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New Report Shows Significant Opportunities Remain for States to Pass Policies to Save Lives and Money from Cancer

The 15th annual “How Do You Measure Up?” report was released to the media last week. The report is now live on acscan.org where you can download the full version. There is also a post on ACS CAN President Chris Hansen’s Cancer CANdor blog here.

I am interested in learning how you can use this report to inform and strengthen your cancer control policy efforts.

Below is the press release that was sent to national and D.C.-based reporters:

A majority of states are missing critical opportunities to pass and implement legislative solutions proven to prevent and fight cancer, according to a report released today by the American Cancer Society Cancer Action Network (ACS CAN). How Do You Measure Up?: A Progress Report on State Legislative Activity to Reduce Cancer Incidence and Mortality grades states on the strength of evidence-based policies that help to prevent a disease that kills roughly 1,650 people a day nationwide, costs patients nearly $4 billion in out-of-pocket costs and in 2014 cost the country as a whole more than $87 billion in direct medical costs.  

The report, an annual snapshot of key state policies, indicates that as the nation is looking toward more state-driven solutions to address chronic disease prevention and access to health coverage, many states are actually falling behind in this area.

“State lawmakers are in a unique position with proven opportunities at their fingertips to reduce the number of people in their states that hear the words, ‘you have cancer,’” said Chris Hansen, president of ACS CAN. “When it comes to this disease, the decisions being made in our state capitals can be the difference between life and death for patients. By passing the proven policies laid out in this report, state lawmakers will not only be saving lives, they’ll be reducing long-term health care costs that can be reinvested back into state economies.”

This 15th edition of How Do You Measure Up? grades states in nine specific areas of public policy that can help fight cancer, including smoke-free laws, cigarette tax levels, funding for tobacco prevention and cessation programs and cessation coverage under Medicaid, funding for cancer screening programs, indoor tanning device restrictions for minors and access to health coverage through Medicaid. The report also looks at whether a state has passed policies proven to increase patient quality of life and offers a well-balanced approach to pain medications.

Overall, the report found that:

  • Twenty states reach benchmarks in only two or fewer of the nine legislative priority areas measured by ACS CAN
  • Twenty-nine states and the District of Columbia measure up in just three to five of the nine areas
  • Only two states – California and Massachusetts – meet benchmarks in six or more of the nine categories
  • No state meets benchmarks in eight or nine policy areas.

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 a state is falling short. 

Unfortunately, the report shows 19 states still have yet to increase access to adequate, affordable health coverage to low-income, working adults through their Medicaid program. Research shows individuals without health care coverage are more likely than those with coverage to be diagnosed with cancer at a later stage, when it is more costly and difficult to treat, and when individuals are less likely to survive. Medicaid provides a critical safety-net for more than 2.3 million Americans with a history of cancer, including one-third of all childhood cancer patients at the point of diagnosis.

“Ensuring access to adequate, affordable health coverage is an absolute necessity for cancer patients, survivors and all of us at risk of developing the disease,” said Hansen. “A cancer diagnosis can often force an individual to have a lapse in coverage if they get too sick to work. These individuals need access to the safety net Medicaid provides, giving patients the chance they deserve to survive and live beyond this disease.”

The report also offers a blueprint for how states can work within the current federal health care law on a state-based approaches to improve access to affordable and adequate health coverage by increasing provider network adequacy and protecting patients from surprise costs.

Despite tobacco being the number one preventable cause of death nationwide, the report also shows that progress is slow when it comes to passing tobacco control measures. From the 14th edition of the report in 2016 to the 15th edition in 2017, only one state implemented a significant cigarette tax increase – California by $2 per pack – and no state passed a comprehensive, statewide smoke-free law. Currently, only four states are meeting the benchmark for funding their tobacco prevention and cessation programs at just 50 percent of the funding level recommended by the Centers for Disease Control and Prevention. Furthermore, just nine states offer the full spectrum of cessation services, including individual, group and telephone counseling and all seven Food and Drug Administration-approved tobacco cessation medications, in their Medicaid programs.

How Do You Measure Up? also highlights major gains states have made recently. In 2017, seven states passed ACS CAN model legislation to increase access to and awareness of palliative care, bringing the new total to 20 states. Not only are states finding that offering palliative care services throughout a patient’s diagnosis and alongside curative treatments can improve patient outcomes, reduce hospital readmittance and increase patient and family satisfaction, it also saves medical costs.

Additionally, prohibiting minors under 18 from using indoor tanning devices, which the World Health Organization classifies as carcinogenic, is a cancer prevention policy that is increasing in popularity nationwide. Currently, 15 states and Washington, D.C., have laws in place that protect young people from the risks associated with these devices (up from 13 states and the District in 2016).

The American Cancer Society estimates that nearly 1.7 million people in the United States will be diagnosed with cancer and more than 600,000 will die from the disease this year.

Report Highlights and Available Resources:

  • Focuses on access to health coverage and cancer screenings, cancer prevention, tobacco control and patient quality of life
  • National trend information and in-depth analysis of more than a dozen specific state-level policy issues proven to help save lives from cancer and improve the financial health of states
  • Local volunteer and patient stories, national and state policy experts on all issues covered in the report are available for interviews
  • High resolution copies of each issue grade map in the report
  • For interactive national and state-by-state details as well as a full copy of the report, visit acscan.org/measure

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