Federal Update
Senate Committee Finalizes Health Funding Bill
The Senate Appropriations Committee completed its work last night on its 2012 fiscal year (FY 2012) Labor-Health and Human Services (HHS) appropriations bill. Four Affordable Care Act (ACA) related amendments were offered. The first, and most significant, would have suspended implementation of the law, prohibited the use of appropriated funds for purposes related to the law, prohibited the hiring of staff for programs authorized in the law, and restricted Center for Medicare and Medicaid Services (CMS) activities. Senator Richard Shelby (R-AL) offered the amendment and it was defeated on a party line vote.
Senator Roy Blunt (R-MO) offered the second amendment, which would have required a CMS actuarial analysis on the impact of the essential benefits package on insurance premiums. The amendment failed by a vote of 15 to 15. The third amendment, offered by Senator Lamar Alexander (R-TN), would have required a CMS actuarial analysis of the impact of state Medicaid costs on state budgets. This amendment also failed by a vote of 15 to 15.
The final ACA related amendment was offered by Senator Lisa Murkowski (R-AK). The amendment would have increased funding for the Low Income Home Energy Assistance Program, which provides funding to states to assist individuals with paying their energy bills, by $500 million in FY2012. The increase would have been paid for through a decrease in the Prevention and Public Health Fund created in the ACA that ACS CAN strongly and actively supports. The amendment failed by a vote of 7 to 23.
Over the past year there have been multiple attempts to impede ACA implementation through the appropriations process and this will likely not be the last time. ACS CAN will continue to engage in the FY 2012 appropriations process and make sure members of Congress are aware that ACS CAN supports full implementation of the law as well as priority programs in the law, such as the Prevention and Public Health Fund.
State "Partnerships" and Health Exchanges
As you know, HHS released a proposed rule to govern the new health care exchanges in July. Within that proposal, HHS referred to the possibility of forming federal-state partnerships, positing that the federal government might run an exchange in a state but allow the state itself to perform some of the exchange's core functions. ACS CAN and other consumer groups have expressed strong reservations about this approach because of concerns that dividing core functions might undermine the "one-stop shopping" concept for consumer service within the ACA.
This week HHS met with state officials and consumer groups to provide more information on the partnership model. The agency suggested it might partner with states to perform consumer assistance functions, such as the navigator program or web portals, and/or "plan management," which would include health plan selection and exchange oversight. ACS CAN and other consumer groups are supportive of allowing states to assume consumer assistance functions provided there is appropriate federal oversight, but strong reservations remain as to allowing states to engage in health plan management. The responsibilities that are inherent in health plan management are integral to other core functions of an exchange such as eligibility for assistance, adverse selection, and plan performance. ACS CAN has expressed our concerns orally and will submit additional written comments. We will provide more information as it becomes available.
State Update
Rhode Island Governor Lincoln Chaffe unveiled an Executive Order establishing a state health insurance exchange earlier this week. He also named individuals to serve on the exchange's inaugural Executive Board of Directors/Governance Board.
To date, a total of 21 states have passed various forms of legislation or had Executive Orders issued establishing a state exchange. Since the ACA became law, 10 states have done so by enacting legislation and 11 have been established via Executive Order.
HealthCare and You Online Chat
Today ACS CAN's Dick Woodruff participated in a web "chat" on annual and lifetime dollar limits on health coverage and how the ACA puts an end to them. The chat was one in a series from the Health care and You coalition, which was launched earlier this year by ACS CAN and other national health groups representing patients, seniors, doctors, nurses, hospitals, and pharmacists to educate the public about the new health law. A replay will be available on the coalition website, HealthCareandYou.org.
Affordable Care Act Helps Young Adults Gain Coverage
One million young adults gained health insurance in 2011 because of ACA implementation according to a National Center for Health Statistics report. The percentage of young adults ages 19 to 25 who have health insurance coverage increased to 69.6 percent, up from 66.1 percent in 2010. The results show that the dependent coverage provision of the law is having a significant impact on improving access to health care for young adults.
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)