The Affordable Care Act:
Implications for
Comprehensive Cancer
Control
An Overview
Webinar November 30, 2011
Join via phone at:
1-888-290-7502
13737910#
Special thanks to:
CCC Policy Webinar Series
and Workshop
Webinar 1:
November 30, 2011
The ACA and
Implications for CCC
Coalitions: Overview
Webinar 2:
December 19, 2011
The ACA and Implications
for CCC Coalitions: Focus
on Medicaid and Exchanges
Partnership for Better Health
ACA Exchange Workshop:
December 20, 2011
Des Moines, Iowa
Today’s Agenda
• Review webinar purpose, expected outcomes
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and opportunities for interaction
Major provisions of the Affordable Care Act that
impact cancer
– Presentation by: David Woodmanse, BA,
MBA, American Cancer Society Cancer Action
Network & Citseko Staples, American Cancer
Society Cancer Action Network
Comprehensive Cancer Control (CCC) coalition
and advocate opportunities to influence
implementation of the Affordable Care Act
Q&A
Webinar expected outcomes
• After participating you will be able to:
– Identify major provisions of the Affordable
Care Act (ACA) that impact cancer
– Identify areas of the ACA that relate to CCC
plans
– Consider ways in which your coalition’s
priorities and advocacy efforts could be
aligned to seize opportunities stemming from
ACA
Opportunities for interaction
during the webinar
• Utilize the webinar tools to ask questions
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or provide feedback at any time
Answer interactive poll
Post questions during Q&A segment of
the webinar
Please press *6 to mute your phone line
States play a critical role…
Opportunity for CCC coalitions as
engines of change
• 80% of implementation is happening at the state level
• CCC coalitions and their plan priorities are an avenue for
supporting ACA implementation
• Coalitions can help create the best possible environment
for ACA implementation through:
– Influencing creation of health insurance exchanges
– Influencing expansion of Medicaid eligibility and
advocating for maintaining Medicaid option for breast
and cervical cancer treatment
– Providing support for and education about expanded
cancer prevention and screening coverage
– Providing support and expertise for responding to grant
opportunities
Which provisions of the ACA are you
most interested in learning more
about?
(switch to polling function)
• Health insurance exchanges
• Pre-existing condition insurance plan programs
• Medicaid expansion
• Medicare changes
• Improving care and streamlining service delivery
for dually eligible Medicaid and Medicare
beneficiaries
• Employer requirements/opportunities
Major provisions of the Affordable
Care Act that impact cancer
• Today’s discussion will provide an
overview of and focus ACA provisions
related to:
– Access to care
– Prevention and early detection
– Quality of care
– Health disparities
– Workforce
The ACA is being
implemented!
In Effect Now
• Eliminating co-pays for proven preventive
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services in new plans
Requiring all health plans sold in health
insurance exchanges to cover essential
benefits for cancer screening, treatment,
and follow-up
Providing Medicare beneficiaries with
annual exams to discuss prevention and
health promotion
In Effect Now
• Improving pain management and quality
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of life
Closing Medicare “doughnut hole” for
prescription drug coverage
Making coverage available for patients
who participate in clinical trials
Making health care more affordable
through ending limits on care and benefits
In Effect Now
• Making health care more easily available
by:
– covering children
– ending rescissions
– creating health benefit exchanges
– creating pre-existing condition
insurance plans for uninsured
Still to come
• Monitoring of health disparities trends
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(2012)
Medicaid payment increases for primary
care physicians (2013)
Pre-existing prohibitions for adults (2014)
Medicaid eligibility expansion to add 16
million beneficiaries (2014)
Health insurance exchanges fully
implemented (2014)
Access to cancer care
• Health Insurance Exchanges
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– Essential Benefits
– State Implementation Efforts
Key dates/opportunities to influence
implementation
Access to cancer care
• Pre-Existing Condition Insurance Plan
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Programs
– High-risk pools for those with cancer
and other pre-existing conditions
– A “bridge” until 2014 when most will be
able to obtain insurance coverage
Key dates/opportunities to influence
implementation
Access to cancer care
• Medicaid Expansion
– States have option now to expand
coverage to adults with incomes at or
below 133% of the Federal Poverty
Level
– New Benefits = Essential Benefits
Cancer prevention and early
detection
• Breast cancer screening
– Health insurance plans required to
provide first-dollar coverage for
mammograms at 40
– Elimination of out-of pocket costs under
Medicare
– Incentive to offer Medicaid beneficiaries
US Preventive Service Task Force
recommended services
Cancer prevention and early
detection
• Colorectal cancer screening
– Health insurance plans required to
cover CRC tests with A or B rating
without out-of-pocket costs
– Elimination of out-of-pocket costs under
Medicare
– Incentive to offer Medicaid beneficiaries
USPSTF recommended services
Cancer prevention and early
detection
• National Prevention Strategy
• Prevention and Public Health Fund
– Community Transformation Grants program designed to improve
community health, reduce chronic
diseases, reduce health disparities, and
promote evidence-based prevention
methods
Quality of care
• Converts Medicare’s voluntary Physician
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Quality Reporting System (PQRS) into a
mandatory program in 2015 – PQRS
includes 10 cancer prevention related
measures
Group health plans and insurers will be
required to report on quality improvement
activities including chronic disease
management and health promotion
Workforce
• $11 billion investment in Community Health
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Centers over 5 years
– 42% increase over current appropriations
– Doubles the number of patients they can care
for
State Health Care Workforce Development
Grants
Expanded loan repayments and scholarships for
primary care workforce
Health disparities
• Increases funding for Community Health Centers
• Requires enhanced collection and reporting of
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data on race, ethnicity, sex, primary language,
disability status, and for underserved rural and
frontier populations
Expands funding for scholarship and loan
repayment for physicians working in underserved
areas
Reauthorizes Patient Navigator Act
Reauthorizes the Indian Health Care and
Improvement Act
ACA and CCC Coalitions
• ACA supports common CCC plan priorities:
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Primary prevention
Early detection
Treatment
Survivorship
Health equity
Utilize evidence-based policy, systems and
environmental changes to sustain efforts
ACA and CCC Coalitions
• Opportunities through:
– Education of the CCC coalition members and
the public – what the ACA does now and in
the future to support best possible cancer care
– Advocacy efforts to influence state policymaker decisions about ACA implementation
– Direct involvement of CCC coalition
leaders/representatives in state ACA
implementation advisory committees or
consortiums
– Alignment and update of CCC plan priority
strategies to take advantage of ACA-based
improvements for cancer prevention and care
A sampling of current CCC
coalition efforts
• Insurance commission presentations to coalition members
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(TX)
ACS Cancer Action Network consultation and state
legislative updates to coalition members (VT)
Posting ACA materials and links on coalition website (UT)
Educating local health care providers about expanded
coverage for cancer screening (UT)
Providing action alerts to coalition members regarding state
Medicaid cuts, changes (ID)
Appointing a coalition representative to serve on or liaison
with state-level ACA coalitions/consortiums (MI)
ACA Resources – State
• Iowa Cancer Consortium
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– http://www.canceriowa.org/News--Publications/Affordable-Care-ActResources.aspx
Kaiser Family Foundation Health Reform Source:
state-by-state information
– http://healthreform.kff.org/the-states.aspx
National Conference of State Legislatures: links
to state ACA implementation entities
– http://www.ncsl.org/?TabId=21995
ACA Resources – National
• Trust for America’s Health – prevention
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resources related to ACA
– http://healthyamericans.org/healthreform/
Official Federal Government Website
– http://www.healthcare.gov/
ACS Cancer Action Network
– http://www.acscan.org/healthcare
Q&A
Post your questions to the webinar site
Preview: Next CCC Policy
Webinar
• Date and time: December 19th, 10:00 am
• Expanded presentation on Medicaid and
•
health insurance exchanges by Citseko
Staples, American Cancer Society Cancer
Action Network
Register:
http://www.canceriowa.org/News--Publications/Affordable-Care-ActResources.aspx
Healthcare Exchange Workshop
The Effects of Health Exchanges on Our State
December 20, 2011
8:30 – 12:00
The Renaissance Savery Hotel
401 Locust Street
Des Moines, Iowa
Special Guest Speakers:
Anne Kinzel, Independent Health Policy Analyst
Jennifer Vermeer, Iowa Medicaid Director
Susan Voss, Iowa Insurance Commissioner
Julie Eckstein, Managing Director, Healthcare &
Government Services, Guidon Performance Solutions
RSVP: Becky@advocacyiowa.com or
call 515-246-3077
Thank you!
Please respond to the webinar evaluation
survey, coming to you soon!