H-5221.1  _______________________________________________

                          HOUSE BILL 3126

          _______________________________________________

State of Washington      55th Legislature     1998 Regular Session

By Representatives Wolfe, Cody, Romero, Costa, Dickerson, Gardner, Keiser, Conway, Anderson, Butler, Veloria, Kastama, Ballasiotes, Cole, Murray, Fisher, Tokuda, Constantine, Ogden, O'Brien, Radcliff, Mitchell, Hankins, K. Schmidt, Chopp, Morris, H. Sommers, Kessler and Kenney

Read first time 02/17/98.  Referred to Committee on Health Care.

Protecting contraceptive health care benefits.

    AN ACT Relating to contraceptive health care benefits; adding a new section to chapter 48.43 RCW; and creating a new section.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF WASHINGTON:

NEW SECTION. Sec. 1.  The legislature finds that:  (1) Over half of all pregnancies are unintended; (2) by reducing rates of unintended pregnancy, contraceptives help reduce the need for abortion; (3) unintended pregnancies lead to higher rates of infant mortality and maternal morbidity, and threaten the economic viability of families; (4) contraceptive services are part of basic health care, allowing families to both adequately space desired pregnancies and avoid unintended pregnancy; (5) many health carriers cover prescription drugs and devices but exclude prescription contraceptives and contraceptive devices; (6) women of child-bearing age spend significantly more than men on out-of-pocket health care costs, with contraceptives and reproductive health care services accounting for most of the difference; and (7) lack of contraceptive coverage in health plans places many effective forms of contraceptives beyond the financial reach of many women, leading to unintended pregnancies.

    The legislature intends to reduce the number of unintended pregnancies and increase equity in coverage of prescription drugs and devices by increasing coverage of contraception services and supplies in health plans that cover prescriptions and that cover similar outpatient services.

NEW SECTION. Sec. 2.  A new section is added to chapter 48.43 RCW to read as follows:

    (1) A health plan issued to individuals or groups shall not exclude or restrict benefits for:

    (a) Prescription of contraceptive drugs or devices allowed under Title 69 RCW or generic equivalents substitutable under chapter 69.41 RCW, if the health plan covers or provides other outpatient prescription drugs or devices; or

    (b) Outpatient contraceptive services if the plan covers or provides other outpatient services provided by a health care provider.

    (2) A health carrier or health plan shall not penalize an individual or group for using or potentially using the contraceptive benefits or services which must be provided under subsection (1) of this section, shall not penalize or reduce the reimbursement of a provider who prescribes contraceptive drugs or devices, or provides contraceptive services, which must be provided under subsection (1) of this section, and shall not provide incentives to a provider to withhold contraceptive drugs, devices, or services which must be provided under subsection (1) of this section.

    (3) Regarding contraceptive drugs, devices, and services required to be provided under subsection (1) of this section, nothing in this section shall be construed to:

    (a) Prevent a health plan from imposing deductibles, coinsurance, other cost-sharing requirements, or other limitations in relation to providing contraceptive drugs, devices, or services, except that such a deductible, coinsurance, other cost-sharing requirement or other limitation shall not be greater than the deductible, coinsurance, other cost-sharing requirement, or other limitation for any prescription drug, prescription device, or any other health outpatient health care service covered under the health plan; or

    (b) Require a health plan to cover experimental or investigative contraceptive drugs, devices, or services, except that the plan must cover experimental or investigative contraceptive drugs at least to the same extent the plan covers any experimental or investigative outpatient prescription drugs, prescription devices, or outpatient health care services.

    (4) This section applies to health plans issued or renewed on or after the effective date of this act.

NEW SECTION. Sec. 3.  If any provision of this act or its application to any person or circumstance is held invalid, the remainder of the act or the application of the provision to other persons or circumstances is not affected.

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