Monday, February 6, 2017

Notebook Page 22 January 2017

The Michigan legislature is finally back in full swing and the Governor provided his annual state of the state address, providing a report card on how Michigan is doing. The new session means a new year for ACS CAN as well and the start of a new educational process with over 40 new lawmakers in the House of Representatives.

Governor Snyder’s State of the State speech to most pundits didn’t move mountains. The speech really provided a report card on how Michigan is doing. Health wise there were not many mentions of major health initiatives except for the efforts in Flint and Healthy Michigan. At last count, Michigan has over 640,000 people on the Healthy Michigan Plan, which is being touted as one of the models of how Medicaid expansion can work in all states. Over the next several months, while discussions are happening around the Affordable Care Act, Governor Snyder will continue to deliver his message that Healthy Michigan is the right direction for the country.

ACS CAN will continue to support the Healthy Michigan Plan and educate lawmakers on why it’s important to continue to offer in Michigan. Along with that, we will be educating on our major campaigns for the year. This year ACS CAN is working on issues surrounding Palliative Care, Tobacco Taxes, Oral Chemotherapy Fairness, and others.

Our efforts surrounding Palliative Care are built off of the report that ACS CAN and partners from ACS and other health groups from around the state put together that outline some of the major hurdles surrounding Palliative Care. One of the major asks in the report is the creation of a Palliative Care Commission on a state level that will look at the palliative care and provide actionable items to the Legislature to better our palliative care systems. We are working with Governor Snyder to create this commission through executive order rather than make it statutorily. Our goal is to have this ready to go by summer 2017.

Tobacco taxes will again be a major campaign for us this year. Michigan currently falls into the bottom third of the country in terms of tobacco prevention funding. Youth are shifting away from traditional tobacco and moving towards new emerging products and the state continues to face future financial issues in it’s Medicaid program. All of those issues and others leads us to ask for an increase in the cigarette tax by $1.50, create parity for other tobacco products, and regulate and tax e-cigarettes as tobacco products. This will provide substantial ongoing revenue for the state to help fund prevention and Medicaid issues.

Finally, Oral Chemotherapy Fairness is back again. I know all of the hard work that all of you did to help us move this issue over the finish line last time but we fall short due to politics rather than common sense. This time around we is fearful that our sponsor last term will be willing to cave to any of the demands from the health insurers, which could potentially leave us on the other side of the issue fighting against the legislation since it would do harm to patients than good. We will continue to keep engaged throughout the process to work and engaged with your volunteers and accounts to fight to greater access to these needed drugs.

On January 28 ACS CAN hold their annual Michigan volunteer training at Michigan State University.  Volunteers from all over the state attended and learned about ACS CAN’s state and federal priorities for 2017.  The top priority at this time is guaranteeing that any replacement for the Affordable Care Act includes the same or better protections for cancer patients.

ACS CAN will focus on four areas, or what we call our four A’s, for any Affordable Care Act replacement.  These are the four areas:

·         No pre-existing medical condition restrictions
·         Plans are prohibited from rescinding or canceling coverage when someone gets sick except in instances of fraud or misrepresentation
·         Availability and renewability of coverage is guaranteed

·         Plans are only able to charge more or less in premiums based on family structure, geography, the generosity of the benefit, age (limited to a ratio of 3 to 1), and tobacco use (limited to a ratio of 1.5 to 1)
·         Plans cannot charge higher premiums because an individual has had a cancer diagnosis
·         Plans can charge older Americans no more than 3 times what they charge younger persons. This keeps health insurance more affordable for older Americans
·         Refundable tax credits provide premium assistance for individuals and families up to 400 percent of the federal poverty level for coverage in a marketplace plan
·         Out-of-pocket spending maximums for individuals and families

·         No lifetime and annual coverage limits
·         Coverage of preventive health services with no cost sharing
·         Requires all plans to provide a minimum level of benefits. Plans offered in the small group and individual markets have additional requirements to provide coverage of 10 categories of essential health benefits.
·         Requires plans to spend at least 80 percent of premiums on healthcare and quality improvement

Administrative Simplicity
·         Standardized summary plan documents that make it easier for consumers to compare plans when shopping
·         Insurance companies are required to streamline insurance appeals process to provide consumers with information about their appeals and the opportunity for external appeals
·         Plan navigators and other health insurance enrollment specialists help consumers apply for and understand coverage in the marketplaces and Medicaid

As always, if you have any questions please don’t hesitate to contact Matt ( or myself ( with any of your questions. Thanks again and remember pitchers and catchers start reporting on February 14th!

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