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1-6-12 Affordable Care Act Update
January 6, 2012
Federal Update
Congress completed its work on the 2012 fiscal year (FY 2012) federal budget in late December. At the start of the budget process, we faced the prospect of draconian cuts to cancer research and prevention, as well as the elimination or consolidation of cancer control programs at the Centers for Disease Control and Prevention (CDC). With the process complete, we are poised to see an increase in funding for research and the preservation of the CDC’s cancer programs.
The final package includes $30.698 billion for the National Institutes of Health (NIH), a $300 million increase (1 percent) in the NIH budget. The National Cancer Institute (NCI) will receive $5.081 billion under the bill, a $23 million (0.5 percent) increase over FY 2011. The National Institute on Minority Health and Health Disparities (NIMHD) will receive $276 million, a $67 million increase (32 percent) over FY 2011. Additionally, the CDC’s cancer programs will be funded at their FY 2011 levels.
Also worth noting, all of the funding levels in the bill will be reduced by an across-the-board cut of 0.189 percent. This will reduce the NIH budget to $30.640 billion and the NCI budget to $5.071 billion. Additionally, there is limited detail in the bill about funding for the Prevention and Public Health Fund. Technically, the Secretary of Health and Human Services (HHS) has the discretion to allocate the fund; however, ACS CAN was told that there is a bipartisan, bicameral agreement as to how the fund should be allocated. Congressional appropriators are expected to send the Secretary a letter that provides this guidance shortly.
Although the omnibus appropriations bill does not include everything ACS CAN advocated for or all that is needed for the fight against cancer, it represents a major accomplishment for our organization and our volunteers.
State Update
Several states have already started their 2012 sessions, and many will be working on legislation to establish their state health exchange. To date, 11 states (CA, CO, CT, HI, IL, MD, NV, OR, VT, WA, WV) and Washington, D.C. have passed legislation. States that do not pass legislation this session will fail to meet the January 2013 deadline when HHS will evaluate each state to determine which are capable of effectively administering and running their own state exchange.
To help prepare Society Division and ACS CAN government relations staff nationwide for the multi-faceted work ahead in regard to Affordable Care Act implementation, ACS CAN conducted trainings with Division advocacy staff in November and December. A final training for Great West staff will be held next week in Denver.
Additionally, a national online training/conference call is planned for later this month to discuss the recent HHS bulletin that provides guidance to states regarding essential health benefits, which are critically important to cancer patients and cancer care.
Litigation
Litigation challenging the Affordable Care Act at the Supreme Court moves forward tomorrow, when the federal government's brief defending the constitutionality of the individual mandate must be filed with the Court. Amicus, or "friend of the court," briefs supporting the government’s argument are due on January 13. As you may remember, the Society, ACS CAN, the American Diabetes Association, and the American Heart Association filed a joint brief in several federal appeals courts, outlining the critical link between insurance status and health outcomes. The brief argued that the individual mandate was a necessary and proper exercise of Congressional authority under the U.S. Constitution in order to ensure patient protections, such as banning pre-existing condition exclusions or annual caps on treatment. A similar brief will be filed with the Supreme Court next week. Attached is a timeline from Politico Pro detailing important dates leading up to the Supreme Court arguments.
New Study Shows Families’ Problems Paying Medical Bills Remain Steady
A recent health tracking survey from the Center for Studying Health System Change reveals that families reported having about the same level of difficulty paying medical bills in 2010 than they did in 2007. This came as a surprise because of rising health costs and the sluggish economy, but may be attributed to Americans cutting back on medical care during economic turmoil. The nearly 21 percent of families that had problems paying medical bills in 2010, however, remains significantly higher than in 2003, when the rate was about 15 percent. The group with the most problems paying medical bills continues to be the uninsured – 27.9 percent reported having difficulty affording health care costs. The study says provisions in the Affordable Care Act should reduce these problems for some families.
As always, thank you for all you do every day to support laws and policies that help cancer patients and their families.
Chris Hansen | President of ACS CAN
ACS Cancer Action Network | American Cancer Society Cancer Action Network, Inc.