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House votes to defend Affordable Care Act in U.S. Court of Appeals

On Jan. 9, the U.S. House of Representatives voted to petition to intervene in a case before the U.S. Court of Appeals for the Fifth Circuit that could determine the future of the Affordable Care Act (ACA). The House will ask to join 17 attorneys general in the appeal of a December District Court ruling that found the entire ACA invalid because Congress eliminated the individual mandate penalty in its 2017 tax reform bill.

If allowed to stand, the ruling would eliminate critical protections for people with pre-existing conditions and minimum insurance standards known as essential health benefits, which ensure comprehensive coverage.

Following is a joint statement from the American Cancer Society Cancer Action Network (ACS CAN), American Diabetes Association, American Heart Association, American Lung Association, and National Multiple Sclerosis Society. The groups, representing millions of patients with serious illnesses, filed a joint amicus brief in District Court in support of upholding the law:

“The House of Representatives has made clear it will defend the nation’s health care law and stand up for the millions of patients who rely on the law for access to comprehensive, high-quality health care coverage. The House’s action affirms that Congress did not intend to strike down the entire law when it zeroed out the mandate penalty and underscores the importance of Congressional intent in this appeal.

“If the ruling is upheld, millions of patients with serious illnesses as well as anyone with a pre-existing condition could be charged more for health coverage or denied access to coverage altogether.  Health plans would no longer be required to cover essential benefits necessary to prevent and treat a serious condition, and plans could once again put annual and lifetime limits on coverage.

“On behalf of patients with cancer, heart disease, stroke, lung disease, diabetes and multiple sclerosis, we commend Members of the House of Representatives for putting patients first and defending the health care law. We are optimistic the United States Court of Appeals for the Fifth Circuit will overturn the lower court’s ruling and preserve health care for millions of Americans.”




  • ACS CAN says Juul-Altria deal puts U.S. public health at risk

    Juul Labs, producer of the e-cigarette and nicotine pods that are extremely popular with young people, announced on Dec. 20 that it will sell a minority stake of its company to Altria Group, the parent company of Philip Morris USA and producer of Marlboro-branded cigarettes. 

    The news that Juul will partner with Big Tobacco comes amid reports of skyrocketing rates of youth e-cigarette use, namely Juul, and advisories from the Surgeon General, who last week called youth use of e-cigarettes a national "epidemic."

    The following is a statement from the American Cancer Society Cancer Action Network (ACS CAN):

    "Today's announcement from Juul Labs and Altria Group is likely to be a major setback for the health of our nation. The company responsible for addicting millions of Americans on cigarettes joining with the company that is responsible for the current skyrocketing rates of youth e-cigarette use and nicotine addiction is deeply concerning. The possible co-branding and marketing of these products could seriously erode progress in reducing tobacco-related death and disease.

    "As these two deep-pocketed industry giants join forces, the need for comprehensive regulatory oversight from the Food and Drug Administration (FDA) has never been more clear. FDA's recent announcements regarding plans to prohibit menthol flavoring in cigarettes and restrict access to some flavored, kid-friendly e-cigarettes are important steps but the agency must do more. The alarming increases in e-cigarette use among youth, coupled with today's announcement from two companies that prioritize maximizing profits over everything else, illustrate the need for FDA to use its full regulatory authority granted to it under the Tobacco Control Act. The health of our children depends on it."


  • Nation's top doctor issues advisory on "epidemic" of youth e-cigarette use

    Survey shows alarming spike in vaping: 1 in 5 12th grade students vaped nicotine in the last 30 days in 2018

    On Dec. 18, U.S. Surgeon General Jerome M. Adams issued a national advisory to parents, teachers, and health professionals regarding the skyrocketing increase of e-cigarette use among youth. 

    Surgeon General advisories are used in cases where rapid and urgent action is needed. This is the first Surgeon General advisory on a tobacco issue and is only the fifth such advisory the office has issued in the last 20 years.

    Just yesterday new data was released showing the number of high school seniors who reported using e-cigarettes in the last month nearly doubled, and earlier this year the Centers for Disease Control and Prevention (CDC) released data showing a 78% increase in e-cigarette use among youth overall in just the last year.

    The annual Monitoring the Future (MTF) survey, conducted annually since 1975 by researchers at the University of Michigan’s Institute for Social Research and funded by the National Institute on Drug Abuse, yesterday reported a stunning rise in use of nicotine in vaping devices since 2017. Between January 2017 and January 2018, the percentage of 12th graders who reported vaping nicotine (not flavoring or other substances) during the past 30 days nearly doubled, from 11% to nearly 21%. Among 10th graders, the increase was almost as great, from 8.2 % to 16.1%. These are by far the biggest one-year increases ever seen for any substance in the history of the MTF survey. 

    The following is a statement from Chris Hansen, president of the American Cancer Society Cancer Action Network (ACS CAN):

    “We commend the Surgeon General for taking action and drawing attention to the epidemic of youth use of e-cigarettes. The rapid rise in the number of youth who use these products is a public health crisis that threatens to erode decades of progress made in reducing tobacco use and nicotine addiction. The advisory urgently calls on parents, teachers and health professionals to work together to curb youth use of these products; many of which come in kid-friendly flavors and contain significant levels of nicotine that can harm developing brains and prime kids for a lifetime of addiction.

    “While a number of states and communities have begun to take action to address this epidemic across the country, community level action alone cannot solve this crisis. The most substantial way to begin reversing this epidemic of e-cigarette use among youth is for the Food and Drug Administration (FDA) to exercise its full regulatory authority and conduct the legally required review of e-cigarettes and cigars, including prohibiting their use of flavoring, in order to be on the market. ACS CAN will continue to call for FDA to move as quickly as possible to regulate all tobacco products and reverse the unprecedented trend of youth use of e-cigarettes.”




  • ACS CAN President Chris Hansen to retire Feb. 1

    ACS CAN Deputy President Lisa Lacasse will succeed him

    Chris Hansen will be retiring on Feb. 1, 2019, after eight years as the president of the American Cancer Society Cancer Action Network (ACS CAN). Lisa Lacasse, ACS CAN deputy president, has been chosen to lead the advocacy organization, and will serve on the Senior Leadership Team.

    Here are three highlights of Chris's leadership:

    • Chris spearheaded our efforts to increase federal funding for medical research, ultimately exceeding our goal and helping to increase research funding for the National Institutes of Health by $8 billion, including $1 billion for the National Cancer Institute.
    • Chris and his team positioned the American Cancer Society and ACS CAN as the authority for cancer patients’ perspectives as the Affordable Care Act was implemented and as it has come under attack. ACS CAN established itself as an influential player with both political parties.
    • Chris also helped make significant headway on how Congress views and prioritizes patients’ quality of life during their cancer experiences. ACS CAN helped shape the Congressional dialogue related to palliative care to focus on the entire cancer experience rather than just end-of-life care.

    "Chris is quick to point out that ACS CAN’s accomplishments are the result of the amazing volunteers and staff across the country, who have worked tirelessly and effectively to make cancer a national priority," said ACS CEO Gary Reedy. "This is most certainly true; however, under Chris’s leadership, we have dramatically expanded our grassroots volunteer force, strengthened our top-caliber professional staff, and increased our ACS CAN revenue to continue to fund this life-saving work."

    Lisa joined ACS CAN in 2008, and has been an integral part of the leadership for every one of our advocacy successes. She has a broad range of skills and expertise, from board relations to strategic planning to oversight for tactical implementation.

    Lisa brings more than 25 years of health care experience to her new role. She began her career in health policy for the Governor of Maine, worked on the executive team of the University of Maryland Medical System and, immediately before joining ACS, was the chief financial officer at the National Institutes of Health Clinical Research Center. 

    She is a graduate of the University of Vermont and has an MBA in Health Care Management from the Wharton School at the University of Pennsylvania.   


  • Federal judge rules against health care law; ACS CAN vows to continue to fight for interests of cancer patients and survivors

    On Friday, Dec. 14, a U.S. District Court judge in Texas overturned the Affordable Care Act and ruled that the entire health care law is unconstitutional. 

    While the ruling could eventually eliminate critical protections for people like cancer patients and survivors, it will not immediately impact their health coverage.

    The law remains as-is during the appeals process. And, some of the state attorneys general who are defending the law have already announced they are prepared to file an appeal.

    The American Cancer Society and ACS CAN submitted a brief together with the American Diabetes Association, American Heart Association, American Lung Association, and National Multiple Sclerosis Society defending the law. ACS CAN will continue its efforts to protect access to health coverage throughout the judicial process.

    Since the day the law was passed, ACS CAN has remained vigilant in defending the provisions that are critical to cancer patients and survivors. This includes prohibiting insurance companies from denying coverage due to pre-existing conditions like cancer, or attempting to drastically increase costs to make quality coverage unaffordable.

    According to the Congressional Budget Office, the impact of invalidating the law is projected to cause as many as 27 million people to lose their coverage by 2020 and jeopardize the federal tax credits that make health insurance affordable for more than 8 million Americans, threatening their access to critical health coverage. The implications on Medicaid expansion are unclear, but ACS CAN will continue to monitor the impact on those who often have no other access to safety net coverage.

    Together with public health partners, ACS CAN will continue to make the case to the courts, Congress and the administration to maintain the protections in the health care law, to maximize our ability to prevent, detect, and treat cancer in this country.

    More about the decision

    In a lawsuit filed this year, a group of Republican governors and state attorneys general challenged the Affordable Care Act, arguing that the requirement that people have health insurance — known as the individual mandate — is unconstitutional, and therefore, so is the entire law.

    At issue was whether the individual mandate still compelled people to buy coverage after Congress reduced the tax penalty for people who do not have health insurance to zero dollars. As part of their 2017 tax reform package, congressional Republicans amended the ACA to eliminate the tax penalty. They zeroed the penalty out without eliminating the instruction to buy insurance. 

    In his ruling, Judge Reed O'Connor of the U.S. District Court for the Northern District of Texas said the penalty-free mandate still amounted to a coercive exercise of government power. The judge asserted that the penalty-free mandate “requires [the plaintiffs] to purchase and maintain certain health-insurance coverage.” He said he would not "parse the A.C.A.'s provisions one by one," but that he had to invalidate the whole law.



  • ACS CAN: Monthly Advocacy Update

    TOBACCO CONTROL

    FDA Announces Plans to Reduce Tobacco Use with Restrictions on Menthol, Flavors, and Access to Flavored E-Cigarettes

    On Nov. 15 the Food and Drug Administration (FDA) formally announced plans to prohibit menthol flavoring in combustible cigarettes, prohibit flavors in cigars, and restrict the sale of some flavored electronic cigarettes to age-restricted in-person locations, with heightened age verification for online sales. The FDA plan comes as newly-released data shows an alarming spike in youth usage of electronic cigarettes significantly driven by the appeal of kid-friendly flavored products. 

    FDA is moving in the right direction, but details regarding how the agency will implement these newly-announced initiatives will be crucial. As we noted previously, you may remember, ACS CAN and other public health groups sued the agency when it issued Guidance in 2017 that halted implementation of key provisions of the "deeming" rule that governs electronic cigarettes.  After the Nov. 15 announcement, FDA filed notice of the announcement with the court in an effort to assert a defense in the pending lawsuit which seeks concrete action by the FDA. We responded that the lawsuit is still necessary because the FDA continues to shirk its statutory obligations under the Tobacco Control Act.

    Prior to the announcement, ACS CAN along with its tobacco control partners, sent a letter to the FDA outlining key actions the agency should take to address the youth e-cigarette use epidemic. Those actions include enforcing premarket review, prohibiting flavors in all products, restricting industry marketing, and preventing the sale of tobacco products to youth.

    Court-Ordered "Corrective Statements" Appear on Cigarette Packages

    The tobacco industry has finally been forced to disclose the truth about its deadly and addictive products directly on cigarette packages. On Nov. 21, major cigarette manufacturers began shipping  court-ordered"corrective statements" affixed to  cigarette packages that state in plain-language that all cigarettes cause cancer, emphysema and heart disease, and that tobacco companies intentionally designed cigarettes with enough nicotine to "create and sustain addiction."

    There are five different corrective statements pertaining to five specific areas in which the industry defrauded the American people: 1) the adverse health effects of smoking; 2) the addictiveness of smoking and nicotine; 3) the lack of significant health benefit from smoking "low tar," "light," "ultra light," "mild" and "natural" cigarettes (products that have been deceptively marketed as less harmful than regular cigarettes); 4) the manipulation of cigarette design and composition to ensure optimum nicotine delivery; and 5) the adverse health effects of exposure to secondhand smoke.

    These statements, which have already appeared in national newspapers, on TV and on tobacco company websites, are the result of a nearly two-decade court battle between the U.S. Department of Justice and the tobacco industry. The American Cancer Society, along with other public health groups, is an intervenor in the case of US v. Philip Morris et al, in which a federal court found tobacco companies guilty of racketeering due to their decades of lying to the American public about smoking and its deadly health effects. The statements represent the first time tobacco companies are compelled to use their cigarette packaging to directly communicate with consumers about the dangerous and addictive nature of their products.

    The tobacco companies estimate the packages with corrective statements will hit retail establishments anywhere between two days and two weeks after shipment.  The court ordered two weeks' worth of product be shipped three times per year for two years at roughly four-month intervals.

    While we have seen meaningful progress in our fight against tobacco use, new evidence reveals that the tobacco industry continues to work to hook a new generation of users to its deadly products. After decades of deception and millions of lives lost, ACS CAN will continue to push for strong regulatory oversight of all tobacco products and access to evidence-based tobacco intervention and cessation strategies. 

    State & Local Activities

    New Tobacco 21 Ordinances

    • Hermantown, Minnesota became the 15th city in the state to raise its tobacco sales age to 21. 

    New Tobacco Taxes

    • Voters passed an ACS CAN-supported tobacco tax ballot measure in Avon, Colorado with nearly 76% of votes cast. The tax on cigarettes will increase by $3.00 per pack. The tax on other tobacco products, including e-cigarettes, will increase by an additional 40% of the retail price starting Jan. 1.

    Restrictions on Electronic Cigarettes & Flavored Tobacco Products 

    • Saratoga, California adopted an ordinance restricting the sale of flavored tobacco. While the ordinance does not include menthol cigarettes, two council members spoke in favor of restricting menthol, so there will be an effort to strengthen the ordinance in 2019.
    • Marin County became the 27th local jurisdiction in California to restrict the sale of flavored tobacco products. The county's ordinance prohibits the sale of all flavored tobacco products, including menthol cigarettes, in the unincorporated parts of the county. 
    • Colorado Gov. John Hickenlooper issued an executive order aimed at curbing the youth e-cigarette use epidemic and addressing youth prevention for other types of tobacco products. The executive order takes several steps within existing state agency authority. The steps include:
      • doubling the number of compliance checks of tobacco and e-cigarette retailers to ensure they are not selling to underage persons;
      • extending the current prohibition on smoking in state buildings to e-cigarettes and vaping;
      • extending prohibitions on smoking and vaping to the grounds of state buildings;
      • issuing a health advisory on e-cigarettes and vaping; and
      • investigating the association between vaping and other risky behavior like binge drinking and substance use and identify programs to prevent these behaviors.

    ACCESS TO CARE

    Majority of Voters Support Health Coverage at No Extra Cost for Patients with Pre-Existing Conditions

    Results from a new nationwide poll released Nov. 27 show nearly seven in ten voters (68 percent) across party affiliations say people with pre-existing health conditions should have access to health coverage without paying more because of their health status and 80 percent agree that simply having health insurance is inadequate. Plans must cover necessary treatments when people have a medical condition and need care the most.

    The poll, which was conducted just before and during the midterm elections, also found 82 percent "disagree" that insurance companies should be able to charge higher prices to sicker customers. Ninety percent said they would be "concerned" and 78 percent say they would be "very concerned" if care for pre-existing conditions was no longer required to be covered.

    More than half of those surveyed indicated that they or an immediate family member have a pre-existing medical condition. The issue of pre-existing conditions protections has been the focus of many legislative efforts and a number of lawmakers have committed to addressing the issue in the upcoming session.

    The poll found strong support for these protections across all demographics and political party affiliations. An overwhelming three-quarters of those who voted for a Democrat (75 percent) and a solid majority who voted for a Republican for Congress (59 percent) say coverage for pre-existing conditions means that people have coverage without paying more.

    ACS CAN commissioned the questions as part of an omnibus poll fielded by Lake Research Partners and The Tarrance Group. The poll of 2,400 of likely voters was conducted November 4-6, 2018.

    State Activity

    • The ACS CAN-supported ballot measure to expand Medicaid in Idaho passed with more than 60 percent of the vote and won a majority of votes in 35 out of Idaho's 44 counties. 
    • Utah voters supported a ballot measure to expand Medicaid expansion with more than 53 percent voting in favor. ACS CAN was part of the coalition that supported the measure.
    • More than 53 percent of Nebraska voters favored an ACS CAN-supported ballot initiative to expand Medicaid coverage in the state.  

    HEALTHY EATING & ACTIVE LIVING ENVIRONMENTS

    State Activity

    • ACS CAN was part of an Oregon coalition that helped defeat Measure 103, a preemptive tax exemption on groceries that would have prohibited local municipalities from taxing sugar-sweetened beverages. The measure was opposed by 57 percent of voters.


  • Progress stalls in reducing dangerous secondhand smoke exposure

    25 states still do not have comprehensive smoke-free state laws

    Millions of Americans remain exposed to secondhand smoke and its proven health hazards, according to data released Dec. 6 by the Centers for Disease Control and Prevention (CDC). The report shows 58 million American nonsmokers still reported exposure to secondhand smoke from tobacco products in 2013-14—the same number as was reported between 2011-2012.

    Additionally, disparities among various population groups persist. Children aged 3-11 years reported exposure rates of 37.8%, while teenagers reported exposure rates of 34%. Almost half (47.9%) of respondents living in poverty reported exposure to secondhand smoke.

    Secondhand smoke can cause cancer, heart disease, stroke, and sudden infant death syndrome. There is no risk-free level of secondhand smoke exposure.

    The following is a statement from Chris Hansen, president of the American Cancer Society Cancer Action Network (ACS CAN):

    “It is unacceptable that one in every four nonsmokers in this country is still exposed to secondhand smoke. It’s clear more work needs to be done to protect people from this dangerous and proven health hazard. While progress has been made, particularly at the local level to reduce secondhand smoke exposure through comprehensive smoke-free laws prohibiting smoking in workplaces and public spaces, those efforts have slowed. Approximately 40 percent of Americans are not currently protected by a local or state smoke-free policy. While California closed a major loophole in its statewide law, no state has passed a comprehensive smoke-free law since 2012; meaning 25 states do not have comprehensive smoke-free state laws that protect nonsmokers from the cancer-causing chemicals in tobacco smoke.

    “It is encouraging that the U.S. Department of Housing and Urban Development recently put a comprehensive smoke-free policy in place for its rent-assisted housing units nationwide. That effort could make a substantial impact on secondhand smoke exposure rates moving forward if effectively implemented in coordination with local housing agency partners, but it is not enough.

    “The data released today should serve as renewed impetus for states and local governments to step up and eliminate secondhand smoke exposure in all workplaces, including restaurants, bars, and casinos. ACS CAN volunteers will continue to advocate for smoke-free laws that protect nonsmokers and smokers alike in their place of work and other public spaces.”




  • ACS and ACS CAN CEO statement on the passing of George H.W. Bush

    The American Cancer Society and the American Cancer Society Cancer Action Network join the nation and the world in mourning the passing and celebrating the life of President George H.W. Bush, who died Friday at age 94. Gary Reedy, chief executive officer for both organizations, issued the following statement:

    "George and Barbara Bush were wonderful friends of the American Cancer Society and the American Cancer Society Cancer Action Network. They were deeply committed to fighting cancer throughout their lives after the loss of their daughter, Robin, at age 3.

    'It was a great honor to know and work with them to make a difference. I worked with President Bush on C-Change and the CEO Roundtable on Cancer, which he founded in 2001 to bring together chief executives to take action to improve prevention, diagnosis, and treatment of cancer. That same year, the American Cancer Society honored George and Barbara with our highest recognition, the Medal of Honor. Most recently, the Bushes served as honorary co-chairs for the campaign to build an American Cancer Society Hope Lodge in Houston, Texas, to provide free housing to cancer patients while they are undergoing treatment.

    "While we mourn the loss of a great man, we celebrate the tremendous impact he had by leading our nation, bringing out the humanity in all of us and improving our quality of life in so many ways, including the fight against cancer."

  • Poll shows voters expect health coverage for pre-existing conditions, without caveats or extra costs

    Nearly 7 in 10 say people should not be charged more based on health status, and that plans must cover necessary care

    Results from a new nationwide poll released today show nearly 7 in 10 voters (68%) across party affiliations say people with pre-existing health conditions should have access to health coverage without paying more because of their health status and 80% agree that simply having health insurance isn't enough; plans must cover necessary treatments when people have a medical condition and need care the most.

    The poll, which was conducted just before and during the midterm elections, also found 82% "disagree" that insurance companies should be able to charge higher prices to sicker customers. Ninety percent said they would be "concerned" and 78% say they would be "very concerned" if care for pre-existing conditions was no longer required to be covered.

    More than half of those surveyed said they or an immediate family member have a pre-existing medical condition. The issue of pre-existing conditions protections has been the focus of many legislative efforts and a number of lawmakers have committed to addressing the issue in the upcoming session.

    "These numbers clearly illustrate what voters expect when lawmakers commit to uphold pre-existing condition protections," said Chris Hansen, president of the American Cancer Society Cancer Action Network (ACS CAN). "Voters understand that simply prohibiting insurers from denying coverage based on your health status alone isn't enough. They expect that people with conditions like cancer will be able to get coverage without paying more and that their plan will cover necessary medical care when and if they need it."

    The poll found strong support for these protections across all demographics and political party affiliations. An overwhelming three-quarters of those who voted for a Democrat (75%) and a solid majority who voted for a Republican for Congress (59%) say coverage for pre-existing conditions means that people have coverage without paying more.

    "We hope these results resonate with elected officials at the federal and state levels as they consider how to strengthen our nation's health care system," said Chris. "ACS CAN looks forward to working with the administration, Congress and state legislators to make sure patient protections under current law, including those for pre-existing conditions, remain intact and that the health insurance markets are strengthened so patients can continue to access quality affordable coverage."

    ACS CAN commissioned the questions as part of an omnibus poll fielded by Lake Research Partners and The Tarrance Group. The poll of 2,400 of likely voters was conducted November 4-6, 2018. Full results can be found here

     




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