House Committee on State, Veterans, & Military Affairs (04/30/2009)

Final
STAFF SUMMARY OF MEETING

HOUSE COMMITTEE ON STATE, VETERANS, & MILITARY AFFAIRS

Date:	04/30/2009	ATTENDANCE

Time:	11:49 AM to 02:37 PM	Casso	*
		Court	X
Place:	HCR 0112	Hullinghorst	X
		Lambert	X
This Meeting was called to order by		Massey	X
	Representative Todd	McCann	*
		Miklosi	*
This Report was prepared by		Murray	X
	Bo Pogue	Nikkel	X
		Labuda	X
		Todd	X
		X = Present, E = Excused, A = Absent, * = Present after roll call

Bills Addressed:		Action Taken:
SB09-250 HCR09-1005 HCR09-1004 SB09-283		Amended, Referred to Appropriations Postponed Indefinitely Witness Testimony and/or Committee Discussion Only Amended, Referred to the Committee of the Whole

11:49 AM

The committee was called to order. A quorum was present.

11:50 AM -- Senate Bill 09-250

Representative Primavera, prime sponsor, presented Senate Bill 09-250, concerning health benefit plan coverage for oral anti-cancer medication. Representative Primavera explained the effect of the bill, and discussed the need for the legislation. Representative Primavera also discussed the effect of similar legislation adopted in Oregon. Committee members received a table detailing the effect of the Oregon legislation on health insurance policies (Attachment A) and a rate filing summary for Oregon (Attachment B).

11:53 AM

The following persons testified regarding Senate Bill 09-250:

11:53 AM -- Dr. Nicholas DiBella, representing the Rocky Mountain Cancer Centers, testified in favor of the bill. Dr. DiBella discussed circumstances in which oral anti-cancer drugs are more effective treatments than other regimens, and explained that oncologists do not prescribe oral medications for personal financial gain. Dr. DiBella responded to questions regarding the number of drugs prescribed for oral cancer treatment, and the need for the bill. Mr. DiBella responded to further questions regarding coverage of the drug treatments by insurers at present, and the efficacy of the drugs in comparison to intravenous cancer drugs. Discussion ensued regarding the role of the state in mandating coverage of oral cancer drugs, and the ability to secure coverage for the drugs without legislation.

12:01 PM -- Dr. Lynn Parry, representing the Colorado Prescription Coalition, testified in opposition to Senate Bill 09-250. Committee members received a fact sheet detailing the coalition's objections to the bill (Attachment C). Dr. Parry discussed the impact of drawing money away from insurance coverage resources, and alternatives for ensuring cancer patients receive proper treatments.

12:04 PM -- Mr. Travis Berry, representing the Colorado Competitive Council, testified in opposition to the bill. Mr. Berry discussed the impact of making health care coverage more expensive, and the ability to treat cancer with forms of treatment other than oral medications. Mr. Berry also discussed the need to keep health care decisions at the doctor/patient level, and costs associated with drug development.

12:10 PM -- Mr. Ben Price, representing the Colorado Association of Health Plans, testified in opposition to Senate Bill 09-250. Committee members received an article from the Wall Street Journal concerning rising drug and hospital treatment prices (Attachment D). Mr. Price discussed the cost of administering oral anti-cancer medicines, and the impact of requiring coverage of the oral medicines on their use in preference to other treatments. Mr. Price also discussed the issue of patient noncompliance with dosage administration when using oral anti-cancer medications, and the benefits accruing to pharmaceutical companies under the bill. Mr. Price then discussed rising drug costs, as identified in Attachment D. Mr. Price responded to questions regarding doctors' preference for oral anti-cancer medicines over intravenous treatments.

12:20 PM -- Ms. Susan Cox and Mr. Jared Freml, representing Kaiser Permanente, testified in opposition to the bill. Committee members received a price sheet for cancer drugs offered by Kaiser (Attachment E), an expert opinion by Dr. Uwe Christians pertaining to Senate Bill 09-250 (Attachment F), and a letter to Ms. Cox pertaining to the side effects of oral anti-cancer medications (Attachment G). Ms. Cox discussed Kaiser Permanente's scope of work, and the impact of the bill on health care costs. Ms. Cox also compared costs for oral cancer treatments to other forms of treatment, and other costs associated with cancer treatment.

12:30 PM

Ms. Cox discussed the information contained in Dr. Christians' expert opinion found in Attachment F. Ms. Cox then discussed the drivers of increased health care costs, and the issue of patient dosage noncompliance when using oral medications. Ms. Cox also discussed the impact of similar legislation in Oregon. Mr. Freml discussed the effects to the patient of taking oral anti-cancer medications. Mr. Freml responded to questions regarding the inability to treat certain types of cancer with medicines other than the oral treatments. Discussion ensued regarding Kaiser's opposition to Senate Bill 09-250 in light of the fact that it already covers oral anti-cancer treatments.

12:41 PM -- Dr. Stephen Leong, representing himself and his patients as a doctor with the University of Colorado Cancer Center, testified in favor of the bill. Dr. Leong discussed the preference for oral anti-cancer medicines for certain types of cancers due to efficacy, and other reasons for preferring oral anti-cancer medicines. Dr. Leong also discussed the costs associated with oral anti-cancer medicines as compared to other treatments, and patient preference for oral treatments. Dr. Leong responded to questions regarding his experience with patients suffering side effects from the oral anti-cancer treatments, and use of the oral anti-cancer treatments by patients living in rural areas.

12:53 PM

Dr. Leong responded to questions regarding the chemotherapy cycle, how patients who aren't covered for oral treatments might acquire the medicine, and the effectiveness of the oral treatments.

12:55 PM -- Dr. Mercedes Dombi, representing Exempla St. Joseph Hospital, testified in favor of Senate Bill 09-250. Dr. Dombi discussed avenues for patients to acquire noncovered oral anti-cancer medications, and explained the efficacy of various types of anti-cancer treatments.

01:03 PM -- Ms. Stephanie Shulman, representing the Rocky Mountain Cancer Centers Foundation, testified in favor of the bill. Ms. Shulman discussed the conveniences afforded by oral anti-cancer treatments, and the cost impacts on patients deciding to further their cancer treatments.

01:05 PM -- Ms. Dana Dzwonkowski, representing the American Cancer Society, testified in favor of Senate Bill 09-250. Ms. Dzwonkowski discussed the impact of oral anti-cancer medicines on patient quality of life.

01:07 PM -- Ms. Cathy Clayton, representing the National Association of Hispanic Nurses and the Colorado Coalition of Black Nurses, testified in favor of the bill. Ms. Clayton discussed the need to move beyond the issue of cost, and objected to the idea that cancer patients are basing treatment decisions on advertising.

01:10 PM -- Representative Kagan, representing one of his constituents, testified in favor of Senate Bill 09-250. Based on his constituent's experience as a cancer patient, Representative Kagan discussed costs associated with cancer treatment and the limiting aspect of cancer treatment costs on patient choice.

01:14 PM

Discussion ensued regarding the effect of prepared amendment L.011 (Attachment H). Ms. Kristen Forrestal, representing the Office of Legislative Legal Services, provided input on the amendment's effect. Ms. Forrestal responded to questions regarding consideration required of doctors under the amendment as to differing types of cancer treatments. Representative Primavera responded to questions regarding the impact of the amendment on the overall purpose of Senate Bill 09-250. Discussion ensued regarding the effect of the amendment on insurance costs.


BILL:	SB09-250
TIME:	01:14:55 PM
MOVED:	Todd
MOTION:	Moved prepared amendment L.011 (Attachment H). The motion passed on an 11-0 roll call vote.
SECONDED:	McCann
		VOTE
	Casso	Yes
	Court	Yes
	Hullinghorst	Yes
	Lambert	Yes
	Massey	Yes
	McCann	Yes
	Miklosi	Yes
	Murray	Yes
	Nikkel	Yes
	Labuda	Yes
	Todd	Yes

Not Final YES: 11 NO: 0 EXC: 0 ABS: 0 FINAL ACTION: PASS

01:24 PM

Representative Primavera provided closing remarks in favor of Senate Bill 09-250.


BILL:	SB09-250
TIME:	01:26:14 PM
MOVED:	Todd
MOTION:	Moved to refer Senate Bill 09-250, as amended, to the Committee on Appropriations with a favorable recommendation. The motion passed on an 8-3 roll call vote.
SECONDED:	Miklosi
		VOTE
	Casso	Yes
	Court	Yes
	Hullinghorst	Yes
	Lambert	No
	Massey	Yes
	McCann	Yes
	Miklosi	Yes
	Murray	Yes
	Nikkel	No
	Labuda	No
	Todd	Yes

Final YES: 8 NO: 3 EXC: 0 ABS: 0 FINAL ACTION: PASS

01:26 PM -- House Concurrent Resolution 09-1005

Representative May, prime sponsor, presented House Concurrent Resolution 09-1005, concerning the creation of an independent redistricting commission. The committee began hearing testimony on the resolution at its April 28th meeting. Committee members received a letter in support of the resolution from Ms. Elena Nunez of Common Cause (Attachment I).

01:27 PM

The following persons testified regarding House Concurrent Resolution 09-1005:

01:27 PM -- Senator Ken Gordon, former Senate Majority Leader representing himself, testified in favor of the resolution. Senator Gordon provided background on the most recent redistricting efforts based on the 2000 census, and how these efforts led him to support the idea of creating a bipartisan commission for redistricting. Senator Gordon discussed the value of competitive elections. Discussion ensued regarding the removal of politics and partisanship from redistricting. Discussion followed regarding the lack of dialogue on the issues covered by the resolution based on the timing of the resolution's introduction.

01:38 PM

Discussion continued regarding the timing of the introduction of House Concurrent Resolution 09-1005, and the chances of the resolution passing through the process during the current legislative session.

01:42 PM -- Ms. Christine Watson, representing the League of Women Voters, testified in favor of the resolution. Ms. Watson discussed past redistricting efforts in Colorado, and the benefits of reducing the size of the Reapportionment Commission. Ms. Watson also discussed a provision in the resolution that reduce the population deviation for districts, and the criteria that can be considered when redistricting is undertaken. Discussion ensued regarding the timing of the introduction of House Concurrent Resolution 09-1005, and the importance of having the legislature refer the measure to the ballot as opposed to having the measure end up on the ballot through initiative. Discussion ensued regarding the ability to amend referenda once approved.

01:54 PM -- Mr. John Straayer, representing himself, testified in favor of House Concurrent Resolution 09-1005. Mr. Straayer discussed how creating an independent redistricting commission would benefit both major political parties, and the benefits of removing politics from the redistricting process. Mr. Straayer supported the configuration of the new independent redistricting commission under the resolution.

01:58 PM

Representative May discussed the positions of other parties with regard to House Concurrent Resolution 09-1005, and the impact of partisanship on redistricting under current law. Representative May also discussed past irregularities and strategies in Colorado redistricting efforts, resulting in judicial action.

02:08 PM

Representative May continued to discuss the most recent redistricting effort in Colorado, and the potential for partisanship to weigh heavily on Colorado's next round of redistricting. Representative May also discussed the potential for the resolution to end up on the ballot by initiative. Representative May responded to questions regarding previous efforts to create an independent redistricting commission, and the process that would be observed if nominations to the commission created by the resolution are deadlocked. Discussion ensued regarding the timing of the resolution's introduction, and the need for a more thorough debate on the measure.


BILL:	HCR 09-1005
TIME:	02:18:26 PM
MOVED:	Massey
MOTION:	Moved to refer House Concurrent Resolution 09-1005 to the Committee on Appropriations. A substitute motion to Postpone Indefinitely the resolution passed.
SECONDED:	Nikkel
		VOTE
	Casso
	Court
	Hullinghorst
	Lambert
	Massey
	McCann
	Miklosi
	Murray
	Nikkel
	Labuda
	Todd

Not Final YES: 0 NO: 0 EXC: 0 ABS: 0 FINAL ACTION: TIE


BILL:	HCR 09-1005
TIME:	02:18:41 PM
MOVED:	Casso
MOTION:	Moved to lay over House Concurrent Resolution 09-1005 until May 7th, effectively Postponing Indefinitely the bill. The motion passed on a 6-5 roll call vote.
SECONDED:	Labuda
		VOTE
	Casso	Yes
	Court	No
	Hullinghorst	Yes
	Lambert	No
	Massey	No
	McCann	Yes
	Miklosi	Yes
	Murray	No
	Nikkel	No
	Labuda	Yes
	Todd	Yes

Final YES: 6 NO: 5 EXC: 0 ABS: 0 FINAL ACTION: PASS

02:20 PM -- House Concurrent Resolution 09-1004

Representative Lambert, prime sponsor, presented House Concurrent Resolution 09-1004. Representative Lambert explained the nexus between the resolution and the Emergency Epidemic Response Committee, and discussed the need for the resolution. Discussion ensued regarding the need to pass the resolution during the current session in light of the fact that it would not go on the ballot until 2010. Representative Lambert responded to questions regarding the opinion of the Executive Department on the resolution, and the line of succession for state representation under the resolution.

02:30 PM

House Concurrent Resolution 09-1004 was laid over until May 1.

02:31 PM -- Senate Bill 09-283

Representatives Scanlan and Summers, prime sponsors, presented Senate Bill 09-283, concerning the redaction by the Secretary of State of tax identification numbers from secured transaction records filed with the Secretary of State. Representative Summers explained the need for the legislation.

02:32 PM

The following person testified regarding Senate Bill 09-283:

02:32 PM -- Mr. Charles Calvin, representing the Colorado Secretary of State Advisory Commission and the Colorado Bar Association, testified in favor of the bill. Mr. Calvin provided background on the collection of social security numbers by government agencies, which subsequently end up in the public record. Mr. Calvin explained how the bill will keep such personal information from becoming available to the public.

02:34 PM

Representative Summers explained the effect of prepared amendment L.006 (Attachment J).


BILL:	SB09-283
TIME:	02:35:08 PM
MOVED:	Todd
MOTION:	Moved prepared amendment L.006 (Attachment J). The motion passed without objection.
SECONDED:	Lambert
		VOTE
	Casso
	Court
	Hullinghorst
	Lambert
	Massey
	McCann
	Miklosi
	Murray
	Nikkel
	Labuda
	Todd
Not Final YES: 0 NO: 0 EXC: 0 ABS: 0 FINAL ACTION: Pass Without Objection


BILL:	SB09-283
TIME:	02:36:02 PM
MOVED:	Lambert
MOTION:	Moved to refer Senate Bill 09-283, as amended, to the Committee of the Whole with favorable recommendation. The motion passed on a 9-0-2 roll call vote.
SECONDED:	Todd
		VOTE
	Casso	Yes
	Court	Yes
	Hullinghorst	Yes
	Lambert	Yes
	Massey	Yes
	McCann	Yes
	Miklosi	Excused
	Murray	Yes
	Nikkel	Excused
	Labuda	Yes
	Todd	Yes
Final YES: 9 NO: 0 EXC: 2 ABS: 0 FINAL ACTION: PASS

02:37 PM

The committee adjourned.