My Reaction to the AG's Opinion on the Contraception Mandate

Late yesterday the Attorney General issued an opinion on two questions I had concerning the contraception mandate.  You can find the complete opinion here:  http://ag.arkansas.gov/opinions/docs/2012-043.html

Here is the bottom line of that opinion: "Second, the Supremacy Clause in the U.S. Constitution requires that any valid federal law will override a conflicting state law. Accordingly, if the regulation is a valid federal law, then any conflicting state laws—whether they be regulatory, statutory, or constitutional—will be preempted"

This should bring concern to all Arkansans.  If Obamacare is upheld and we go forward with implementing the healthcare exchanges we will be subject to whatever regulations HHS puts into place regardless of whether it is good for Arkansas or is in line with our values.

I believe this latest mandate is an assault on not only our states rights but also on our religious freedoms and will work diligently to fight against it.

I stand with the majority of Arkansans who oppose this encroachment on our freedoms. I stand with Cardinal Dolan, Pastor Rick Bezet and the others of faith who have said they will not comply with this mandate.  I hope you will stand with us.

Here to Serve,
David Meeks

Attorney General's Opinion on the Contraception Mandate

Recently the Obama administration mandated that all contraception, including abortion-inducing drugs be included in healthcare plans. This raised the question about whether there were any state laws that might come into conflict with the mandate.  After doing some preliminary research, I have found several state statues that may be in conflict with the new mandate.

To that end, I have sent over a request to the Attorney General to get an opinion.  The wording of the opinion and the research can be found below. Thank you to Representatives Kim Hammer and Lori Benedict for signing on to the opinion.

If you know of any other statues that may be in conflict with the new mandate, please contact me at david.meeks@arkansashouse.org

Here to Serve,

David Meeks

_____________________________________________________________

Dear General McDaniel:

I am writing to request your official opinion on the following questions.

1) Would any state statutes and/or amendments, including those I have enclosed with this request, conflict with the Contraception Mandate?

2) Based on Arkansas Constitutional Amendment 68, would the Contraception Mandate prohibit the legislature from appropriating money to entities that may dispense abortion-inducing drugs listed in the mandate?

If there is any way you might expedite your response to this question, it would be greatly appreciated 

Amendments:

---->Amendment 2 § 24. Religious liberty.

 "All men have a natural and indefeasible right to worship Almighty God according to the dictates of their own consciences; no man can, of right, be compelled to attend, erect, or support any place of worship; or to maintain any ministry against his consent. No human authority can, in any case or manner whatsoever, control or interfere with the right of conscience; and no preference shall ever be given, by law, to any religious establishment, denomination or mode of worship, above any other."

---->Amendment 68 I have been told that a possibility exists Amendment 68 could affect certain grants to hospitals, because we appropriate the money. On a separate note, others I have talked to said that the State Employee Health Insurance probably wouldn't be affected by the Mandate and Amendment 68 because it is considered to be self funded.

State Statues:

http://statutes.laws.com/arkansas/title-20/subtitle-2/chapter-16/subchapter-6/20-16-601

---->20-16-601  This deals with abortion and would come into play if they required a physician to administer an abortion inducing drug.

http://insurance.arkansas.gov/PandC/Insurance%20Code%20&%20related%20chapters/Chapter791.htm

---->23-79-510: (2)  EXCLUSIONS.  Subject to the contractual policy form language adopted by the board, the following services, supplies, drugs, or articles whether prescribed by a physician or not shall not be covered:

                    (R)  Any expense or charge for oral contraceptives used for birth control or any other temporary birth control measures;

Subchapter 11

— Equity in Prescription Insurance and Contraceptive Coverage Act

23-79-1101. Title.

This subchapter shall be known and may be cited as the “Equity in Prescription Insurance and Contraceptive Coverage Act”.

23-79-1102. Definitions.

As used in this subchapter:

               (1)(A)  “Health benefit policy” means an individual or group plan, policy, or contract for health care services issued, delivered, issued for delivery, or renewed in this state, including those contracts executed by the State of Arkansas on behalf of state employees, by a health care corporation, health maintenance organization, preferred provider organization, accident and sickness insurer, fraternal benefit society, hospital service corporation, medical service corporation, provider-sponsored health care corporation, or other insurer or similar entity.

                               (B)  “Health benefit policy” does not include:

                                               (i)  Accident-only, credit, specified disease, dental, hospital indemnity, Medicare supplement, long-term care, or disability income insurance policies;

                                               (ii)  Coverage issued as a supplement to liability insurance;

                                               (iii)  Workers' compensation or similar insurance; or

                                               (iv)  Automobile medical-payment insurance;

               (2)  “Insurer” means an accident and sickness insurer, fraternal benefit society, hospital service corporation, medical service corporation, health care corporation, health maintenance organization, or any similar entity authorized to issue contracts under Title 23 of this Code; and

               (3)  “Religious employer” means an entity that:

                               (A)  Is organized and operated for religious purposes and has received a section 501(c)(3) designation from the Internal Revenue Service;

                               (B)  Has as one (1) of its primary purposes the inculcation of religious values; and

                               (C)  Employs primarily persons who share its religious tenets.

23-79-1103. Parity for contraceptives.

(a)  Every health benefit policy that is delivered, issued, executed, or renewed in this state or approved for issuance or renewal in this state by the Insurance Commissioner on or after August 12, 2005, that provides coverage for prescription drugs on an outpatient basis shall provide coverage for prescribed drugs or devices approved by the United States Food and Drug Administration for use as a contraceptive.

---->(b)  Nothing contained in this subchapter shall be construed to require any insurance company to provide coverage for an abortion, an abortifacient, or any United States Food and Drug Administration-approved emergency contraception.

23-79-1104. Extraordinary surcharges prohibited.

(a)  No insurer shall impose upon any person receiving prescription contraceptive benefits pursuant to this subchapter any:

               (1)  Copayment, coinsurance payment, or fee that is not equally imposed upon all individuals in the same benefit category, class, coinsurance level, or copayment level receiving benefits for prescription drugs; or

               (2)  Reduction in allowable reimbursement for prescription drug benefits.

(b)  This subchapter shall not be construed to:

               (1)  Require coverage for prescription coverage benefits in any contract, policy, or plan that does not otherwise provide coverage for prescription drugs;

               (2)(A)  Preclude the use of closed formularies.

                               (B)  However, the formularies shall include oral, implant, and injectable contraceptive drugs, intrauterine devices, and prescription barrier methods; or 

  ------->  (3)  Require any religious employer to comply with this subchapter.

ISP Filed on Healthcare Mandates

I have filed an interim study proposal to look at the healthcare mandates here in Arkansas.  Here is a link to the copy of the ISP: http://www.arkleg.state.ar.us/assembly/2011/2011R/Pages/ISPIRDetail.aspx?ispid=2011-187

According to a 2010 report, the Council for Affordable Health Insurance had Arkansas with 45 different mandates.
You can view a copy of the report here: http://www.cahi.org/cahi_contents/resources/pdf/MandatesintheStates2010.pdf

Of note from the report:  "Although most mandates only increase the cost of a policy by
less than 1 percent, 40 such mandates will price many people out of the market.  It is the accumulated impact of dozens of mandates, not just one, that makes health insurance unaffordable."

If we are to make health insurance more affordable to the people of Arkansas, this is just one area we need to take a closer look at.

Here to Serve,
David Meeks
email: david.meeks@arkansashouse.org

A Hard Decision

Today I personally made one of the most difficult votes that I have had to make all session. I voted against HB1315, An Act to Provide Health Insurance Coverage for Autism Spectrum Disorders.

The bill would mandate insurance companies cover Autism Spectrum Disorders.

http://staging.arkleg.state.ar.us/ftproot/bills/2011/public/HB1315.pdf

Here are the main reasons why I voted against the bill:

• 1) It’s another government mandate. There are already around 40 different mandates in Arkansas that increase premiums by around 5% to 15%. This is not the only mandate the Arkansas Legislature is considering this session. SB66 requires insurance to cover diagnosis and treatment of morbid obesity.
• 2) It will add around $30 to private insurance policies per year. While this may not be a lot, it does put an even greater burden on families already stretched to the limit in these economic conditions. As stated in point one, mandates add to the cost of insurance. For the Arkansan spending $800 a month ($9,600/yr) on insurance, you are paying at least $40 a month ($480/yr) due to mandates.
• 3) Our schools already receive over $100 million in federal funding under Individuals with Disabilities Education Act. This act includes children with Autism.
• 4) I believe in the people of Arkansas and believe that there are other solutions that will help solve this issue without the government having to mandate coverage.

A couple of possible solutions:

• Non-profit Autism/Disabilities organizations work thru the communities and schools to help those in need.
• Insurance companies offering riders that cover certain disabilities and offer the rider to everyone so that people can choose to help rather than force.

We need to work to make our healthcare system better. My philosophy is less government. Let the people, medical, and insurance companies come up with free market solutions.

Today I did not vote against Autism. I voted against more government, and higher premiums.

If you have any questions about this or any other vote, please feel free to contact me. My email address is david.meeks@arkansashouse.org