2023 Advocacy Accomplishments

• On March 23, 2023, on the 13th anniversary of the Affordable Care Act, the North Carolina legislature voted to expand Medicaid, making North Carolina the 40th state to increase eligibility for Medicaid health coverage for more than 600,000 people. This long-overdue win follows more than a decade of advocacy by ACS CAN, together with cancer patients, survivors and their families who collectively called on the state legislature to take this lifesaving action. Following passage, the North Carolina legislature passed the Fiscal Year 2023 budget in September, including additional funds for Medicaid expansion.   Pictured below is a photo from the North Carolina bill signing event. 

• Congress voted to pass the Fiscal Responsibility Act just before a looming early June 2023 deadline that avoided inclusion of Medicaid work requirements, which could have erected barriers to care. In the lead-up to the debt ceiling deal, ACS CAN activated our volunteers nationwide to call, visit, and write to their lawmakers, urging them to oppose any debt ceiling proposal that threatened funding for cancer research or created barriers to health insurance through Medicaid. Volunteers made over 3,000 calls and sent nearly 25,000 messages to key Senate offices. We also launched a full-scale advertising campaign in key newspapers, including The Washington Post and The New York Times, as well as regional websites and publications. Through our ad campaign, we generated:      

• • 13.9M impressions in one week and were active across social media channels with the hashtag #NoCutstoCuresorCare.       

• • Across our @ACSCAN social accounts, posts reached 90K accounts and generated over 185K impressions.      

• During the COVID-19 pandemic, Congress put protections in place to ensure that Medicaid enrollees were able to keep their health coverage with no disruptions. The unwinding of these protections in 2023 and the subsequent coverage gaps have a major negative impact on access to care, including necessary prevention and early-detection screenings. ACS CAN is playing a major role to educate those who may be impacted and elevating patient voices of those who are facing coverage disruptions. At least 11 million Medicaid enrollees from all 50 states and the District of Columbia have been disenrolled as of November 27, 2023, based on the most current data. We joined with our partners in the Protect Patient Access to Coverage and Connecting to Coverage coalitions to take action.  ACS CAN worked alongside the American Cancer Society to ensure health systems, physicians, providers and the general public knew the best strategies to support individuals who learned they had been disenrolled.     

• • In Arkansas and Florida, we joined with our state coalition partners to call on the state government to pause the renewal process so that states can analyze this early data and make sure those who are still eligible will not become uninsured.      

• Lawmakers voted in June 2023 to reauthorize Medicaid expansion in New Hampshire to ensure thousands of people, including cancer patients and survivors, have access to the affordable health care they need.   Pictured below is the New Hampshire team hosting a reauthorization Medicaid expansion educational event. 

• ACS CAN helped secure several wins in 2023 advocating for extended postpartum coverage under Medicaid. These efforts provided increased access to health care coverage for over 43,000 people in eight states, including non-Medicaid expansion states, Wyoming and Mississippi. In Alaska (pictured below), Governor Mike Dunleavy signed legislation that will extend eligibility for postpartum Medicaid. These significant wins help to ensure individuals and families have affordable health coverage, which we know is critical to reduce cancer incidence and mortality.       

• Both ACS CAN and the American Cancer Society actively support access to patient navigation services, noting the critical role navigation plays in helping patients overcome health care system barriers and surviving cancer. ACS CAN kicked off 2023 by drafting a white paper about patient navigation that provided legislative, regulatory and payment model options to highlight important considerations to significantly expand the long-term financial stability of patient navigation services. This white paper has served as the foundation to help inform ACS CAN’s legislative advocacy campaign strategy and key policy recommendations to increase access to patient navigation services and was also shared with key partners, such as the White House Cancer Moonshot Office and the First Lady’s Policy Team.  
• Later in the year, an ACS CAN survey found an overwhelming majority of patients and survivors (91%) agreed that having access to a patient navigator was very important for cancer patients. However, only 55% of those surveyed said their oncology provider had a patient navigator on staff – further emphasizing the need for sustainable funding models for patient navigation services.   

• The foundational work ACS CAN executed on patient navigation played a critical role in the Centers for Medicare & Medicaid Services (CMS) issuing first-time reimbursement codes for patient navigation services for those with serious illness, like cancer.  The proposed codes were included in the final 2024 Medicare Physician Fee Schedule rule. ACS CAN issued two letters to CMS, one along with 59 partners, that provided comments on how the new navigation payment approach should be implemented. In November, CMS issued the final rule on the new payment code, which reflected many of the recommendations made by ACS CAN and our partners, including ensuring patient consent in advance of providing patient navigation services, either in writing or verbally.   
• • ACS CAN have been long-standing advocates of the important role patient navigation services play in survivorship against cancer. Access to affordable coverage significantly improves chances of diagnosing, treating, and surviving cancer. Interruptions in insurance can have catastrophic effects on cancer patients who cannot delay treatment. 
• The 2023 ACS CAN 12th National Forum on the Future of Health Care brought together experts in the field to examine ways of paying for these services (pictured below).  Over 500 people participated in person and virtually. In case you missed it, you can watch the virtual recording of the event here. 

• ACS CAN successfully advocated for legislation to improve affordability of prescription drugs by regulating copay accumulator adjustments. This legislation to ensure third-party copay assistance is counted toward a patient’s out-of-pocket cost obligations was enacted in Colorado, New Mexico and Texas in 2023.      

• After 15 years of relentless advocacy work, oral chemotherapy fairness legislation passed on October 12, 2023, providing Michiganders more affordable access to cancer treatments. Michigan Governor Gretchen Whitmer signed the bill (pictured below), which will ensure out-of-pocket costs for cancer patients for oral and intravenous (IV) chemotherapy are similar.    

As a result of ACS CAN’s federal lobbying, on July 11, 2023, the Palliative Care and Hospice Education and Training Act (PCHETA) was reintroduced by U.S. Senators Tammy Baldwin and Shelley Moore Capito. The bipartisan bill would create a national public education and awareness campaign to educate patients and providers about the availability and benefits of palliative care, expand federal research, and establish palliative care education and training programs for doctors, nurses and other health professionals. The Senate’s inclusion of $12.5 million for palliative care research in its version of the FY2024 LHHS bill would help millions of people during their cancer journeys by investing in a strategy to focus, expand, and intensify national research programs in palliative care at the National Institutes of Health. Funding for these activities is likely to be included in the final version of the bill, expected later in 2024.  ACS CAN applauded Senators Baldwin and Capito for joining our fight in prioritizing important services for people with cancer and survivors.      

Hawaii Governor Josh Green signed HB907 into law, ensuring more Hawaii residents can access audio-only telehealth. Telehealth services can assure cancer survivors a much-needed lifeline when questions arise, and this legislation will increase access to quality care, especially for individuals in rural areas with limited broadband access.       

• As part of our advocacy on the Inflation Reduction Act, ACS CAN successfully urged Congress to enact major improvements to the Medicare program: (1) an annual cap on total Medicare Part D out-of-pocket prescription medication costs and (2) a mechanism that would allow a Medicare enrollee the option to “smooth” out or pay the required cost sharing in capped monthly costs. In September, ACS CAN sent a letter to the Centers for Medicare & Medicaid Services (CMS) expressing strong support for the option beneficiaries have to pay their annual cost sharing in monthly installments (known as the Medicare Prescription Payment Plan) and urging improvements for patients.   

• Additionally, ACS CAN President Lisa Lacasse participated in one of a series of CMS patient listening sessions on the implementation of the Medicare Drug Price Negotiation Program, another provision of the IRA. These listening sessions sought input relevant to drugs selected for the first round of negotiations.  ACS CAN will continue to elevate the importance of affordability of drug therapies, as well as innovation needed to improve cancer outcomes for patients. 

• Key patient protections that ACS CAN has identified as necessary to ensure that the new prescription negotiation program is implemented in a way that benefits cancer patients directly are detailed in this April 2023 letter to CMS with additional input in September 2023.  ACS CAN has an important perspective to continue to elevate, strongly encouraging CMS to actively monitor implementation of the Medicare Prescription Payment Plan in real time as it relates to patient affordability and access to their medicines. 

• In April, ACS CAN joined other patient groups in advocating for deference to the FDA’s scientific authority in issuing drug approvals and protecting patients in the case challenging approval of mifepristone. A district court and then the Court of Appeals for the Fifth Circuit blocked the agency’s approval. ACS CAN has joined two briefs in the case, one at the circuit court and the other urging the U.S. Supreme Court to accept the appeal. The Supreme Court did accept the case in December. If the lower courts’ rulings are allowed to stand, patients may no longer have the security of knowing that determinations about drug safety ultimately lie with the experts but could be decided by judges.  
• On August 2, 2023, ACS CAN and the American Cancer Society filed an amicus brief defending the No Surprises Act in the case of Haller v. Health and Human Services (HHS) in the U.S. Court of Appeals for the Second Circuit. The brief was filed in support of patient protection provisions of the No Surprises Act (NSA) being challenged in the case and provided extensive scientific research from the American Cancer Society on the high costs of cancer that lead to financial hardship and worse patient outcomes for cancer patients and higher chances of death.        
• ACS CAN led amicus briefs filed at the U.S. Court of Appeals for the Fifth Circuit defending provisions of the Affordable Care Act requiring many preventive services be covered without cost sharing by private insurers. The filings included data highlighting how preventive care such as colorectal cancer screening saves lives and is cost-effective, as well as services that would be lost under a lower court ruling in March that threatened to upend patient care. Fortunately, the Fifth Circuit granted the stay we requested in June, effectively upholding access to no-cost preventive services while the case is pending.    
• An amicus brief led by ACS CAN helped result in the June 2023 victory at the U.S. Supreme Court in a case that upheld Medicaid patients’ ability to enforce their benefits using civil rights laws. The brief provided extensive scientific data on the crucial role Medicaid plays in preventing and treating life-threatening illnesses, with an emphasis on studies about cancer prevention and treatment.   
• We led an amicus brief at the U.S. Supreme Court illustrating the importance of judges deferring to agencies such as the Centers for Medicare & Medicaid Services on Medicare and Medicaid policies.   

• Comprehensive coverage of biomarker testing is critical to ensure equitable access to the testing required to match patients with innovative cancer therapies at the right time. ACS CAN was instrumental in the passage and enactment of legislation to expand insurance coverage of comprehensive biomarker testing and ensured this coverage keeps pace with the latest advances. In 2023, Arkansas, California, Georgia, Kentucky, Maryland, Minnesota, New Mexico, Oklahoma, Texas and New York passed and signed legislation to expand biomarker testing into law, bringing the total to 14 states that have enacted such legislation to date.   Pictured below shows ACS CAN volunteers standing with Kentucky Governor Andy Beshear at the bill signing. 

• As of July 1, 2023, approximately 220,000 retail stores across the nation that sold cigarettes were required to display public signage highlighting the deadly consequences of cigarette smoking. Thanks in part to ACS CAN’s efforts, under a federal court order, the signs were installed near cigarette displays in 220,000 retail stores nationwide between July 1 and September 30 and must be displayed until June 30, 2025. This victory is the final and long-overdue step implementing “corrective statements” tobacco companies were ordered to make in a 2006 landmark ruling that found the industry was guilty of decades of lies that led to addiction, disease, and premature death for millions of people.  

• ACS CAN worked with tobacco control partners in filing numerous amicus briefs supporting the FDA in cases in which the agency had issued marketing denial orders for flavored e-cigarette products to get them off the market.  With our help, the FDA has won the majority of these challenges.  We successfully defended the FDA rule requiring graphic warnings on cigarette packages and advertisements.

• In January 2023, ACS CAN celebrated Ohio Governor Mike DeWine’s veto of House Bill 513, which restricts the authority of communities to pass local laws regulating the sale of tobacco products that are stronger than state law. Through 275 patch-through calls and 155 actions taken, our volunteers contributed to this important veto. ACS CAN also executed media advocacy tactics to publicly state our opposition to preemption and support the governor’s veto, earning over 100 mentions. Governor DeWine used our statistics during his press conference announcing his veto. Although the Ohio State Legislature voted to override the governor’s veto, ACS CAN thanked DeWine for standing up for the health of Ohioans and will continue our advocacy work to protect kids from Big Tobacco.

• In Oregon, the legislature amended state law to require eight additional tobacco manufacturers to make equity payments for every unit of their product sold. The funds, expected to amount to $4 million to $5 million annually, are to be allocated for the Oregon Health Plan.      

• Thanks to ACS CAN’s efforts, tobacco retailers in Bakersfield, California, are now required to apply for a license and pay licensing fees as part of a comprehensive tobacco retail licensing ordinance holding retailers accountable for following state and local tobacco laws, including the statewide law that ended the sale of flavored tobacco products.      

• Our California team received funding approval from the California Department of Public Health Tobacco Control Program for three tobacco grants for nearly $2 million over two years. Two of the grants will focus on work with Hispanic/Latino and African American populations. Our work will center on the adoption and implementation of tobacco retail licensing policies in multiple jurisdictions and engage priority populations in the San Francisco East Bay, Delta region and San Joaquin Valley.       

• ACS CAN and the Campaign for Tobacco-Free Kids coalition released an analysis of the public health benefits and cost savings that New York residents can expect to see with Governor Kathy Hochul’s proposed $1 per pack cigarette tax increase, as well as saving over 15,300 lives.       

• ACS CAN also advocated for and was successful in the Senate Appropriations Committee providing specific money and directing the FDA to address drug shortages, and the backlog of premarket tobacco product applications, as well as complete the rule-making process to prohibit menthol cigarettes.     
• Minnesota was the first and only state to date to take JUUL and Altria to court, which resulted in a settlement. Together, JUUL and Altria will pay a total of $60.5 million to the state of Minnesota over an eight-year period. The ACS CAN Minnesota team (pictured below) championed legislation to ensure all payments after attorney’s fees are dedicated to commercial tobacco prevention and cessation, totaling approximately $43 million.    

• The Pennsylvania Legislature passed and Governor Josh  Shapiro certified the 2023-24 budget, which includes important cancer prevention and treatment priorities for Pennsylvanians. ACS CAN advocated for the inclusion of a $2.563 million funding allocation for the Pennsylvania Breast and Cervical Cancer Early Detection Program (PA BCCEDP).     
• On June 7, 2023, the U.S. House and the Senate introduced the Screening for Communities to Receive Early and Equitable Needed Services (SCREENS) for Cancer Act, a bill that would reauthorize the National Breast and Cervical Cancer Early Detection Program (NBCCEDP) through 2028, preserving access to the program. For over 30 years, the NBCCEDP has effectively provided critical breast and cervical cancer screenings, follow-up, diagnosis and treatment to lower-income, uninsured and underinsured women. Thanks to ACS CAN’s advocacy efforts, the U.S. Senate Committee on Health, Education, Labor and Pensions voted to advance the legislation in December 2023. ACS CAN continued to advocate for policies to reduce the disparities in breast cancer by improving access to prevention and early detection services, patient navigation services, insurance coverage, in-network facilities, and clinical trials.    
• Pictured below, in March 2023, ACS CAN CEO Dr. Karen E. Knudsen and ACS CAN President Lisa A. Lacasse joined other health organizations at the White House at the Cancer Moonshot Colorectal Cancer Forum. Patients, oncologists, researchers, and advocates discussed progress and opportunities in colorectal cancer awareness, screening, access and treatments.     

Throughout 2023, ACS CAN steadily worked to advance the Medicare Multi-Cancer Early Detection (MCED) Screening Coverage Act.  MCED creates a pathway to ensure timely Medicare coverage of new, innovative multi-cancer screening tests and expand access to early detection once FDA approved and clinical benefit is shown. Through our advocacy, MCED has gained the active support of a bipartisan majority of members in both the House and Senate.       

• ACS CAN submitted comments supporting the U.S. Department of Health and Human Services’ (HHS) proposed rule to expand federal insurance coverage eligibility for Deferred Action for Childhood Arrivals (DACA) recipients, who are three times as likely to be uninsured than the general U.S. population. ACS CAN supports the proposed rule because it would remove barriers to accessing health care services, which is critical to reducing health disparities and saving more lives from cancer. In our comments, ACS CAN urged HHS to finalize the rule as proposed before the 2024 open enrollment season began.       

• In 2023, we reactivated our Cancer Votes program to target two local races in Memphis, Tennessee, and St. Louis, Missouri, where ACS CAN is working to reduce cancer disparities. We asked local candidates questions about their positions on addressing social determinants of health, including food insecurity to inform voters about each candidate’s stance on these issues. Learn more by viewing the voter guides we published for the Memphis Mayoral Race and the St. Louis Board of Aldermen Race.       

• On April 3, 2023, ACS CAN filed an  amicus brief,  along with more than a dozen other groups, urging the U.S. Court of Appeals for the Fifth Circuit to preserve protections in the Affordable Care Act (ACA) for Lesbian, Gay, Bisexual, Transgender and Queer (LGBTQ+) patients receiving health care services in the case of Neese vs. Becerra. The brief makes clear that LGBTQ+ patients already face significant health disparities and that allowing a lower court ruling to stand that would limit protections for LBGTQ+ individuals against discrimination would widen these disparities and lead to worse health outcomes.                                                       

• ACS CAN led an amicus brief defending the rights of immigrants to enroll in Medicaid without it adversely affecting their right to be in the United States.   

• In 2023, ACS CAN continued to support public policies that reduce the disproportionate burden of cancer experienced by Tribal communities. We requested that Congress increase funding levels and provide advanced appropriations in Fiscal Year 2024 for the Indian Health Service, which would provide funding stability for an agency that has been historically underfunded.     
• In September 2023, ACS CAN released a follow-up companion piece to ACS CAN’s flagship policy report, The Costs of Cancer. The Health Equity and the Costs of Cancer series of fact sheets examines the costs of cancer for several communities and populations to highlight the impact of the costs of cancer. The resources released include new communities, as well as a targeted look at three of the most common cancer types:       

The Costs of Cancer in the LGBTQ+ Community     

The Costs of Cancer in People of Color     

The Costs of Cancer in Working-age People     

The Costs of Breast Cancer     

The Costs of Prostate Cancer     

The Costs of Colorectal Cancer    

• ACS CAN hosted a virtual briefing for members of Congress and their offices on the American Cancer Society’s Facts & Figures 2023 report, focusing on prostate cancer incidence, cancer screening and outcome disparities and the cancer burden in Native American communities.   

• In April 2023, ACS CAN participated in the National Medical Association’s  National Colloquium on African American Health. The annual event (pictured above) is designed to raise awareness of health care and public policy issues and brings together stakeholders to address access to essential services and improvements in health outcomes for minority populations.      

•  In May 2023, ACS CAN sponsored the National Tribal Health Conference, an event attended by over 1,000 people from across the country. Team members from the American Cancer Society and ACS CAN spearheaded a breakfast panel and program with more than 50 attendees, featuring numerous leaders and experts in Tribal health. Participation in this event was a terrific opportunity to foster relationships with Tribal health leaders, specifically with the National Indian Health Board, the nation’s leading Tribal health advocacy organization, and to demonstrate our organization’s unique breadth and depth in our ability to address longstanding health disparities.        
• Also in May, ACS CAN sponsored the Asian Pacific American Institute for Congressional Studies (APAICS) Legislative Leadership Summit Gala (pictured below) and spoke on the importance of reducing health disparities to eliminate cancer diagnosis for all.   

• In July 2023, ACS CAN and the American Cancer Society partnered with the Alaska Native Tribal Health Consortium to hold the first-ever Alaska Native Colorectal Cancer Research Symposium. The two-day event focused on why Alaska Native people have the highest colorectal cancer incidence rate in the world.   

• ACS CAN sponsored the Congressional Hispanic Caucus Institute’s 46th Annual Awards Gala, an event attended by President Biden with the theme  of “Our Moment in History,” to celebrate the invaluable contributions of the Hispanic/Latino community.   

• ACS CAN hosted the Southern Arizona Hispanic/Latino Community Forum in Tucson, Arizona. Survivors, oncologists and community members came together to discuss cancer disparities in the Hispanic/Latino community in Southern Arizona. The group worked together to develop a plan to address these disparities through public policy by focusing on screening and patient navigation policies.       

• ACS CAN hosted informative panels in April at the Delta Sigma Theta Sorority, Inc.’s  34th annual "Delta Days in the Nation's Capital” event (pictured below centered) to examine data from the American Cancer Society Facts & Figures 2023 report and discuss the cancer landscape for the Black community.      

• In 2023, ACS CAN trained more than 50 Black Voters Matter (BVM) staff and partners in Georgia on Medicaid expansion and unwinding, creating trusted sources of health care information in communities of color statewide. Our partnership yielded more than 30 opportunities to meet Georgians at community events across Middle and South Georgia. Through these events, we received eight storyteller referrals, gained a health equity film participant, received earned media coverage, and placed co-branded ACS CAN and BVM Medicaid expansion and unwinding materials in the hands of more than 10,000 Georgians during in-person discussions.       

• ACS CAN participated in the 52nd  annual  Congressional Black Caucus Foundation (CBCF) Annual Legislative Conference (ALC), the nation's leading policy conference on issues impacting African Americans and the global Black community, in September in Washington, D.C. ACS CAN team members participated in a plethora of engagement opportunities alongside national industry leaders, elected officials, health care professionals and citizen activists. Held concurrently with the CBCF Annual Legislative Conference, ACS CAN participated in and cosponsored a separate event, The House of Inclusion, (pictured below) to reinforce the importance of health equity.     

• ACS CAN Atlanta-based coalition partner H.E.A.R.T. Coalition engaged the community in a discussion about Big Tobacco’s predatory tactics on the day of the American Cancer Society Great American Smokeout® event in mid-November.       

• ACS CAN sponsored and attended the 47th annual National Hispanic Caucus of State Legislators Summit, which focused on key priorities for Latino families and issues that impact their communities. ACS CAN also sponsored and attended the National Black Caucus of State Legislators Annual Legislative Conference, which focused on policy issues of national and state importance and shared best practices for implementing policies that will protect and benefit all Americans.      

• As part of the Collaboration for Equitable Health, ACS CAN partnered with community-based organizations in Atlanta, Georgia; Charlotte, North Carolina; Chicago, Illinois; Memphis, Tennessee; and St Louis, Missouri, to work on capacity and coalition building and uplifting community voices through advocacy forums, policy planning, and storytelling (pictured below). Our partners are strong advocates in their communities and together, we are identifying and addressing disparities widening the gap in health equity.