UPDATE: On April 1 the General Assembly passed a state budget and related bills, including one freezing health departments’ pension payments at the current level. House Speaker David Osborne said more bills are likely to pass when the legislature returns April 13, including one to help rural hospitals.
By Melissa Patrick
Kentucky Health News
As lawmakers head back to Frankfort to pass a budget — and other bills, despite Gov. Andy Beshear’s repeated request that they pass only a budget and anything related to the coronavirus — several big bills related to other aspects of health are pending, including some controversial measures.
Beshear, a Democrat, denied the request of the Republican legislative majority to call a special session after the threat abates, if they adjourned early. He said it might not be safe to call them back in time to pass a budget, which must be done by June 30. The lawmakers plan to pass the budget and other bills Wednesday, April 1, and return April 14 to reconsider vetoed bills.
Beshear indicated at his daily press conference Tuesday that the budget would be the only bill passed. “These folks need to pass a budget and get of town,” he said. “My understanding is that now, that’s the plan.”
One big health-related bill that has been expected to pass is House Bill 32, which would tax electronic cigarettes. It has been promoted as a way to reduce teen use of the products by increasing their price and to bring state government more money — an increased concern in light of the pandemic, which is likely to cause a recession and a drop in state revenue.
HB 32 was trimmed down in a Senate committee to place a 15 percent wholesale tax on e-cig products and a $1.50 per-pod tax on Juul-type products, which is expected to bring in $25 million a year. The original bill was estimated to bring in $50 million, and that could be trimmed down even further, as two Senate floor amendments have been filed to decrease the tax to 10%.
The original version would have put a 25% tax on e-cig products, while raising the tax for “other tobacco products,” such as cigars, to 25% from the current 15%, and add e-cigs to the list. It would have also doubled the per-unit tax on non-smokable products, but did not touch the tax on traditional cigarettes.
Health departments: Another health-related bill to watch is one that has been touted in the House as part of a three-phase approach to create a sustainable solution to local health departments’ pension-driven financial woes.
House Bill 171, sponsored by Rep. Jim DuPlessis, R-Elizabethtown, would move health departments, regional universities and quasi-governmental agencies away from a “percentage of pay” pension formula to a model that requires them to pay only what they owe the system over a certain period, called “level-dollar funding.” It is in the Senate State and Local Government Committee but has had two official readings, so it could pass quickly.
It could pass another way: in a House committee substitute to SB 249, with a change to include a new 30-year-amortization period for the pension debt, rather than the 27 years in HB 171. It also adds a layered, 20-year closed amortization period for any future increases or decreases in actuarially accrued liabilities after the 2019 valuation. SB 249 has received two readings in the House, and DuPlessis has said negotiations will likely be done through SB 249.
It would allow the Cabinet for Economic Development to provide loans to struggling hospitals for three purposes: to maintain or upgrade their facilities; to maintain or increase staff; or to provide health-care services not currently available. The bill has had two readings and is in the Senate Appropriations and Revenue Committee.
Insulin costs: Another important health-related bill would cap the monthly cost of insulin for many Kentuckians at $100. HB 12, sponsored by Bentley, would require state-regulated insurance plans to cap a patient’s cost for a 30-day supply of each insulin prescription at $100 “regardless of the amount or type of insulin needed to meet the covered person’s insulin needs.” It does not include Medicaid, Medicare or self-insured government plans.
The Senate committee substitute for HB 12 would also establish an insulin assistance program. This language comes from SB 23, sponsored by Sen. Phillip Wheeler, R-Pikeville. HB 12 has had two readings and is in the Senate Rules Committee.
Abortion: At least one anti-abortion bill is likely to move; it has been awaiting final passage for some time. Senate Bill 9, sponsored by Sen. Whitney Westerfield, R-Hopkinsville, would require health-care providers to give “medically appropriate and reasonable life-saving and life-sustaining medical care and treatment” to any infant born alive, including after a failed abortion, and would make not doing so a felony. A House committee removed references to research, so it would not inhibit ongoing research.
Critics of the bill say the state already has laws to prevent this from happening and the bill does not account for palliative care needed when infants will not live, or will not have quality of life.
Another abortion bill that could pass is House Bill 451, sponsored by Rep. Stan Lee, R-Lexington, which would expand the power of the attorney general to shut down abortion providers. The Senate Judiciary Committee added authority for Attorney General Daniel Cameron to block abortions under gubernatorial emergency orders limiting “non-urgent” medical procedures.
Sen. Ralph Alvarado, R-Winchester, has filed a floor amendment to ban abortion from being deemed an urgent procedure in the state of emergency Beshear declared for covid-19. Democratic Floor Leader Morgan McGarvey of Louisville has filed an amendment to allow abortions in the case of a nonviable fetus, rape, incest, or threat to the mother’s life.
HB 451 has had only one reading in the Senate, so it could not pass Wednesday unless the Senate suspended the readings requirement, which the state constitution allows it to do. Majority Floor Leader Damon Thayer said last week that was a possibility, but he voiced skepticism of the idea because it might set a precedent that legislative leaders would like to avoid. The legislature could pass it April 14 or even April 15, the day the session must end, but Beshear could veto it without fear of a legislative override.
Another abortion bill pending is House Bill 67, sponsored by Rep. Joseph Fischer, R-Fort Thomas, which would, in effect, ban abortion in Kentucky if Roe v. Wade is overturned. It would have the constitution say, “To protect human life, nothing in this Constitution shall be construed to secure or protect a right to abortion or require the funding of abortion.” The bill has had no readings in the Senate, but is a constitutional amendment that would go directly to the Nov. 3 ballot, not to Beshear, so it could pass if the legislature met April 15 or if it suspended the readings requirement.
Here are some other health-related bills that could pass:
HB 29, sponsored by Rep. Steve Riley, R-Glasgow, would extend temporary license for long-term care administrators to nine months, not six. It awaits House concurrence with a Senate substitute that would prohibit certification or renewal of an assisted-living community if it is owned, manged or operated by a person who has been convicted of certain crimes it would also change the appeals and renewal processes.
HB 46, sponsored by Rep. Jerry Miller, R-Louisville, would allow full-time state employees a paid leave of absence of 240 hours for donating a human organ and 40 hours for donating bone marrow. This bill is on the Senate consent calendar, which is used to pass bills en masse without debate.
HB 8, sponsored by Rep. Rob Rothenburger, R-Shelbyville, would boost Medicaid reimbursements for ambulance services by setting up a trust fund to allow them to draw a federal match. This bill is on the Senate consent calendar.
SB 30, sponsored by Sen. Stephen Meredith, R-Leitchfield, would limit the number of managed-care organizations to three, from the current five. This bill has received a reading in the House and been returned to the Health and Family Services Committee.
SB 237, sponsored by Sen. Max Wise, R-Campbellsville, would allow collection of tissue samples from post-mortem exams of children who have died from Sudden Infant Death Syndrome to be used for research purposes, with a parent’s permission. This bill is also in the House Health and Family Services Committee, with one reading.
A more comprehensive list of health bills in the General Assembly, compiled by Kentucky Health News in a Google Doc, is available here.