2024 Advocacy Accomplishments

• In March, North Carolina volunteer Lori Kelley introduced former President Joe Biden and shared her personal journey of navigating the Medicaid coverage gap alongside the former President and Vice President Kamala Harris during an Affordable Care Act (ACA) event in Raleigh, North Carolina. The event took place just after the 14^th anniversary of the signing of the law and the first anniversary of the signing of North Carolina Medicaid expansion legislation. ACS CAN played a key role in the passage of both pieces of legislation. View the video from the event.

• In July 2024, ACS CAN’s North Carolina team celebrated a milestone victory when Governor Roy Cooper (pictured below) announced that over 500,000 North Carolinians had enrolled in the Medicaid expansion program to receive lifesaving care in just seven months since enrollment began on December 1, 2023. ACS CAN was instrumental in passage of the law that expanded access to Medicaid in the state.

• ACS CAN and the Idaho Supports Medicaid coalition premiered a short film Idaho Supports Medicaid: In Our Words that explored how Medicaid expansion is working and saving lives for over 90,000 Idahoans. After Idahoans decisively passed Medicaid expansion on the ballot in 2018, the program was implemented in 2020 just before the start of the COVID-19 pandemic and provided Idahoans the peace of mind that comes with knowing you can see a doctor when you need one. The film is a powerful testament to the experience of Idaho residents and providers who have seen the benefits of expansion and whose lives would be drastically different without it. 

• In South Carolina, ACS CAN premiered Medicaid Covers Us short film, Hope for a Healthier South Carolina, at ACS CAN’s annual Pink Tea. The film featured key perspectives from various sectors, including a person affected by the coverage gap, a registered nurse and CEO of a Federally Qualified Health Center (FQHC), an insurance agent who has faced the challenge of turning away individuals due to them being in the coverage gap, and a faith leader. Together, they advocate for the expansion of Medicaid across South Carolina.

• ACS CAN supported the introduction of the Health Care Affordability Act of 2024. Sponsored by U.S. Senators Jeanne Shaheen (D-NH) and Tammy Baldwin (D-WI) the bill would make permanent the Affordable Care Act enhanced tax credits that help make health insurance coverage affordable for an estimated 20 million people. The ACA enhanced tax credits allow more people to purchase comprehensive health insurance coverage, critical to prevent, detect, treat, and survive cancer. The tax credits contributed to historic enrollment in Marketplace plans after they took effect and helped to reduce the uninsured rate. With health insurance status being one of the most significant determining factors in surviving a cancer diagnosis, this bill would save lives. 
• ACS CAN helped defeat legislation in Missouri and Wisconsin that would have allowed the sale of farm bureau health plans that avoid compliance with important patient protections and skirt state and federal health insurance laws.  

• ACS CAN’s foundational work on patient navigation played a critical role in the Centers for Medicare and Medicaid Services (CMS) issuing first-time reimbursement codes for patient navigation services for those with serious illness, like cancer. The proposed Principal Illness Navigation codes were included in the final 2024 Medicare Physician Fee Schedule rule and were implemented on January 1, 2024. In September, ACS CAN once again filed joint comments on the patient navigation provisions of CY2025 Medicare Physician Fee Schedule Proposed Rule encouraging CMS to build upon last year’s progress to increase access to patient navigation services by reimbursing for these services under Medicare – such as telehealth and removing copays. ACS CAN will continue to advocate for legislation and policies to increase access to patient navigation for people with cancer, prioritizing policies that create sustainable funding to ensure patient access to patient navigation services across the cancer continuum. 
• On September 18 – 20, ACS CAN co-facilitated a session during the American Cancer Society National Navigation Roundtable (ACS NNRT) 2024 annual meeting (pictured below) focused on connecting local initiatives to broader policy changes at the state and federal levels by exploring strategies for establishing patient navigation as a standard of care, and by emphasizing the role of patient and provider advocacy in driving healthcare reform. These sessions set the stage for cooperation in states as we drive toward sustainable patient navigation care so that every patient who hears the words, “You have cancer” will have someone to help navigate the process.

• The American Cancer Society's capital campaign to construct a new Hope Lodge in San Antonio got a lift in 2024 from the efforts of ACS CAN. Led by incredible grassroots volunteers who are both heavily engaged with ACS and well connected civically, a $1 million appropriation was secured from the City of San Antonio. ACS CAN’s Texas government relations team helped facilitate the successful ask and the resulting work with the municipality. Thanks to this public contribution secured by advocates, the project is near the point at which the American Cancer Society can break ground on the latest Hope Lodge.
• ACS CAN successfully advocated for new laws in Oregon and Vermont that will ensure prescription drug copay assistance is counted toward patient out-of-pocket obligations, improving affordability and access to cancer therapies.   

• ACS CAN joined 49 advocates and volunteers representing 22 states and 15 organizations with the Patient Quality of Life Coalition (PQLC) on Capitol Hill for its 9^th Annual PQLC Lobby Day. Advocates visited 48 Senate and 2 House offices, elevating the patient voice and urging passage of the Palliative Care and Hospice Education and Training Act (PCHETA). The Lobby Day attendees also thanked appropriators for FY24 palliative care funding and requested that the Senate hold a markup in the Health, Education, Labor and Pensions Committee, to be followed by a vote on the Senate floor. PQLC, a coalition led by ACS CAN, is made up of more than 40 organizations working collectively to advance the interests of patients facing serious illness by supporting policies that improve and expand access to high-quality palliative care services. 

• ACS CAN hosted its 13^th annual National Forum on the Future of Health Care (pictured below) on May 9 to focus on cancer and the burden of medical debt. Through a series of robust panel discussions, the conference explored how corporations and other healthcare stakeholders are addressing medical debt, and highlighted opportunities to address the problem at national, state and local levels. Each panel included an ACS CAN volunteer who shared compelling stories about how medical debt has impacted their cancer treatment and quality of life. Data was shared by policy experts in the field and ACS CAN released data from a new Survivor Views  survey on medical debt, which highlighted half (49%) of cancer patients and survivors reported being burdened by medical debt, along with some (13%) who said they anticipate medical debt as part of their treatment plan.

• In June 2024, the Minnesota Debt Fairness Act bill was signed at the State Capitol (pictured below) by then Governor Tim Walz to help reduce the burden of medical debt for countless Minnesotans fighting cancer across the state. 
• Also in June, Consumer Financial Protection Bureau (CFPB) proposed a rule to lessen the impact of medical debt on an individual’s credit. ACS CAN was invited to present Survivor Views survey data on medical debt to CFPB in support of the rule and submitted comments. 
• In July 2024, New Jersey Governor Phil Murphy signed into law the Louisa Carmen Medical Debt Relief Act, which prohibits debt collectors from reporting a patient's medical debt to consumer reporting agencies.
• The Senate Committee on Health, Education, Labor and Pensions held a hearing in July 2024 on addressing medical debt, titled, "What Can Congress Do to End the Medical Debt Crisis in America?" ACS CAN submitted  comments  to the committee ahead of the hearing calling on Congress to put forth policy solutions that address the root cause of medical debt by both reducing current medical debt and preventing future medical debt. 

Through the Judicial Advocacy Initiative (JAI), ACS CAN works with attorneys who donate time and incredible legal expertise to help advance our mission by representing ACS CAN in influential court cases, regulatory proceedings, and legislative drafting to further mission goals. From its inception in August 2008 until December 2024, the program has resulted in over $7.1 million in contributed services from law firms, with more than $646,226 contributed in 2024 alone.  Learn more about our Judicial Advocacy Initiative.    

• The Braidwood Management v. Becerra  lawsuit challenges the constitutionality of provisions of the Affordable Care Act (ACA) that require private insurers to cover preventive services recommended by the US Preventive Services Task Force (USPSTF), Advisory Committee on Immunization Practices (ACIP) and Health Services, and Resources Administration (HRSA) without copay. In September 2022, a US District Court struck down the ACA provision, putting access to preventive care, including cancer screenings, at risk for 150 million people. In June 2024, on appeal, the U.S. Court of Appeals for the Fifth Circuit affirmed the district court’s opinion that the USPSTF structure was unconstitutional but drastically narrowed the remedy to only apply to the plaintiffs with less than 100 employees. However, the circuit court left open the possibility of a different outcome for ACIP and HRSA recommendations. The government petitioned the Supreme Court of the United States (SCOTUS) to hear the case. ACS CAN has led four amicus briefs in the case, most recently on October 21, 2024, at SCOTUS, including 35 patient and health care provider groups in support of the government. 

• ACS CAN published a paper in the Journal of Clinical Oncology  finding that while incorporating pharmacogenomic (PGx) testing into cancer care can help improve patient outcomes, barriers to PGx testing, discovery, and implementation are impacting its adoption and creating disparities that impact diverse populations. A form of precision medicine, PGx testing examines how variations in a patient’s inherited genes may impact how they respond to drugs. The paper described ACS CAN’s policy recommendations, which have been integrated into advocacy work including several comment letters and incorporating PGx testing more formally into our state biomarker work. The paper was also the subject of an Oncology Times article, and was cited by the American Pharmacogenomics Association,

• ACS CAN and other tobacco control partners celebrated in March when the U.S. Court of Appeals for the Fifth Circuit upheld the FDA’s final rule requiring graphic warnings on cigarette packages and advertisements in its entirety in RJ Reynolds Tobacco et al v. FDA. The Fifth Circuit en banc refused to hear an appeal of the case; Big Tobacco petitioned the Supreme Court of the United States (SCOTUS), which also declined to hear the case. The litigation is headed back to the district court for some unresolved claims, but the Fifth Circuit en banc and SCOTUS declining industry appeals represent major steps forward in finally getting the warnings on cigarette packs and ads. ACS CAN and partners have supported the FDA as amicus (friend of the court) at every level of the case. 
• 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 (MDOs) for flavored e-cigarette products as part of the premarket review process. Following dedicated advocacy, the FDA has won the majority of these challenges. Eight different circuit courts have upheld MDOs, while only two circuits have vacated them. SCOTUS accepted one of these appeals and heard oral arguments in early December in the case of FDA v. Wages and White Lion Investments dba Triton Distribution. In the litigation, the Fifth Circuit en banc vacated MDOs for flavored e-cigarette products such as Jimmy the Juiceman and Strawberry Astronaut, and the FDA appealed. ACS CAN has filed dozens of amicus briefs supporting the FDA in these cases since late 2021, including most recently at SCOTUS in September. 

• After the adverse ruling by the Fifth Circuit mentioned above, manufacturers of flavored e-cigarettes all began to file legal challenges to the FDA’s MDOs in that venue. FDA v. R.J. Reynolds Vapor Co. concerns where an e-cigarette manufacturer can properly sue to challenge an FDA MDO. The Tobacco Control Act allows “any person adversely affected” by a denial order to sue in the D.C. Circuit or the circuit in which the person resides or has its principal place of business. When Reynolds received denial orders for its menthol Vuse e-cigarettes, it did not sue in the D.C. Circuit or its home Fourth Circuit, both of which had previously upheld FDA MDOs for flavored e-cigarettes. Instead, Reynolds added retailers located in the Fifth Circuit that sold menthol Vuse and sued in that circuit; the court allowed them to do it. However, the Supreme Court granted the FDA’s petition to review the Fifth Circuit’s venue holding. ACS CAN and tobacco control partners filed an amicus brief supporting the FDA.
• ACS CAN continues as an intervenor in a decades-long case brought by the U.S. Department of Justice in which Big Tobacco was convicted of fraud and conspiracy in violation of the Racketeer Influenced and Corrupt Organizations (RICO) Act for misleading the public about the dangers of tobacco and manipulation of the products to make them more addictive. As a result of US v. Philip Morris et al, Big Tobacco has been required to post rotating “corrective statements” on television, newspapers, their websites, product package “onserts” and in retail stores. The statements are posted at over 220,000 tobacco retailers across the nation until June 30, 2025, and in September, Big Tobacco was required to pay $3.5 million in civil fines to the U.S. Treasury because 16% of retailers were not in compliance with the requirements. 
• In late November, ACS CAN joined an amicus brief supporting plaintiffs suing the FDA to compel it to issue a rule prohibiting menthol flavor in cigarettes in the case of African American Tobacco Leadership Council v. FDA. The brief provided extensive scientific evidence on how menthol increases youth initiation, increases addiction and reduces cessation, which has led to significant health disparities in African Americans and the aggressive marketing of menthol.

• In Maryland, the legislature increased the state cigarette tax by $1.25 per pack, raising it from $3.75 per pack to $5 per pack. The sales tax on e-cigarettes was increased from 12% to 20%, and the tax on other tobacco products was increased from 53% of the wholesale price to 60%. Evidence is unequivocal that an increase in tobacco price leads to more adults quitting and prevents youth from starting to use these addictive and deadly products. 
• In Michigan, the legislature passed the state’s budget with a $2.5 million  increase in tobacco prevention and cessation funding, which brought the state’s total spending to $4.3 million.

• In April, ACS CAN’s California team celebrated the Emeryville, California City Council (pictured above) which unanimously passed the first reading of a comprehensive Tobacco Retail Licensing ordinance that ended the sale of all flavored tobacco and set a minimum price and pack size for cigar products. It also ended the sale of all tobacco in pharmacies, restricted new retailers within 1,000 feet from youth areas, and included a mandatory annual compliance visit and annual youth decoy operation. The Council strengthened the policy at the last minute to add 90-day rechecks for stores that fail compliance visits. A second measure also passed to remove the exemption for smoking lounges. 
• In August, ACS CAN participated in the Annual National Conference of State Legislatures Legislative Summit in Louisville, Kentucky. The ACS CAN State and Local Prevention Campaign teams completed our Fact-Based Tobacco Control Policies: How Does Your State Measure Up?  report, as well as one-pagers for each state; Washington, D.C., Guam, Northern Mariana Islands, and Puerto Rico for the summit.
• Through grassroots advocacy, ACS CAN helped to gain significant increases in tobacco control funding in Colorado, Louisiana, Michigan, Missouri, South Carolina and Tennessee. Additionally, we advocated to pass smoke-free ordinances in Athens/Clarke County, Georgia; Ball and Dodson, Louisiana; Osyka, Mississippi and Tarkio, Missouri.

• ACS CAN’s California team successfully advocated for Governor Gavin Newsom to sign a bill into law on July 16 to extend the California Breast Cancer Voluntary Tax Contribution Fund and the California Cancer Research Voluntary Tax Contribution Fund (SB 1172). These programs would generate approximately $1 million annually for cancer research.
• The ACS CAN teams in Alaska, Mississippi and Vermont advocated for legislation to eliminate out-of-pocket costs for individuals who need additional breast cancer imaging tests after an abnormal mammogram or because of other risk factors. 

• On June 27, ACS CAN volunteers and cancer advocates from across the country attended the markup of the Nancy Gardner Sewell Medicare Multi-Cancer Early Detection (MCED) Screening Coverage Act in Washington, D.C., (pictured above) to show our support for access to early detection. Rep. Terri A. Sewell personally identified ACS CAN Alabama volunteer Kimberly Alexander (also pictured) in the chamber, who sadly lost her life to cancer shortly after the hearing. While volunteers were in attendance, the U.S. House Committee on Ways and Means unanimously passed the legislation that could provide a pathway to coverage of multi-cancer early detection in Medicare, once FDA approved and clinical benefit is shown. ACS CAN was acknowledged as a strong supporter of the bill publicly and repeatedly by members of the Ways and Means Committee, including U.S. House Budget Committee Chair Jodey Arrington (R-TX) and Lead Bill Sponsor Rep. Terri A. Sewell (D-AL).

• In March, ACS CAN launched new policy recommendations to support equitable cancer care and eliminate cancer disparities in Lesbian, Gay, Bisexual, Transgender, and Queer/Questioning (LGBTQ+) communities. ACS CAN commissioned the National LGBT Cancer Network to produce a report on the challenges faced by LGBTQ+ people impacted by cancer. ACS CAN’s LGBTQIA+ & Allies Engagement Group was also instrumental in informing these policy recommendations. 
• On June 3, ACS CAN's Young Leaders Caucus (YLC) hosted a virtual event (pictured below), Stories of Young Adult Survivorship, that focused on adolescent and young adult (AYA) cancer survivorship, and the social, emotional and financial challenges associated with this specific age group.

• In an amicus brief, ACS CAN and partner groups strongly urged the U.S. District Court for the District of North Dakota to deny a motion for a stay and preliminary injunction in Kansas vs. United States of America, which challenges a new rule issued by HHS that expands health insurance coverage eligibility to Deferred Action for Childhood Arrivals (DACA) recipients under the Affordable Care Act (ACA). The brief argues that the final rule expanding insurance coverage eligibility to DACA recipients – which ACS CAN supported -- aligns with Congress’s intent in passing the ACA because it will improve patient outcomes and public health and reduces uncompensated care costs by decreasing the number of uninsured individuals. Unfortunately, the district judge ruled against HHS in December, but ACS CAN will continue to engage on appeal.
• ACS CAN and public health partners filed an amicus brief asking the court to consider the potential ramifications for our nation’s public health before taking action that might disrupt Medicaid access for populations that already face significant barriers accessing health care services. The brief detailed how eliminating barriers to Medicaid enrollment reduces socioeconomic inequities and promotes financial stability, including for immigrant communities where many are not offered health care coverage through their employment.  In a victory for public health in October, the court ruled in favor of the government, so the rule stays in place.
• ACS CAN filed two amicus briefs, one in late November and one in early December, advocating for LGBTQ+ individuals’ rights to health care services without discrimination. The cases at issue will help determine whether protections in section 1557 of the Affordable Care Act (ACA) are defined broadly to cover gender identity or are narrowly construed as only protecting sex as assigned at birth.  
• In December 2024, ACS CAN and other public health groups applauded the court the U.S. Court of Appeals for the Fifth Circuit for upholding the non-discrimination provision of the ACA in the case of Neese v. Becerra. The court vacated a lower court ruling based on the plaintiffs’ lack of standing in the case, which challenged protections in the ACA for Lesbian, Gay, Bisexual, Transgender and Queer (LGBTQ+) patients receiving health care services.