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While roughly 83% of adults in the United States will visit a health care provider in the next year, an estimated
News
4/7/11 Affordable Care Act Update
April 11, 2011
Capitol Hill Update
FY2011 House Budget Resolution
House Budget Committee Chairman Paul Ryan (R-WI) released a FY2012 budget resolution this week that includes severe cuts to several areas of critical importance to people with cancer, including Medicare, Medicaid, medical research, and disease prevention programs.
The resolution would go beyond cutting Medicare. It would fundamentally change Medicare as we know it by converting it to a “premium support” model -– essentially a modified and yet-to-be defined voucher program limiting the care Medicare would cover. This could very adversely affect many cancer patients given that half of all new cancer diagnoses involve people over age 65, most of whom are in Medicare.
In addition, the resolution would convert Medicaid into a block grant program providing states with fixed dollar amounts that could lead to restrictions in eligibility, enrollment and benefits for cancer patients. An estimated 9 percent of adults and 25 percent of children with cancer are covered by Medicaid and the State Children's Health Insurance Program (SCHIP). Medicaid also provides treatment to low-income women diagnosed with cancer through the successful National Breast and Cervical Cancer Early Detection Program. In addition, Medicaid provides lifesaving cancer screenings to millions of people who would not otherwise get them.
The resolution also proposes deep cuts in domestic spending for health care, some of which is likely to hit cancer research at the National Institutes of Health and cancer prevention and early detection programs at the Centers for Disease Control and Prevention. It also projects elimination of the new Prevention and Public Health Fund created in the Affordable Care Act. The fund currently supports efforts in every state to help reduce tobacco use, fight the obesity epidemic that is contributing to cancer, and increase access to lifesaving cancer screenings. The fund is changing the health care system’s focus from primarily treating people when they get sick to keeping people healthy in the first place, an approach numerous public health experts have long supported. .
The House Budget Committee approved the resolution Wednesday, and the full House will likely debate it next week. As many of you already know, ACS CAN is encouraging its grassroots advocates nationwide to contact their lawmakers in opposition to provisions that would cut and restructure Medicare and Medicaid, and reduce funding for cancer research, prevention and control.
Read the ACS CAN press release.
ACA Defunding Bills
The House Energy and Commerce Committee this week approved bills to reverse key protections that help cancer patients and their families access affordable, timely health care. Two of the proposals would be particularly harmful to patients -- H.R. 1217 would repeal the new Prevention and Public Health Fund (as would the budget resolution described above), and H.R. 1213 would effectively end planning grants that are helping states create new health benefit exchanges designed to help consumers compare the costs and benefits of different health insurance plans and choose the one that best meets their needs. These measures are likely to be debated on the House floor next week. ACS CAN strongly opposes both bills, which are anti-prevention, anti-patient and anti-consumer. We are encouraging advocates to tell lawmakers of their opposition to these bills.
Senate Passes 1099 Bill
The Senate this week passed H.R. 4, the 1099 Taxpayer Protection and Repayment of Exchange Subsidy Overpayments Act, the so-called 1099 bill.
ACS CAN supported legislation to repeal the burdensome 1099 reporting requirement on small businesses. But we, along with our public health partners, opposed paying for the repeal by requiring consumers to return the entire federal premium subsidy they receive if they somehow exceed the income threshold by getting a new job or a raise during the year. That requirement could result in families receiving surprise tax bills for as much as $10,000 at the end of the tax year. The requirement could discourage individuals and families from purchasing coverage through state-based exchanges for fear that getting a promotion or a new job might cost them thousands of dollars. ACS CAN supported an amendment offered by Sen. Robert Menendez (D-NJ) that would have mitigated the impact on families, which unfortunately failed.
Read the ACS CAN press release.
Regulation on Accountable Care Organizations (ACOs) Released
Last week, the Department of Health and Human Service (HHS) published a proposed rule for Accountable Care Organizations (ACOs), which are intended to encourage greater integration and coordination of health care delivery. Under the proposed rule, ACOs that meet certain requirements and achieve health outcome measures would be eligible to share any savings they achieve for treating Medicare recipients. The ACS CAN policy team has begun reviewing the lengthy proposal to determine how ACOs might affect the care that cancer patients and survivors in Medicare receive.
State Update
Society and ACS CAN staff in many states continue working to protect consumer and patient interests in legislative efforts to establish health insurance exchanges. They are also working to protect Medicaid programs and budgets that are coming under constant attack. If there are new or existing legislative proposals regarding state insurance exchanges that have not yet been shared with the ACS CAN office in Washington, DC, please send them to [email protected]. If there are Medicaid issues that states would like assistance with, please contact [email protected].
Medicaid
The governors of 16 states and the Virgin Islands this week outlined their opposition to the Medicaid block grant proposal in the House 2012 budget resolution in a letter to House and Senate leaders. The governors said that although they support flexibility and improvements to Medicaid, they believe that the, block grants would “severely undercut our ability to provide health care to our residents and adequately pay providers.” Read the letter:
Litigation Update
Oral arguments are set in the appeals of three cases challenging the constitutionality of the Affordable Care Act. The arguments will take place in three federal circuit courts of appeal in May and June. The Society and ACS CAN joined the American Diabetes Association and the American Heart Association in filing amicus briefs in the 6th and 4th Circuits for the Michigan and Virginia cases, respectively. The groups will file a brief in the 11th Circuit, which includes Florida, on April 11. Three federal judges have upheld the constitutionality of the law on the merits, while a federal judge in Virginia struck down the individual mandate provision. A Florida judge invalidated the entire law, but then suspended his ruling pending the appeal.
Medicaid Surprisingly Popular According to New Poll
A recent Kaiser Family Foundation poll asked Americans about their attitudes toward Medicaid, and the results were surprising to those who expected weak support for the program. Only 13 percent of respondents said they would support major funding reductions for Medicaid, slightly more than the 8 percent who said they support major funding cuts to Medicare or Social Security. Additionally, 59 percent of respondents said Medicaid was “very important” or “somewhat important” to their families. The survey is summarized here.
As always, thank you for all you do every day to support laws and policies that help cancer patients and their families.
Christopher W. Hansen
President
American Cancer Society Cancer Action Network (ACS CAN)