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
Request for Comments Regarding Exchange Provisions in the Affordable Care Act
On Tuesday, the Department of Health and Human Services (HHS) released a “Request for Comments” regarding provisions in the Affordable Care Act that require the creation of state based health exchanges. HHS is soliciting comments in advance of final rulemaking. Specific areas that HHS is interested in includes: what type of information will be useful for consumers when they are trying to enroll in a plan, what resources people will need to successfully navigate the health exchange and purchase health insurance coverage, and how eligibility and enrollment can be coordinated more effectively among the Children’s Health Insurance Program (CHIP), Medicaid and the Exchanges. ACS CAN will submit comments in conjunction with other patient and consumer groups that address these areas.
High Risk Pool Program Regulations
Last Friday, HHS released an interim final rule for the High-Risk Pool Program created in the Affordable Care Act. The federal Pre-Existing Condition Insurance Plan (PCIP) has been up and running since July 1, as have several new state-run high-risk pools across the county.
HHS released interim final rules to clarify the rights that consumers have if they participate in the new high-risk pool plan. The regulation is generally very good, but there are a few specific areas where ACS CAN may recommend changes or clarifications. We will let you know if and when we file comments.
Funding for the Prevention and Public Health Fund
Last week, the Senate Appropriations Committee passed its 2011 fiscal year (FY11) Labor-HHS-Education bill. The Committee report details the proposed distribution of the $750 million available for FY11 through the Prevention and Public Health Fund that was created though the Affordable Care Act.
A sum of $542 million will go to the National Center for Chronic Disease Prevention and Health Promotion at the Centers of Disease Control and Prevention (CDC), which includes the Office of Smoking and Health, the Division of Nutrition, Physical Activity, and Obesity, and the Division of Cancer Prevention and Control. Of the total, $270 million is earmarked for Community-Based Prevention Grants. An additional $90 million will be used to enhance smoking cessation and youth tobacco prevention efforts.
Medicaid Protections – Federal Medicaid Assistant Percentages (FMAP) Funding
Earlier today the Senate passed a bill that will provide $16.1 billion to extend increased state Medicaid funding for an additional six months. Speaker Nancy Pelosi has announced that she will call the House back into session next week to vote on the bill. The six-month extension will protect the health coverage of thousands of cancer patients, and prevent many states from making cuts to life-saving cancer prevention programs across the board.
Lawsuits and Other State Challenges to the Affordable Care Act
Twenty-two states have joined two lawsuits challenging the requirement in the Affordable Care Act in which individuals must have health insurance coverage beginning in 2014, the so-called “individual mandate.” There are Supreme Court precedents upholding the federal government’s power to regulate a wide variety of commercial activity, and most Constitutional scholars believe these lawsuits will ultimately fail. It is important to remember that similar challenges were brought against the Social Security Act, the Civil Rights Act and other historic legislation. All of those past challenges failed.
Thus far the American Cancer Society and ACS CAN have declined to intervene in these lawsuits. However, we are continuing to monitor them closely because the many reforms in the law – such as the requirement that insurers cover individuals with pre-existing conditions – can only be effective if everyone is part of the system. A successful legal challenge to the individual mandate could endanger the provisions of the law that are so beneficial to cancer patients, necessitating that the Society and ACS CAN reconsider the decision not to intervene.
Status of Virginia Lawsuit
On Monday, the federal district court in Virginia denied the federal government’s motion to dismiss the lawsuit filed by the attorney general of Virginia challenging the individual mandate. This was a procedural ruling that allowed the suit to move forward. The court did not rule on the merits of the claim, only that the Virginia attorney general has standing to challenge the law.
Twenty-one other states are parties to a second lawsuit also challenging the individual mandate. That case is currently pending in the federal district court in Florida.
State Election Ballot Initiatives Challenging the Affordable Care Act
Opponents of the legislation have also launched ballot initiatives and legislative efforts in several states to overturn the mandate. It is important to remember that these efforts are largely symbolic because the Affordable Care Act takes precedence over state law. While there is some confusion being generated about the law, these activities nevertheless allow citizens to express their points of view.
Florida: In a separate action from the federal lawsuits, a Florida state circuit court judge last week threw out a proposed state constitutional amendment planned for the November ballot. That matter is now being appealed to the Florida Supreme court. That ballot initiative was also designed to oppose the individual mandate in the Affordable Care Act.
Missouri: On Tuesday, Missouri primary voters passed Proposition C, a ballot initiative designed to oppose the individual mandate. Again, this initiative will have no real impact given that the federal law takes precedence.
Christopher W. Hansen
President
American Cancer Society Cancer Action Network (ACS CAN)