An update on Utah health care bills this session

The deadline for submitting bill requests without special legislative approval has passed, so as Utah’s Legislature moves into the second half of the 45 day regular session, we are not likely to see many new surprises. So far 52 health related bills have been introduced with 44 requests.

Here are some highlights of those we have been watching:

HB 71 – Health Education Amendments

The bill encourages sexual health education in schools directed toward abstinence, but would allow the inclusion of information about the medical characteristics, effectiveness, limitations, and risks of contraceptive methods or devices.  It would also prohibit the advocacy or encouragement of the use of contraceptive methods or devices.  It has received a favorable recommendation by the House Education Committee and has been placed on the House calendar for a third reading/vote.

HB 73 – Medical Payment Rates Amendments

This has been passed by both chamber and sent on to the Governor for signature. It would require the Department of Health (DOH) to automatically report to the legislature when it applies for, or receives a change in any Medicaid capitation rate. Up until now, the DOH only had to report when it requested a rate change. Because changes in the capitation rates can greatly affect the budget, this amendment will likely give the Legislature greater clarity regarding Medicaid budget demands in the budgeting process.

HB 113 – Hygiene Tax Act

Following a growing national trend, this bill would exempt incontinence, feminine hygiene products and diapers from sales tax in an effort to keep these necessary health related items more affordable. This is the fourth time this bill has been brought before the legislature and it again has stalled after it was voted to be held by the House Revenue and Taxation Committee on Feb. 20.

HB 121 – End of Life Prescriptions

This “death with dignity” bill that would establish a procedure for a terminally ill individual to end his or her life. Though introduced each year since 2015, it has not yet succeeded and it appears again to be still in the House Rules Committee where it has remained since January 28th.

HB 136 – Abortion Amendments

The original version of HB 136 would change Utah’s current law that prohibits abortions after viability, or around 22 weeks, to restrict abortions after 15 weeks gestation with limited exceptions. It has since been amended to loosen the restriction to after 18 weeks. If passed, the bill would likely be held up by court challenges as have been faced recently in other states that have passed restrictions. Rep. Action stated that the Utah Attorney General’s Office estimated the law could cost up to $2 million to defend. The House Judiciary Committee passed the bill back for a floor vote by a close 7-5 margin. Expected heated debate from both parties as it moves forward.

HB 178 – Health Care Charges

Despite its innocuous title, HB 178 is a health care price transparency bill. Introduced by Rep. Brad Daw, the bill creates a commission to study the cost of creating and maintaining a health care price transparency tool that is available to the public and incorporates cost data from providers, health plans, non-profit health care organizations, HMOs, hospitals, and employers that provide self-funded insurance plans. The bill has moved on to the Senate where it is sponsored by Sen. Allen Christensen and has received a favorable recommendation by the Senate Health and Human Services Committee, but was tabled on Feb. 21st to discuss its fiscal impact.

The tool would be required to report price information on common health care procedures, like preventative care or diabetes maintenance, in user-friendly and accurate manner.  Currently the state collects similar data, but it is not required to publish or make it easily searchable for the average person.

HB 370 – Pharmacy Benefit Manager Amendments

There has been criticism of PBMs for driving up drug prices by not passing on rebate and cost differential savings on to patients. This bill would impose a fiduciary duty on PBMs to insurers they are contracted with and would require reporting of rebates and fees to the Department of Insurance. It has been sent to the House Health and Human Services Committee and was passed out of the committee on Feb. 25.

HB 392 – Telemedicine Reimbursement Amendments

This bill would mandate mental health parity in telemedicine services by mandating that telemedicine mental health services be paid at the same Medicaid rate as traditionally provided services. It was introduced on February 21st and is waiting for committee assignment in the House Rules Committee.

HB 399 – Prohibition of Conversion Therapy on Minors

Announced and introduced last week, HB 399 would ban “conversion therapy” on minors in the state in an effort to prevent LGBT youth suicide. Though the bill would protect youth from attempts to change their sexual or gender identity, it does not exclude therapy aimed at reducing pre-marital or extramarital sex or counseling with regard to religious or moral beliefs. If passed Utah would become the 15th state to ban the practice.

SB 11 – Medicaid Dental

This bill was passed by both chambers last week with strong support and forwarded on to the governor. It restores dental coverage for adults 65 and over on Medicaid. The University of Utah Dental School has agreed to pay the state’s portion of the federal Medicaid rate to make the bill fiscally neutral. The state estimates that an additional 10,200 clients age 65 and older will gain coverage under the bill.

 SB 96 – Medicaid Expansion Adjustments

With a highly public debate, this bill will roll back Medicaid the expansion passed in November with Proposition 3.  Passed by both chambers with a greater than 2/3 majority, the bill will take effect immediately and will avoid a citizen referendum.  The amended version that passed will provide for a dialed back “partial” expansion that will move Medicaid eligibility to 100% FPL (versus 138% FPL) while directing the state to apply for a federal waiver that would grant the traditional 90 percent matching funds. Though CMS has represented that this waiver would be approved, nothing like that has been approved before. Just in case, the bill includes a backstop that would allow the state to fall back to the original Prop. 3 plan if CMS denies the federal waiver.