In order to bring you the latest cancer-related health care policy and news, we at NCCS combined our ACA Updates and What Caught Our Eye (WCOE) content into a weekly email and blog post. We aim to make this a concise, one-stop summary of what you need to know as we continue working together to make cancer care better for everyone.

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Administration Action Threatens Coverage for People with Pre-existing Conditions

In a court filing yesterday, the Department of Justice (DOJ) stated that it would not defend key provisions of the Affordable Care Act in a lawsuit brought by Texas and several other states. One provision is the individual mandate, which was repealed in the tax bill passed by Congress and signed into law last December. Also at issue in the case is coverage and premiums for people with pre-existing conditions. In a blog post for The Commonwealth Fund, Timothy Jost explains the Trump administration’s action and the potential consequences for people with pre-existing conditions:

If the judge buys the administration’s argument, and if his ruling is upheld on appeal, 52 million Americans with preexisting conditions could face denial of coverage or higher premiums. The administration’s argument would also allow insurers to charge women, older people, and people in certain occupations higher premiums. This policy change would jeopardize coverage not just for consumers in the individual market, but also people with preexisting conditions who have employer-sponsored coverage. If these people lost or left their jobs, they may not be able to get individual market coverage.

NCCS will continue to monitor the situation and share ways that advocates can weigh in on this important issue for cancer survivors.

HHS Won’t Prohibit “Silver Loading” on ACA Plans

When President Trump stopped cost-sharing reduction payments to insurers, they began a practice known as “silver loading.” The insurers targeted their premium price increases into the silver-level plans of the Affordable Care Act. Since the silver plans are the benchmarks for determining subsidies, silver loading resulted in higher subsidies for people who chose those plans while leaving bronze and gold plans with minimal increases. This practice helped consumers but cost the federal government more in subsidy payments. HHS Secretary Alex Azar this week confirmed during a congressional committee hearing that the administration would not seek to stop insurers from doing this in 2019, but refused to confirm if future efforts to stop the practice would or would not be pursued.
More on Kaiser Health News »

Health Care Taking Center Stage Again?

Since last year’s bruising fight in Congress to repeal the Affordable Care Act and until last night’s DOJ decision, health care has largely stayed out of the spotlight.  As Vox's Dylan Scott puts it:

Repeal was a clean, simple, and big story. “Sabotage” — in the form of cutting CSRs, expanding non-Obamacare insurance, and slashing outreach — is more nebulous. People still care about health care, but they aren't hearing about it in the news every day anymore. The threat on health care can feel less real, even if sabotage is having very concrete effects.

However, trends are emerging that may bring health care back into the national spotlight, especially in light of recent developments regarding the legal challenge in Texas.  Axios points out “prescription drug costs are the issue du jour. Premiums for ACA coverage are also skyrocketing. Medicare’s financial footing is getting weaker.” More and more people are not just hearing about health care issues like last year, they’re starting to feel the impacts this year and could be a factor in the upcoming midterm elections. “This will be the first midterm in a decade that Obamacare will not be the issue that unites and energizes Republicans.”


Revised Michigan Medicaid Proposal Would Still Reduce Coverage and Access to Care

Via Center on Budget and Policy Priorities

While we’re seeing some encouraging trends with several states moving towards Medicaid expansion, there are also some very concerning examples. Michigan is near passage of bill that would add work requirements for Medicaid coverage. By one estimate, 54,000 Michiganders would lose their health care coverage. Further, the “new bill puts Michigan’s entire Medicaid expansion under the Affordable Care Act (ACA) — covering 670,000 people — at risk. That’s because Michigan would be required to end its expansion if the federal Centers for Medicare & Medicaid Services (CMS) doesn’t approve an additional waiver that raises premiums on some Medicaid beneficiaries.”
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Live Like Lola

Via Washington Post

The Washington Post, through words and photos, shares the powerful story of Lola Muñoz. A young girl facing diffuse intrinsic pontine gliomas (DIPG), an aggressive brain cancer. “For nearly a year and a half, photojournalist Moriah Ratner followed Lola and the Muñoz family on a journey marked by pain as well as laughter, fear as well as joy, anguish and finally peace. Her camera captured a girl dealing with inevitable loss while trying resolutely to live.”
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Op-Ed: “The ‘cruel joke’ of compassionate use and right to try: Pharma companies don’t have to comply”

Via STAT News

The father of a child with a rare-disease provides a blunt perspective on compassionate use and right to try. He points out that: “While the FDA has a compassionate use program to allow people access to experimental drugs, it can’t compel a company to provide those drugs. The newly signed ‘right-to-try’ law doesn’t either.”
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