SB 514-FN – AS INTRODUCED
2008 SESSION
01/10
SENATE BILL 514-FN
AN ACT relative to mercury exposure reduction and requiring insurance coverage for mercury-free fillings, vaccines, and injections for certain persons.
COMMITTEE: Health and Human Services
This bill requires health products containing mercury to be labeled by the manufacturer or wholesaler. This bill also requires insurance coverage for mercury-free fillings, vaccines, and injections for all pregnant women, women who might become pregnant, and children under 12 years of age.
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Explanation: Matter added to current law appears in bold italics.
Matter removed from current law appears [in brackets and struckthrough.]
Matter which is either (a) all new or (b) repealed and reenacted appears in regular type.
08-2818
01/10
STATE OF NEW HAMPSHIRE
In the Year of Our Lord Two Thousand Eight
AN ACT relative to mercury exposure reduction and requiring insurance coverage for mercury-free fillings, vaccines, and injections for certain persons.
Be it Enacted by the Senate and House of Representatives in General Court convened:
1 Statement of Purpose. The general court finds the following:
I. Mercury is a persistent, bio-accumulative toxin that poses a significant risk to human health, wildlife, and the environment.
II. Mercury is a heavy liquid metallic chemical compound and elemental mercury, and mercury compounds are known to be toxic and hazardous to human health and the environment.
III. Human exposure to mercury can result in significant damage to the central nervous system, the kidneys, and the liver and may impair child development.
IV. Recent research by the Environmental Protection Agency concludes that 16 percent of women of childbearing age have unsafe mercury blood levels, and that the annual number of newborn infants at risk in the United States is 630,000.
V. There has been a threefold increase in mercury loading to the environment over the past 150 years. Much of the mercury deposited from the atmosphere is from human and natural sources, but anthropogenic emissions exceed those that occur naturally.
VI. Mercury waste emitted from dental clinics has been shown to fail the federal Environmental Protection Agency’s Toxicity Characteristic Leaching Procedure and, therefore, is a regulated hazardous waste.
VII. The National Academy of Sciences reported in 2001 that “the major source of exposure to elemental mercury in the general United States population is due to mercury vapor released from dental amalgams.”
VIII. The American Dental Society estimates that the dental industry releases into the environment 100 million dental amalgams annually. Each dental amalgam has approximately 0.5 grams of mercury.
IX. Researchers for the United States Naval Dental Research Institute have indicated that, when discharged into the environment, waste dental mercury may methylate, become bioavailable, and subsequently biomagnify in fish as methylmercury, the most toxic form of mercury.
X. The primary means of exposure to methylmercury is the consumption of contaminated fish and shellfish.
XI. The United States Food and Drug Administration, the Environmental Protection Agency, and the Vermont Department of Health recommend limiting the consumption of certain commercial saltwater fish, including canned tuna.
2 New Subdivision; Mercury Labeling. Amend RSA 149-M by inserting after section 58 the following new subdivision:
149-M:59 Mercury Labeling Required.
I. A manufacturer or wholesaler shall not offer for final sale in this state, sell at a final sale in this state, or distribute in this state any health product that contains mercury, unless the product is labeled. All labels shall be legible and shall inform the purchaser, using words or symbols, in a minimum of 10-point font, that mercury is present in the product and shall clearly identify that the mercury-added product should not be disposed of or placed in a waste stream destined for disposal until the mercury is removed and reused, recycled, or otherwise managed to ensure that the mercury in the product does not become mixed with other solid waste or wastewater. Component, product, and package labels shall be placed so that they are clearly visible. A label shall also be visible prior to sale.
II. By no later than October 1, 2008, each manufacturer required by this subdivision to label shall certify to the department that it has developed a labeling plan for its mercury-added products that complies with this section, and that this labeling plan shall be implemented for products offered for final sale, sold at final sale, or distributed in New Hampshire after January 1, 2009. The labeling plan shall include detailed descriptions of the products involved and the label size, font size, material, wording, location, and attachment method for each product and for the product packaging. The plan shall include how prior-to-sale notification will be provided, if required. The plan shall be submitted to the department, together with the certification.
149-M:60 Rulemaking. The commissioner shall adopt rules pursuant to RSA 541-A, relative to:
I. Further labeling requirements.
II. Format of forms required under this subdivision.
III. A requirement that a person who knows she is pregnant or who might become pregnant or a person who is under 12 years of age shall not be vaccinated with a mercury-containing vaccine or injected with a mercury-containing product, except in times of an emergency or epidemic as determined by the commissioner.
3 New Section; Coverage for Mercury-Free Fillings, Vaccines, and Injections; Individual. Amend RSA 415 by inserting after section 6-n the following new section:
415:6-o Coverage for Mercury-Free Fillings, Vaccines, and Injections; Individual. Each insurer that issues or renews any individual policy, plan, or contract of accident or health insurance providing benefits for medical or hospital expenses, shall provide to certificate holders of such insurance, who are residents of this state, coverage for mercury-free fillings, vaccines, and injections for all pregnant women, women who might become pregnant, and children under 12 years of age. The benefits included in this section shall not be subject to any greater deductible than any other benefits provided by the insurer. The coinsurance required by the certificate holder shall not exceed the amount allowed under the contract for the reasonable and customary charge for the services provided. This section shall not be subject to the provisions of RSA 400-A:39-a.
4 New Section; Coverage for Mercury-Free Fillings, Vaccines, and Injections; Group. Amend RSA 415 by inserting after section 18-s the following new section:
415:18-t Coverage for Mercury-Free Fillings, Vaccines, and Injections; Group. Each insurer that issues or renews any policy of group or blanket accident or health insurance providing benefits for medical or hospital expenses, shall provide to each group, or to the portion of each group comprised of certificate holders of such insurance who are residents of this state, coverage for mercury-free fillings, vaccines, and injections for all pregnant women, women who might become pregnant, and children under 12 years of age. The benefits included in this section shall not be subject to any greater deductible than any other benefits provided by the insurer. The coinsurance required by the certificate holder shall not exceed the amount allowed under the contract for the reasonable and customary charge for the services provided. This section shall not be subject to the provisions of RSA 400-A:39-a.
5 Coverage for Mercury-Free Fillings, Vaccines, and Injections. Amend RSA 420-A:2 to read as follows:
420-A:2 Applicable Statutes. Every health service corporation shall be governed by this chapter and the relevant provisions of RSA 161-H, and shall be exempt from this title except for the provisions of RSA 400-A:39, RSA 401-B, RSA 402-C, RSA 404-F, RSA 415-A, RSA 415-F, RSA 415:6, II(4), RSA 415:6-g, RSA 415:6-k, RSA 415:6-m, RSA 415:6-o, RSA 415:18, V, RSA 415:18, VII-a, RSA 415:18, XVI and XVII, RSA 415:18-a, RSA 415:18-j, RSA 415:18-o, RSA 415:18-r, RSA 415:18-t, RSA 415:22, RSA 417, RSA 417-E, RSA 420-J, and all applicable provisions of title XXXVII wherein such corporations are specifically included. Every health service corporation and its agents shall be subject to the fees prescribed for health service corporations under RSA 400-A:29, VII.
6 Coverage for Mercury-Free Fillings, Vaccines, and Injections. Amend RSA 420-B:20, II to read as follows:
III. The requirements of RSA 400-A:39, RSA 401-B, RSA 402-C, RSA 404-F, RSA 415:6-g, RSA 415:6-m, RSA 415:6-o, RSA 415:18, VII-a, RSA 415:18, XVI and XVII, RSA 415:18-j, RSA 415:18-r, RSA 415:18-t, RSA 415-A, RSA 415-F, RSA 420-G, and RSA 420-J shall apply to health maintenance organizations.
7 Study Of New Hampshire’s Fish Consumption. The department shall make a comprehensive reevaluation of New Hampshire’s fish consumption. The reevaluation shall take into account recent findings on the cardiovascular effects of fish consumption on adults and shall consider also the more restrictive advisory now in place in the state of Massachusetts which directs women of childbearing age, pregnant women and nursing mothers, and children under the age of 12 not to eat fish caught in the waters of Massachusetts. The department shall report its findings and recommendations to the governor and general court no later than December 1, 2008.
8 Effective Date.
I. Section 7 of this act shall take effect upon its passage.
II. The remainder of this act shall take effect 60 days after its passage.
LBAO
08-2818
12/17/07
SB 514-FN - FISCAL NOTE
AN ACT relative to mercury exposure reduction and requiring insurance coverage for mercury-free fillings, vaccines, and injections for certain persons.
FISCAL IMPACT:
The Insurance Department states this bill will increase state revenue, county expenditures, and local expenditures by an indeterminable amount in FY 2008 and each year thereafter. The Department of Environmental Services states this bill will increase state expenditures by $4,724 in FY 2008, $14,767 in FY 2009, $13,187 in FY 2010, $13,601 in FY 2011 and $14,058 in FY 2012. There will be no fiscal impact on county and local revenue.
METHODOLOGY:
The Insurance Department states this bill requires certain mercury disclosures on health products and requires insurance coverage for mercury-free vaccines. The bill also requires a comprehensive reevaluation of New Hampshire’s fish consumption. The Insurance Department states vaccine costs are funded in part by the federal government and in part by assessments against insurance companies. To the extent the cost of vaccines increase because of the disclosure requirements and mercury-free option, assessments will increase. This will result in premiums to increase for both fully insured plans and stop loss coverage purchased by group plans subject to ERISA. Government plans are not subject to ERISA so the cost of stop loss coverage will not be impacted. To the extent the tax base increases, premium tax revenue and employer costs will increase.
The Department of Environmental Services states it will need ¼ of a Program Specialist I position for rulemaking activities, review of labeling plans, and outreach and technical assistance to vaccine distributors, municipalities, and other affected parties. The Department indicates it would need to hire a part-time person or reassign existing staff to the new duties, displacing their current duties. If the Department hires a part-time person it would have the following expenditures:
FY 2008 |
FY 2009 |
FY 2010 |
FY 2011 |
FY2012 | |
¼ of Program Specialist I position (LG 19) |
$2,066 |
$9,073 |
$9,463 |
$9,848 |
$10,272 |
Benefits @ 7.65% |
158 |
694 |
724 |
753 |
786 |
Administrative Costs |
2,500 |
5,000 |
3,000 |
3,000 |
3,000 |
Total |
$4,724 |
$14,767 |
$13,187 |
$13,601 |
$14,058 |
This bill does not establish positions or contain an appropriation.
The Department states it has already completed a comprehensive reevaluation of the state’s fish consumption advisory. The Department would have a minimal fiscal impact related to printing the report.