Sen. Laurie Monnes Anderson, D-Gresham, was forced to spike the House’s version of Senate Bill 93 on the Senate floor Tuesday after reports it might cost the Oregon Educators Benefit Board a whopping $1.3 million, but she and Sen. Elizabeth Steiner Hayward, D-Beaverton, believe they’ve now found a technical amendment to solve that problem.
Senate Bill 93 requires health insurance companies to pay for a 90-day supply of medications for members who have an existing prescription. Consumers also have a choice between a brick-and-mortar pharmacy and a mail-order pharmacy. SB 93 does not apply to Schedule II drugs, which are often highly addictive. The bill first passed the Senate with little fanfare at the end of April on a 29-1 vote.
The Senate version only included generic drugs but SB 93 was amended in the House Veterans Affairs Committee to include brand-name drugs -- something Steiner Hayward pushed for, along with the veterans committee vice-chairwoman, Rep. Deborah Boone, D-Seaside.
Steiner Hayward said chronic brand-name medications already have passed a prior authorization hurdle from insurance companies. Boone was concerned about patients getting their medications after a tsunami, earthquake or wildfire, and also wanted to include all chronic medications. “After a natural disaster, Oregonians could have trouble accessing their drugs for a medical condition,” she said.
Moda Health opposed adding brand-name drugs, and PacificSource Health Plans didn’t want the bill further amended from the Senate version. But it passed easily on a 45-7 vote with just a handful of Republicans, including Rep. Julie Parrish of West Linn and Rep. Knute Buehler of Bend, opposed.
But Parrish warned about the cost impact of SB 93, and as it headed back to the Senate, Monnes Anderson received warnings from school districts that 90-day supplies of chronic, brand-name medications would send their costs soaring. Beaverton School District could see an increase of $1.1 million to its self-insured prescription drug benefit. The cost to OEBB was put at $1.3 million.
“That’s baloney,” said Steiner Hayward, who argued that for established drugs, the health insurance companies would be filling them anyway, regardless if patients picked up their drugs every 30 days or every 90 days. OEBB interim director Kathy Loretz didn’t respond to questions.
On the House side, Rep. Mitch Greenlick, D-Portland, argued that SB 93 would save costs by removing a barrier for patients, keeping them on the same drugs to remain in stable condition, otherwise their healthcare costs could be much greater.
“The estimates that this will increase costs are nonsense,” Greenlick told his colleagues. “Is it less expensive or more expensive to issue one three-month prescription or three one-month prescriptions? … The more likely option is that it’ll cost less rather than more.”
SB 93 is similar to HB 3343, which Gov. Brown signed last week, offering women 12-month supplies for birth control.
Steiner Hayward was assigned to a conference committee to amend the bill to gain consensus in the Senate. Only some minor technical language was necessary, she said, including clarifying language around reimbursement and allowing insurers to use the law when they initiate new contracts with pharmacies. .
Insurers would still be required to provide 90-day disbursements for all chronic medications, both brand-name and generic, said Monnes Anderson, who met with health plans and pharmacists to work out the details.
