Empowering patient voices through voter registration
While roughly 83% of adults in the United States will visit a health care provider in the next year, an estimated
News
10-14-10 Affordable Care Act Update
October 15, 2010
Below is this week’s update on the Affordable Care Act. As always, thank you for all you do every day to support laws and policies that help cancer patients and their families
Delaware Candidate Debates
ACS CAN was invited to join AARP, the University of Delaware, and Delaware First Media, a non-partisan, non-profit news service, to sponsor the U.S. House and U.S. Senate candidate debates in Delaware on October 6 and 13, respectively. The debates were an excellent opportunity to elevate cancer policy issues, promote ACS CAN as the leading voice of cancer patients, and reinforce the fact that fighting cancer must be a national priority for elected officials.
The Senate debate aired on CNN Wednesday evening with lead anchor Wolf Blizter as co-moderator. ACS CAN was recognized along with the other co-sponsors at the top of the broadcast. The Affordable Care Act was, not surprisingly, among the topics, coming in the form of a multi-part question that referenced several provisions in the law of crucial importance to people with cancer and their families. ACS CAN has been asking federal candidates across the country about these provisions as well, and provided background materials on these issues to the debate moderators in advance.
In addition, ACS CAN ran an advertisement in conjunction with the debates that invited the public to join us in support of policies that help fight cancer. The ad ran in print and online in the Wilmington News Journal and Politico, as well as on the websites of CNN, The New York Times, The Philadelphia Inquirer, The Washington Post, and The Wall Street Journal. View the ad.
New Information Added to Healthcare.gov Website
Additional consumer information was recently added to the Department of Health and Human Services’ (HHS) consumer-friendly website: www.Healthcare.gov. On October 1 the website launched a new tool to help consumers make better informed choices. Detailed information on benefits and monthly premium estimates, as well as cost-sharing information including annual deductibles and out-of-pocket limits for health plans, is now available. Also, information about the percent of people in the plan who pay more than the base premium estimate due to their health status, as well as the percent of people denied coverage by a health plan is available. More than 225 insurance companies so far have provided information about their individual and family plans for more than 4,400 policies, including policies in every state and the District of Columbia.
Update on Lawsuits
A federal judge in Florida ruled today that portions of a lawsuit brought by 20 states and the National Federation of Independent Business (NFIB) challenging the constitutionality of the Affordable Care Act may go forward. Specifically, U.S. District Judge Roger Vinson said he would hear arguments on provisions in the law requiring nearly all Americans to purchase health insurance, known as the individual mandate, and those related to Medicaid expansion. A hearing is set for December 16.
The judge dismissed parts of the lawsuit that related to taxation, including the contention that the penalty for people who fail to buy insurance is a “direct tax.” In addition, he rejected claims that the law violates a state’s sovereignty as an employer and the challenge to the requirement that states enforce the law. He also declined to hear further on the plaintiff’s position that the individual mandate violates due process. Read “Florida Judge: Fight Against Insurance Mandate Can Proceed” in The Hill “Healthwatch” blog.
In contrast, last week a federal judge in Michigan upheld the constitutionality of the individual mandate in the Affordable Care Act that will require everyone to purchase health insurance starting in 2014. The lawsuit, which the Thomas More Law Center filed, argued that Congress overstepped its authority by requiring individuals obtain health insurance or pay a fine. Read the Washington Post story about the decision.
U.S. District Judge George Steeh found that Congress acted consistent with its power under the commerce clause, which allows it to regulate interstate commerce. Judge Steeh also said that Congress was trying to lower the overall cost of insurance by requiring participation. “Without the minimum coverage provision, there would be an incentive for some individuals to wait to purchase health insurance until they needed care, knowing that insurance would be available at all times,” Steeh wrote in his opinion.“ In turn, this would aggravate current problems with cost shifting and lead to even higher premiums.”
Arguments in another lawsuit will be heard in a Richmond, Virginia federal court this Monday, October 18. You may recall that a federal judge ruled in August that the case could go forward. The case was brought by Virginia Attorney General Ken Cuccinelli.
Health Insurance Coverage for Children with Pre-Existing Conditions
HHS Secretary Sebelius sent a letter to the National Association of Insurance Commissioners (NAIC) yesterday outlining the tools available to insurers for controlling adverse selection (the disproportionate enrollment of sick patients) in child-only policies, as well as options for states to help preserve coverage for children with pre-existing conditions.
The letter is in response to reports that some insurers have decided to renege on their commitment to provide coverage options for children with pre-existing conditions. The Affordable Care Act makes it illegal for insurance companies to deny coverage to children with pre-existing conditions and makes discrimination against all individuals with pre-existing conditions illegal in 2014. A report released this week from the House Energy and Commerce Committee found that more than 651,000 people were denied coverage because of a pre-existing medical condition between 2007 and 2009.
The secretary’s letter said insurers can institute open enrollment periods and can base premium rates on health status (which is permissible under the law until 2014). States are also encouraged to open up their Children’s Health Insurance Programs (CHIP) to allow middle class families to purchase child-only coverage at a full premium. HHS is also working to ensure that all Pre-existing Condition Insurance Plan (PCIP) programs are open to children, and that the premium rates reflect the health risks of children, which are lower than those of adults.
Update on State Activity: ACA Implementation
Several states (Kentucky, Minnesota, Montana and Wisconsin) have already shared with ACS CAN proposed legislation that would create state exchanges, signaling the beginning of the legislative process for implementing ACA at the state level. Last week, California became the first state to create a health exchange since the ACA was enacted. The law provides a basic framework that gives state agencies the authority to establish the infrastructure for a state exchange. However, critical issues of governance and details regarding how insurers are able to operate inside and outside the exchanges still need to be determined.
Additionally, as all states begin the process of gearing up to establish state exchanges, the Society and ACS CAN have been invited to have a seat at the table on a number of state oversight committees and/or work groups. The states where we have already secured seats are Hawaii, Montana, Oklahoma, Texas and Washington.
Today, a crucial vote will be taken on the medical loss ratio issue by a committee of state insurance commissioners. The entire national membership of the National Association of Insurance Commissioners will then cast the final vote at a meeting next week in Florida. While industry has been making a strong push to weaken the proposed guidelines, patient groups led by the Society and ACS CAN have continued to ask individual insurance commissioners to hold firm and vote on the side of consumers and patients.
Federal Funding Released for Community Health Centers
HHS officials last Friday announced $727 million in grants to 143 community health centers as part of the Affordable Care Act's focus on expanding access to health centers — a key resource for millions of underserved, uninsured and low-income Americans.
It’s the first allocation of the $11 billion over five years authorized by the Affordable Care Act for the construction, expansion and operation of community health centers nationwide. HHS estimated an additional 745,000 patients will be served through the expanded centers. Click here for the list of all 143 grantees.
The National Center on Minority Health and Health Disparities is Elevated to an Institute at the National Institutes of Health (NIH)
The National Institutes of Health (NIH) recently announced the transition of the National Center on Minority Health and Health Disparities (NCMHD) to the National Institute on Minority Health and Health Disparities (NIMHD) as authorized by the Affordable Care Act. The transition gives the new institute a more defined role in NIH's research agenda relating to health disparities. NIMHD promotes minority health, conducts and supports research, training, research infrastructure, fosters emerging programs, disseminates information, and reaches out to minority and other health disparity communities.
Christopher W. Hansen
President
American Cancer Society Cancer Action Network (ACS CAN)