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7-1-1- This Week in Health Care Reform Implementation

Below is this week’s update on the Affordable Care Act. As always, thank you for all you do every day for cancer patients and their families. If you have any questions, please don’t hesitate to contact Carter Steger, senior director, State and Local Campaigns, at Carter.seger@cancer.org, (202) 661-5727, or Keysha Brooks-Coley, associate director, Federal Affairs, at keysha.brooks-coley@cancer.org, (202) 661-5720. Enjoy the holiday weekend!

 

Pre-Existing Condition Insurance Plan (PCIP)

 

The new high-risk pool program authorized in the Affordable Care Act launched today in many states across the country.  Twenty-eight states have agreed to administer their own program, and the federal government will administer its plan, the Pre-Existing Condition Insurance Plan (PCIP) in 22 states. Many state-administered plans will start accepting applications today with coverage to begin on August 1, and all state plans will likely be up and running by September 1.

 

Applications for the PCIP will also be available starting today on a new Department of Health and Human Services website, www.healthcare.gov, with coverage to begin August 1. Funding for the program will be provided to states based on the same funding allocation that is used for the State Children’s Health Insurance Program (SCHIP).

 

All of the high-risk pool plans must offer individuals a standard rate, providing people with serious conditions such as cancer the same premium rate that healthy individuals receive. The annual out-of-pocket limit on all of the plans is $5,950.

 

On June 25, a story about the high risk pools appeared in The New York Times. Additional information on the details of the new PCIP, as well as the state-administered high risk pool plans can be found at www.healthcare.gov and at www.pcip.gov. You can also read ACS CAN’s press release.

 

New Healthcare.gov Website

 

As mentioned above, the new consumer web portal authorized in the Affordable Care Act was launched today. Healthcare.gov was created as a resource for consumers in need of health insurance coverage. The website provides information that will help people navigate the current health insurance market and enables them to shop for public insurance programs, such as Medicaid and the Pre-Existing Condition Insurance Plan (PCIP - the federally administered high risk pool) and more than 1,000 private insurance products. Information can be tailored to an individual’s specific needs and geographic location. The new website will also include information on health care reform implementation.

 

The government website that provided information during the legislative debate and the early days of implementation, www.healthreform.gov, will continue to live on the web but its content will be frozen.

 

Regulations for Prevention Benefit in Medicare

 

Last Friday, June 25, the Centers for Medicare & Medicaid Services (CMS) released a new rule that makes significant improvements to preventive care benefits under Medicare.  Beginning January 1, 2011, Medicare will cover annual wellness visits so that doctors and patients can develop a personalized prevention plan that takes a comprehensive approach to improving a patient’s health. In addition, beginning January 1, 2011, Medicare beneficiaries will no longer have to pay any out-of-pocket costs for effective preventive services – including mammograms, colonoscopies, and the annual wellness visit.

 

Overall, the rule will greatly reduce financial barriers to access these life-saving cancer tools. ACS CAN will submit comments to CMS on priority areas during the public comment period. 

 

 

National Prevention Strategy

 

On Wednesday, June 30, the National Prevention, Health Promotion and Public Health Council created by the Affordable Care Act issued its first status report outlining the priorities for a National Prevention and Health Promotion Strategy. The report is an important step toward the creation of a first-ever national prevention strategy that will help transform the current ‘sick care’ system, which focuses on treating those who are ill, into one that does a far better job of keeping people healthy.

 

The report emphasizes what people with cancer and their families strongly believe -- that eliminating cancer as a major health problem should be a top national priority.  As we know, 60  percent of cancer deaths could be prevented each year if all Americans were to stop smoking, get screened for cancer, eat healthy, and exercise regularly. The report calls for greater investment in cancer prevention strategies that expand tobacco control, improve nutrition and physical activity, combat obesity, and increase utilization of high-value preventive services such as cancer screening tests. Read the National Prevention Strategy Report and ACS CAN’s press release.

 

Christopher W. Hansen

President

American Cancer Society Cancer Action Network (ACS CAN)

 

 

 

 



Massachusetts Updates

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Unless specifically noted otherwise, the Society, and not ACS CAN, is conducting the activities described on this page.