Date: 04/19/2006

Final
BILL SUMMARY for HB06-1252

HOUSE COMMITTEE ON HEALTH AND HUMAN SERVICES

Votes: View--> Action Taken:
Adopt L.010 (Attachment A). The motion passed 8-5
Adopt L.014 (Attachment E). The motion failed 5-8
Adopt L.015 (Attachment J). The motion failed 6-7
Adopt L.018 (Attachment K). The motion failed 4-9
Adopt L.020 (Attachment G). The motion failed 2-1
Adopt L.024 (Attachment I). The motion passed 10-
Reconsider L.022 (Attachment F). The motion fail
Refer the bill, as amended, to the Committee on Fi
Substitute motion to adopt L.022 (Attachment F). 		PASS
FAIL
FAIL
FAIL
FAIL
PASS
FAIL
PASS
FAIL



12:04 PM -- House Bill 06-1252

Representative Frangas, sponsor, presented the bill regarding discount prescription drug programs. Strike below amendment L.010 and a related fiscal memo were distributed to members (Attachments A and B). The amendment creates two programs: Colorado Cares Rx Program and Colorado Cares Rx Clearinghouse. Discussion on the bill focused on the provisions of L.010. Representative Frangas discussed L.010, including its enrollee fees. He stated the bill puts people, particularly low-income persons, before profits. Representative Stafford discussed costs of a similar discount prescription drug program in Ohio. She stated start-up costs for that program were $10 million. Representative Frangas stated his bill relies on different implementation mechanisms than Ohio's program. He stated a large portion of the bill's fiscal impact is associated with the Colorado Benefits Management System (CBMS). Representatives Green and Cloer discussed family incomes associated with 250 percent of the federal poverty level (FPL). Committee members discussed program eligibility requirements.

The following persons testified:

12:27 PM -- Rex Wilmouth, Colorado Public Interest Group (CoPIRG), spoke in opposition to the bill and distributed a document to committee members (Attachment C). He stated his support for a bulk purchasing, consumer discount program. Representative Frangas and Mr. Wilmouth discussed the Maine discount drug program.

12:36 PM -- Dennis Roe, Colorado Progressive Coalition, spoke in opposition to the bill. He described the bill is the right concept but lacking teeth to have a real impact. He also stated the bill is riddled with confusing provisions similar to the Medicare Rx program. He encouraged the state to join a multi-state drug purchasing pool to reduced prescription drug costs. Representative Frangas stated his support for importation of low-cost prescription drugs from Canada.

12:43 PM -- Susan Cox and Julie Stoss, Kaiser Permanente, came to the table to testify against the bill together. Ms. Stoss stated the bill will harm the insured, particularly state employees by driving up their drug prices. She stated the bill will also disclose proprietary information on drug price discounts. A solution would be to "de-link" the program's drug prices from industry drug prices. Ms. Cox described Kaiser's involvement in the bill's creation.

12:51 PM -- Mark Kinney, Rx Plus Pharmacies, spoke in opposition to the bill. He stated community pharmacies shouldered the greatest costs associated with the Ohio discount drug program. He discussed net margins for pharmacies compared to pharmaceutical manufacturers. He stated concerns regarding the bill's audit provisions and its voluntary nature. He stated the Medicaid program has a audit process that would be more acceptable than the bill's audit provisions.

01:00 PM -- Val Kalnins, Colorado Pharmacists Society, and Val Gheller, Colorado Professional Employees, came to the table to testify together against the bill but did state support for L.014. Mr. Kalnins read a statement from the Ohio Pharmacists Society. Mr. Gheller stated concerns with drug discounts associated with the bill.

01:04 PM -- Brad Young, Rx Plus Pharmacies, spoke in opposition to the bill.

01:06 PM -- Chris Howes, Colorado Retail Council, spoke in opposition to the bill.

01:08 PM -- David Smith, Great West Life Insurance, spoke in opposition to the bill. He is particularly opposed to the bill's reporting requirements. He stated the bill includes a pharmacy benefits manager (PBM) model not currently used by Great West.

01:16 PM -- A.W. Schnellbacher, AARP, spoke in opposition to the bill and distributed a document to committee members (Attachment D). He described administrative costs he expects the state to incur under the bill, including those for outreach and contract oversight.

01:22 PM -- Steve Adams, AFL-CIO, spoke in support of the bill and discussed the coalition of groups that have come together to support the bill. They include the AFL-CIO and pharmaceutical manufacturers.

01:25 PM -- Catherine Benevidez-Clayton, Hispanic Nurses Association of Colorado, spoke in support of the bill. She stated she knows several patients at her clinic who would benefit from the bill.

01:27 PM -- Mike McCarty, Colorado Cross Disability Coalition, spoke in support of the bill.

01:28 PM -- Chris Hapgood, Mental Health Association of Colorado, spoke in support of the bill. He stated the bill provides the mentally ill access to drugs to help them be productive members of society.

01:31 PM -- Dr. John O'Brien, PhRMA, stated his job is to find meaningful drug discount programs. He stated one difference between Colorado Rx and manufacturers' discount programs is its ability to get discounted drugs at the local pharmacies under the Colorado proposal. He stated the bill does not exclude any prescription drugs; all manufacturers have the option of participating. He described the costs of the Ohio discount drug program. Dr. O'Brien and Representative Cloer discussed income qualifications of drug discount programs.

01:48 PM -- Sheila Hicks, Colorado Cross Disability Coalition, spoke in support of the bill. She stated the bill will be a significant benefit to disabled people, particularly mentally disabled persons.

01:51 PM -- Rob Hernandez, National Alliance on Mental Illness (NAMI), spoke in support of the bill. He discussed problems faced by families of the mentally ill.
01:57 PM -- Jeff Lewis, Heinz Foundation, spoke in support of the bill. He discussed reasons for the bill's dispensing fee.


02:03 PM

The committee recessed and moved to Senate Committee Room 356.


02:16 PM

The committee reconvened in SCR 356.

02:17 PM -- Mr. Lewis discussed drug costs and benefits of drug program audits. He stated the purpose of audits is to give the state information regarding drug discounts. He discussed dispensing fees paid to pharmacies and costs of the Ohio discount drug program. He described problems associated with the Ohio program, including lack of public outreach and public knowledge of the program. He answered questions about why the state should fund a voluntary program. He stated the bill moves the state toward offering a state pharmaceutical assistance program (SPAP). Such a program will help the uninsured access the prescription drugs they need. He discussed drug discounts available through the federal 340B program. Representative Frangas described what he described as the ebb and flow of interest and enrollment in discount drug programs.


02:47 PM

Representative Frangas addressed questions about Colorado Care Rx enrollment criteria.

02:49 PM -- Mark Kinney returned to the table to answer committee member questions. He described dispensing fees paid to pharmacies. He stated the Ohio drug program has not been successful at least partially because of a lack of marketing. He stated pharmacies were not a part of HB 1252's drafting process.


02:58 PM

Representative Frangas made concluding remarks. He stated the bill offers Colorado's uninsured the opportunity to buy drugs that are otherwise unaffordable. He described the bill's beneficiaries as the working poor. He stated his belief that the bill's fiscal impact can be reduced through implementation changes. He addressed a suggestion that the bill's provisions be sunsetted. He stated his support for a 3- to 5-year sunset date.


03:08 PM

Representative Soper moved and committee members discussed L.014 (Attachment E).


03:12 PM

The committee recessed.


03:27 PM

The committee reconvened. Representative Cloer moved L.022 (Attachment F) as a substitute motion to L.014.
BILL:HB06-1252
TIME: 03:33:01 PM
MOVED:Cloer
MOTION:Substitute motion to adopt L.022 (Attachment F). The motion failed 5-8.
SECONDED:Kerr J.
VOTE
Berens
No
Cloer
Yes
Green
No
Kerr A.
Yes
Kerr J.
Yes
Lundberg
No
Riesberg
No
Soper
No
Stafford
No
Sullivan
Yes
Weissmann
No
Frangas
Yes
McGihon
No
Not Final YES: 5 NO: 8 EXC: 0 ABS: 0 FINAL ACTION: FAIL


03:34 PM

Representative McGihon distributed and moved L.020 (Attachment G).
BILL:HB06-1252
TIME: 03:36:49 PM
MOVED:McGihon
MOTION:Adopt L.020 (Attachment G). The motion failed 2-11.
SECONDED:Stafford
VOTE
Berens
No
Cloer
No
Green
No
Kerr A.
No
Kerr J.
No
Lundberg
No
Riesberg
Yes
Soper
No
Stafford
No
Sullivan
No
Weissmann
No
Frangas
No
McGihon
Yes
Not Final YES: 2 NO: 11 EXC: 0 ABS: 0 FINAL ACTION: FAIL


03:43 PM

Representative McGihon distributed and moved L.021 (Attachment H). The motion died for lack of a second.
BILL:HB06-1252
TIME: 03:45:08 PM
MOVED:Weissmann
MOTION:Reconsider L.022 (Attachment F). The motion failed 6-7.
SECONDED:Cloer
VOTE
Berens
No
Cloer
Yes
Green
No
Kerr A.
Yes
Kerr J.
Yes
Lundberg
No
Riesberg
No
Soper
No
Stafford
No
Sullivan
Yes
Weissmann
Yes
Frangas
No
McGihon
Yes
Not Final YES: 6 NO: 7 EXC: 0 ABS: 0 FINAL ACTION: FAIL


BILL:HB06-1252
TIME: 03:46:48 PM
MOVED:Soper
MOTION:Adopt L.014 (Attachment E). The motion failed 5-8.
SECONDED:Stafford
VOTE
Berens
No
Cloer
No
Green
Yes
Kerr A.
No
Kerr J.
No
Lundberg
No
Riesberg
Yes
Soper
Yes
Stafford
Yes
Sullivan
No
Weissmann
No
Frangas
No
McGihon
Yes
Not Final YES: 5 NO: 8 EXC: 0 ABS: 0 FINAL ACTION: FAIL


03:48 PM

Representative Stafford distributed and discussed L.024 (Attachment I). She described the amendment as placing a four-year sunset date on the bill's programs.
BILL:HB06-1252
TIME: 03:51:35 PM
MOVED:Stafford
MOTION:Adopt L.024 (Attachment I). The motion passed 10-3.
SECONDED:Lundberg
VOTE
Berens
No
Cloer
No
Green
Yes
Kerr A.
Yes
Kerr J.
Yes
Lundberg
Yes
Riesberg
Yes
Soper
Yes
Stafford
Yes
Sullivan
No
Weissmann
Yes
Frangas
Yes
McGihon
Yes
Not Final YES: 10 NO: 3 EXC: 0 ABS: 0 FINAL ACTION: PASS


03:52 AM

Representative McGihon distributed and discussed L.015 and L.018 (Attachments J and K).
BILL:HB06-1252
TIME: 04:00:57 PM
MOVED:McGihon
MOTION:Adopt L.015 (Attachment J). The motion failed 6-7.
SECONDED:Stafford
VOTE
Berens
No
Cloer
No
Green
Yes
Kerr A.
Yes
Kerr J.
No
Lundberg
No
Riesberg
Yes
Soper
No
Stafford
Yes
Sullivan
No
Weissmann
Yes
Frangas
No
McGihon
Yes
Not Final YES: 6 NO: 7 EXC: 0 ABS: 0 FINAL ACTION: FAIL

BILL:HB06-1252
TIME: 04:01:39 AM
MOVED:McGihon
MOTION:Adopt L.018 (Attachment K). The motion failed 4-9.
SECONDED:Stafford
VOTE
Berens
No
Cloer
No
Green
Yes
Kerr A.
Yes
Kerr J.
No
Lundberg
No
Riesberg
No
Soper
No
Stafford
No
Sullivan
No
Weissmann
Yes
Frangas
No
McGihon
Yes
Not Final YES: 4 NO: 9 EXC: 0 ABS: 0 FINAL ACTION: FAIL


04:03 PM

Committee member made concluding remarks on the bill.
BILL:HB06-1252
TIME: 04:04:15 PM
MOVED:Frangas
MOTION:Adopt L.010 (Attachment A). The motion passed 8-5.
SECONDED:Green
VOTE
Berens
Yes
Cloer
Yes
Green
Yes
Kerr A.
Yes
Kerr J.
Yes
Lundberg
No
Riesberg
No
Soper
Yes
Stafford
No
Sullivan
No
Weissmann
Yes
Frangas
Yes
McGihon
No
Not Final YES: 8 NO: 5 EXC: 0 ABS: 0 FINAL ACTION: PASS


BILL:HB06-1252
TIME: 04:06:04 PM
MOVED:Frangas
MOTION:Refer the bill, as amended, to the Committee on Finance. The bill passed 10-3.
SECONDED:Cloer
VOTE
Berens
Yes
Cloer
Yes
Green
Yes
Kerr A.
Yes
Kerr J.
Yes
Lundberg
No
Riesberg
Yes
Soper
Yes
Stafford
No
Sullivan
No
Weissmann
Yes
Frangas
Yes
McGihon
Yes
Final YES: 10 NO: 3 EXC: 0 ABS: 0 FINAL ACTION: PASS

04:09 PM

The committee adjourned.