2019 Utah Legislative Session Summary

An estimated 11,620 Utahns will be diagnosed with cancer in 2019 and an estimated 3,310 will die from the disease. ACS CAN staff and volunteers spent the 2019 legislative session educating elected officials about cancer’s toll on public health and encouraging them to make cancer a top priority. ACS CAN does this by working on key public policies that are firmly rooted in scientific evidence that promote prevention and access to early detection, treatment, and follow-up care. To this end, ACS CAN in Utah worked on the following during the 2019 Utah legislative session.

Priority Issues

Tobacco Age Amendments (HB 324)
ACS CAN Position: oppose

After numerous failed attempts, Utah became the eighth state to raise the age of sale for tobacco products to 21 with the passage of HB 324. Unfortunately, ACS CAN was not able to support this legislation. The bill that ultimately passed will not provide the public policy results legislators are looking for.

When done right, ACS CAN supports raising the age of sale for tobacco products because it promises to curb tobacco use, protect kids, and save money and lives. Ninety five percent of adult smokers become addicted to tobacco before they turn twenty-one. If people do not begin using tobacco products before the age of 21, most will never start.

However, HB 324 continues to punish youth for purchasing and for possessing tobacco. Holding kids responsible for buying and using tobacco has not proven effective and places blame on the victims of the tobacco industry’s marketing and irresponsible sales by retailers rather than where it belongs.

HB 324 also includes an exemption for active duty military, along with their spouses and dependents. Tobacco use is not a rite of passage or a sign of adulthood. Military leaders understand the impact that tobacco use has on military readiness and are working to curb tobacco use among military members. The U.S. Army Surgeon General says soldiers who smoke are less combat ready and take longer to heal. Tobacco use among active duty military has enormous physical and fiscal impacts on troop readiness and reduces soldiers’ fitness.

Lastly, HB 324 retains and adds to the preemption in Utah law, limiting the authority of local governments to pass strong tobacco control policies. Many important public health policies are often developed and passed at the local level, long before state legislatures act. While states should set a minimum standard for public health protections, they should not prevent local governments from going above and beyond that minimum standard.

Medicaid Expansion Adjustments (SB 96)
ACS CAN position: oppose

Utah voters passed Medicaid expansion, also known as Proposition 3, in November 2018 with 53% of the vote. This proposition would expand Medicaid access to approximately 150,000 low-income Utahns with incomes between zero and 138% of federal poverty and is financed by a small sales tax increase.

SB 96 essentially repeals the voter approved expansion and seeks to replace it with a more limited, partial Medicaid expansion. While there were some changes made along the way, the bill that the Governor signed includes the following:

• The state will only expand Medicaid to cover all Utahns who make up to 100% of the federal poverty level (about $12,500 for an individual) for up to one year.  The state will pay 30% of these costs, with the federal government paying 70%.
• In the meantime, the state will request permission from the federal government to: partially expand Medicaid for individuals making between 0 and 100% of federal poverty, implement work and related administrative reporting requirements, restrict the number of people who can enroll in the Medicaid program and limit (cap) the amount of federal funds that Utah can receive to cover these newly eligible low-income parents and adults. (NOTE: Many of the provisions in Utah’s waiver have never been approved before and could violate some provisions of the federal health care law.)
• If the waiver is denied, then the voter approved Proposition 3 will go into effect, though the state will seek approval for work requirements for that full expansion population.

ACS CAN opposed this bill for numerous reasons; however, the overarching themes are that we believe the bill is bad for cancer patients, places undue burdens on them to comply with work and related administrative reporting requirements and does not cover as many Utahns as a full Medicaid expansion under Proposition 3 would.

Monitored Legislation

Retail Tobacco Specialty Amendments (HB 274)
The original intent of this bill was to limit the sale of some flavored tobacco products, excluding menthol flavored products, to retail tobacco specialty stores. The bill was weakened to only include flavored electronic cigarettes rather than all flavored tobacco products.  This bill passed the House and Senate committee.  It was never voted on by the full Senate.

Electronic Cigarette and Other Nicotine Product Amendments (HB 252)
In short, this bill aimed to tax electronic cigarettes at the same rate as all other tobacco products, which is 86% of the manufacturer’s sales price.  The bill also created definitions for “alternative nicotine product” and “nontherapeutic nicotine product.” The bill passed the House and was never debated in the Senate.

Prescription Drug Importation Program (HB 267)
Had it passed, this legislation would have required the state health department to request approval for importing certain prescription drug from Canada.  The stated goal was cost reduction.  This bill passed the House and failed in a Senate committee.

Medical Treatment Authorization Amendments (SB 264)
This bill addresses the process of obtaining prior authorization from an insurance company for health care. Among other things, the bill requires an insurer to post certain information regarding requirements for the authorization for health care, prohibits an insurer from denying certain requests for authorization of health care, and requires an insurer to respond to a request for authorization for health care within a certain time period.  The bill passed.

Treatment Medication Amendments (SB 241)
This bill would have prohibited a health benefit plan from requiring step therapy for certain drugs used to treat stage-IV advanced metastatic cancer or associated conditions. The bill was never heard.