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Oklahoma becomes 37th state to increase access to health coverage through Medicaid

Oklahomans approval of Medicaid expansion will improve health outcomes and reduce cancer disparities for 200,000 citizens now eligible for health care coverage.  

On June 30, a majority of voters responded "yes" to Question 802, which asked if Medicaid should be fully expanded to low-income adults earning less than $17,609 a year for an individual and $36,156 for a family of four, as permitted under the federal health law. The vote was 340,279 to 333,761.

The following is a statement from Lisa Lacasse, American Cancer Society Cancer Action Network (ACS CAN) president. 

"This victory is an incredible development for public health in Oklahoma, which currently has the second-highest uninsured rate in the nation. According to American Cancer Society research, uninsured rates in Medicaid expansion states fell from nearly 10 to about 3.5 percent between 2011-2014,while in non-expansion states the decline was much smaller, from 15 to 14 percent. This decline in the number of uninsured, also resulted in a statistically significant shift toward stage I diagnosis in common cancers like, lung, breast and colon. ACS studies have found, for instance, low income women were 25% more likely to adhere to screening guidelines in expansion states than in non-expansion states. Early detection of cancer increases a patient's chance for survival&#and decreases treatment costs. With this vote, Oklahomans have elected to save lives and long-term health care costs.

"Tuesday's vote also comes as more than two-thirds of Oklahoma's rural hospitals operate at a loss, and at least half the state's hospitals are at-risk of closure. Ensuring more individuals have access to health coverage through Medicaid will mean much needed additional revenue to these hospitals, by ensuring rural residents have greater access to cancer screenings, treatment and follow-up care, as well as positively impacting rural community economies statewide where these health systems are located. 

"ACS CAN is grateful to all our volunteers in Oklahoma who worked hard to encourage their fellow Oklahomans to vote yes on Question 802 and commends the voters for standing up for the health of their neighbors, family and friends."  

When the initiative goes into effect, Oklahoma will join the 36 other states, and the District of Columbia, that have increased access to their Medicaid programs to cover more low-income residents. 




  • ACS CAN supports lawsuit to force FDA to take action against menthol tobacco products

    ​Tobacco industry’s targeting of African Americans must end

    On June 17, the African American Tobacco Control Leadership Council (AATCLC) and Action on Smoking and Health (ASH) filed a lawsuit in the U.S. District Court in the Southern District of California claiming that the Food and Drug Administration’s (FDA) failure to ban menthol cigarettes violates federal law, and that continued delay was projected to result in an estimated 4,700 premature deaths in the African American community.

    The case argues that FDA is in violation of the Administrative Procedure Act for unreasonably delaying action required by the Tobacco Control Act, passed in 2009, and despite compiling extensive scientific data showing that menthol poses a public health risk beyond that of regular cigarettes. 

    Below is a statement from Lisa Lacasse, ACS CAN president.

    “The American Cancer Society Cancer Action Network (ACS CAN) has been urging FDA to prohibit menthol, including in cigarettes, in our call for a total flavor prohibition in all tobacco products for years. The agency’s inaction is a curious deference to the tobacco industry on a product, which if prohibited, would help reduce tobacco initiation among youth and stimulate cessation among adult users, saving lives from disease and death caused by menthol cigarettes. ACS CAN strongly supports The African American Tobacco Control Leadership Council (AATCLC) and Action on Smoking and Health’s (ASH) decision to file suit against FDA on this issue. 

    “Big Tobacco has used menthol cigarettes to deliberately and aggressively target African Americans, youth, LGBTQ communities and low-income communities for decades. And it has worked. African Americans consistently report the highest prevalence of menthol cigarette use. It is well documented that menthol in cigarettes increases smoking initiation, decreases successful quitting and leads to greater addiction. Failing to address menthol flavoring in tobacco is failing to address a serious health inequity in our country.

    “Smoking is the number one cause of preventable death and the leading contributor to lung cancer. Removing this weapon from Big Tobacco’s arsenal would help address health disparities in tobacco-related disease and save lives. 

    “In the vacuum created by FDA, Congress has worked to take its own action. ACS CAN is encouraged by the House passage of The Reversing the Youth Tobacco Epidemic Act in February to prohibit menthol cigarettes and all other flavored tobacco products. Furthermore, some cities and states across the country have made progress in ending Big Tobacco’s targeting of children by ending the sale of all flavored tobacco, including menthol cigarettes which target African Americans. However, FDA has the power and obligation to make this change swiftly and effectively throughout our country. We stand with AATCLC and ASH in their call for the agency to stop the tobacco industry’s shameless targeting of African Americans with menthol products, including cigarettes.”




  • Oklahoma's Medicaid waiver puts public health at risk

    ​If approved, it would result in enrollment freezes, delays in care, and fewer covered benefits

    ACS CAN submitted comments this week to the Centers for Medicare and Medicaid Services (CMS) urging the agency to reject Oklahoma’s SoonerCare 2.0 Healthy Adult Opportunity Section 1115 waiver application.

    Oklahoma is the first state to file a waiver application seeking CMS approval to implement guidelines released by the administration in January which would fundamentally alter the Medicaid program.

    A statement from Lisa Lacasse (pictured here), president of ACS CAN, follows:

    “If approved, Oklahoma’s 1115 waiver would be detrimental to public health in the state. Current events have shone a spotlight on the importance of access to health insurance coverage, as well as the health disparities that exist when it comes to accessing health care in this country. Oklahoma’s waiver is a step in the wrong direction in addressing these problems.

    “The SoonerCare 2.0 application includes several changes to the Medicaid program under the auspices of more state flexibility, but in reality would lead to enrollees paying more for coverage and would cap Medicaid funding, resulting in enrollment freezes, delays in care, and fewer covered benefits. Capped funding could also lead to freezes in services, which for cancer patients could mean inability to access their lifesaving treatment and ultimately, lower chances of survival.

    “The application also includes administrative reporting (work) requirements, which would create more red tape for Medicaid enrollees and likely result in qualified individuals losing their health coverage. If approved, cancer patients, who are often unable to work while in active treatment, may find themselves without access to the program.

    “For countless Oklahomans, Medicaid is a lifeline. However, the changes outlined in the SoonerCare 2.0 application would make it more difficult for people to gain access to coverage and harder for them to maintain their coverage when they need it most. With unemployment rates at an all-time high and most individual’s health coverage tied to their employment, Oklahoma should instead be working to extend eligibility to the program to help its residents recover physically and economically from this pandemic.

    “ACS CAN urges CMS to stand up for public health and act to reduce health disparities by rejecting Okalahoma’s SoonerCare 2.0 waiver application. ACS CAN is further advocating for increased access to the existing program without waiver by encouraging voters to vote “Yes” on State Question 802, on June 30, to increase access to Medicaid coverage for an estimated 200,000 low-income Oklahomans. More than 20,530 people in Oklahoma are expected to be diagnosed with cancer this year and there are already more than 207,260 cancer survivors in the state – many of whom rely on Medicaid or would greatly benefit from receiving their health care through expansion of the program.”


  • ACS CAN submits testimony on health disparities

    Aims to reduce disparities in cancer prevention, diagnosis, and care

    The American Cancer Society Cancer Action Network (ACS CAN) submitted testimony on June 17 to the House Energy and Commerce Committee on the topic of racial and ethnic disparities in the health care system that often result in an unequal cancer burden. 

    The hearing is focused on disparities in the overall health care system, as well as those around COVID-19.

    ACS CAN is working to create equity by supporting policies that:
    • Ensure everyone has access to affordable, quality health insurance coverage, including expanding Medicaid to cover more low-income individuals
    • Maintain key provisions of the Affordable Care Act, such as patient protections that improve availability and affordability of quality care that aid lower socioeconomic status and racial/ethnic groups
    • Ensure all health insurance – regardless of payer – provides coverage for essential, evidencebased early detection and preventive services with no additional patient cost sharing
    • Increase funding for community health centers and the National Breast and Cervical Cancer Early Detection Program (NBCCEDP), which provides community-based breast and cervical cancer screening and treatment services through the Medicaid program to low-income, uninsured, and underinsured women – a majority of whom are from racial/ethnic minority groups
    • Ensure that qualified health plans provide materials in appropriate languages and access to language translation services
    • Ensure clinical trials enroll diverse patient populations that reflect the broader patient population with cancer (e.g., The Henrietta Lacks Enhancing Cancer Research Act (H.R. 1966))
    • Guarantee coverage of the routine care costs of clinical trial participation for Medicaid enrollees with a life-threatening condition (e.g., The Clinical Treatment Act (H.R. 913))
    • Engage community leaders and community-based organizations – especially those serving racial and ethnic minority groups as well as medically underserved communities – to effectively disseminate information about the importance of clinical research participation as a social justice issue
    • Increase access to comprehensive tobacco cessation programs in Medicaid and private insurance plans to provide counseling and state quit lines to individuals of lower SES who have higher smoking rates than other populations

    ACS CAN works on evidence-based public policies at all levels of government that seek to reduce disparities and improve health outcomes, including decreasing disparities in cancer screening and early detection, improving access to health care and insurance coverage, and greater access to cancer research and clinical trials.

    Read the full testimony submitted to the committee.



  • ACS CAN holds virtual Medicaid Covers Us events in Oklahoma and Tennessee

    ​Marks launch of public education project in both states

    This month, the American Cancer Society Cancer Action Network (ACS CAN) held virtual events publicly launching the Medicaid Covers US project in two additional/new focus states: Oklahoma and Tennessee. 

    The events focused on the role of Medicaid in helping Oklahomans and Tennesseans meet their health care needs and how having access to insurance coverage plays a critical role in achieving health equity and reducing disparities.  

    Funded in part by a grant from the Robert Wood Johnson Foundation, Medicaid Covers US aims to create an open dialogue about the critical role Medicaid plays in helping Americans stay healthy, go to work, and care for their families.  

    Speakers at both events included public health experts, health economists, cancer control leaders, providers, and cancer patients.

    More than 110 people joined the Oklahoma virtual launch event on June 4. Panelists included:

    • Sara Barry, MEd, LBP, CEO of Oklahoma Primary Care Association
    • David Blatt, Kaiser Family Foundation Endowed Professor of Practice, University of Oklahoma-Tulsa
    • Lydia Nightingale, MD, Variety Care Women’s Health Medical Director
    • Citseko Staples Miller, director, State and Local Campaigns, ACS CAN

    The June 10 Tennessee virtual launch event was attended by 80 people. Panelists included: 

    • John Bell, MD, director, University of Tennessee Medical Center Cancer Institute
    • Katina Beard, CEO, Matthew Walker Community Health Center
    • Melinda Buntin, PhD, Vanderbilt University 
    • Maria Moore, executive hospice care consultant, Avalon and Kindred Hospice 
    • Citseko Staples Miller, director, State and Local Campaigns, ACS CAN

    At both events, new videos – six in each state -- were unveiled of storytellers describing how the Medicaid program has impacted their lives, families, and communities. Several of the videos feature health care providers who underscore the need for Medicaid expansion, especially for those who have lost their employer-sponsored health insurance over the past few months and are now uninsured in the midst of the Covid-19 pandemic. These include Shana Solis, a nurse practitioner in Oklahoma City, OK. 

    The short patient and provider videos can be found be viewed at www.MedicaidCoversUS.org/ok and at www.MedicaidCoversUS.org/tn.

    To learn more about the Medicaid Covers US project, visit MedicaidCoversUS.org.



  • ACS CAN's new Junior Cancer Fighter Action Center teaches kids the power of advocacy

    With the school year ending and many summer camps and activities being cancelled due to the Covid-19 pandemic, the American Cancer Society Cancer Action Network (ACS CAN) is helping to fill the gap with the launch of a new online action center for kids.

    Located on ACS CAN’s website, the Junior Cancer Fighter Action Center provides elementary and middle school-age children and their parents, grandparents, and loved ones with a series of fun and educational activities to help them learn about advocacy, fighting cancer, and ACS CAN. It features videos, advocacy opportunities, and fun activities that kids can complete on their own, as well as with the help of an adult. 

    The action center is the brainchild of Becki Panoff, associate director, social media and digital content for ACS CAN and the mother of three young children. Becki’s two oldest children inspired the concept and helped to test the content for target age groups. 

    “The Junior Cancer Fighter Action Center is a great way for kids to learn about advocacy, fighting cancer and ACS CAN during a time when we’re all at home, and parents are looking for activities for their kids,” she said. “The educational activities give kids an opportunity to learn and do activities with their parents, grandparents or adult in their life, or do them independently - giving mom and dad a little break.”

    One feature of the action center includes the opportunity for kids to participate in a longstanding ACS CAN fundraiser, Lights of Hope. It highlights the beautiful artwork of ACS Media Relations Director Charaighn Sesock’s 14-year-old daughter, Stefania, pictured above. Stefania, who is an ACS CAN Youth Ambassador and is fundraising for Lights of Hope for the first time, is using social media to encourage family and friends to donate and support her efforts for ACS CAN.

    The activity center is not meant to be a formal educational curriculum, nor is it intended to be promoted to schools or school systems. Rather, it’s a series of fun activities to provide ACS CAN volunteers with some great ways to interact with (and help occupy) the children in their lives while they’re at-home, while potentially fostering a new generation of advocates. 

    For more information, visit fightcancer.org/junior.




  • Cancer patients increasingly face COVID-19 health impact

    Second ACS CAN survey finds more delays in care, financial strain, and negative mental health effects

    Cancer patients and survivors are finding it increasingly challenging to get necessary health care as the COVID-19 pandemic persists. Many are experiencing financial stress and mental health issues as they try to navigate the difficult health and economic environment. 

    In an ACS CAN survey of cancer patients and survivors, 87% of respondents said the pandemic had affected their health care in some manner, up from 51% in an April survey. Of those in active treatment, 79% reported delays to their health care (up from 27%), including 17% of patients who reported delays to their cancer therapy like chemotherapy, radiation, or hormone therapy. The most commonly reported effects for those in active treatment were changes to in-person cancer provider appointments (57%*), and delays in access to imaging services (25% up from 20%) and surgical procedures (15% up from 8%). Delayed access to support services, including physical therapy or mental health care, remained steady (20%).

    Nearly 1 in 4 patients surveyed say the pandemic has made it more difficult to contact their providers with questions about their health care needs, and 1 in 5 say they are worried their cancer could be growing or returning due to delays and interruptions caused by the COVID-19 outbreak.

    “The situation is getting worse, not better for cancer patients during this pandemic,” said Lisa Lacasse, president of ACS CAN. “Health practitioners continue to work to balance safety for an immunocompromised population at increased risk for contracting COVID with timely treatment to prevent the spread of cancer. Unfortunately, this results in delays in treatment for many cancer patients.”

    Patients are also under significant financial strain. Forty-six percent said the COVID-19 pandemic had impacted their financial situation and ability to pay for care in some way (up from 38%). And nearly a quarter (23%) said they worry they may lose their health insurance due to the pandemic and its effects on the economy.

    While a majority of respondents said they are sheltering in place, 18% said they were working outside the home, including 11% of those still in active treatment. More than a third (34%) of patients say they’re anxious the pandemic will make it hard to afford basic household expenses. Concerns are especially prevalent among lower-income patients, with more than half (54%) of those earning $30,000 or less reporting that they’re worried about affording essentials like rent, food, and utilities

    This combined medical and financial stress has resulted in nearly half (48%) of patients saying the COVID-19 pandemic has had a moderate or major effect on their mental health. In particular, 67% said they worry it will be harder for them to stay safe when social distancing and other restrictions are relaxed in their area, and 70% of patients worry they will be unable to find protective equipment like gloves or masks to help keep them safe.

    The survey also collected feedback from a small group of providers and caregivers who similarly reported concern about delayed care and difficulties providing support for patients while being unable to see them, as well as a lack of personal protective equipment. Caregivers, like patients, reported anxiety over reopening and the increased potential for their and their loved one’s exposure to the virus.

    “A cancer diagnosis brings any number of challenges and stressors, but right now it’s even more fraught with additional barriers to timely and affordable care that could be further exacerbated by job loss – like millions of Americans have already endured,” Lisa said. “COVID-19 has shone a spotlight on the barriers to affordable health care that cancer patients have long faced. The survey responses highlight the increasing and urgent need for Congress to swiftly pass measures that help these patients alleviate their physical, financial and emotional strain during and beyond the pandemic.”

    The web-based survey was taken by more than 1,200 cancer patients and survivors. This sample provides a margin of error +/- 3% and 96% confidence level.  Additional input was provided by 111 caregivers and 139 health care providers supporting cancer patients and survivors.

    A full polling memo can be found here.

    NOTE: The previous survey did not distinguish between cancer provider and other in-person provider appointments, so no comparison is available.




  • House stimulus package would expand access to health coverage, provide relief for nonprofits that serve patients

    Special health exchange enrollment period, COBRA subsidies, and increased Medicaid funding among numerous health provisions

    On May 15, the U.S. House of Representatives approved he Heroes Act, a package of legislative proposals aimed at addressing numerous pandemic-related health, research, and economic relief needs.

    The bill still needs Senate approval, and it is not expected to be back in session until sometime in June.

    Included in the bill are several provisions that would make it easier for Americans to maintain or gain health insurance coverage, including: a special enrollment period for private coverage through the federal health exchange, subsidies to cover the premium costs of maintaining employer-sponsored health insurance for those who have recently been laid-off or had their hours reduced, and increased federal funding for Medicaid to help states meet their residents' growing need for the health coverage. The bill also calls for ending patient cost sharing for COVID-19 associated treatment expenses for those on Medicare and private insurance.

    If enacted, federal agencies would also be given authority to modernize their data collection methods and infrastructure related to health inequities. The National Institutes of Health (NIH) would receive $4.75 billion to expand COVID-19 research and to help support the shutdown and startup costs of biomedical research laboratories nationwide. And, additional nonprofits would be able to access necessary relief funds through the business relief programs.

    A statement from Lisa Lacasse, president of the American Cancer Society Cancer Action Network (ACS CAN), and issued before the bill's approval, follows:

    "The need to ensure Americans can maintain or obtain health coverage is more urgent than ever. Millions of Americans—including those with a history of cancer— have lost their jobs and their employer-sponsored health insurance. Many others were uninsured when this pandemic hit and need access to care. Providing subsides to help people keep their health plans, allowing a special enrollment period for those who want to obtain coverage, and increasing Medicaid funding to meet growing health coverage needs, is critical to keeping patients and the public as healthy as possible.

    "Additionally, because cancer patients are at increased risk of developing severe COVID-19 complications, eliminating cost sharing for testing and all COVID-19 associated treatment costs could help patients avert extreme financial burdens.

    "Considering the burden from this virus is falling disproportionately on communities of color that lack access to quality health care, we welcome the requirements for agencies to collect demographic data on COVID-19 as a first step in addressing these inequities.

    "The funding for NIH is an important initial investment in getting critical biomedical research restarted, but much more funding will eventually be necessary.

    "All of these measures, along with enabling additional nonprofits to begin seeking economic assistance through the business relief programs, are important for implementing a comprehensive approach to the pandemic's wide and varied effects.

    "On behalf of all those impacted by cancer, we urge the House to quickly pass this legislation and for the Senate to take it up and swiftly give millions of Americans the vital assistance they need." 


  • 20 patient groups urge Supreme Court to uphold health care law

    ​COVID-19 pandemic makes clear the urgent need for patient protections and access to health insurance.

    Twenty patient groups representing millions of Americans with pre-existing conditions filed an amicus curiae (“friend-of-the-court”) brief today with the U.S. Supreme Court in the case California v. Texas (previously Texas v. United States), citing the devastating impact patients would face should the court rule to invalidate the Affordable Care Act (ACA).

    The U.S. Supreme Court agreed to hear the case after the Court of Appeals for the Fifth Circuit struck down the individual mandate without a tax penalty as unconstitutional and sent the case back to the District Court to determine if the mandate can be “severed” from the rest of the law. The District Court previously ruled the entire law was invalid.

    The patient groups argue the law has expanded access to health insurance coverage and has improved patient outcomes as Congress intended. Congress’s decision to keep the ACA in place after eliminating the tax penalty tied to the individual mandate reinforces that intent.

    Following is the groups’ joint statement:

    “While the coronavirus pandemic further highlights the importance of access to meaningful health insurance coverage for millions of Americans – especially for those who are at high-risk of being severely affected by the virus – patient protections in the ACA provide an essential lifeline for countless Americans who have pre-existing or acute conditions like heart disease, cancer, diabetes, and lung diseases.

    “If the entire health care law is invalidated, health plans could once again deny coverage to anyone with a pre-existing condition, set arbitrary lifetime and annual limits on care, and skirt essential benefits necessary to prevent and treat acute conditions. The link between access to comprehensive health coverage and patient outcomes is well established. Because of the ACA there have been statistically significant shifts toward early-stage diagnosis for several common cancers, a surge of people getting screened for and diagnosed with diabetes, and a significant drop in uninsured substance abuse or mental health disorder hospitalizations in states that expanded Medicaid.

    “Invalidating the law would likely reverse these gains. It also would jeopardize the federal tax credits that make health insurance more affordable for millions of Americans, threatening their access to critical health coverage, and rescind Medicaid expansion funding, crippling the safety net health insurance program at a time when millions more unemployed Americans have no alternate coverage option.

    “Undoing the patient protections and improved health care access would ignore the will of Congress at the expense of millions of Americans who would lose their coverage and millions more who would likely be unable to obtain coverage due to pre-existing conditions. We urge the Supreme Court to uphold the decade-old law and preserve access to health insurance – and therefore health care—for millions of Americans.”

    Read a copy of the brief.


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