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5-12-11 Affordable Care Act Update
May 16, 2011
Capitol Hill Update
Earlier today, the House Energy and Commerce Subcommittee on Health approved "The State Flexibility Act" (HR 1683). The bill, introduced last week, would repeal the “maintenance of effort” requirements (MOE) included in the Affordable Care Act (ACA), which prevents states from cutting their Medicaid rolls ahead of the program’s expansion in 2014. The full Energy and Commerce Committee will vote on the legislation next, likely the week of May 23. The Congressional Budget Office estimates that roughly 300,000 people would become uninsured as a result of eliminating the MOE requirements. ACS CAN opposes the MOE repeal because doing so could threaten cancer patients’ access to lifesaving treatment, add to the number of uninsured and weaken our nation’s health care system.
Read the joint media statement from ACS CAN, the American Diabetes Association and the American Heart Association that was issued yesterday.
State Update
Yesterday Washington State became the fourth state with a law to establish a health insurance exchange, joining California, Maryland, and West Virginia. Also this week, Vermont’s legislature sent a bill to set up a state insurance exchange to their governor, who is expected to sign it. Vermont’s exchange is of special interest because it would establish a single-payer health insurance system in the state. Bills in Colorado and Hawaii are also awaiting signatures, while New Mexico’s governor vetoed an exchange bill. Finally, there are now just two states -- Georgia and Indiana -– where the governor is bypassing the legislative process and initiating a state exchange via executive order.
Litigation Update
On Tuesday, the Fourth Circuit Court of Appeals heard oral arguments in two cases brought in Virginia, marking the first time that an appeals court has considered a lawsuit challenging the Affordable Care Act. The cases that have been filed center on the law’s requirement that individuals purchase health insurance (the so-called "individual mandate"). At the crux of all the court challenges is the claim that Congress exceeded its constitutional authority to regulate commerce by requiring people to purchase a good or service. The federal government argues that health care is unlike any other commodity because everyone consumes it at some time.
During the Fourth Circuit arguments, a three-judge panel asked probing questions of both sides, including some implying that the state of Virginia may not have standing to sue the federal government gained particular notice. Under that theory, only individuals forced to purchase insurance against their will would be eligible to bring such a case against the federal government. The Fourth Circuit is often referred to as the "rocket docket" because it tends to rule faster than most appeals courts, meaning its decision could be announced within the next few weeks. Meanwhile, oral arguments are scheduled for early June in the Sixth and 11th Circuits, which will hear the cases brought in Michigan and Florida. To date, three federal trial judges have upheld the law on the merits, and two have struck down the law in whole or in part. Most experts believe the US Supreme Court will ultimately decide the challenge, with a hearing in the spring of 2012 and a final decision before the Court’s summer adjournment.
The American Cancer Society and ACS CAN filed friend of the court briefs in all federal circuits that are hearing appeals that argue that the individual mandate is necessary to the overall function of the Affordable Care Act's new health insurance coverage, and that health insurance status is clearly linked to cancer outcomes. The American Diabetes Association and the American Heart Association joined the Society and ACS CAN on the amicus briefs, which also provided studies linking those chronic conditions to insurance status.
Listen to or read NPR’s coverage of the arguments and Washington Post columnist E.J. Dionne’s “Health Care Lawsuits: Delaying the Inevitable.”
New Report Shows State-by-State Impact of Medicaid Changes in House Budget Plan
As many as 44 million poor and disabled Americans could be forced out of Medicaid over the next 10 years if congressional proposals to repeal the Affordable Care Act and transform Medicaid into a block grant to states succeed. According to a Kaiser Commission on Medicaid and the Uninsured report, projected federal spending on Medicaid between 2012 and 2021 would fall 34 percent, with states receiving $243 billion less annually in federal Medicaid money by 2021. States in the South and West that have not built up their health care safety nets in recent years would be among those hit hardest. The Los Angeles Times provides more information about the impact on specific states.
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)