Vermont Action Center

Enhancing Access to Health Care – Catamount Health

The American Cancer Society is dedicated to ensuring that all Vermonters have access to timely, affordable and quality health care and that Catamount Health remains a viable source for health care coverage.  Uninsured Vermonters are twice as likely to be diagnosed with cancer at a stage later than the insured and therefore are more likely to die due to a lack of coverage.  The gaps and failings of our health care system are directly contributing to needless cancer suffering and death.   ACS is committed to the success of the Catamount Health program and to improving coverage by removing financial and coverage barriers that prevent Vermonters from accessing quality and affordable health care.

The American Cancer Society recommends the following:

·         Eliminate the pre-existing conditions clause which excludes individuals with cancer from coverage for one year under Catamount Health. The pre-existing conditions clause forces many Vermonters with serious illnesses to pay substantial out-of-pocket costs for their care, or worse, go without treatment. Delaying treatment means a lower survival rate and higher medical costs.  The financial repercussions of denying individuals coverage due to a pre-existing condition can be catastrophic. One in five insured persons with cancer use all or most of their savings dealing with the disease.  Excluding Vermonters from coverage when they need it most is discriminatory and financially impractical.  Discouraging enrollment runs counter to Catamount’s goals.

·          Keep Catamount Affordable, the premiums for Catamount are high for many Vermonters who struggle to pay for their monthly premiums, out-of-pocket expenses, and deductible when diagnosed with cancer. Increases to premiums continue to outpace increases to overall inflation and workers’ earnings. Vermonters should not be forced to choose between food, shelter, and medical care. Access to affordable, quality care is a necessity, not a luxury.

·         Eliminate the 12-month uninsured waiting period which undermines the intention of Catamount Health, a program created to provide coverage for the uninsured.  This rule greatly impacts Vermonters who cannot afford their current health insurance plan and are forced to make financial choices between their health and other life necessities. This requirement forces individuals affected by it to assume the very dangerous risk of being uninsured for 12 months before eligible for comprehensive coverage.

Early Detection – Breast Cancer Screenings

Vermont’s Breast and Cervical Cancer Early Detection Program, Ladies First program facilitates life-saving breast and cervical cancer screenings and post-diagnostic screening and treatment services to women 18-64 years of age who need them most low-income, uninsured, underinsured, rural, and racial and ethnic minority women.  Without this coverage, these women will not benefit from advances in early detection.

Breast cancer is the most common form of cancer among women in this country, accounting for nearly 1 in 4 cancers diagnosed.   Effective screening methods are available to diagnose breast cancer early, when treatment is most successful, but too few women have access to the lifesaving tests they need.  As a result, they are often diagnosed with cancer at late stages, when they are less likely to survive long-term.

In 2009, breast cancer will account for 14% of new cancer cases in Vermont and 480 women will be diagnosed with breast cancer. While the impact of the disease is apparent,

• only 63% of women in Vermont aged 40-64 had a mammogram in the past year
• only one-third of eligible women aged 40-64 are currently screened for breast cancer
• among the uninsured, only 38% of women were screened

Many states supply state funds in addition to the federal funds which support the Breast and Cervical Cancer screenings that is not the case in Vermont where no state funds go directly to the screening program. Furthermore, 4 full-time federally funded positions have been lost through attrition between 2008 -2009.  It is critical that this program continue to effectively and efficiently serve the needs of Vermont’s women.  Adequate staffing levels are needed to administer the program; without adequate staffing in place it is difficult to provide services efficiently and to effectively evaluate program progress.  The failure to fill the positions may result in a loss of federal funds down the road; and may mean that fewer women are aware of the program and that the program itself is unable to effectively target its efforts to serve these women.

More than 90 women in Vermont will die of breast cancer this year -- many of them simply because they lacked access to early detection screening.  The American Cancer Society recommends the 4 full-time federally funded positions to the Ladies First program that were eliminated be restored.

Prevention – Tobacco Control

Tobacco use causes more than 800 Vermont deaths each year. It is the single most preventable cause of death and disease in Vermont.  Approximately 87,000 adult Vermonters (18%) and 6,300 (16%) youth in grades 8 through 12 identify themselves as current smokers. One-third of all tobacco users will die prematurely because of their addiction to tobacco. Treating smoking-related illness in Vermont costs $233 million every year, $72 million of which are taxpayer funded Medicaid expenditures.  Smoking-related illness results in another $197 million in productivity losses each year.

Tobacco Control Funding:  level funding for Vermont’s Tobacco Control Program is necessary to ensure continued progress in the reduction of tobacco use in Vermont.  The Tobacco Control Program receives $4.8 million only a fraction of the $40 million the state receives annually from the Master Settlement Agreement (MSA), which is less than half of what the CDC recommends.  The American Cancer Society along with our partners through the Coalition for a Tobacco Free Vermont recommend level funding for FY2010.   Tobacco Control saves money and lives.

Vermont has made significant progress since the Tobacco Control Program began:

• Youth smoking has declined from 31% to 16% but has remained flat since 2005
• Smoking rates among adults have declined, dropping to 17.6%

Tobacco Disparities continue to grow --  increasing the unmet needs of Vermonters

• 44% of those receiving mental health services smoke
• 39% of low-income Vermonters smoke

Using the Tobacco Trust Fund to supplement the Tobacco Control Program,   the Trust Fund was established to provide a long-term, sustainable funding source for the Tobacco Control Program and to ensure that Vermonters have access to effective prevention and cessation programs for years to come. Using some of its funds to help protect and preserve the program now makes sense, along with a plan to ensure the Trust Fund remain a stable source for years to come, such as not overprescribing Master Settlement dollars, ensuring unspent funds go back to the Trust Fund, and not tapping into Trust Fund earnings.  ACS recommends that no further funds be taken from the Tobacco Trust Fund beyond the supplement to the Tobacco Control Program, and that all borrowed funds be returned in order to maintain the integrity of the fund and to create a sustainable funding source in the future.

Prevention – Nutrition Labeling

Overweight and obesity represent a serious and growing health problem in Vermont.  The science linking excess weight, physical inactivity and poor nutrition to cancer is now well established. One-third or 186,000 of the 500,000 cancer deaths that occur in the U.S. each year can be attributed to poor diet, physical inactivity, and overweight and obesity.  The biological link between overweight and obesity to cancer is believed to be related to multiple effects on fat and sugar metabolism, immune function, hormone levels and proteins that affect hormone levels, and other factors related to cell proliferation and growth.  Overweight and obesity increase the risk of several cancers, including: Colon, Esophagus, Breast, Endometrial, and Kidney. 

Everyone should be able to make healthy life choices about nutrition by having easy, affordable, and equitable access to information and healthy foods. While living a healthy lifestyle ultimately is an individual choice, substantial social, structural, economic and cultural barriers exist. People cannot begin to address their personal health without tools to make healthy decisions.  With two-thirds of adults and 17.6 percent of children in the U.S. classified as overweight, fostering healthy behaviors to prevent obesity and maintain a healthy weight may be among the most critical actions we can take to promote wellness and reduce the burden of cancer in this country.

Increased consumption of more high-calorie convenience foods, beverages and meals outside the home and increased portion sizes have substantially contributed to the obesity epidemic. People cannot accurately access the nutritional value of their meal unless the information is provided. Low-income Vermonters are at greatest risk due to the need to convenience in meal preparation from longer work days and the lack of healthy alternatives in their neighborhoods.

The American Cancer Society supports individuals having access to nutritional information in order to make informed choices about their diets. Restaurant menus and menu boards offer a significant opportunity to inform consumers and promote awareness for making healthy eating choices. ACS supports at a minimum that consumers should be able to see on a menu, menu board, drive-thru menu board, or food tag item the calorie information when ordering their food or drinks.  American Cancer Society recommends the passage of H.120, which ensures that Vermonters have the basic information necessary to making healthy choices when they eat out. 

Quality of Life – Pain

ACS supports increasing knowledge of and access to appropriate pain management and palliative care.