News
December Monthly Advocacy Update
Our deepest condolences go out to those who lost loved ones in the tragic shootings in Arizona on Satuday and we pray for the full and speedy recovery of those who were injured, including Congresswoman Gabrielle Giffords. In addition, we offer our thoughts and support to Society and ACS CAN colleagues in the Great West Division and across the country who had a personal connection to one or more of the victims. In light of this incident and the unspeakable pain it has caused so many, let us join in hoping for a peaceful year ahead.
Cancer Research and Prevention Programs
To learn more, visit http://fightcancer.org/research.
In the final days of 2010, the lame duck 111th Congress and the president approved a temporary spending bill that will fund government operations through March 4, 2011. With few exceptions most agencies and programs, including cancer research and prevention programs, remain at 2010 fiscal year (FY10) levels. With work on 2011 fiscal year appropriations still remaining and the 2012 budget cycle beginning, ACS CAN’s signature campaign will be off to a fast start in 2011.
In the states, ACS CAN and Society Divisions will be trying to prevent cuts to programs that help fight cancer. Tobacco prevention and control programs will remain a ripe target. Fierce battles are expected around Medicaid and cancer screening and treatment programs for low income and underserved populations, like those associated with the National Breast and Cervical Cancer Early Detection Program.
Affordable Care Act
To learn more, visit http://fightcancer.org/healthcare.
In Congress
In response to the tragedy in Arizona, congressional leaders postponed legislative activity that had been scheduled for this week, including a vote to repeal the Affordable Care Act. Ultimately the repeal bill is certain to pass the House, but the current Senate majority and the White House will vigorously oppose it, and therefore it has no realistic chance of becoming law. Immediately following House passage, a separate vote will be held on a resolution that vaguely instructs the three House Committees with jurisdiction for health care to report out legislation (no timeframe is specified) that would replace the existing law.
From there the action will likely shift to the three jurisdictional committees in the House of Representatives for oversight hearings on specific provisions and programs established in the law that Republicans find egregious. In addition, Administration officials such as Secretary of Health and Human Services Kathleen Sebelius will be called to the Hill for questioning on implementation. On the other side of the Capitol, the Democrat-controlled Senate committees with jurisdiction over health care will hold hearings intended to defend provisions in the law that have gone into effect and discuss the groundwork currently underway to establish state health care exchanges by 2014.
The debate over the Affordable Care Act unfortunately has been highly charged and politicized. Hopefully that will change, especially in the wake of the tragedy in Arizona. ACS CAN, it has always been about the “cancer lens.” ACS CAN will not defend the entire law at every turn, and has long recognized that adjustments and improvements to the law will be necessary, but will continue to defend provisions that are helping people with cancer to access lifesaving care. Lawmakers from both political parties must know that these specific provisions are transforming a health care system that for decades has failed to provide access to health care coverage or made it unaffordable for many cancer patients, survivors, and their families.
State Implementation Update
State legislative sessions are getting underway. With almost 700 new state legislators across the country (many of them brand new to the political process), ACS CAN has an opportunity to identify and cultivate new allies and champions to help advance the fight against cancer. In addition to ongoing work on other cancer-related priority issues, Considerable efforts will be made to educate new and returning state legislators about the Affordable Care Act, provisions in the law that benefit cancer patients and their families, and the work necessary to implement the law at the state level.
To date, California is the only state to pass a law establishing a health exchange, although several states started the process and debated the issue in their legislatures last year, including Montana, Kentucky, and Michigan. That work now resumes just as draft proposals are already circulating in a number of states, including Alabama, Mississippi, Oregon, and West Virginia. Many others will soon follow, with each state taking its own approach on how to establish and govern health exchanges.
Affordable Care Act implementation will make up a substantial part of Divisions’ advocacy portfolio. ACS CAN’s state and local campaigns team, with strong support from the policy team, stands ready to work with Society Divisions to ensure that every state protects the well being of cancer patients throughout this intricate process. For example, ACS CAN hosted Division state government relations directors for training on December 7-8. Critical elements of the law were reviewed, with a focus on the work that needs to be done over the next few years to develop the state health benefit exchanges.
In addition, the nearly 100 participants received important information about Medicaid and its expanded role given passage of the Affordable Care Act. Medicaid will be a big issue in many state legislatures, especially with so many states experiencing economic problems. ACS CAN and Society Division staff and volunteers in at least 20 states will be working to protect or expand Medicaid coverage and at least 14 states will be working to protect or expand Medicaid funding.
Finally, the ACS CAN policy team developed the “ACS CAN Evaluative Framework for Assessing the Small Business Health Insurance Options Program (SHOP) and Health Benefits Exchange Proposals.” This document covers issues that may arise as health benefit exchanges proposals are developed and debated in the states. The questions are organized by six criteria -- availability, affordability, adequacy of coverage, administrative simplicity, governance, and financing -- to illustrate the kinds of inquiries and analyses that should be considered in determining whether ACS CAN should take a position on a specific exchange proposal.
Updated Messaging Materials Available
ACS CAN has updated its talking points on provisions of the Affordable Care Act that help people with cancer and their families.
•The talking points focus more on key provisions already in effect that help cancer patients and families, including those that became effective on January 1, 2011.
“The Affordable Care Act: How It Helps People with Cancer and Their Families,” is
Now available on the ACS CAN website. Click on this link to read it
"The Affordable Care Act: How It Helps People with Cancer and Their Families," are now available on the ACS CAN website https://www.fightcancer.org/content/new-simple-guide-explains-how-the-affordable-care-act-helps-cancer-patients-and-their-loved-ones/
Mini-Med Policies
On December 9, the Administration issued new guidance on limited-benefit health plans, also known as “mini-med” policies that will provide consumers with more information about the limitations of such policies. Read the ACS CAN statement.
You may recall that mini-med policies were the subject of a December 1 Senate Commerce, Science, and Transportation Committee hearing. Steve Finan, ACS CAN’s senior director of policy, and ACS CAN volunteer Eugene Melville of Riverside, California testified before the committee. Read the ACS CAN press statement.
Prevention and Early Detection
Politico ran a letter to the editor from Dr. Seffrin on December 9 urging Congress not to gut the Prevention and Public Health Fund created by the Affordable Care Act. The letter details the importance of investing in disease prevention and says the fund should not be used as a “political piñata.” With authorization to provide $17 billion over 10 years, the Prevention Fund is increasingly targeted as a resource to make up health care funding shortfalls in other areas.
Legal Challenge
On December 13, a federal judge in the Eastern District of Virginia ruled that the provision in the Affordable Care Act that requires all Americans to purchase insurance, commonly known as the “individual mandate,” was unconstitutional. Significantly, the judge denied the plaintiff’s request to issue an injunction to prevent further implementation of the law. As a result, key insurance reforms and investments in prevention that will benefit people with cancer continue to move forward even as the US government appeals the ruling.
More than a dozen federal judges have now ruled on cases brought against the law.
To date, all but the judge in Virginia’s Eastern District have either upheld the law or dismissed the challenges, although a federal judge in Florida heard arguments on December 17 in a separate lawsuit brought by multiple states and is likely to comport with the December 13 decision. The US Supreme Court is expected to make the final determination on the constitutional questions surrounding the Affordable Care Act.
Smoke-Free
The latest report from the US Surgeon General on secondhand smoke reaffirmed the fact that there is no such thing as a safe cigarette or a safe level of secondhand smoke. Read ACS CAN statement. To learn more about ACS CAN's work on the issue, visit http://fightcancer.org/smokefree.
Point-of-Sale Warnings
As you may recall, earlier this year the New York City Board of Health adopted measures requiring tobacco vendors to post visible and vivid point-of-sale warnings about the dangers of tobacco use with a call to smokers to quit immediately along with contact information for cessation services. These warnings include pictures of diseased lungs and other graphic signs to help educate consumers on the dangers of tobacco use.
Tobacco retailers and manufacturers sued to invalidate the regulations, contending that federal law preempts the requirements and that the city violated their First Amendment rights. The American Cancer Society, ACS CAN, and other health groups filed a friend of the court brief to help defend the law. Last week, a US Federal District Judge ruled in favor of the plaintiffs, citing the Federal Cigarette Labeling Act as preempting the city's actions. The city is planning to appeal the ruling.
The judge’s conclusion is troubling and, if allowed to stand, could raise questions about other state and local requirements about the point of sale. At the same time, however, there was some good news in the decision. First, the judge did not take into account the Family Smoking Prevention and Tobacco Control Act, which grants states and localities broad authority in the area of sales and distribution, making the decision vulnerable on appeal. Second, the judge acknowledged cited the Society and ACS CAN’s brief by name in the decision and acknowledged, the disturbing and deadly statistics surrounding tobacco use. Finally, because the Court invalidated the law on preemption grounds, no conclusion was reached or precedent set on the First Amendment question.
E-Cigarettes
In early December, the DC Circuit Court of Appeals struck down the Food and Drug Administration (FDA)'s authority to regulate electronic cigarettes (e-cigarettes) as combination "drugs" and "devices” unless manufacturers make health or cessation claims for their products. Instead, the Court held that e-cigarettes would more appropriately be classified as "tobacco products", now that FDA has authority to regulate tobacco under the Family Smoking Prevention and Tobacco Control Act.
ACS CAN and other public health groups petitioned the DC Circuit Court of Appeals at the end of December to have a special "en banc" session with the all of the court’s judges to re-hear the case. A three judge panel of the court made the prior adverse decision. ACS CAN’s goal is to overturn the decision without having to go to the US Supreme Court. In addition, ACS CAN is assessing the impact of this ruling and working with Division advocacy staff to provide guidance for state legislative sessions.
The public health petition urges the court to hear the case because regulation of nicotine replacement therapy is essential in reducing tobacco use. ACS CAN is concerned that the DC Circuit's decision will hinder efforts to reduce mortality and morbidity associated with tobacco use, and undermine incentives to develop new, better alternatives to nicotine products. Under the current decision, e-cigarette manufacturers can market potentially harmful and addictive products without knowing the full effects of the products, likely leading to greater nicotine use by children and others.
Obesity - President Signs Child Nutrition Act
On December 13, President Obama signed the Child Nutrition Act. Among other things, the bill creates federal standards for foods sold in school vending machines and a la carte lines during school hours, improve nutrition standards for school meals, increase federal reimbursement rates for school meals, strengthen local wellness policies, and support farm-to-school programs to get locally grown fruits and vegetables into schools. Passage of this legislation will help fight the nation's obesity battle, starting with children and adolescents in school settings. ACS CAN supported the law and is now assessing its impact at the state level and working with Division advocacy staff to provide guidance for state legislative sessions. Read the