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F I S C A L I M P A C T R E P O R T
SPONSOR Stewart
ORIGINAL DATE
LAST UPDATED
1/27/06
HB HJM 9
SHORT TITLE Study Contraceptive Use & Insurance Coverage
SB
ANALYST Lewis
APPROPRIATION (dollars in thousands)
Appropriation
Recurring
or Non-Rec
Fund
Affected
FY06
FY07
NFI
(Parenthesis ( ) Indicate Expenditure Decreases)
Duplicates SJM 12
SOURCES OF INFORMATION
LFC Files
Responses Requested/Received From
Public Regulation Commission (PRC)
Health Policy Commission (HPC)
Department of Health (DOH)
SUMMARY
Synopsis of Bill
House Joint Memorial 9 requests that that the Insurance Division of the Public Regulation Com-
mission update its 2002 survey of health insurers and report to the appropriate legislative com-
mittee no later than November 2006.
The joint memorial further requests that:
the New Mexico Health Policy Commission collect and evaluate relevant health studies and
other information and determine the benefits to the state, its people and the health insurance
industry of having prescription contraceptive coverage;
the Insurance Division ascertain if the level of knowledge of and compliance with the re-
quirement to offer coverage of prescription contraception has increased and also determine if
there are limits placed on the varieties of contraception that are covered by private insurers;
the Insurance Division extend the focus of the 2002 study to ascertain whether prescription
contraceptives are covered by insurers that offer hospital and medical expenses reimburse-
pg_0002
House Joint Memorial 9 – Page
2
ment and managed care contracts;
the Insurance Division prepare a list for public dissemination of health insurers that do not
provide prescription contraceptive coverage;
the Insurance Division use the data collected as a result of the study to begin a dialogue with
insurance companies to encourage greater coverage of prescription contraceptives;
the New Mexico Health Policy Commission and the Department of Health cooperate to pre-
pare educational materials for the public regarding availability and access to prescription
contraceptives;
the New Mexico Health Policy Commission serve as the lead agency to coordinate efforts
with the Insurance Division and provide two copies of the report generated pursuant to this
memorial to the library of the Legislative Council Service; and that copies of this memorial
be transmitted to the New Mexico Health Policy Commission, the Superintendent of Insur-
ance and the Secretary of Health.
FISCAL IMPLICATIONS
No fiscal impact.
SIGNIFICANT ISSUES
The Department of Health (DOH), notes that Sections 59A-22-42 and 59A-46-44, NMSA 1978,
require health insurance providers that offer a prescription benefit to offer coverage for prescrip-
tion contraceptive drugs or devices. This law took effect June 15, 2001 and applies to policies
issued, extended or renewed after July 1, 2001.
Among women giving live birth in 2001-2002, the New Mexico Pregnancy Risk Assessment
Monitoring System (PRAMS) estimated that 43.3% of pregnancies were unintended. 43.5% of
women who did not want to get pregnant were using some form of contraception, indicating a
lack of access to effective contraceptive methods or failure to use a method correctly. An esti-
mated 206,600 women in New Mexico, including 33,120 teenagers, are in need of affordable
contraceptive services and supplies per year.
The Insurance Division of the Public Regulation Commission (PRC) notes that proponents of
this memorial believe that the insurance industry is not making contraceptive coverage available
except as mandated by law. However, the Insurance Division’s 2002 survey indicated that:
there was substantial compliance with the requirements mandated by Section 59A-22-42
and 59A-46-44; and that
all companies writing group major medical insurance policies and managed care con-
tracts were offering this coverage.
When asked about the “WHEREAS” statement in the memorial that, “the study found that of
589 health insurers surveyed, fewer than ten percent, or 47 insurers, offered coverage of pre-
scription contraceptives,” The Insurance Division notes that very few health insurance plans
(a category that includes disability income, individual medical insurance and other coverages
in addition to group major medical policies and managed care plans) include prescription
drug coverage. Moreover, individual medical insurance policies are not required to offer pre-
scription coverage.
pg_0003
House Joint Memorial 9 – Page
3
ADMINISTRATIVE IMPLICATIONS
The Insurance Division will be required to conduct surveys and participate with the Health Pol-
icy Commission in drafting reports, but indicates that such work can be performed with existing
personnel and within existing budgets, with minimal fiscal impact.
ML/mt