News
Monthly Advocacy Update
Access to Care – Health Care Reform
History Made - Major Milestone for the Mission
On Tuesday, March 23, President Barack Obama signed health care reform legislation. After a small White House ceremony, the president spoke at an event before an audience that included George W.P. Atkins, chair of the American Cancer Society’s National Board, Alan Thorson, MD, FACP, president of the National Board, and John R. Seffrin, PhD, the chief executive officer of the Society and ACS CAN. Later in the week, the House and Senate approved a smaller package of improvements that the president signed on Tuesday, March 30.
Passage of the legislation is a significant step forward in the Society’s overall efforts to improve access to care nationwide and marks a major milestone in the fight against cancer. Society and ACS CAN volunteers and staff can be proud of what has been accomplished, not just on the legislative front, but of all that has ensued since the joint Access to Care initiative began in 2006 when the Society’s Board of Directors set nationwide goals calling for sweeping reductions in the number of people who are uninsured or cannot afford the out-of-pocket costs for lifesaving care.
Meaningful Improvements
Although the law is not perfect, overall the legislation meets ACS CAN’s reform priorities by:
1. Increasing the emphasis on disease prevention, such as by reducing or eliminating out-of-pocket costs for lifesaving cancer screenings,
2.Guaranteeing nearly all Americans access to quality, affordable health care, regardless of whether one has a pre-existing health conditions, and;
3.Emphasizing patients’ quality of life, such as by ensuring access to treatment for pain.
More specifically, ACS CAN's analysis concluded that the law would improve access to health care by ensuring the availability of adequate and affordable insurance coverage to nearly all Americans. Critical reforms would specifically eliminate discrimination based on health status and preexisting conditions, and abolish arbitrary limits on annual and lifetime benefits for most plans, which have been so detrimental to cancer patients over the years.
The law also would help to transform the health care system to focus more on prevention and early detection by requiring all insurance plans to provide coverage for essential, evidence-based preventive measures with no additional co-pays. ACS CAN also believes the bill would go a long way toward reducing the disparities in prevention and treatment of cancer among low-income and minority populations through the expansion of Medicaid and inclusion of tax subsidies.
Immediate and Near-Term Improvements
Many of the reforms will not take effect until 2014, but several provisions will be in place before the end of the year:
• Within 90 days of enactment, uninsured people with a pre-existing condition will be able to apply for coverage in a national high-risk pool;
• In six months, the ban on lifetime limits takes effect; health plans will be prohibited from denying coverage to children with pre-existing conditions’ dependents can stay on their parent’s insurance policy up to age 26; and health plans will be barred from dropping people from coverage when they get sick; and,
• Seniors will immediately begin to get relief from the gap in Medicare prescription drug coverage, also known as the “donut hole.”
Voices Heard
As you know, ACS CAN helped shape the debate and acted as a leading voice for patients throughout the process. This would not have been possible without the persistence of ACS CAN’s powerful grassroots volunteer movement who ensured that the voices of cancer patients, survivors, and caregivers were heard. In dozens of face-to-face meetings, media events, videos, and rallies, they educated lawmakers, the media, and the public about the many challenges cancer patients face in obtaining care in the nation’s current health care system. They also underscored the need for reform in thousands of calls, letters, and emails to their legislators. Most recently, ACS CAN advocates delivered more than 56,000 signed petitions to their Members of Congress, urging lawmakers from both political parties to seize the historic opportunity to pass meaningful health reform.
Unfortunately, the rhetoric has been very heated and the legislative process criticized as politically partisan. Please remember that for ACS CAN the issue has always been about patients, not politics. Throughout this effort ACS CAN has been singularly focused on whether the provisions of the legislation would meaningfully improve the health care system for cancer patients. ACS CAN has consistently encouraged bipartisan support for meaningful health care reform, and as a nonpartisan organization, ACS CAN’s ultimate goal has been to ensure that people with cancer are no longer denied lifesaving treatment, charged far more than they can afford for critical care, or issued insurance plans that are inadequate to meet their needs.
Moving Forward
The road to meaningful health care reform has been long and arduous, but the journey is not yet over as ACS CAN turns to implementation. I know many of you are getting questions (and have some of your own) about what happens next. Preparations for this phase have been underway since January. Now that the law is on the books, more comprehensive information and communication tools about its implications for the Society, ACS CAN, and constituents will be made available in the coming weeks and months.
A priority focus of this work will be to ensure the hard-fought protections for cancer patients remain intact. And while ACS CAN succeeded in strengthening the legislation during the months-long debate, what passed could have been stronger. ACS CAN must be vigilant to ensure not only that the law works in the most effective way possible for those with cancer and their families, but also that the law’s shortcomings are addressed and enhancements made as quickly as possible.
Finally, remember that health care reform is just one part of the Society and ACS CAN’s broader goal to expand access to quality care nationwide. Rest assured that moving forward, the Society and ACS CAN will continue to lead the way, achieve results, and make a major contribution on behalf of those fighting cancer.
Many thanks to volunteers and staff in the Mid-South and Midwest Divisions for waging successful campaigns to enact legislation in Iowa and Kentucky requiring insurers to cover the routine care costs of cancer patients in clinical trials. Thirty-two states and the District of Columbia now have such laws on the books or a voluntary agreement in place.
Cancer Research and Prevention Programs
ACS CAN’s campaign to fight cuts to cancer prevention programs and sustain investments in cancer research is in full swing. Over the past month, ACS CAN has been meeting with members of Congress and staff in Washington, DC and across the country. During the Presidents’ Day recess, ACS CAN volunteers targeted 70 members of Congress for outreach in their states and Congressional districts.
Throughout this spring, ACS CAN will be working to build support among Members of Congress to ensure that the proposed cuts to cancer screening and prevention programs are rejected. ACS CAN also is working to cultivate long-term support for the research programs that are essential to improving how cancer is prevented, detected, and treated.
Following the recess, ACS CAN and its partners in the One Voice Against Cancer (OVAC) coalition ran ads in Congressional publications and websites to promote the need for sustained support for cancer research. The message to Congress was clear: funding for cancer research is good for our nation’s health and our economy. View OVAC’s funding priorities for 2011 federal fiscal year.
The President’s budget provides a $1 billion increase for medical research over last year’s funding level, including an additional $161 million specifically for cancer research. This is an important step toward sustaining and capitalizing on the progress currently being made through research. ACS CAN and OVAC are asking Congress to ensure that the scientific discoveries of today are pursued to the fullest extend possible, and that the current level of support is sustained next year.
In addition to promoting research investments, ACS CAN is fighting back hard against proposed cuts to the National Breast and Cervical Cancer Early Detection Program (NCCEDP). Most recently, ACS CAN sent letters to the Secretary of Health and Human Services and Congressional leadership, expressing strong opposition to the president’s proposal to strip $4 million from the NBCCEDP budget, which would result in 7,000 fewer women being screened for cancer next year. ACS CAN is urging Congress to reject this funding proposal and to fully fund the NBCCEDP.
ACS CAN recently won a reversal of an adverse breast and cervical coverage decision in Tennessee. Through the Health Insurance Assistance Service (HIAS) and the National Call Information Center (NCIC), ACS CAN learned that the state had wrongfully denied Medicaid coverage to a patient because she had a “cancer-only” private insurance policy even though having such coverage should not have precluded her from Medicaid as the state contended.
ACS CAN worked through its Judicial Advocacy Initiative to make the federal Centers for Medicare and Medicaid Services (CMS) aware of the case as an example of a practice that could affect the ability of many other women in the state to obtain cancer care through Medicaid. At CMS's request, Tennessee performed a comprehensive review of their records and found that this was an isolated case and reinstated the patient’s Medicaid eligibility.
ACS CAN will continue to monitor screening and treatment programs to ensure enforcement of all related laws and regulations as part of the ongoing effort to improve access to care.
Colorectal Cancer
Kudos to the Mid-South! Volunteers and staff in Arkansas secured $5 million in the state budget for the statewide colorectal cancer screening program for the underserved. The money, which will be administered through the University of Arkansas Medical System, will be available beginning July 1, 2010 and because of state budget rules it cannot be eliminated or reduced. The Society in Arkansas was instrumental in the creation of a pilot program that led to the statewide program and lawmakers’ commitment to it.
ACS CAN and 11 partner organizations issued the 2010 Colorectal Cancer Legislation Report Card this month and unfortunately it showed the least improvement in a single year since the report began in 2004, with Vermont being the only state in 2009 to pass a bill to require insurance carriers to cover the full range of screenings. The state also capped out-of-pocket costs at $100. Read the press release.
The slowed progress is likely attributable to state legislators waiting to see the outcome of the federal health care reform debate. Including Vermont, 22 states and the District of Columbia received A’s. Ten other states require varying degrees of coverage, with scores of B, C or D. Eighteen states received Fs for failing to require any screening coverage.
Protecting Kids from Big Tobacco
On March 18, the U.S. Food and Drug Administration (FDA) announced landmark restrictions on marketing tobacco products to children and teens as part of the federal government’s implementation of the Family Smoking Prevention and Tobacco Control Act, which granted the FDA the power to regulate the manufacture, marketing and sale of tobacco products. The restrictions take effect June 22, 2010, the one year anniversary of the law. Read the ACS CAN press release.
The tobacco industry spends more than $35 million every day to aggressively market its products to addict new, young smokers, keep current users from quitting and mislead the public about the harms of its products. Every day, 3,500 children pick up their first cigarette and 1,000 children become addicted smokers. Placing restrictions on these addictive and deadly products is a critical step toward saving lives.
On March 30-31, the U.S. Food and Drug Administration (FDA) held the first meeting of its new Tobacco Products Scientific Advisory Committee. Established as part of the Family Smoking Prevention and Tobacco Control Act, the 12-person Committee is tasked with making recommendations to the FDA commissioner regarding safety, dependence, and health related to tobacco products. Priority issues to be addressed include the use of menthol and the impact of dissolvable tobacco product.