STAND. COM. REP. NO. 2112

Honolulu, Hawaii

RE:    S.B. No. 2323

       S.D. 1

Honorable Ronald D. Kouchi

President of the Senate

Twenty-Eighth State Legislature

Regular Session of 2016

State of Hawaii

Sir:

     Your Committee on Commerce, Consumer Protection, and Health, to which was referred S.B. No. 2323 entitled:

"A BILL FOR AN ACT RELATING TO INSURANCE COVERAGE OF HEALTH SCREENINGS,"

begs leave to report as follows:

     The purpose and intent of this measure is to ensure insurance coverage for sexually transmitted disease screenings, including screenings for human immunodeficiency virus and acquired immunodeficiency syndrome, during a female insured's annual gynecological examination.

     Your Committee received testimony in support of this measure from the Department of Health; The American Congress of Obstetricians and Gynecologists, Hawaii Section; Hawaii Medical Association; Hawaii Medical Service Association; Hawaii State Coalition Against Domestic Violence; Healthy Mothers, Healthy Babies; and one individual.  Your Committee received comments on this measure from the Department of Commerce and Consumer Affairs, Hawaii Employer-Union Health Benefits Trust Fund Board of Directors, and American Council of Life Insurers.

     Your Committee finds that despite clear national recommendations for sexually transmitted disease testing, rates of testing in young women are troublingly low.  This is of particular concern in Hawaii, which has the fifteenth highest rate of chlamydial infection in the country, with significant disparities across age and racial and ethnic groups in disease prevalence.  Unrecognized and untreated sexually transmitted infections can result in pelvic inflammatory disease, ectopic pregnancy, infertility, and chronic pelvic pain.  Your Committee further finds that research has shown that preventive health services can save lives and improve health by identifying illnesses earlier, managing illnesses more effectively, and treating illnesses before they develop into more complicated, debilitating conditions.  Furthermore, under the federal Patient Protection and Affordable Care Act, private health plans are required to cover recommended preventive health services without any patient cost sharing.

     Your Committee additionally finds that this measure proposes to ensure insurance coverage for sexually transmitted disease screenings, including screenings for human immunodeficiency virus and acquired immunodeficiency syndrome, during a female insured's annual gynecologic examination.  However, according to testimony received by your Committee, sexually transmitted disease testing may be medically indicated more often than annually and is often indicated outside of an annual gynecologic examination.

     Finally, your Committee notes that after further discussion with the Insurance Division of the Department of Commerce and Consumer Affairs, it appears that the insurance coverage proposed by this measure would not trigger a new mandate for health insurance coverage for grandfathered and transitional health care plans.

     Your Committee has amended this measure by:

     (1)  Clarifying that the insurance coverage proposed by this measure shall cover sexually transmitted disease testing in accordance with national professional guidelines, such as those of the United States Preventive Services Task Force and the federal Centers for Disease Control and Prevention;

     (2)  Clarifying that the insurance coverage proposed by this measure shall not apply to limited benefit health insurance coverage as described in section 431:10A-102.5, Hawaii Revised Statutes; and

     (3)  Making technical, nonsubstantive amendments for the purposes of clarity and consistency.

     As affirmed by the record of votes of the members of your Committee on Commerce, Consumer Protection, and Health that is attached to this report, your Committee is in accord with the intent and purpose of S.B. No. 2323, as amended herein, and recommends that it pass Second Reading in the form attached hereto as S.B. No. 2323, S.D. 1, and be referred to your Committee on Ways and Means.

Respectfully submitted on behalf of the members of the Committee on Commerce, Consumer Protection, and Health,

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ROSALYN H. BAKER, Chair