This evening, the President gave his annual address to Congress and called for a freeze in domestic spending while at the same time calling for innovation and acknowledging the importance of biomedical research.

“As someone who is committed to winning the fight against cancer, I was pleased to hear the President talk about the importance of innovation. However, it is counterproductive to proclaim that ‘this is our generation’s Sputnik moment’ while calling for a spending freeze for domestic programs.

Now is not the time for across the board cuts to domestic spending. If we are going to find a cure for cancer in our lifetimes, we need a sustained investment in proven research programs – programs that encourage innovation and ensure discoveries make it from bench to bedside as quickly as possible.

On behalf of the thousands of Americans who will be diagnosed with colorectal cancer this year and on behalf of the millions of Americans living with colorectal cancer I urge the President and Congress to renew the fight against cancer with smart and sustained investments in biomedical research that will not only save thousands of lives but encourage innovation and help stimulate the economy by creating much-needed jobs.”

- Carlea Bauman, President of the Colorectal Cancer Coalition

Forty years ago when President Nixon signed the National Cancer Act into law we didn’t understand how a normal cell becomes a cancer cell. Since 1971, we have invested millions and made great advances in biomedical research.

Over the last forty years, we’ve seen a transformation in how we treat cancer from treatments that don’t distinguish between healthy and cancerous cells to more effective, targeted therapies. Scientists working on the Cancer Genome Atlas are building a comprehensive database of the DNA changes associated with 20 major tumor types and we can look forward to the day when cancer treatments are tailored to the specific DNA changes in each patient’s tumor.

To date, the growth in knowledge about cancer biology and genetics is perhaps the greatest success of the national cancer effort since passage of the National Cancer Act.

But we have a long way to go. Cancer still remains a leading cause of death in the United States.

This year over 560,000 Americans will die from cancer – almost one every minute.

Now is not the time for across the board cuts to domestic spending. Americans recognize the importance of federal support for cancer research regardless of the economic climate. Nearly nine in ten respondents (89 percent) to a national nonpartisan poll of households with a history of cancer, think it is important that the President and Congress increase funding for cancer research and related programs. The survey, commissioned by the American Cancer Society Cancer Action Network, also found that support for federal cancer research funding is high regardless of party affiliation, with 85 percent of Republicans, 87 percent of independents, and 96 percent of Democrats polled responding favorably.

Today’s investments in cancer research are the key to addressing tomorrow’s public health and economic crises. Last year, colorectal cancer cost the US economy $14 billion. Cancer incidence is projected to nearly double by 2020, particularly among the baby boomer population. As these rates climb so too will the cost to our economy.

In one of his first addresses to Congress, President Obama called for, ‘a new effort to conquer a disease that has touched the life of nearly every American by seeking a cure for cancer in our time.’

We will be working hard to make sure that the President and Congress live up to that call, and the fight against cancer doesn’t get lost in the push to cut spending. We can’t lose ground in the fight against cancer by reducing spending for life-saving research.

The House is set to vote this afternoon on the Improving Access to Clinical Trials Act of 2010 (S. 1674) introduced by Senator Ron Wyden (D-OR).

The bill provides that the first $2,000 per year received by an individual for participation in a clinical trial shall not be counted as income for the purpose of calculating Social Security benefits.  This provision was included in the House-passed health care reform bill last November, but was not included in the final bill the President signed into law in March.

The Senate already passed this bill on August 5.  House passage later today will clear the bill for review and signature by the President.

Health reform is back in the news this week.  Why?  Today marks the six-month anniversary of the President signing this landmark legislation into law and several of the most-talked about and popular provisions of the law take effect today.

The provisions taking effect today that impact the colorectal cancer community are:

Coverage of Preventive Services: New plans must provide dozens of preventive services – including colonoscopies – without charging a copayment (any preventive service with an A or B rating from the Unites States Preventive Services Task Force must be covered).
Why This Is Important: Eliminating cost sharing requirements for preventive colorectal cancer screening will lower the cost of screening services for individuals which will help to increase population-based screening rates thereby helping to lower the incidence and mortality rates from this disease that is preventable and treatable if caught early.
Loophole: The law waives the deductible when a screen turns diagnostic, but not the co-pay. The Colorectal Cancer Coalition believes a fix needs to be enacted so that the co-pay is waived for a screening colonoscopy when it turns therapeutic.

Elimination of Lifetime Limits: No lifetime limits on benefit payouts.
Why This Is Important: Many colorectal cancer patients face a lifetime of cancer treatment. Caps on insurance result in very difficult decisions about the care they will receive and how they are going to pay for it.
Loophole: Lifetime limits are still generally permitted to the extent that the benefits are not “essential health benefits.” Future regulations will define the term “essential health benefits.” For now, the term includes at least the following categories of service: ambulatory patient services; emergency services; hospitalization; maternity and newborn care; mental health and substance use disorder services; prescription drugs; rehabilitative services and devices; laboratory services; preventive and wellness services and chronic care management; and pediatric services.

Elimination of Annual Limits: Begins to phase out annual limits on benefit payouts, starting by making the limit no less than $750,000. While the lifetime prohibition is immediate, the prohibition against annual dollar limits is phased in through 2014 for “essential health benefits.”
Why This Is Important: See above – same reason that the elimination of lifetime limits is important.
Loophole: May be limited in some cases. Employers whose plans don’t meet requirement can apply each year for a waiver. Individual plans that are grandfathered are also exempt.

Prohibition Against Recissions: The Affordable Care Act prohibits health insurance plans from dropping you or reducing your benefits if you become sick. Applies to both grandfathered and non-grandfathered plans.
Why This Is Important: Newly diagnosed patients will no longer have to worry that they might lose their health insurance coverage because of their cancer diagnosis.

A lot of attention has focused on the elimination of pre-existing condition exclusions. Eliminating pre-existing conditions exclusions is very important for cancer patients. Pre-existing condition exclusions lock the millions of Americans with at least one chronic illness (nearly one third of the population) into existing plans and employment. While this provision takes effect for children today, it is phased in and it is not until 2014 that all group health plans will be prohibited from imposing any pre-existing condition exclusions on children and adults.

Read more about the provisions taking effect today in a special guest blog from Jay Angoff, Director of the Office of Consumer Information and Insurance Oversight “Six Months of the Affordable Care Act: Rights and Protections for Cancer Patients.”

And to learn more about provisions that have already taken effect, and about the provisions that are still to come and will be phased in until the Affordable Care Act fully takes effect in 2018 take a look at our Health Reform and You Webpage.

And remember there is still work to be done! Even after all the provisions of the Affordable Care Act take effect in 2018, many Americans may be newly insured but will still fail to receive the right treatment at the right time. The Colorectal Cancer Coalition continues to support research to help develop new treatments and to support efforts to increase awareness about the importance of early detection and screening.

By Jay Angoff, Director of the Office of Consumer Information and Insurance Oversight

Jay Angoff (image courtesy of the U.S. Department of Health & Human Services)

If you or a loved one has lived with cancer – you probably know more about the American health insurance system than you ever wanted. While most Americans have health insurance, few really know much about how their insurance works until the worst possible moment, when they are sick and need potentially life-saving care.

During the health reform debate, President Obama talked about the devastation of watching his mother battle both ovarian cancer and her insurance company. Unfortunately, such stories are all too common.

Thanks to the Affordable Care Act, fewer cancer patients are going to have to fight that two-front war. And many of the new patient rights and protections that will help cancer patients are beginning to take effect NOW, starting September 23rd. For example:

• Ending limits on care and benefits. Insurance companies can’t impose lifetime limits. And in most health plans, annual limits will be restricted. This means that your health insurance will be there right with you, covering your treatments, as long as you need it.
• Ending rescissions. If you get sick, your insurance company can’t drop you from coverage just because you made a mistake on your paperwork. If you keep paying your premiums and act in good faith, you won’t face losing your health insurance the moment you need it most.
• Appealing denied claims. If you are in a new plan, and your insurance company denies a claim, you have new rights to a fast and fair appeals process so you can ask them to reconsider that denial. This holds insurance companies accountable for delivering the benefits patients are entitled to.
• Covering kids. Cancer can strike at any age. Now, plans that offer coverage to your kids will have to continue covering them up to age 26, as long as they can’t get coverage through their own job. And most insurance companies can’t deny coverage to kids under age 19 because of a pre-existing condition, so you know you can buy your kids coverage if your employer doesn’t cover them.
• Choosing your own doctors. Now, new health plans have to let patients choose their own doctor from the plan’s network. And if you are in an emergency medical situation, you can’t be charged more to get treatment at a hospital out of your network.
• Keeping you healthy. As the saying goes, an ounce of prevention is worth a pound of cure. Now, new plans have to provide a number of preventive services without cost sharing. These include numerous cancer screenings, so more cancer cases will be detected early, as well as counseling and screenings to help prevent chronic conditions that contribute to poor health like heart disease, diabetes, and obesity.

Fighting cancer is a fight for your life – Americans shouldn’t have to fight their insurance companies at the same time. Now, thanks to the Affordable Care Act, patients have new tools and resources to get the care they need and take back control from insurance companies.

Leading up to this evening’s vote on health care reform legislation in the House, much of the debate has focused on whether or not Speaker Pelosi has lined up the 216 votes needed to send a bill to the President.

So, what exactly will the pending legislation do?

Take a look at a side-by-side chart comparing some of the provisions in the House-passed, Senate-passed, and pending House reconciliation bills that C3 thinks are important for people living with colorectal cancer.  The chart also includes links to the full text of each of the bills, so that you can read the complete legislation.

The House Budget Committee is expected to begin marking up the health care reform reconciliation bill on Monday, beginning the next step in the legislative process to get a final health care reform bill sent to the President.  Democrats are still awaiting a cost estimate from the Congressional Budget Office, which is expected to be released at some point this weekend.

The reconciliation bill will contain changes to the Senate bill needed to get the support of House Democrats.  Passing an amended bill under reconciliation rules will allow the Senate to consider and pass the changes under special rules requiring a simple majority to pass rather than a 60-vote majority.  Congressional leaders hope to send a final bill to President Obama no later than the Easter Congressional recess.

The two key differences between the House and Senate bills are the public option and pay-fors.  The House bill would create a government-sponsored insurance plan (i.e., a public option), but the Senate bill is silent on this point.  How to finance the health care expansion is also a contentious issue.  House members refused to consider the so-called Cadillac tax (i.e., a tax on expensive insurance plans) but the Senate has taken the opposite approach to financing and included a wealth surtax (the so-called millionaires’ tax) rather than including a Cadillac tax.  The House bill also has stricter language against funding for abortion.

The Senate passed their bill on Christmas Eve by a vote of 69-39.  And the House passed their bill on Nov. 7, 2009 by a vote of 220-215.

C3 has been closely following the various health reform proposals introduced in Congress because access to care is critical to preventing, treating and beating colorectal cancer.  Read more about the provisions in the House-passed and Senate-passed bills that will affect colorectal cancer patients.

This morning, President Barack Obama completed his first routine periodic physical examination as President at the National Naval Medical Center in Bethesda, Maryland.  The President’s exam included a colorectal cancer screening test.  Dr. Jeff Kuhlman, a Navy captain and Physician to the President, Chief White House Physician and Director of the White House Medical Unit examined the President.  Dr. Kuhlman, issued the following report following the exam:

“The President completed all age-appropriate screening tests, to include colorectal cancer screening.  A CT-colonography was performed with normal results.  Follow-up colorectal cancer screening is recommended in 5 years for routine colon cancer screening.”

Screening is just one important way to prevent colorectal cancer.  Take a few minutes to read more about preventing colorectal cancer.

At 10am (eastern) this morning, the President will host a bipartisan meeting at the Blair House to discuss health reform legislation.  The meeting will be broadcast live – C‑SPAN coverage begins at 9:45am ET on C‑SPAN3, C‑SPAN.org and C‑SPAN Radio.  The entire meeting will also be streamed live on www.WhiteHouse.gov.

View a side-by-side comparison of the House-passed and Senate-passed bills here.  View the President’s health reform proposal here.

The President will offer brief opening comments, followed by Republican and Democratic Members of Congress chosen by their colleagues.  They will then begin discussions around following four themes:

1. Controlling costs;
2. Insurance reforms;
3. Reducing the deficit; and
4. Expanding coverage.

The President will be seated in the middle of one side of the hollow square, with the Vice President, Secretary Sebelius, and congressional Leadership seated alongside him at the table.  Members of Congress will be seated by caucus around the square.

Members of Congress expected to attend the meeting include:

• Senator Harry Reid, D-NV, Majority Leader
• Senator Mitch McConnell, R-KY, Republican Leader
• Senator Dick Durbin, D-IL, Majority Whip
• Senator Jon Kyl, R-AZ, Republican Whip
• Senator Max Baucus, D-MT, Chairman of the Finance Committee
• Senator Chuck Grassley, R-IA, Ranking Member of the Finance Committee
• Senator Tom Harkin, D-IA, Chairman of the Health, Education, Labor and Pensions Committee
• Senator Mike Enzi, R-WY, Ranking Member of the Health, Education, Labor and Pensions Committee
• Senator Chris Dodd, D-CT, Member of the Health, Education, Labor and Pensions Committee
• Senator Chuck Schumer, D-NY
• Senator Patty Murray, D-WA
• Senator Kent Conrad, D-ND
• Senator Jay Rockefeller, D-WV
• Senator Ron Wyden, D-OR
• Senator Lamar Alexander, R-TN
• Senator John Barrasso, R-WY
• Senator Tom Coburn, R-OK
• Senator John McCain, R-AZ
• Speaker Nancy Pelosi, D-CA
• Representative Steny Hoyer, D-MD, Majority Leader
• Representative John Boehner, R-OH, Republican Leader
• Representative James Clyburn, D-SC, Majority Whip
• Representative Eric Cantor, R-VA, Republican Whip
• Representative Charles Rangel, D-NY, Chairman of the Ways and Committee
• Representative Dave Camp, R-MI, Ranking Member of the Ways and Means Committee
• Representative Henry Waxman, D-CA, Chairman of the Energy and Commerce Committee
• Representative Joe Barton, R-TX, Ranking Member of the Energy and Commerce Committee
• Representative George Miller, D-CA, Chairman of the Education and Labor Committee
• Representative John Kline, R-MN, Ranking Member of the Education and Labor Committee
• Representative John Dingell, D-MI, Chair Emeritus of the Energy and Commerce Committee
• Representative Xavier Becerra, D-CA
• Representative Louise Slaughter, D-NY
• Representative Robert Andrews, D-NJ
• Representative Jim Cooper, D-TN
• Representative Paul Ryan, R-WI
• Representative Marsha Blackburn, R-TN
• Representative Charles Boustany, R-LA
• Representative Peter Roskam, R-IL

** Note: Senator McConnell and Leader Boehner will designate one additional Republican member to attend.**

The fiscal year 2011 budget process got underway today when President Obama sent Congress his budget proposal.  The President’s $3.8 trillion budget includes a three-year freeze on non-security discretionary spending in order to save about $250 billion over 10 years and start narrowing the $1.6 trillion gap between proposed budget outlays and tax receipts.  The freeze caps the overall level of spending so that some programs get increases (for example, cancer research at NIH and NCI receives a funding increase), while other programs (including some of the cancer control programs at the CDC) are cut.  The freeze comes on top of a proposal to eliminate, or scale back, 120 programs in order to save more than $20 billion.

U.S. Department of Health and Human Services (HHS) Secretary Kathleen Sebelius issued the following statement of support,

“[u]nder this budget, we will provide the health and human services that Americans depend on more effectively, slashing waste and focusing programs on results.  And we’ll make many of the necessary investments our country has been putting off for years, including investments in fighting health care fraud, strengthening our public health infrastructure, and getting serious about health and wellness,” said Sebelius. “This budget is a big step toward a healthier, stronger America.”

The President’s budget includes $32.09 billion for the National Institutes of Health (NIH).  The proposed funding level for NIH would be an increase of $1 billion (3.2 percent) over last year to support innovative projects from basic to clinical research.  The increase in funding for the NIH will allow the agency to initiate 30 new drug trials in 2011, and double the number of novel compounds in Phase 1 – 3 clinical trials by 2016.  In addition, FY 2011 funding will support the completion of a comprehensive catalog of cancer mutations for the 20 most common malignancies, setting the stage for complete genomic characterization of every cancer as part of medical care within 10 years.

The NIH budget includes:

• $5.26 billion for the National Cancer Institute – an increase of $161 million (3.16 percent); and
• $219 million for the National Center on Minority Health and Health Disparities – a $7 million increase (3.5 percent).

The President’s FY 2011 budget proposal also provides $2.5 billion for the Food and Drug Administration (FDA) – an increase of $148 million (6.26 percent) over last year.  The funding increases for the FDA include increases to bring more lower cost generic drugs and generic biologics to market as well as funding to expand post-market safety surveillance of medical products, and to support FDA’s efforts to make safety data more comprehensive and accessible to patients, providers, and scientists.

That is the good news.

The bad news is the Centers for Disease Control and Prevention (CDC) budget.  The President’s FY 2011 budget proposal reduces funding for CDC cancer prevention and control programs, including the Office of Smoking and Health, by $19 million (3.9 percent) below last year’s funded level.  Specifically, the National Breast and Cervical Early Detection Program is cut by $4 million (2 percent) and the Office of Smoking and Health is cut by more than $3 million (3.2 percent).

The CDC’s Colorectal Cancer Screening, Education & Outreach program is funded at $45 million.  This is the same level the program was funded at for fiscal year 2010.

Two CDC cancer control programs are eliminated under the President’s budget.  The Geraldine Ferraro Blood Cancer Program, which received $4.7 million in FY 2010, and the Gynecologic Cancer and Education and Awareness (Johanna’s Law) Program, which received $6.8 million in FY 2010, are zeroed out under the President’s FY 2011 budget proposal.

There are a number of provisions in both the House and Senate health care reform bills that will affect colorectal cancer patients.  Click here to see a chart outlining and comparing these provisions.

This month both the House and Senate took historic votes and moved a couple of steps closer to getting the President a final health care reform bill to sign, but there is a long road ahead before Congress has a final bill that will be ready for the President.  On November 7, the House passed the Affordable Health Care for America Act by a vote of 220-215.  And, on November 21, by a party-line vote of 60-39 the Senate voted to move forward with debate on the Patient Protection and Affordable Care Act.

The Senate is expected to begin floor debate and consideration of amendments the week of November 30 and continue debate until right before Christmas.  A vote on final passage of the health reform bill is expected in the Senate sometime between December 18-23.

If the Senate passes a health reform bill, that bill will have to be combined with the House bill into a “conference report.”  Both the House and Senate will then have to vote again on the conference report.  House and Senate leadership has indicated that they would like to consider a final health care reform conference report the second or third week of January in order to send a bill to the President before the State of the Union address.

C3 will continue to work with legislators to advocate for improvements to the pending bills that will provide all Americans with the access to care that is critical to preventing, treating and beating colorectal cancer.  See the document below for a summary and comparison of some of the provisions in the House and Senate bills that C3 thinks are important for people living with colorectal cancer.

Please feel free to share your thoughts with us by leaving comments below.

Comparison of House and Senate Health Reform Bills 11 24 09 – FINAL