Hawaii-2011-SR51-Introduced

WHEREAS, the Legislature finds that insurance plans, contracts, and policies in the State of Hawaii are not required to include coverage for tobacco cessation methods; and

WHEREAS, the Legislature finds that there is no requirement that insurers cover comprehensive tobacco-dependence treatment recommended by the United States Public Health Service for beneficiaries in the State of Hawaii; and

WHEREAS, the United States Department of Health and Human Services indicates that counseling and pharmacotherapy increase the chances of successfully quitting smoking, especially when compared to unassisted attempts, and that about 95 percent of people who try to stop smoking without pharmacological aid will relapse or continue to smoke within one year of an attempt to stop using tobacco; and

WHEREAS, more than half of current smokers in Hawaii tried quitting smoking in 2009 and more than 87 percent of adult smokers plan to quit smoking according to the Department of Health; and

WHEREAS, the Campaign for Tobacco-Free Kids indicates that annual health care costs of $336,000,000 in Hawaii are directly caused by smoking of which $117,000,000 is paid for by the State Medicaid program; and

WHEREAS, an actuarial study conducted by Milliman, Inc. found that each employee or dependent who quits smoking reduces annual medical and life insurance costs by at least $210 almost immediately; and

WHEREAS, the State of Massachusetts saw significant health improvements after two years of providing United States Food and Drug Administration-approved pharmacotherapies and counseling to Medicaid beneficiaries, including 33,000 less smokers and a reduction in the number of hospitalizations for heart attack, emergency room visits for asthma, and claims for maternal birth complications; and

WHEREAS, the Legislature also finds that because of the numerous health risks associated with smoking and tobacco use, including lung disease, heart disease, cancers, and other health problems, there is a definite and tangible health benefit that will result from having less tobacco users in Hawaii; and

WHEREAS, it is in the State’s interest to assist tobacco users in addressing their tobacco dependence by ensuring that tobacco cessation and tobacco dependence treatment services are available to as many people as possible, including beneficiaries of health insurance; and

WHEREAS, such a tangible health benefit translates to financial benefits in prevented deaths, surgeries avoided, and other financial savings due to costly health procedures averted by keeping the population in good health; and

WHEREAS, mandated coverage for tobacco cessation would enable the prevention of a myriad of health problems related to tobacco use; and

WHEREAS, mandatory coverage for tobacco cessation should also require individual and group hospital and medical service contracts that provide health care coverage to provide coverage that requires no co-payment for tobacco cessation claims by using methods such as the following:

(1) Telephone, individual and group counseling, and intervention sessions; and

(2) Prescription coverage for all nicotine replacement products and tobacco cessation medications approved by the United States Food and Drug Administration and as recommended by the United States Public Health Service Guideline, Treating Tobacco Use and Dependence;

and

WHEREAS, mandatory coverage for tobacco cessation should not have barriers that impede obtaining service; thus, there should be no requirement for prior authorization, no annual or lifetime limits on cessation attempts or costs, no limits on treatment duration, no requirements that medication and counseling be used together, and no requirements that less costly medications be used before other medications will be covered; and

WHEREAS, health plans in Hawaii should be required to promote the provision of such tobacco cessation benefits to their members; and

WHEREAS, section 23-51, Hawaii Revised Statutes, requires that:

"[b]efore any legislative measure that mandates health insurance coverage for specific health services, specific diseases, or certain providers of health care services as part of individual or group health insurance policies, can be considered, there shall be concurrent resolutions passed requesting the auditor to prepare and submit to the legislature a report that assesses both the social and financial effects of the proposed mandated coverage";

and

WHEREAS, section 23-51, Hawaii Revised Statues, further provides that:

"[t]he concurrent resolution shall designate a specific legislative bill that:

(1) Has been introduced in the legislature; and

(2) Includes, at minimum, information identifying the:

(A) Specific health service, disease, or provider that would be covered;

(B) Extent of the coverage;

(D) Limits on utilization, if any; and

(E) Standards of care.

For purposes of this part, mandated health insurance coverage shall not include mandated optional";

and

WHEREAS, section 23-52, Hawaii Revised Statutes, further specifies the minimum information required for assessing the social and financial impact of the proposed health coverage mandate in the Auditor’s report; and

WHEREAS, H.B. No. 1443 (2011) and S.B. No. 1452 (2011) mandates that health insurers provide coverage for tobacco cessation, effective July 1, 2011; now, therefore,

BE IT RESOLVED by the Senate of the Twenty-sixth Legislature of the State of Hawaii, Regular Session of 2011, that the Auditor is requested to conduct an impact assessment report, pursuant to sections 23-51 and 23-52, Hawaii Revised Statutes, of the social and financial impact of mandating health insurance coverage for tobacco cessation; and

BE IT FURTHER RESOLVED that the Auditor is requested to report findings and recommendations to the Legislature no later than 20 days prior to the convening of the Regular Session of 2012; and

BE IT FURTHER RESOLVED that certified copies of this Resolution be transmitted to the Auditor, the Insurance Commissioner, who, in turn, is requested to transmit copies
to each insurer in the State that issues health insurance policies.

	OFFERED BY:	_____________________________

Report Title:

Tobacco cessation

THE SENATE	S.R. NO.	51
TWENTY-SIXTH LEGISLATURE, 2011
STATE OF HAWAII