Bills requiring health insurers to cover colorectal cancer Screening tests are being considered by the New Mexico Legislature. Health insurance policies issued in the state would be required by these bills (HB 510 and SB 851) to “provide coverage for colorectal screening for determining the presence of precancerous or cancerous conditions and other health problems.”

The House Consumer and Public Affairs Committee gave HB 510 a “do pass” recommendation and referred it to the House Health and Government Affairs Committee on February 13, while on February 16 the Senate Corporations and Transportation Committee gave a similar recommendation to SB 851 and referred it to the Senate Public Affairs Committee.

Something I’ve not seen in other colon and rectal cancer screening mandates is this requirement:

“The coverage shall make available colorectal cancer screening, as determined by the health care provider in accordance with the evidence-based recommendations of the United States preventive services task force [USPSTF].”

According to its web site the USPSTF is “the leading independent panel of experts in prevention and primary care” whose “recommendations are considered the ‘gold standard’ for clinical preventative services.”

A Fiscal Impact Report was written for each bill (Senate here and House here) and following are some items I found interesting:

• New Mexico received the grade of “F” in the Colorectal Cancer Legislation Report Card issued by the National Colorectal Cancer Research Alliance;
• 38% of New Mexico adults age 50 and older reported never having had a colorectal cancer screening examination;
• Colorectal cancer is very treatable when detected early and can be prevented by removal of polyps; and
• Citation of a recent analysis by the American Cancer Society which “shows that colorectal cancer screening have risen faster and are significantly higher in states that have passed these coverage laws.”

The Senate version (SB 851) is sponsored by Sen. Cynthia Nava while Rep. Andrew J. Barreras is the sponsor of the House version (HB 510). If you are a resident of New Mexico, contact your state legislators and tell them to vote “yes” on these bills.

In 2003 I participated in my first One Voice Against Cancer Lobby Day. One of the speakers told us of the following statement made by President Bush: “In order to win the war on cancer we must fund the war on cancer.”

Shortly before his 2007 State of the Union Address in January, the President made an appearance at the National Institutes of Health (NIH) and said that cancer deaths are declining because of advances made in research and education. An article in the New York Times about this visit quoted the President as saying “The NIH is one of America’s greatest assets, and it needs to be nourished. It makes sense to spend taxpayers’ money on cancer research.”

On Monday, February 5 the President released his fiscal year 2008 budget and the same New York Times article said NIH funding is “basically flat”. Actually, they’re wrong. It’s a cut of about $300 million, or more than 1%. For the National Cancer Institute the President requested $4.782 billion, approximately $11 million less than this year’s appropriated level.

This makes me wonder just how serious the President is when it comes to funding the war on cancer. Inadequate funding in recent years will hurt. Basic research will not be done. Potential treatments will be delayed. Young researchers will leave the field for other areas.

We can not let the President, or Congress for that matter, simply say “I’m against cancer,” without also making them back up their stated commitment with the necessary dollars. It is past time for them to make cancer a higher priority in the appropriations process and give it adequate funding.

Sympathy is fine but it does not pay the bill. The President and Congress must give us deeds and not words; they must put their money where their mouths are. It is up to us, citizens of this country living with colon and rectal cancer, to tell them “Show us the money!”

On Wednesday, January 31, the House of Representatives passed a Continuing Resolution (CR) that will continue funding government agencies through the end of the fiscal year (September 30, 2007). The bill now moves to the Senate, where it is expected to pass. The CR contains an additional $2.3 billion in funds that have been restored for Labor-HHS-Education appropriations (which includes funding for cancer research, prevention and related programs). Read what C3 did to support the restoration of funds here.

There is definitely good news in this. The National Institutes of Health (NIH) receive an overall increase of $620 million, including $483 million that will be used for inter-agency research programs. And the boost in NIH funding was accompanied by calls from Senators Harkin (D-IA) and Specter (R-PA), the chair and ranking member of the Labor-HHS-Education Appropriations Subcommittee, to increase momentum for health research funding in 2008. Senator Specter remarked, “I look forward to working with Senator Harkin to further increase funding levels for these departments, which have not even kept up with inflation.”

However, we at C3 are not celebrating. Unfortunately, despite the best efforts of cancer advocates, the increase does not translate into a clear funding victory for colorectal cancer or other cancer patients. Instead, the overall increase provided to the National Cancer Institute (NCI) remains small (probably about $46 million, when adjusting for programmatic accounting shifts). And the Centers for Disease Control and Prevention (CDC) receives the same funding for cancer prevention programs as in 2006.

Yes, the outcome could have been much worse, but we are not pleased that the overall appropriations increase, in the end, translates to less than 1% for direct cancer research – not enough to keep up with inflation…yet again.

This victory will be a hollow one for cancer patients, those who are seeking better cancer treatments now and in the future – unless we really are able to hold Congress’s feet to the fire this year and insist that colorectal cancer become a priority and that NCI and CDC programs be dramatically augmented in fiscal year 2008 and well into the future.

Just two weeks ago, the President announced that cancer deaths are declining because research, education, screening and treatment have improved. But that good news can’t be shared with more than 50,000 Americans who died from colon and rectal cancer last year! And any reaction to the favorable announcement of declining deaths must be accompanied by our absolute rejection of continued Presidential cuts to cancer funding and Congressional “flat funding” of NCI and CDC.

Last year, C3 was learning the ropes, and we produced an extraordinary effort by our advocates to save funding from draconian cuts. The “victory” on the continuing resolution demonstrates how important our work is. It shows how much cancer advocates can and are influencing the course of their government’s decisions, but it also clearly shows how much farther we have to go this year!

The battle is just beginning, and we intend to show Washington, DC what we’re made of when we Call-On Congress in March.

Last week, the US House of Representatives passed legislation that will provide federal funding for stem cell research. C3: Colorectal Cancer Coalition believes that stem cell research holds promise for expanding medical breakthroughs, and we support legislation that will give the researchers the tools they need to fight cancer and other diseases. This is why we chose to add our name to a letter that was sent to the US Senate and House of Representatives last week. The letter was signed by over 500 patient advocacy groups, health organizations, research universities, scientific societies, and religious groups.

From the letter:

The legislation, HR 3, will allow the federal government to fund stem cell research that includes donor-approved excess embryos from in vitro clinics that have been donated by the patients specifically for research (which currently get discarded). This would expand the number of stem cells currently available to researchers.

From the letter:

The Stem Cell Research Enhancement Act is pro-patient and pro-research. A vote for the Stem Cell Research Enhancement Act will be considered support of more than 100 million patients in the U.S. and substantial progress for research.

The bill will now proceed to the Senate and, hopefully, on to the President’s desk for signing. As you may recall, he vetoed similar legislation last year. We sincerely hope the President will consider the life-saving potential that stem cell research holds and will sign this legislation into law.

Also, as we told you in December, C3 was closely monitoring the appropriations situation currently facing Congress. In the first week of January, C3 was one of 200 organizations who signed onto a letter to the Democratic leadership calling on them to provide at least $7 billion above the President’s budget request for health, labor and education programs (including cancer research). The letter stated in part:

A full year continuing resolution for FY 2007 at the FY 2006 levels would leave these critical programs $2 billion short of the goal established by the full Senate when it adopted the Specter-Harkin budget amendment as well as the commitment made by the House leadership to significantly increase funding for these urgent priorities. Further, failure to meet these commitments would result in total funding for these programs $2 billion below the FY 2005 level.

We learned last week that the letter was well-received by the leadership in the House and Senate who oversee such funding. We are hopeful that, as Congress debates whether or not to increase funding and resources for one war that they will not forget that the war on cancer rages on.

Cancer funding at the Federal level has been flat in recent years. In other words, the actual dollar amount allocated to the National Cancer Institute (for cancer research) and Centers for Disease Control (for cancer control programs) hasn’t gone up or down in any significant way. However, when you factor in inflation, this actually means that cancer funding has been decreasing. As put by NCI Director Dr. Niederhuber in a recent meeting of the National Cancer Advisory Board:

“…because of the higher inflation index for biomedical research, flat budgets represent an actual 3 to 5.5 percent decrease (about $150M) in the operating budgets….”

To avoid this inflationary cut, the Senate voted in favor of an amendment offered by Senators Specter (R-PA) and Harkin (D-IA) which would put back $7 billion into the appropriation for Labor-HHS-Education, above President Bush’s budget request. You may remember that it’s Labor-HHS-Education that funds the National Cancer Institute.

Unfortunately for us, the 109th Congress went home for holiday break without completing the Labor-HHS-Education Appropriation bill, as Dusty talked about last week. To keep the federal government running, Congress passed what is called a Continuing Resolution (CR) which keeps the funding for 2007 at levels that were passed for 2006. This CR expires in mid-February 2007. It wasn’t a perfect solution, but at least the government is still running…for now.

In mid-December we got word from the incoming Democratic leadership that they weren’t going to try to get the funding bills passed AT ALL for FY07. They were just going to extend the CR through until the end of FY07. And just deal with figuring out funding for FY08. This is not good news.

But there is one ray of hope. The Democrats who oversee the committee that decides funding for things like cancer research have stipulated that the Congress may adjust some departments funding levels and “earmarks” based on the demonstration of “urgent need.” C3 sympathizes with this dilemma, but we are quite certain that cancer research, screening and education programs are a most “urgent need.”

We have joined with our partners at One Voice Against Cancer and other health-related organizations to make sure Congress sees our point of view. We have to be prepared yet again for a tough fight to fund colorectal cancer research and programs when 2007 rolls around. Be sure to sign up as a One Minute Advocate because we might be calling on you to help us in this effort.

In the meantime, allow me to extend my heartfelt wishes to you and all those you love for a truly joyous holiday season.