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9-16-10 Affordable Care Act Update
September 17, 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
Update on Senator Johanns’ Amendment
Last week, we previewed a vote coming up in the Senate on an amendment to Small Business Jobs and Credit Act that was offered by Senator Mike Johanns (R-NE). The amendment addressed a provision in the Affordable Care Act that increases reporting requirements for small business.
ACS CAN opposed the amendment because its financial offset was to strip the Prevention and Public Health Fund ($17 billion over 10 years) of nearly all its funding. As you know, the Affordable Care Act established the Fund to support important prevention programs like tobacco cessation, obesity and nutrition programs and public health infrastructure. The amendment would have also made significant changes to the individual mandate requirements included in the new law that would increase premiums for individuals and families.
On Monday, ACS CAN sent a letter to all Senators on Monday urging them to oppose the amendment. The following day the Senate defeated the Johanns' amendment by a vote of 52-46.
Thanks to your hard work we defended the Prevention and Public Health Fund, which is playing a critical role in transforming the nation’s health care system with a dedicated stream of resources to pay for much-needed cancer screenings, tobacco cessation and obesity prevention programs that will help save thousands of lives from cancer every year.
Estimated Number of Uninsured Rose in 2009
U.S. Census Bureau figures released today show that there were an estimated 50.6 million uninsured people in the United States in 2009, an increase of 4.3 million from 2008 and a much bigger jump than the previous year, when the increase in the number of uninsured was estimated at 500,000. These estimates mark the first time there has been decrease in the absolute number of insured people in this country, and it reflects the lowest rate of insurance coverage nationwide in the 23 years that the Census Bureau has tracked that figure. The biggest loss of health coverage was among employed workers, a trend that is likely due to some employers dropping coverage for workers and other workers declining their employer coverage. This is not surprising given the state of the economy over the past two years and the fact that many working people are now “underemployed” – working for lower wages than they previously had.
ACS CAN staff has not thoroughly analyzed the data yet because they were released just this morning, but we will report back on anything of particular importance from a cancer perspective. Expect the numbers to be widely reported in the next few days, and be aware that much may be said as to why these changes represent a reason to support or oppose the Affordable Care Act. It is important to remember that the numbers released today are from 2009 and reflect the health care system before the Affordable Care Act was enacted. Moreover, the decrease in the number of insured – and specifically the decrease in the number of workers with insurance – demonstrates the need for a system that helps people retain and afford coverage when they are between jobs, in the case of job loss, or in other times of transition without having to contend with medical underwriting, pre-existing conditions, and other obstacles that the Affordable Care Act addresses.
The Census Bureau’s press release that summarizes the data is here.
Announcement of Federal Prevention Funding
The Department of Health and Human Services (HHS) this week announced the allocation of several grants from the current fiscal year made through the Prevention and Public Health Fund, including:
$16.8 million to train the public health workforce, including funding for 27 Public Health Training Centers. Details can be found here.
$31 million to 10 communities in eight states, and one award to a state health department to support public health efforts to reduce obesity and smoking, increase physical activity, and improve nutrition. Details can be found here.
ACS CAN to Comment on Rule Governing Coverage of Preventive Services in Private Health Plans
ACS CAN will submit formal comments to HHS on the interim final rule for preventive services. Under the Affordable Care Act, new plans are required to offer certain preventive services at no cost to patients. The services will be covered in plan years that begin after September 23, when several of the law’s important provisions go into effect. They include services rated “A” or “B” by the U.S. Preventive Services Task Force (USPSTF).
ACS CAN’s comments address specific issues in the regulation that pose potential problems or require clarification. ACS CAN would prefer that the law include a more expansive list of cancer screenings than the USPSTF recommends, such as all those recommended in American Cancer Society guidelines, but the law does not provide such flexibility. However, the HHS secretary is required to develop an essential benefits package that all plans in the new health exchanges and some plans outside the exchanges will be required to offer. ACS CAN will advocate that a broader set of prevention services be included as essential benefits when comments on a proposed essential benefits package are being accepted.
Note that the new law specifically negates the USPSTF’s November 2009 decision to weaken its recommendation for breast cancer screening in women aged 40 and over, but that the new law exempts “grandfathered” plans in existence when it was signed from the requirement to cover these services with no cost-sharing.
Important Provisions of the Affordable Care Act will go into effect on September 23
September 23 will mark six months since the Affordable Care Act was signed into law, and several provisions that benefit people with cancer and their families will go into effect on that date. For more information, go to www.fightcancer.org.
Outreach on High-Risk Pools
Politico’s health care blog included a brief item today saying that HHS is developing plans to conduct targeted outreach about the new high-risk pool program, called the Pre-Existing Condition Insurance Plan (PCIP). Richard Popper, director of the department's Office of Consumer Information and Insurance Oversight, told the National Governor’s Association that outreach efforts will focus on states that did not previously have a high-risk pool. An HHS spokeswoman told Politico that the department is working with insurers to educate consumers about the new plan, such as by mentioning PCIP as a potential option in letters to applicants who have been denied coverage. Politico reported that applications for PCIP are unexpectedly low in some states – for example, Iowa has received just 32 applications for its pool.
Christopher W. Hansen
President
American Cancer Society Cancer Action Network (ACS CAN)