blue Shield and as a physician I am happy to sit down and review whatever has been mandated from him in the past to try and see if we can save money in an area that perhaps is on trail or unnecessary at this time. Again I will just ask you, and I say this as a physician, as a small business owner and as a legislator. This is a good bill, this is money well spent and I would ask for your support, and Mr. Chairman when the time is appropriate, I'd like to be recognized for a motion. >> State your motion. >> It's an approval of the bill as stated in house bill 1048. >> Hold that motion until the appropriate time. At this time we have several people from the public that would like to speak, we're gonna have 1-4, and then one again and then we're going into committee discussion. Miss Lasader. [BLANK_AUDIO] [BLANK_AUDIO] Please state your name for the purpose of the minutes. >> My name is Christine Lasader, very good to see you all, thank you Mr. Chairman and members for allowing me a moment to speak. I am here speaking today because when I first saw this legislation, I realized that it was impacting me right now in my everyday life. I'm a stay-at-home mum, and have recently been through the set therapy process and it negatively impacted myself very severely and my family. I stay at home with my boys. So with that being said, my personal experience since January of this year, my doctor re-prescribed me a medication that I have been taking for over three years. That same month I was told by my insurance carrier, by my pharmacy that I could not take that medicine anymore and I needed to try two out of three other medication before I would be allowed to go back on the one I had been taking. One of the three that I was offered to try, with also set therapy so if I were to choose that one, I'd also have to try two others before I could do that one. So in essence I was kinda led down a maze and I wasn't really sure where to go. So I was trying to be compliant and go along with everything, I tried one of the medicines and it did not work and it was dilapidating, it was scary and it was sad. and I had to have help from my husband and other family members just to get through it. I should also let you know that in January when we went through our re-enrollment process our insurance broker knew every medication that I was on as well as the rest of my family. And also knew all the doctors that we saw and at no time was set therapy ever brought up, at no time was it indicated that this medication I was on I would not be allowed to take. So the same month that I re-enrolled for my health insurance was the same month I was prescribed the medicine I've been taking for over three years which was the same month I was told I could no longer take it. So months, and months, and months go by and I fought back because I had no choice. The only other alternative I had was to keep going the route hole of the stare and I was not going to do that, and my husband really helps me, had family members and other friends help me, I spent countless hours on the phone with my insurance company who was on the phone on conference calls with my pharmacist and with my doctors, and it was hard work, and just about

a month or so ago I got back on track, I'm able to get the original medication that I was prescribed but it hurts me to think that I had to work that hard to advocate for myself, and there are a lot of people out there, that do not have the time or the patience or the ability, or the wherewithal to pull themselves together and spend a week's worth of time on the phone trying to get medicine that they are dully prescribed. So I felt compelled to share my story because I'm living it, I just went through it, and I am just like everybody out here, I've got kids at home that I take care of every single day, and that is my job, that is my responsibility and the medicine that I take helps me do that to the very best of my ability so thank you. >> Thank you. >> Mr. Billy Thompson. >> Thank you Mr. Chairman, members of the committee. [COUGH] Excuse me, standing with me today is Gary Salmeto/g representing the North Carolina Chamber, I'm the state director of the national federation of independent business and you had from the state chamber last week. We stand together on behalf of our business members in our position to house bill 1048 and a survey of our members over and over for several years their leading concern is the rising cost of healthcare, and very few issues come close to that issue. Now it's a critical time for holding down healthcare cost for North Carolina citizens and businesses. The North Carolina General Assembly should not add to that cost by adding even more state mandates. Right now North Carolina as you probably all know have probably one of the most mandates in the nation, right up there with California. There are 57 mandates that are required to be covered. State mandates take away the choice from individuals and small businesses about the kind of insurance they can buy and the kind of insurance they can afford. On behalf of any of these 8,000 members, small businesses and the chamber's 35,000 businesses that employ probably combined over 1.5 million people, we ask that you oppose house bill 1048 because it is an additional cost to mandate that hurts the small businesses of North Carolina. Thank you and we appreciate your opposition to this bill. >> Representative Louis. >> Thank you Mr. Chairman, members, I wanna address some of the issues that were brought up and first of all I wanna say unequivocally that I respect the opinion of the ENFIB and I respect the opinion of the chamber. Part of the reason that the sponsors of this bill have brought it forward I understand that a mandate meaning when you cover something that's not currently being covered, that that drives up the cost of healthcare because you have to provide in, when you quote policies you have to provide for that additional coverage. In my opinion respectfully, what this bill is trying to do is to make sure that a patient gets the medicine that they are prescribed when they are prescribed without having to jump through multiple hoops. I also wanna say that I'm very fortunate in Hornette County to represent a significant number of retired military folks. Fort Brag brought some really good folks to our area and I can't tell you the number of retired soldiers or more often their families that come forward and they say things to me like, we finally got Joe to go to the doctor and of course they are referring to a psychiatrist to get some help, and he was brave enough to go the first time. [LAUGH] But when he went to get his prescription fill, he didn't get quite what the doctor said he needed to get. It didn't work and the courage to go back that second time, or the third time, or the fourth time, si sometimes just a little bit too hard to swallow. Members, if I was in, and I respect you as people of your word, if all of

you have told me the truth about where you stand on this bill, if we were to vote right now, the vote would be 18 to 15, and the bill would pass. However, if I intend to finish this budget and to finish the other matters before the general assembly and hopefully move to a Saturday adjournment time. With that being said, a vote of 18 to 15 and a protracted floor fight that my friend from New Hanover has already promised me, and she's really good at debate, so I take her at her word. After conferring with the other bill sponsors, but with the commitment that I think we brought awareness to this, with the commitment that maybe somebody out there who is listening in on this proceedings and is struggling right now just like Christine was to get the medicine that they need, but maybe quite don't have the contacts to be frank that she had. In fact the last point I'm gonna make before I conclude this remarks and we can get out of this hot room Mr. Chairman is I can't tell you the number of legislators, you folks, that have come up to me and said this happened to me but I talked to and they would call the very good and very responsive insurance company rep, the first thing when you're a legislator you can do that, and you know what? It offers good results pretty fast but there is only 170 of us that have that kind of access, I hope that the work of the select committee during the interim and the deliberations that we've had here can shed some light on this subject, and can help us and encourage the providers to work with us and to address these concerns going forward, but with that Mr. Chairman, I on behalf of the bill sponsors I'm gonna ask that the bill not be considered by this committee today. >> Thank you Representative Louis and as we all know, you don't have to worry about the oxygen mask gulping from this room because the pressure is never gonna going to disappear. This meeting is adjourned. [SOUND]