With the substitute bill, there is no longer a fiscal impact on the SCC. I will be watching the committee meeting. I was not able to register to speak because I just found out HB 146 is on the agenda. Katie Johnson

I write in support of HB 312, requiring the VA Health Benefit Exchange to establish an annual Marketing plan - a unanimous JCHC recommendation. This simple step will ensure that Virginians who currently rely on the federal exchange and uninsured Virginians are informed and supported when VA moves to a state-based exchange in 2023. Currently, there are 307,946 Virginians enrolled through the federal Marketplace. It will take planning and coordination between the state-based exchange, navigators and certified application counselors, and brokers and agents, as outlined in HB 312, to prevent coverage losses during this transition.

I write in support of HB 312, requiring the VA Health Benefit Exchange to establish an annual Marketing plan - a unanimous JCHC recommendation. This simple step will ensure that Virginians who currently rely on the federal exchange and uninsured Virginians are informed and supported when VA moves to a state-based exchange in 2023. Currently, there are 307,946 Virginians enrolled through the federal Marketplace. It will take planning and coordination between the state-based exchange, navigators and certified application counselors, and brokers and agents, as outlined in HB 312, to prevent coverage losses during this transition.

The National Multiple Sclerosis (MS) Society strongly supports HB 312, which would direct the Virginia Health Benefits Exchange to develop and implement an annual marketing plan that includes consumer outreach and navigator programs. Through this funding, the Commonwealth can help ensure a smooth transition to a state-based exchange and guarantee that people living with multiple sclerosis have access to enrollment assistance and comprehensive coverage. Access to affordable, high quality health care is critical for people with MS to live their best lives, and health insurance coverage is essential for people to be able to get the care and treatments they need. We thank Delegate Rasoul for bringing this important legislation forward and urge lawmakers to support this bill.

The National Multiple Sclerosis (MS) Society strongly supports HB 312, which would direct the Virginia Health Benefits Exchange to develop and implement an annual marketing plan that includes consumer outreach and navigator programs. Through this funding, the Commonwealth can help ensure a smooth transition to a state-based exchange and guarantee that people living with multiple sclerosis have access to enrollment assistance and comprehensive coverage. Access to affordable, high quality health care is critical for people with MS to live their best lives, and health insurance coverage is essential for people to be able to get the care and treatments they need. We thank Delegate Rasoul for bringing this important legislation forward and urge lawmakers to support this bill.

Members of the Committee Thank you for the opportunity to provide comments on House Bill 312 sponsored by Delegate Rasoul. House Bill 312 directs the Virginia Health Benefits Exchange to develop and implement an annual marketing and outreach plan, including in person assistance. It also provides additional funds to ensure a smooth transition to a state run exchange in the coming years. It was an important recommendation from the JCHC. The American Lung Association strongly supports this bill as an integral way to ensure Virginians have access to care. The American Lung Association is the leading organization working to save lives by improving lung health and preventing lung disease, through research, education and advocacy. The work of the American Lung Association is focused on four strategic imperatives: to defeat lung cancer; to improve the air we breathe; to reduce the burden of lung disease on individuals and their families; and to eliminate tobacco use and tobacco-related diseases. The American Lung Association believes everyone should have quality and affordable healthcare coverage. The Lung Association strongly supports the focus on improving outreach and enrollment activities to connect consumers with quality and affordable coverage. We support activities to extend the open enrollment period for ACA marketplace plans, increase funding for Navigator services and invest in other outreach and enrollment activities. Studies have shown the success of consumer assistance in getting people enrolled in coverage,1 and as recently as 2019, a significant share of the population was unaware that the ACA provided subsidies for coverage and expanded Medicaid.2 We urge you to prioritize investments that can reduce disparities in coverage. Thirty million U.S. residents lacked health insurance in 2020, and disparities among uninsured remain, with most non-white groups more likely to be uninsured than whites.3 Of the 10.9 million people currently eligible for ACA marketplace coverage subsidies but unenrolled, 30% are Hispanic, 59% have a high school diploma or less, 42% are young adults, 16% live in rural areas, and 11% do not have internet access at home.4 The American Lung Association thanks the Virginia General Assembly for their continued commitment to the health and wellbeing of the residents of the Commonwealth. The American Lung Association strongly supports House Bill 312 which would ensure that all Virginians have access to quality and affordable healthcare and encourages swift action to move the bill out of committee and passage by the General Assembly. [1] Karen Pollitz et al. “Consumer Assistance in Health Insurance: Evidence of Impact and Unmet Need,” Kaiser Family Foundation, Aug. 7, 2020; Karen Pollitz et al, “2016 Survey of Health Insurance Marketplace Assister Programs and Brokers,” Kaiser Family Foundation, Jun. 8, 2016. 2 Mollyann Brodie et al., “The Past, Present and Possible Future of Public Opinion on the ACA,” Health Affairs, Feb. 19, 2020. 3 Kenneth Finegold et al., Trends in the U.S. Uninsured Population, 2010-2020,U.S. Department of Health & Human Services’ Office of the Assistant Secretary for Planning & Evaluation (ASPE), Feb. 11, 2021. 4 Daniel McDermott and Cynthia Cox, A Closer Look at the Uninsured Marketplace Eligible Population Following the American Rescue Plan Act, KFF, May 27, 2021.

B420 Danny’s Law is imperative to every single person who has directly or indirectly been affected by the Opioid Epidemic. Too many children have buried their parents. Too many parents have buried their children. Too many grandparents are raising their grandkids. How many more lives have to be lost for the state of VIRGINIA to wake up and WANT to be a part of a solution to a world wide problem? The Opioid Epidemic shows me The War on Drugs failed to protect the people for whom it was intended for. The amount of lives lost and changed has reached an unbelievable number, and yet here we are, advocating for a Bill to be passed to help addicts get proper medical attention. If an addict shows up to the ER because of a drug overdose, isn’t the addict silently screaming the same words as a suicidal patient who speaks, “I want to die?” I hope B420 Danny’s Law helps change the world for the generations to come, and starts to keep medical professionals accountable for their ignorance. “WHEN THE POWER OF LOVE, OVERSEES THE LOVE THE POWER, THE WORLD WILL KNOW PEACE” || Jimi Hendrix

I am writing in support of HB 306 to be heard in committee tomorrow morning, which will allow a religious exemption to vaccines during an epidemic. Religious exemptions exist so that citizens can act freely in mind, body and spirit. Even in a time of an epidemic, citizens must have the opportunity to act on their conscience whatever that may be. The Nuremberg Code requires bodily autonomy and informed consent for any medical treatments to one’s body. Having religious exemption makes sure that remains the rule of law. As we’ve seen over the last two years, government has retained control over persons and their bodies in a way that would make Thomas Jefferson role over in his grave. Let Virginia continue to be religiously free, as the birthplace of religious freedom. Support HB 306.

I would like to speak please -Amy Lee Story

In January of 2013, my brother overdosed and was treated at a northern Virginia hospital. EMTs saved his life and I am grateful, but what followed was tragic. He was released hours later with no resources, no referrals, and most importantly - no narcan. A month later I came home to the house we lived in together and found him unresponsive. I did not have Narcan. If he had been given it in the hospital that day I could have used it and maybe saved him. But they didn’t give it to him. If he had been started on buprenorphine that day, his likelihood of fatal overdose would have been reduced by 50%! But they didn’t start him on it. Every year we set a new record for number of drug overdose deaths. The number of fatalities in Virginia has almost quadrupled in the last decade. We have the tools to drastically reduce these numbers - narcan, buprenorphine, peer support - but they aren’t being used where they are needed most. Our hosptitals. In Fairfax County the jail is providing better healthcare for people with addiction than our hospitals are. When someone comes into the jail they receive buprenorphine, are connected with a peer support specialist, and are released with a box of narcan in their personal effects. There are only two hospitals in the whole of Virginia that are coming close to providing those three basic best-practices. If you use opioids for a long enough you are likely to end up in one of three places: jail, the hospital, or the morgue. In those first two settings we have a fleeting opportunity to help someone find recovery. By the third one it’s too late. For decades our hospitals have failed people with substance use disorders - a our sons, sisters, fathers - and it’s time we insist that they close the gaps in care that are costing so many lives.

As a recovering addict I speak from experience when I say we need this bill passed. Naloxone saves my life more than once when I was in my active addiction. Having it on hand saved my life. I was no where near a hospital and a friend administered it to me. When the ambulance finally did get there I had already come to. If we would have had to wait for them I would have died. The sheriff that came with them gave me information and told me to get help. I did and I've been sober for 3yrs. We need to give ALL addicts that overdose that opportunity to have Naloxone on hand and have resources to help get them out of addiction. We do recover.

Please vote to support this bill. We need to do more to support our neighbors and loved ones who struggle with addiction. I've seen a family member die from addiction and another who has struggled for decades. If we do more intervention when people come into emergency rooms, maybe we can save more people from a terrible fate. Thank you, Lindsey Gleason

As a spouse of a person in recovery, the link between our local healthcare system and recovery is vital. During my husband's active addiction, we visited our local emergency room to seek help in entering recovery as our primary physician was unwilling to help us. The only help that was offered was fluids and a list of AA groups in the area. Had we had access to peer recovery systems, information on medication assistance recovery, and ANY information I firmly believe my husband's addiction would have ended there. Fortunately, after many months of PERSONAL searching for a recovery program that we could afford (with no help from our insurance, doctors, or community services board), my husband achieved recovery. Out of the 15 recovery programs within 75 miles of our home, only two are viable programs. Many are cash only, no mental health offered, pick up your pills at 7 am with your cash and go about your day kinds of programs. A complete overhaul of these programs and investigations into the doctors who oversee these programs is also VERY much needed in our community.

In January of 2013, my brother overdosed and was treated at a northern Virginia hospital. EMTs saved his life and I am grateful, but what followed was tragic. He was released hours later with no resources, no referrals, and most importantly - no narcan. A month later I came home to the house we lived in together and found him unresponsive. I did not have Narcan. If he had been given it in the hospital that day I could have used it and maybe saved him. But they didn’t give it to him. If he had been started on buprenorphine that day, his likelihood of fatal overdose would have been reduced by 50%! But they didn’t start him on it. Every year we set a new record for number of drug overdose deaths. The number of fatalities in Virginia has almost quadrupled in the last decade. We have the tools to drastically reduce these numbers - narcan, buprenorphine, peer support - but they aren’t being used where they are needed most. Our hosptitals. In Fairfax County the jail is providing better healthcare for people with addiction than our hospitals are. When someone comes into the jail they receive buprenorphine, are connected with a peer support specialist, and are released with a box of narcan in their personal effects. There are only two hospitals in the whole of Virginia that are coming close to providing those three basic best-practices. If you use opioids for a long enough you are likely to end up in one of three places: jail, the hospital, or the morgue. In those first two settings we have a fleeting opportunity to help someone find recovery. By the third one it’s too late. For decades our hospitals have failed people with substance use disorders - a our sons, sisters, fathers - and it’s time we insist that they close the gaps in care that are costing so many lives.

Please consider passing this bill. Many other illnesses are treated with evidence based practices though substance use is not. It is time to move forward with substance use as a disease defined by DSM criteria and allow these individuals access to adequate care. This bill can only help improve the outcomes. These are individuals deserve is access as a human right.

Good afternoon! My name is Amalia and I am a woman in long-term recovery from Substance Use Disorder. Overdose is a part of my story. Gratefully, I lived to tell it and to get the opportunity to help those who are struggling today. I lead a team of Certified Peer Recovery Specialists as part of a federal grant-funded Post Overdose Response Team. We have repeatedly approached the hospitals in our 10 county catchment, offering our services at no cost to them and have been denied. Peers are being utilized in Emergency Departments across the country and are having much success in reaching those suffering with Substance Use Disorder through relating our stories and offering hope. Peer Specialists follow up with these patients, which is something hospital staff does not have the time to do. We can be an asset to the ER team and together stand a much better chance of saving lives! It is time for the state of Virginia to catch up with the procedures that are working to make a difference in other states. Peer Recovery Specialists are proven to make a difference in the numbers of lives saved! We want the opportunity to keep even one Virginian from dying from an overdose today! Thank you

My nephew was critically injured in a car accident when he was 26. He lost his arm and then his shoulder. The insurance company (BC/BS) has denied him a prosthetic 4 x so far, calling it experimental and unnecessary, although the independent review determined that he met all the criteria for a prosthetic. Because his was a shoulder disarticulation amputation, a prosthetic would, even if it did not replace his fingers, need to provide movement for his wrist, elbow and shoulder. It is estimated by two different prosthetic companies to cost approximately $175,000 if he had to pay out of pocket. There is no possible way for him to afford this. B/c the insurance company is not required to cover it, he is unable to obtain a prosthetic that would allow him to work and re-enter society fully. Please pass this legislation so young people like him, full of promise but rendered victims of unforeseen and random, momentary events, are not saddled with entirely unmanageable burdens that could be transcended for this one requirement.

Please move to support Del. Roem's HB925. Thank you from prosthetic device wearers.