Montana Legislature considers resuming lethal injection, restricting voter registration, reducing drug costs and increasing teacher pay in Week 5

Bills Aim to Reduce Prescription Drug Costs in Montana

A House committee tabled a bill in the Montana Legislature that would have limited copays for insulin to $35 for a month's supply after it drew support from families and healthcare providers who say the price of the drug has become otherwise unaffordable.

Rep. Jessica Karjala, D-Billings, presented House Bill 222 to members of the House Human Services Committee on Monday, Feb. 1.

"The bottom line is that the price of insulin with insurance has become prohibitive, and often, out of reach for too many people," Karjala said.

Many who testified in support of the bill told personal stories of struggling to cover the rapidly increasing cost of insulin, some saying they had to choose between living expenses and paying for the medication.

Marci Butcher, a Helena resident who told the committee she was representing both her family and the Montana Association of Diabetes Care and Education Specialists, expressed her support for the measure, saying her husband has struggled with Type 1 diabetes for years. Butcher called the illness a complicated disease that requires complicated drugs and instruments to treat, but said the price of insulin has "skyrocketed" in the last few years.

"What used to be a $25 medication when he was first diagnosed now costs about $300 per vial," Butcher said. "Pretty soon, we're going to be paying $2,000 per year on insulin."

Bri Runde testified in support of the bill and brought her two young sons to the hearing, both of whom doctors diagnosed with diabetes. Runde said her sons depend on insulin to treat the illness, and called the price of the drug "outrageous."

"We, as well as most other Type 1 diabetes families out there, need this bill to get passed so we can afford to keep our boys alive and healthy," Runde said.

Alison Sharkey-Hines, a resident of Butte, told the committee her son born in October was premature, with lungs that were undeveloped due to her diabetes. Sharkey-Hines said he passed away at two weeks old due to her inability to afford enough insulin to control her blood sugars during the pregnancy.

"I think if we were to cap the cost of insulin, we could prevent other families from going through what me and my son did," Sharkey-Hines said.

Opposition to the bill came from health insurance companies, who said that while the price of insulin is out of control, price caps such as HB 222 would force insurance premiums higher for all plan holders as the companies work to make up lost revenues.

Jennifer Hensley, a representative from PacificSource Health Plans -- a regional nonprofit health insurer -- said pharmaceutical companies are not transparent with the reason insulin is priced so high, and that those companies are the source of the extreme price of insulin in the first place.

"HB 222 is the equivalent of fixing a screen door on a submarine," Hensley said. "It wouldn't stop the price of the meds."

John Doran, the vice president of external affairs at Blue Cross and Blue Shield of Montana, said he knew that everyone in the committee room wished the price of the drug would go down, but said HB 222 wasn't the answer.

"While this bill sounds good on its face, it's the devil in the details, and the details in this bill demonstrate that the bill will not only lead to higher insulin costs, it's going to make insulin more unobtainable for the brave people who shared their stories today," Doran said.

The committee tabled the bill on Feb. 4, meaning the bill will not move further unless the committee votes to revive it.

Another bill introduced the week before is trying to attain some of the drug price transparency the insurance companies asked for during HB 222's hearing.

Senate Bill 137, sponsored by Sen. Steve Fitzpatrick, R-Great Falls, would force prescription drug companies, pharmacies and health insurance providers to disclose information on drug prices in Montana.

Mountain Health Co-op CEO Richard Miltenberger testified in support of the measure and said the bill takes an important first step in reducing drug prices.

"This is something we can do -- is create this transparency," Miltenberger said.

Brian Warren, a representative from the Biotechnology Innovation Organization and the Montana Bioscience Alliance said the bill would fail to lower costs because it doesn't mandate transparency at all steps of the process, like asking health insurers what they do with the rebates they receive or what they do with the money patients pay at the pharmacy counter.

"We're not opposed to so much as what's in this bill as much as what's not in this bill," Warren said. "We think that if you want to pass something meaningful, you should look at a more comprehensive approach."

The committee voted 10-0 to advance the bill for additional debate in the full Senate.

UM Legislative News reporter James Bradley contributed reporting to this story.

Lawmakers Seek New Limits on Voter Registration in Montana

After an election that brought record voter turnout in Montana and huge gains for the state's Republican party, lawmakers in Helena are considering bills that would apply new restrictions on voter registration.

One, if signed into law in its current form, would close voter registration at noon the day before the election. In Montana, voters have been able to register on election day for 14 years.

The House State Administration Committee had tabled House Bill 176 during a meeting on Friday, Jan. 29, but quickly revived the bill the following Tuesday and passed it, on a 10-9 vote, on to the full House with new amendments.

Rep. Sharon Greef, R-Florence, sponsored the bill, which was originally set to close voter registration the Friday before election day. During the bill's first hearing, Greef called the measure an "election integrity bill" and said she was happy to support newly-elected Secretary of State Christi Jacobsen's goal of ensuring "election integrity in Montana."

"We are blessed with the privilege of voting, but also must accept responsibility for the privilege," Greef said. "Elections don't pop up out of the blue and surprise us."

Proponents, including Jacobsen, said the bill would bring Montana in line with the majority of states in the country that do not allow same-day voter registration, and would also prevent "fraud," though no proponents cited evidence, nor is there any credible evidence nationwide, for voter fraud caused by same-day registration.

During the bill's first committee hearing, Democrats and some Republicans raised concerns that the bill would disenfranchise eligible voters in Montana based on when they choose to register.

When the bill reached the full House, some Republicans tried to amend the bill and restore it to its original form, closing voter registration the Friday before an election. That effort failed, though the bill still passed the House in a 64-33 vote. Some conservatives indicated they would lobby the Senate to amend the bill.

The House Taxation Committee heard testimony on a measure from Rep. Brad Tschida, R-Missoula, on Tuesday, Feb. 2 that would take away income tax deductions for parents of college-age dependents if their students do not register to vote at their home address.

Tschida said House Bill 240 would prevent college students from leaving what he called a "trail of increase" behind them as they vote to raise property taxes in the cities they live in while going to college, then leave upon graduation.

"I don't want to see property taxes jacked through the roof as we're seeing around the state of Montana," Tschida said.

The bill had no proponents, but two organizations testified against it, saying the bill would unnecessarily complicate Montana tax laws and discourage students from voting.

"Having to return to a home community to vote presents a number of hurdles that schooling, jobs, and personal lives don't account for," said Ruthie Barbour of Forward Montana, a political youth advocacy group.

Tschida said the bill does not constitute voter suppression, and that dependents would still be able to register for absentee ballots to be mailed to their residential address.

"We're not preventing anyone from voting. That's a strawman argument trying to build some opposition to this," Tschida said.

If passed by the committee, it will head to the full House for additional debate.

Bill Looks to Restart Montana Executions by Lethal Injection

After a judge blocked the state of Montana from carrying out the death penalty by lethal injection in 2015, legislators are considering a bill to bring the law in line with the judicial decision.

Representatives in the House Judiciary Committee heard testimony on House Bill 244 on Wednesday, Feb. 3. The measure would provide that lethal injection can be carried out with a substance in a "lethal quantity sufficient to cause death." Montana law currently requires the administration of an "ultra-fast-acting barbiturate" -- a sedative used to induce a coma -- before the lethal injection is given. HB 244 would strike that requirement after District Judge Jeffrey Sherlock ruled the drug Montana was using did not meet the standard of "ultra-fast-acting."

Rep. Dennis Lenz, R-Billings, sponsored the bill on behalf of Attorney General Austin Knudsen, who testified in support of the bill. Knudsen said the state "has not been able" to execute anyone since 2015, and that this bill would change that.

"The language you see in front of you is what we believe is going to give us the strongest legal position to defend that and be able to actually carry out the will of this Legislature," Knudsen said.

Several county attorneys testified alongside a representative from the Montana County Attorney Association in support of the bill, saying it makes a simple fix to allow the death penalty to be carried out in Montana as intended by law.

Committee Chair Barry Usher, a Republican representing parts of Yellowstone and Musselshell Counties, asked witnesses to structure their testimony carefully when he asserted that the bill was not about the death penalty, but specifically about changing the language around the type of drug used in the process. Usher shut down testimony from a proponent and several opponents who began to talk about the death penalty in general.

Sam Forstag opposed the bill on behalf of Montana's chapter of the American Civil Liberties Union, saying Judge Sherlock's ruling did not expressly permit the change in HB 244, which Forstag said too broadly defines what drugs can be used in lethal injections.

"It is hard to reconcile granting the state such a broad prerogative in what can be done to our citizens," Forstag said. "The functional result of this change, if it were to succeed, is state authority to inject people with whatever drug hasn't yet been precluded in an ever-shifting scramble."

SK Rossi, representing the Montana Innocence Project, said a "yes" vote on the bill would be a "yes" vote to reinstate the death penalty in Montana.

"I think it's a little disingenuous to call this a technical change," Rossi said.

Committee members debated over whether Judge Sherlock's 2015 ruling ordered the Legislature to make the change in HB 244.

In fact, Sherlock wrote in his decision that the state's remedy "is to ask the Legislature to modify the statute to allow the use of pentobarbital or other slower acting drugs" instead of just ultra-fast-acting barbiturates. However, Sherlock only ordered the State of Montana stop using the barbiturate until "the statute authorizing lethal injection is modified in conformance with this decision."

Some Democrats on the committee agreed with opponent testimony that the new language too broadly defines what drugs can be used in lethal injections, but Knudsen said the change brings Montana in line with most other states that do not specify the use of a single drug. He added that not just any drug can be used for lethal injection.

"There is a bevy of case law, both state and, predominantly, from the U.S. Supreme Court, outlining the process and what is, frankly, cruel and unusual punishment," Knudsen said.

In his closing remarks, Lenz said he disagreed with the ACLU's assertion that "anything" could be used for lethal injection under the bill.

"I mean, I don't think somebody at the prison is going to be grabbing a jug of antifreeze and heading to be killing somebody with that," Lenz said. "That's ridiculous."

At the start of the hearing, Usher promised members of the public there to testify that a bill more directly addressing the death penalty would be coming down the pike later in the session.

The committee did not take immediate action on the bill. If passed, it will head to the full House for additional debate.

Education Bills Seek Higher Teacher Pay, Special Needs Support and Opt-In Sex Ed

Lawmakers in the Montana House of Representatives are considering a slate of education bills aimed to increase starting teacher pay, allow special needs students to remain in high school longer and require parents to opt-in to sexual education courses for their children.

House Bill 143, one of the bills prioritized by Gov. Greg Gianforte's budget, would add incentives for school districts to increase starting teacher pay.

"Nothing dictatorial about this bill," Rep. Llew Jones, R-Conrad, the bill's sponsor, said. "Just an incentive package to incentivize an increase in the beginning teacher pay, thus hopefully more folks will enter the teaching field, and those who do enter the teaching field will stay in Montana."

The bill passed the House in a 95-2 vote and is heading to the Senate.

The House Education Committee also heard public comment on a bill seeking to extend the age special needs students are allowed to attend public school.

Rep. Fred Anderson, R-Great Falls, is sponsoring House Bill 233, which would revise current law to include special needs students over the age of 18 in calculations for school funding.

Montana is the last state in the nation that does not allow special needs children to stay in high school after age 18. Instead, they are put on a waiting list for adult disability services. There are currently 2,500 people receiving special needs services from the state, and 2,300 are on the waiting list, according to Beth Brenneman, an attorney with Disability Rights Montana, who spoke in support of the bill.

Proponents of the bill, like Sen. Chris Pope, D-Bozeman, said allowing kids just a few more years in school would help them thrive as adults with jobs and personal lives.

"House Bill 233 provides a golden key: a diploma that unlocks an active and participatory life," Pope said. "A pathway to the workforce, earning a paycheck and otherwise optimizing the prospect of an active future participation in community life."

Other proponents shared their own personal stories about their special needs children who under current law would be left without professional help for upward of three years after they turn 18.

The House Education Committee did not take immediate action on the bill, which will head to the full House for additional debate if approved.

Later in the week, Sen. Cary Smith, R-Billings, introduced Senate Bill 99 to the Senate Education and Cultural Resources Committee in a hearing that stretched for nearly two hours, in part due to lengthy opposition from witnesses. The bill would require parents of children attending public school to provide written consent for their student to be enrolled in sexual education courses.

"What this bill is about is transparency," Smith said. "I believe that parents should be able to know exactly what's being taught to their children in school."

Another part of the bill would also prohibit organizations that provide abortions from handing out materials in schools.

Supporters of the bill cited public outrage at a 2010 announcement by the Helena School Board that comprehensive sex education would soon be taught in schools, with elements introduced as early as Kindergarten.

The Montana Legislature took up bills similar to HB 233 in 2011 and 2013, but Democratic governors Brian Schweitzer and Steve Bullock vetoed both.

"There were things in the fourth and fifth grade curriculum that we couldn't even talk about in detail during radio and television interviews," said Jeff Laszloffy, representing the Montana Family Foundation. "The parents of Montana would have to wait for a governor willing to help them protect their children."

Opponents of the bill, which far outnumbered proponents, said the bill would potentially keep children from learning critical information that could prevent them from falling victim to sexual abuse or perpetrating it themselves.

"Sexual education can serve as a way to find the students that need help," said Rosemary Howell, a Helena resident and childhood sexual abuse survivor. "Kids need to be educated so they can protect themselves and ask for help when they need it, without shame."

UM Legislative News reporter James Bradley contributed reporting to this story.

Austin Amestoy is a reporter with the UM Legislative News Service, a partnership of the University of Montana School of Journalism, the Montana Broadcasters Association, the Montana Newspaper Association and the Greater Montana Foundation. He can be reached at [email protected].