Policy Update
Preventive Care Coverage
On February 20, the Department of Health and Human Services (HHS) and Department of Labor issued an FAQ which clarified the coverage of some cancer preventive services. The FAQ clarifies that if a polyp is found during a screening colonoscopy, insurers may not impose a co-pay on that service. This was an issue that the American Cancer Society, ACS CAN and the Kaiser Family Foundation highlighted in a report concerning the inconsistent implementation of this provision of the Affordable Care Act (ACA). In addition, the FAQ further clarified that if a patient has a prescription for an over the counter tobacco cessation product, then the issuer must cover that product at no cost to the patient. Finally, HHS and DOL state that the preventive services regarding genetic counseling and evaluation for the routine breast cancer susceptibility gene (BRCA) include both the counseling and the genetic testing.
FYI, the FAQ was issued in conjunction with the final Essential Health Benefits Rule. ACS CAN is reviewing the entire final rule and will have a summary in next week's ACA update.
Tobacco Surcharge
Under the ACA, insurers can add as much as a 50 percent surcharge on smokers' health insurance premiums in the individual and small group market. However, the law also gives states the flexibility to reduce or ban the tobacco surcharge. ACS CAN is encouraging states to restrict the use of this surcharge. Higher premiums are not proven to reduce smoking and, in fact, may result in reduced access to health care for those who need it most. A large percentage of smokers in these markets could find health insurance unaffordable as a result of the surcharge (also, if a person is eligible for subsidies in the exchange, the subsidy does not apply to the surcharge--i.e., they have to pay the surcharge entirely out-of-pocket). States will see greater public health and economic benefits through increased tobacco excise taxes, implementation of strong smoke-free laws, and funding prevention and cessation programs in their state than by raising insurance rates on tobacco users. Applying the tobacco surcharge goes directly against the purpose of the ACA - to provide access to quality, afford able health insurance to more people, especially those with serious health problems. For more, read The Washington Post report and see attached talking points.
State Tobacco Rating Talking Points Feb 20.docx
State Update
Last Friday was the deadline for states to inform HHS if they were planning to operate a partnership exchange with the federal agency. New Hampshire governor, Maggie Hassan, announced that her state would be joining Arkansas, Delaware, Illinois, Iowa and Michigan in operating a partnership exchange beginning in 2014.
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 Cancer Action Network, Inc.