News
January 2012 Monthly Advocacy Update
CANCER RESEARCH AND PREVENTION
During his State of the Union address on January 24, President Obama noted the importance of cancer research and implored Congress to keep funding for it in tact. Specifically, he said: "Today, the discoveries taking place in our federally financed labs and universities could lead to new treatments that kill cancer cells but leave healthy ones untouched...Don't gut these investments in our budget." The president's statement is encouraging and another indication of the impact ACS CAN advocates nationwide are having in elevating the issue. ACS CAN will remain vigilant in its work to stave off potentially devastating cuts to cancer research in the future, Congress has been demonstrating increased support as evidenced by their increasing funding for the National Institutes of Health and National Cancer Institute budgets in the final 2012 fiscal year spending bill.
During the speech, ACS CAN held its annual State of the Union Address Online Chat, where more than 300 advocates posted nearly 1,300 comments during the speech. Volunteers shared their personal stories and thoughts in the spirit of helping make cancer a national priority in 2012. In addition, ACS CAN President Chris Hansen shared his thoughts on the address in a new video.
Training Opportunity TODAY
Today (Wednesday, February 8) at 2:00 pm ET, ACS CAN will host a webinar on the Affordable Care Act-created Pre-Existing Condition Insurance Plan (PCIP). PCIP is a high risk pool for people with pre-existing conditions who are currently unable to obtain or afford health insurance. The program is temporary and unable to serve all in need, but it does serve as an important first step to unlocking the health care system for people with pre-existing conditions.
Representatives from HHS will lead the seminar, explaining how the program works and what organizations like the Society and ACS CAN can do to ensure that eligible patients are aware of it. For more information, please contact Katie Riley at [email protected].
ACS CAN also concluded a series of training sessions for Division advocacy staff focused on the Affordable Care Act in Denver on January 10-11. The training focused mainly on the work states must do to develop state health exchanges including designing campaigns to further those efforts. Similar sessions were held in Washington, DC in November and Indianapolis in December, providing opportunities for every Division to participate. In addition, ACS CAN hosted a webinar for staff on the Essential Health Benefits (EHB) bulletin and its potential impact on Friday, January 27. To access a recording of the call, dial 888-203-1112 and enter passcode 69895600.
Litigation Update
Last month the American Cancer Society and ACS CAN filed a joint a friend-of-the-court brief with the U.S. Supreme Court along with the American Diabetes Association and the American Heart Association in the litigation challenging the constitutionality of the Affordable Care Act. Numerous other groups also filed in support of the provision last week, including AARP, the American Nurses Association, and the American Academy of Pediatrics. Read the joint media statement.
The brief is based in significant part on the Society's own peer reviewed studies showing that the uninsured are more likely than people with private insurance to be diagnosed with cancer at its later stages, and are less likely to survive the disease. These findings drove ACS CAN's support for key provisions of the law that expand access to health care for people with cancer and their families by prohibiting insurers from:
- Denying coverage to anyone with a pre-existing condition;
- Terminating coverage when a patient's care exceeds arbitrary dollar limits; or
- Raising premiums to unaffordable levels in response to a diagnosis.
The law also includes provisions that place an unprecedented emphasis on disease prevention. When fully implemented, all of these provisions will help patients receive lifesaving care and prevent them from going deep into debt to pay for it.
The Supreme Court arguments, which will span an unprecedented three days from March 26-28, will focus on other important questions in addition to the individual responsibility requirement. The questions include whether 1) the constitutionality of the mandate can be determined in advance of the mandate's 2014 effective date, 2) other provisions can remain law if the requirement is struck down, and 3) the law's expansion of Medicaid is constitutional. ACS CAN is monitoring the debate on all of these issues with the hope that they are decided in a way that ensures broad access to care for people with cancer. A decision is expected before the court adjourns for the summer.
Summary of Benefits Coverage
The chief executive officers of ACS CAN, the American Heart Association, the American Diabetes Association, Consumers Union, and AARP sent a letter to the president in late January urging him to issue a strong, final regulation on the Summary of Benefits and Coverage (SBC). In a sign that this issue is of the highest priority, this is the first time since the enactment of the Affordable Care Act that all of these organizations' CEOs have signed onto a letter regarding a specific regulation.
Read the ACS CAN press release.
Under the Affordable Care Act, insurers (and self-insured plans) are required to provide consumers with a standardized form that explains the basics of insurance and allows for direct comparison of plans using examples of "typical" scenarios. The National Association of Insurance Commissioners, working with various stakeholders including consumers, developed a prototype and tested it with consumers (with help from Consumers Union and the insurance industry's trade group, America's Health Insurance Plans). The three scenarios tested include maternity, diabetes, and treatment for Stage II breast cancer. (The breast cancer case is based on a model Georgetown University developed for ACS CAN.)
The final regulation governing the SBC provision is at the White House for a final review. Consumer groups have heard that implementation of the provision could be postponed and that the final regulation may be weakened. ACS CAN and other consumer groups strongly believe that the SBC is vital to enhancing consumer knowledge and understanding of health insurance. For the first time, consumers will have a document that could be enormously helpful to them in better understanding their options and making an informed decision.
Essential Health Benefits Bulletin
On January 31, ACS CAN filed comments with the Department of Health and Human Services (HHS) on the Essential Health Benefits Bulletin - the first communication from the administration laying out guidelines for determining a minimum standard of benefits in each state.
The comments acknowledge the underlying effort to provide flexibility to states, but encourage the administration to strengthen the guidelines in a number of ways including, providing a uniform definition of coverage that:
- Addresses a continuum of care, regardless of geographic location
- Prohibits efforts by insurers to subtly discriminate against certain medical conditions
through benefit manipulation like service or dollar amount limits; and,
- Require transparency for consumers and consumer advocates, including access to timely
and easy-to-understand plan information.
Though significant, the bulletin, which was advisory and has no force of law, leaves many critical issues from a cancer patient's perspective unaddressed. The comments only address the issues raised in the bulletin as ACS CAN waits for HHS to issue a formal regulatory proposal.
In Congress
Representative Joe Pitts (R-PA), chair of the House Energy and Commerce Committee, announced last month that repeal and replacement of the Affordable Care Act is one of his priorities. The committee held multiple hearings last year on repealing a number of the law's' individual provisions; however, a bill specifying what would replace the health law if it were repealed has not been introduced. The committee plans to mark up a "replacement package" in April, providing a preemptive response to the Supreme Court decision expected in June. Policy proposals likely to be in the bill include medical liability reform, high-risk pools, and allowing health insurers to sell their products across state lines.
State Update
Many states are working to pass legislation to create health benefit exchanges during their newly opened 2012 legislative sessions. Approximately 20 states with almost no foundation to build on from 2011 sessions are trying to pass legislation this year while another 10 states are building on executive orders or legislation that passed last year but fell short of actually establishing an exchange. In addition, the 11 states (CA, CO, CT, HI, IL, MD, NV, OR, WA, WV, VT, plus Washington DC) that passed exchange legislation in 2011 have outstanding issues to resolve during this legislative session in order to finish the process.
The remaining states either do not have a legislative session scheduled in 2012, or officials have stated there will be no attempt to pass legislation to establish an exchange. A recent Robert Wood Johnson Foundation-Urban Institute study concluded that the 15 states that have made the least headway in setting up health exchanges have the highest rates of uninsured residents and would see the largest percentage drop in the rate of uninsured residents under the Affordable Care Act.
Progress varies widely, but this is a critical year as states are required to demonstrate "significant progress" on their exchanges by January 1, 2013. The exchanges must then be implemented by January 1, 2014, although HHS officials have been stressing there may be some flexibility for states that miss the deadline. The federal government will operate exchanges in states that fail to establish them.
More Young Adults Have Health Insurance
An analysis of census data by the Employee Benefit Research Institute (EBRI) reports that the number of young adults aged 19 to 26 has gone up from 24.7 percent in 2009 to nearly 28 percent in 2010. EBRI attributes the increase to the provision in the Affordable Care Act allowing young adults to obtain coverage up to age 26 through a parent's employer-based health plan.
Education and Information
As new guidance and regulations are released around the Affordable Care Act, polling continues to show Americans don't understand the basics of the law. Now is an opportune time to help to ensure that staff, volunteers, and the public at large have accurate information about the critical patient protection provisions and what they mean for them. Please remember to mention HealthCareandYou.org and the Society's consumer-friendly booklet about how key provisions in the law are helping people with cancer and their families in your outreach efforts. The guide is available online and in print through Ariba:
Item/Catalogue Number: 5600.00
Description: The Affordable Care Act: How It Helps People With Cancer and Their Families
Price: $0.082
FAMILY SMOKING PREVENTION AND TOBACCO CONTROL ACT
The American Cancer Society and ACS CAN, along with several health partners, recently filed a brief to support the US government's appeal of a decision the Dispute Resolution Body (DBR) of the World Trade Organization (WTO) made to allow clove cigarettes to be sold in the US. Under the Family Smoking Prevention and Tobacco Cessation Act (FSPTCA), clove cigarettes are banned. The DBR decision was brought about by a challenge from Indonesia, the single-largest exporter of clove cigarettes to the US. Indonesia charges that the ban on cloves restrains trade, violates an international trade agreement, and is unjust given that the law allows for the manufacture and sale of menthol cigarettes. The DBR sided with Indonesia, saying that there was not sufficient evidence of a difference between cloves and menthol to warrant the ban.
The brief provides critical health data that explains the need to distinguish between clove cigarettes and menthol, arguing that the provisions of the FSPTCA represent a good faith effort by the US Congress to address a complex, but critically important issue based on legitimate public health considerations without discriminatory intent or effect. In addition, the brief argues that the ban on cloves, but not menthol, provides important public health protections, while acknowledging that developing regulations for a product as uniquely harmful as tobacco presents vexing challenges. In developing long-term, comprehensive solutions to this problem and protecting the health of their citizens, governments must be able to make reasonable distinctions, take incremental steps, and implement policies that take into account the unique circumstances within their borders without being subjected to challenge under international trade agreements.
ACS CAN's "Cancer Votes" electoral program is underway at the presidential level with trained volunteers in early primary states attending and tracking all of the candidates' public campaign events in order to ask them about where they stand on cancer issues. Although not selected to speak at every event, volunteers did take advantage of opportunities to question Representatives Ron Paul and then-candidate Michelle Bachmann directly about their stance on funding for cancer research.
Other efforts include mailing palm cards to more than a thousand people in South Carolina, including hundreds of ACS CAN members and action takers. Volunteers also attended candidate debates in Charleston, Spartanburg, and Myrtle Beach. Most recently, Florida and Nevada ACS CAN volunteers and staff used the Republican contests in their states to organize, raise funds, and increase ACS CAN visibility.
In addition, ACS CAN staff leadership met with policy advisors from the Romney and Perry campaigns and provided materials on cancer policy issues. ACS CAN is working to schedule meetings with the remaining campaigns from both parties.
Chris Hansen | President
ACS Cancer Action Network | American Cancer Society Cancer Action Network, Inc.