WASHINGTON, D.C. – August 15, 2013 – A majority of states are not measuring up on legislative solutions that prevent and fight cancer, according to a new report released today by the American Cancer Society Cancer Action Network (ACS CAN). As the changing health care landscape presents new opportunities to prevent a disease that kills 1,500 people a day in this country, many state legislatures are missing opportunities to enact laws and policies that could not only generate new revenue and long-term health savings, but also save lives.
The report, How Do You Measure Up?: A Progress Report on State Legislative Activity to Reduce Cancer Incidence and Mortality, was released at the National Conference of State Legislatures annual meeting in Atlanta, GA. The annual report finds that 38 states have reached benchmarks in only three or fewer of the 10 legislative priority areas measured by ACS CAN, the advocacy affiliate of the American Cancer Society. Only 12 states and the District of Columbia met between four and six of the benchmarks. No states met the benchmarks in seven or more of the 10 policies measured by the report.
“Today we are saving 400 more lives per day from cancer than we did 20 years ago, and we know what we need to do to finish the fight. States can save more lives and health care dollars when they enact evidence-based policies to encourage prevention, guarantee access to affordable health care, curb tobacco use and focus on patients’ quality of life,” said John R. Seffrin, PhD, chief executive officer of ACS CAN. “State lawmakers have countless new opportunities to dramatically reduce the burden of cancer, a disease that still kills 1,500 people in this country every day.”
Now in its 11th year, How Do You Measure Up? identifies specific policy actions that state legislatures can take to fight cancer, including adequate breast and cervical cancer early detection program funding; comprehensive smoke-free laws; tobacco prevention and cessation program funding; tobacco taxes; restrictions on tanning bed use by minors; improved access to Medicaid; balanced pain policies; time requirements for physical education in schools and access to palliative care.
A color-coded system is used to identify how well a state is doing. Green represents the benchmark position, showing that a state has adopted evidence-based policies and best practices; yellow indicates moderate movement toward the benchmark and red shows where states are falling short.
No state received a green rating in seven or more of the measures. Only Illinois, Massachusetts and Rhode Island reached a benchmark in six legislative areas in the fight against cancer. Ten states – Alabama, Idaho, Indiana, Louisiana, Mississippi, Missouri, North Carolina, Oklahoma, South Carolina and Tennessee – did not meet the benchmark on any of the 10 issues and another 11 received high marks on only one issue.
How Do You Measure Up? also offers a blueprint for effective implementation of provisions of the Affordable Care Act that benefit cancer patients and their families, such as establishing new insurance market rules, consumer-based health insurance marketplaces and policies that ensure access and affordability of prescription drugs that can improve patients’ quality of life.
“Because of tremendous progress over the past decade, nearly half of the states have a strong smoke-free law, the average state cigarette tax is now $1.53 and people with cancer and their families have better access to lifesaving health care,” said Chris Hansen, president of ACS CAN. “But we cannot effectively conquer cancer unless state and local policymakers do all they can to deter tobacco use and guarantee funding and access to programs and services that are proven to work.”
In the past 10 years, only three states – California, Missouri and North Dakota – have not raised their cigarette tax. The current average state cigarette tax is $1.53, with 20 states and the District of Columbia still having taxes of less than $1.00 per pack. No state comes close to matching the health and economic costs attributed to smoking, which are estimated at $10.47 per pack. For every 10 percent increase in the retail price of a pack of cigarettes, youth smoking rates drop by 6.5 percent and overall cigarette consumption declines by 4 percent
Two states – Massachusetts and Minnesota – successfully increased their tobacco taxes this year. Minnesota increased their tax by $1.60, bringing the new total to $2.83 per pack. Massachusetts jumped to the second highest tax in the country with a $1 increase bringing their total per-pack cigarette tax to $3.51. Massachusetts also increased the excise tax on other tobacco products, such as cigars and smokeless alternatives to 210 percent of the wholesale price – making it the highest tax of its kind in the country. Both state increases took effect after July 1 and were not reflected in the report.
No state passed comprehensive smoke-free legislation in the recent legislative session; however, a number of cities and counties were able to pass laws making them 100 percent smoke-free. Currently, 24 states, Puerto Rico, the U.S. Virgin Islands and the District of Columbia have a comprehensive smoke-free law in place that covers all types of workplaces, bars and restaurants.
Within the last few years, the tobacco industry has been making significant investments in the development and marketing of new tobacco products – including snus, sticks, orbs, dissolvables, hookah and electronic cigarettes – all of which may keep existing tobacco users hooked and entice youth to start the deadly habit. Tobacco companies are waging a war of distraction by touting these new products as “reduced harm.” The fact remains that, while not all tobacco products are equally harmful, there is no such thing as a safe tobacco product.
Access to Health Care
States are working to implement new insurance market rules required under the Affordable Care Act (ACA), including consumer-based health insurance marketplaces and policies that ensure access and affordability of prescription drugs that can improve patients’ quality of life.
States are also considering whether to accept funds that the federal government has allocated to increase access to health coverage to hard-working adults and families through state Medicaid programs. To date, nearly half of all states have decided to accept the funding and many more states will continue to grapple with the decision into the 2014 legislative sessions.
Unfortunately, many states are slashing funding to the National Breast and Cervical Cancer Early Detection Program (BCCEDP), which provides low-income and uninsured women with access to lifesaving mammograms and Pap tests. According to the report, only seven states have reached the benchmark in providing screenings for breast and cervical cancer early detection.
Other findings in the report:
• Only five states – California, Illinois, Nevada, Texas and Vermont – have enacted comprehensive laws restricting tanning bed use for minors under 18.
• Only four states have met the benchmark for effective statewide strategies to improve access to and knowledge of palliative care services.
• Twenty three states and D.C. will participate in full Medicaid expansion and 24 states will not provide residents access to coverage through Medicaid expansion. The final outcome is unknown for three states still in legislative session – Pennsylvania, Michigan and Ohio.
• When federal and state funds are counted together, Alaska and North Dakota are the only two states currently funding their tobacco prevention programs above Centers for Disease Control and Prevention (CDC) recommended levels.
• No state met the benchmark for physical education time requirements. Thirty six states require less than 90 minutes of physical education per week.
An estimated 1.6 million people in the United States will be diagnosed with cancer and more than 580,000 will die from the disease this year. Roughly half of all cancer deaths in the United States could be prevented if everyone in America were to stop using tobacco products, get screened for cancer, eat a healthy diet and exercise regularly.
For a copy of the complete report, visit www.acscan.org.
ACS CAN, the nonprofit, nonpartisan advocacy affiliate of the American Cancer Society, supports evidence-based policy and legislative solutions designed to eliminate cancer as a major health problem. ACS CAN works to encourage elected officials and candidates to make cancer a top national priority. ACS CAN gives ordinary people extraordinary power to fight cancer with the training and tools they need to make their voices heard. For more information, visit www.acscan.org.
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