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
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5-3-12 Affordable Care Act Update
May 4, 2012
State Lead Ambassador Summit
Last weekend ACS CAN hosted its sixth annual State Lead Ambassador Summit in St. Louis for 48 volunteer leaders and their staff partners. The Summit included a town hall meeting where volunteers and staff asked questions and discussed ongoing strategies for implementing the Affordable Care Act (ACA). Later in the weekend, breakout sessions were held on the essential health benefits provision of the law and why it is so important to achieving adequate coverage for cancer patients and survivors. At the end of the discussion, participants had the chance to build their own essential health benefits package as part of a group exercise designed to parallel conversations being held in state governments with a variety of stakeholders, including ACS CAN.
Federal Update
Last week, the Treasury Department released a notice requesting comments on several approaches to determining "minimum essential coverage" under the ACA. Beginning in 2014, large employers (50 or more workers) will be required to offer plans that cover at least 60 percent of allowed costs for certain categories of benefits. (This is different than the essential health benefits requirement, which only applies to health plans in the individual and small-group markets.) If an employer fails to meet the coverage level, it may be subject to an assessment by the government.
Although the notice is only the first step in the regulatory process and much could change, ACS CAN and other consumer groups are concerned about the approach outlined in the notice. The minimum level of coverage, though low, is in the law; however, the calculation methods Treasury suggests could be subject to manipulation that results in a level of coverage that is inadequate for a cancer patient. ACS CAN is very concerned that some large employers could decide to provide substandard coverage. Workers in such organizations would be disqualified from receiving more adequate, subsidized coverage in the exchange. The minimum essential coverage standard could fall well short of the adequate coverage ACS CAN wants to establish for plans subject to the ACA's essential benefits provision.
ACS CAN is working with other consumer groups to press for more rigorous standards and levels of coverage employers must meet to satisfy minimum essential coverage requirements for large group market and self-insured plans.
State Update
Last Friday, California joined Washington in being the only two states to designate a benchmark plan for the private health insurance market that will serve as the essential health benefits (EHB) for all individual and small group plans offered inside the exchange and in the outside market. The selection in California, as designated by the legislature, is the Kaiser Small Group HMO Plan. As it is a "small group" plan, it will include all state health mandates passed in the state through 2011.
States have until September 30 to designate a benchmark plan from a group of 10 already offered in the state to serve as the EHB. States that do not make a choice by then will automatically default to the level of benefits offered in the largest (by enrollment) small group plan in the state.
New Report Shows Many Americans Have Pre-Existing Conditions
A new report from the Government Accountability Office (GAO) found that between 36 million and 112 million Americans have pre-existing conditions. The provision of the ACA that prohibits insurance companies from denying coverage to individuals with pre-existing conditions could benefit all of these people, the report said. The GAO also found that cancer was the condition with the highest associated annual costs - about $9,000 a year on average.
Advocacy Accomplishments 2011 Year in Review Now Available
Advocacy Accomplishments 2011 Year in Review, a joint publication of the American Cancer Society and the American Cancer Society Cancer Action NetworkSM (ACS CAN), is now available. This annual report provides a comprehensive summary of legislative, policy, grassroots, regulatory, litigation, and media advocacy achievements at the local, state, and federal levels. This year's report highlights the Society and ACS CAN's joint Access to Care initiative and the continued implementation of and education about critical patient protections in the ACA that are expanding access to quality, affordable care, placing an increased focus on prevention, and improving quality of life for cancer patients and their families. The report can be ordered through the Nationwide Distribution Center. Item/Catalogue Number is 7660.11. The report is also posted online at https://www.fightcancer.org/accomplishments.
Chris Hansen | President
ACS Cancer Action Network | American Cancer Society Cancer Action Network, Inc.