Federal Update
Medicare and Medicaid Fact Sheets for Deficit Reduction Debate
On January 1, Congress agreed to a deal that temporarily averted the automatic tax increases and spending cuts that were scheduled to take effect. The legislation, the American Taxpayer Relief Act, only included minor spending reductions but none that would negatively impact Medicare and Medicaid beneficiaries with cancer. However, the legislation was not a long-term solution to the nation's fiscal issues, and additional budget negotiations are imminent that could impact Medicare and Medicaid eligibility and benefits. Because Medicare and Medicaid are critical programs for patients with chronic diseases, ACS CAN is partnering with the American Heart Association and the American Diabetes Association to include the patient voice in the debate. The attached fact sheets have been developed that can be used to help explain the importance of the Medicare and Medicaid programs to patients with chronic disease.
Medicaid~0117.pdf Medicare Fact Sheet~Rev0113.pdf
FDA Committee Votes to Reschedule Pain Medications Containing Hydrocodone
Last Friday the Food and Drug Administration (FDA) Drug Safety and Risk Management Advisory Committee met to consider evidence related to potentially rescheduling hydrocodone-combination medications from a Schedule III classification to the more restrictive Schedule II. The American Cancer Society testified that products containing hydrocodone are used often and effectively to address the acute and exacerbating pain many cancer patients experience. Policies must be balanced to allow for patient access while also deterring abuse.
Current evidence does not demonstrate that reclassifying medication that contains hydrocodone will measurably address current problems with abuse of these products. However, evidence does indicate that regulatory changes moving these drugs to Schedule II would interfere substantially with patient access to quality pain care and result in needless suffering. Prescriptions for Schedule II medications cannot be transmitted by telephone or fax, nor can they be refilled. The proposed policy change would require patients to see their doctor for office visits with greater frequency simply to refill a prescription, and may prove to be extremely costly to patients and our health care system.
The Committee voted 19-10 in favor of rescheduling hydrocodone combination medications. The FDA will now be required to accept or reject the committee's recommendation through the formal regulatory process.
The Society's testimony is attached.
FDA Hydrocodone Rescheduling Oral Comments Kirch Jan 2013.docx
Policy Update
Last week, ACS CAN submitted comments on the proposed regulation regarding wellness programs. The proposal would update a regulation issued in 2006, pursuant to changes in the Affordable Care Act (ACA). ACS CAN is a strong supporter of comprehensive employee wellness programs. Promoting and maintaining healthy behaviors are important in the fight against cancer, and worksite wellness programs can contribute positively to improving health if structured properly. However, we are concerned that rewards and penalties tied to health status could jeopardize employees' or their dependents' access to affordable, quality health care or be used, even if only inadvertently, as a means of discriminating based on health status.
As an organization that relies on rigorous, scientific evidence as the basis for our policy, ACS CAN agrees with the administration's assertion that there is insufficient peer reviewed research demonstrating the efficacy of financial incentives in motivating long-term behavior change. However, it is likely that employers will continue to experiment with these and other approaches to improve employees' health, enhance workforce productivity, and lower health care costs. It is therefore critical that financial incentives and penalties intended to motivate behavioral changes are designed in a way that protect employees from discrimination based on health status and preserve access to affordable, quality health care. Financial incentives should be a part of a comprehensive, evidence-based program to encourage healthier behaviors.
ACS CAN's comments addressed a number of specific issues raised in the proposal, with an emphasis wellness programs that have a demonstrated potential for improving health. The comments encourage the Departments of Labor and Health and Human Services to require programs that are designed to ensure all participants are provided support to achieve improved health. The comments also include concerns about incentives or penalties that could price some individuals out of coverage if they are unable to meet program goals. Additionally, the comments strongly recommend that in all cases, the affordability provisions of the ACA supersede wellness plan design. Highlighting an example of a penalty that could erect new barriers to care for those who need it most, the comments call out the tobacco surcharge, and urge the Administration to prohibit programs from imposing higher costs on tobacco users unless they also provide full and complete access to robust cessation programs.
Increasing Access to Medicaid
Last week, ACS CAN made several outreach efforts to national and state reporters to share the results of public opinion polling that shows registered voters in key states want their state to accept federal funds that are available to broaden access to health care coverage through Medicaid. The surveys were conducted in Florida, Iowa, Kentucky, Michigan, New Jersey, New Mexico and Texas - states that have been wrestling with the decision of whether to accept federal dollars that have been set aside to finance the cost of providing health care coverage to up to 16 million hard working, low-income individuals nationwide.
ACS CAN also briefed ACS CAN field staff, corporate partners, and more than 25 health and consumer advocacy groups on the poll and also shared the results of a study done late last year as part of an effort to develop more effective messaging on the benefits of increasing access to care through Medicaid.
The polls were conducted by a bipartisan pair of firms, Lake Research Partners and GS Strategy Group. A brief summary of the most important message points is attached, which can be circulated to staff and volunteers, and a summary of media coverage the poll generated.
Medicaid Polling clips 2013.xlsx ACS CAN Medicaid Poll Summary Final.pdf
TurboTax May Be Better Analogy for Health Exchanges
Health insurance exchanges created by the Affordable Care Act have been described as "online marketplaces" like Travelocity, where people will be able to shop for health plans like they do for plane tickets. But a consumer focus group in Colorado suggests that people are going to need something more like TurboTax. Like taxes, buying insurance can be complicated and rife with confusing jargon. And the decisions consumers make are high stakes: The wrong choice can cost a consumer big money and dramatically impact the coverage they receive.
The insight comes from discussion groups convened last summer by three Colorado nonprofits. The groups interviewed 414 people in eight urban and rural locations to help the state's exchange board understand what people will need from the exchange. Consumers said they know very little about insurance and will need a lot of customer support, and only a few said they would be comfortable choosing a policy on their own.
Roughly one in five participants are concerned the exchange won't offer enough "human support." More than half in the discussion group were under 30 years old. Only 17 said they turned to the Internet for help picking a health plan now, and others then named brokers/agents (22), employers (45) or "myself/nobody" (44).
ACS CAN recognizes that some consumers find enrolling in the exchange challenging, especially if they have not purchased insurance in the past, and is working with Enroll America, a nonprofit dedicated to educating uninsured Americans about the law and helping them to enroll in a health plan as the exchanges go live.
As always, thank you for all you do every day to support laws and policies that help cancer patients and their families.
Chris Hansen | President
ACS Cancer Action Network | American Cancer Society Can