8-9-10 Monthly Advocacy Update

Cancer Research and Prevention Programs

Despite the tough economic times, representatives and senators on the Appropriations committees showed solid support for cancer research and prevention programs before adjourning for the August recess.

 

Senate Action

On July 29, the Senate Appropriations Committee approved a $1 billion (3.2 percent) increase for the National Institutes of Health (NIH) over the 2010 fiscal year (FY10) budget, for a total of $32 billion in FY11. This amount includes $5.2 billion for the National Cancer Institute (NCI). Read the ACS CAN press release.

 

Unfortunately an amendment from Senator Arlen Specter (D-PA) that would have added another $1 billion to the NIH budget failed. The NIH budget does, however, include $50 million for the Cures Acceleration Network authorized in the Affordable Care Act through a bill by Senator Specter. The Network was created to bridge the gap between lab discoveries and life-saving therapies. Housed in the NIH Director’s office, the Network identifies and directs funding to priority “high need cures” for which commercial market incentives are unlikely to result in adequate or timely development.

 

ACS CAN advocates were also successful in an effort to have the Committee include language in its bill report urging NCI to maintain support for the Breast Cancer Surveillance Consortium. The Consortium is designed to improve surveillance and clinical practices and for nearly 20 years has been a strong complement to Society-sponsored breast cancer research. The language also calls for the Consortium to expand current data collection and surveillance systems to other widely prescribed cancer screening tools.

 

The Committee also allocated $582 million for the cancer programs at the Centers for Disease Control and Prevention (CDC). This is $101 million over last year’s budget and $120 million over the president’s request. The Office of Smoking and Health received an $87 million increase for a total of $197 million when funding from the Prevention and Public Health Fund created by the Affordable Care Act is included. The Comprehensive Cancer Control Initiative received $30 million, up from $21 million in FY10, a 45 percent increase.

 

Most CDC programs, however, were flat funded, including the Colorectal Cancer Screening, Education and Outreach Program. Funding was restored to two programs the president’s budget eliminated: the Geraldine Ferraro Blood Cancer Program and the Gynecologic Education and Awareness program will both be funded at the same level as last year, $5 million and $7 million respectively.

 

The Committee set funding levels for the Health Resources and Services Administration (HRSA) Nursing Program at $292 million, up from $48 million in FY10, a 20% increase. The HRSA Patient Navigator Program, which ACS CAN fought to create, received $5 million, the same as last year.

 

House Action

In the House, the Labor-HHS Appropriations Subcommittee approved its FY 11 spending bill on July 15 by a vote of 11-5. Like the Senate version, the bill included a $1 billion (3.2 percent) increase for NIH for a total of $32 billion, $1 billion more than FY10, with $5.2 billion of that going to NCI and $50 million to the Cures Acceleration Network. Read the ACS CAN press release.

 

The House bill also includes nearly $6.8 billion total for the CDC, $32 million more than FY10 and $170 million above the President’s request. Funding levels for CDC cancer programs, such as the National Breast and Cervical Cancer Early Detection Program, are not yet available. The CDC will receive an additional $594 million from the Prevention and Public Health Fund created by the Affordable Care Act. Like the Senate bill, the House Subcommittee allocated $292 million for the HRSA nursing programs, a 20 percent increase over FY10.

 

Recess Activities

During the August congressional recess ACS CAN advocates will be making the case for federal funding for vital cancer programs directly to lawmakers as they return home. Activities include creation of an online “National Family Album” with photos and stories from cancer survivors about how research has affected them, promoting ACS CAN’s poll of families affected by cancer in the media and other venues, and partnering with a local cancer center on an activity or media event. The grassroots activities will build momentum for the ACS CAN Leadership Summit and Lobby Day being held September 26-29 in Washington, DC.

 

National Breast and Cervical Cancer Early Detection Program

 

ACS CAN Launches Ad Campaign

On August 9, ACS CAN launched a print and online advertising campaign in targeted congressional districts to highlight the need for more funding for the National Breast and Cervical Cancer Early Detection Program (NBCCEDP). The program has provided more than 9 million screening exams to more than 3 million women and diagnosed more than 40,000 cases of breast cancer and more than 2,000 cases of cervical cancer since it launched in 1990. But with limited funding, the program is able to serve fewer than 1 in 5 eligible women. Read the ACS CAN press release.

 

The print ad features a blindfolded woman beside text that reads, “We can’t fight cancer if we can’t see it.” The ad goes on to say, “When it comes to cancer, screening is seeing…  It's time to take the blindfolds off and to stop cancer before it starts.” Online advertising that features the “Screening is Seeing” theme will also run this month.

 

Congress showed its commitment to making prevention and early detection a national priority by including an increase for the NBCCEDP in FY 2011, funding bills approved by the Senate Appropriations Committee.  But even with increases, funding continues to fall short of the program’s fully authorized level of $255 million.

 

In addition to the ad campaign, ACS CAN advocates will be working through the congressional recess to boost both federal and state funding that supports the NBCCEDP. Activities include a radio media tour featuring American Cancer Society Immediate Past President, Elizabeth “Terry” T.H.  Fontham, MPD, DrPH, educational forums for state and federal lawmakers, partnering with Making Strides Against Breast Cancer participants, and sending anniversary cards to lawmakers.

 

ACS CAN Marks NBCCEDP’s 20^th Anniversary

On July 27, ACS CAN hosted an event to mark the 20th anniversary of the NBCCEDP on Capitol Hill. Speakers included: Senator Debbie Stabenow (D-MI), Representative Sue Myrick (R-NC), and Representative Debbie Wasserman Schultz (D-FL), Dr. Marcus Plescia, director of the CDC’s Cancer Prevention and Control Division, and ACS CAN volunteer Vonnie Uzoukwu, a breast cancer survivor who benefited from the program. Read the ACS CAN press release.

 

During the event, ACS CAN unveiled Decades of Detection: Progress and Challenges of the National Breast and Cervical Cancer Screening and Treatment Program, a new report that highlights stories of women who the NBCCEDP successfully served and emphasizes the need for adequate funding so the program can screen more women.

 

How Do You Measure Up?

On July 28, at the National Conference of State Legislatures’ annual meeting, ACS CAN released the eighth annual How Do You Measure Up?: A Progress Report on State Legislative Activity to Reduce Cancer Incidence and Mortality . The report evaluates each state’s policies (as a result of a legislative vote or a ballot initiative) on six specific issues: breast and cervical cancer early detection program funding; access to care for the uninsured; colorectal screening coverage laws; smoke-free laws; funding for tobacco prevention programs; and tobacco taxes. The report also examines affordability of health coverage, pain management, and investments in nutrition and physical activity promotion. Read the ACS CAN press release.  Look inside the report to find out how your state did.

Unfortunately, nearly half of all states are falling short on legislative solutions to prevent and fight cancer, with 23 states reaching ACS CAN’s benchmark on none or only one of the six priority areas. No state has met all of the benchmarks for effective cancer-fighting policies and only one state — Hawaii — reached benchmarks in five of the six areas. Seven states — Alabama, Florida, Idaho, Mississippi, Oklahoma, South Carolina, and Tennessee — did not meet the benchmark on any of the six issues. Sixteen states received high marks on only one issue.

But despite budget crises in many states, there was some positive progress:

•        Since the 2009 report, 11 states and the District of Columbia have passed tobacco tax increases. The current national average tax is $1.45 per pack, up from $1.28 in 2009. Forty-seven states have increased tobacco taxes since 2002. 

•        Nearly 79 percent of the US population is covered by some kind of smoke-free workplace law, with three states — Kansas, Michigan, and Wisconsin — implementing comprehensive smoke-free workplace laws in the past year. Thirty-five states plus the District of Columbia and Puerto Rico have 100 percent smoke-free workplaces and/or restaurants and/or bars. Twenty-two of those states plus the District of Columbia and Puerto Rico are 100 percent smoke-free in all three categories.

•        Twenty-seven states and the District of Columbia have laws ensuring private insurance coverage for the full range of colon cancer screenings.

•        Ten states spend more than 50 percent of the CDC-recommended funding level towards tobacco prevention. In 2010, North Dakota became the first and only state to fully fund its tobacco control program.

•        Many states are working on policies and programs to reduce the cancer risk related to poor nutrition, lack of physical activity, and obesity. In addition, many state legislatures fought hard to preserve coverage for lifesaving cancer screenings and treatments and to stave off attempts to cut state funds that support these programs, such as the National Breast and Cervical Cancer Early Detection Program.

 

The report was distributed to national health policy reporters and Washington-based bureaus. ACS CAN also worked with Divisions to localize press releases. Stories have appeared in publications such as The Detroit Free Press and Birmingham Business Journal. A nationwide radio media tour covered national outlets, including ABC Radio, Wall Street Journal Radio, and National Metro Networks, and 15 targeted states where Division spokespeople conducted 32 interviews reaching more than 5,100 station affiliates and a potential audience of more than 18 million. ACS CAN also did outreach through blogs and social media networks, such as Twitter.

 

Access to Care - Affordable Care Act

 

Regulations

 

Prevention Benefits

On July 14, the Department of Health and Human Services (HHS) released interim final rules for prevention benefits included in the Affordable Care Act.

 

The regulations require new individual and group health plans to provide beneficiaries with certain preventive benefits at no cost starting September 23, 2010 (“grandfathered plans” do not have to comply with the regulation). Preventive services with a rating of "A" or "B" in the current recommendations of the United States Preventive Services Task Force, including cancer prevention tools such as mammograms, colonoscopies, and tobacco cessation counseling, must be offered at no cost. The rules will encourage millions of people to protect their health by taking advantage of lifesaving preventive measures. ACS CAN will submit comments on the rules within the 60-day public comment period. Read ACS CAN’s press release.

 

The rules were announced at an event at George Washington University Hospital in Washington, DC featuring First Lady Michelle Obama, Dr. Jill Biden (wife of Vice President Joe Biden), and HHS Secretary Kathleen Sebelius. Also in attendance was ACS CAN volunteer and Wisconsin State Lead Ambassador Kathi Hansen, a seven-year breast cancer survivor whose cancer was detected early thanks to a routine mammogram. 

 

Consumers’ Right to Appeal

On July 22, HHS released an interim final rule on provisions in the Affordable Care Act that will standardize internal and external processes that patients can use to appeal decisions made by their health plan. Beginning on or after September 23, 2010, new health plans must adopt an internal process that allows consumers to file an appeal when a claim for a covered service has been denied. Those plans are required to instruct consumers about how they can begin the appeals process. In addition, states will have to provide consumers with access to a standard external appeals process. HHS will work with states to establish or update their external appeals process to meet the new federal standards. If state laws do not meet federal standards, comparable federal external appeals standards will protect consumers in those states.   

ACS CAN has reviewed the regulation and considers it to be an important improvement in providing patients with important rights and clear information about those rights. ACS CAN will work in partnership with other organizations to make formal comments for improvements and clarifications on specific issues raised in the regulation.

 

High Risk Pools

The federal Pre-Existing Condition Insurance Plan (PCIP) has been up and running since July 1, as have several new state-run high-risk pools across the country. On July 31, HHS released interim final rules for the High-Risk Pool Program created in the Affordable Care Act to clarify the rights that consumers have if they participate in the new high-risk pool plan. The regulation is generally very good, but there are a few specific areas where ACS CAN may recommend changes or clarifications.

 

State Health Exchanges

On August 3, HHS requested public comments in advance of final rulemaking on provisions in the Affordable Care Act regarding the creation of state-based health exchanges. Specific areas that HHS is interested in include: what type of information will be useful for consumers when they trying to enroll in a plan, what resources people will need to navigate the health exchange and purchase health insurance successfully, and how eligibility and enrollment can be coordinated more effectively among the State Children’s Health Insurance Program, Medicaid and the Exchanges. ACS CAN will submit comments in conjunction with other patient and consumer groups that address these areas.

 

FDA Takes First Step Toward Implementing Menu Labeling Provisions

Last month the Food and Drug Administration (FDA) announced that it will solicit comments from the public on how to proceed with new federal menu labeling requirements under the Affordable Care Act. The provisions require chain restaurants and retail food establishments with 20 or more locations that offer substantially the same menu items to list calorie information on menus and menu boards, including drive-through me