Cancer Policy News from the Wisconsin Cancer Collaborative | October 2022
Help us shape the next Policy Agenda
Every two years, the WCC’s Policy Committee develops a new Policy Agenda designed to reduce our state's cancer burden and advance the goals of the Wisconsin Cancer Plan.

Our 2021-2022 Policy Agenda includes goals such as expanding access to health insurance, decreasing tobacco use, reducing barriers to cancer screenings, and lowering cancer costs for patients and families. Of the 12 legislative items included in the current Policy Agenda, 9 bills were introduced, and 3 bills became law.

Our next Policy Agenda, covering the 2023-2024 legislative session, will be discussed and approved at the Policy Committee’s December meeting.

We want to hear from you. What policy-related issues affect your work and your community? To share your thoughts as we draft the 2023-2024 Policy Agenda, please email WCC Policy Coordinator Amy Johnson by Nov. 1.
Legislative updates
Inflation Reduction Act lowers prescription drug and insurance costs
The Inflation Reduction Act, passed by Congress in September, includes significant changes designed to lower health care costs for patients on Medicare and Affordable Care Act (ACA) plans.

Medicare changes:
Starting in 2026, the federal government will be allowed to negotiate drug prices for 10 drugs, gradually scaling up to 20 drugs by 2029. Negotiations would apply to high spending brands and biologics without generics or biosimilar equivalents. 
Drug manufacturers are now required to pay rebates for drug prices that increase above the rate of inflation. This provision will apply to single-source drugs and biologicals under Medicare Part B, and all covered drugs under Medicare Part D.
The new law also caps drug costs under Medicare Part D to $2,000 per year starting in 2025. Premium growth will be limited to no more than 6% per year beginning in 2024 and running through 2030.

The Inflation Reduction Act extends monthly premium subsidies for insurance plans purchased through the ACA marketplace. The subsidies were passed in 2021 as part of the American Rescue Plan Act and were set to expire at the end of 2022.

The subsidies have significantly reduced health insurance costs for low-income and middle-income households. The new law extends these subsidies through the end of 2025.

ACA Marketplace Open Enrollment for 2023 begins Nov. 1, 2022, and runs through January 15, 2023.
PACT Act expands health care for veterans with cancers caused by burn pits

In August, President Biden signed into law the PACT Act, offering life-saving health care options for veterans exposed to burn pits and similar toxic substances.

Under the Veterans Administration’s disability rating system, a veteran’s disability must be connected to their military service, requiring veterans to prove their service caused their health condition. However, the VA recognizes some presumptive conditions that do not require proof of cause. 

The PACT Act expands eligibility to Gulf War era and post-9/11 veterans who were exposed to burn pit and other toxic substances. Under the new law, 12 types of cancers have been added to the list of presumptive conditions, and veterans diagnosed with these cancers will be eligible for disability services through the VA. 
Federal bill would reauthorize funding for Wisconsin Well Woman Program

The federal program partners with states to provide free breast and cervical cancer screening and diagnostic services for women who are low income, uninsured, or underinsured. In Wisconsin this is known as the Wisconsin Well Woman Program, which serves women between the ages of 45 and 64, and provides mammograms and cervical cancer screenings.

The bill is unlikely to advance in Congress’s current session and would need to be reintroduced next year. If passed, the bill would allow Congress to increase funding for the national program, giving state programs like the Wisconsin Well Woman Program more funding for their services.
Federal tobacco prevention and control updates
Ban on menthol cigarettes and flavored cigars may go into effect next year
The Food and Drug Administration (FDA) continues to move forward with plans to ban menthol flavors from cigarettes and prohibit all flavors (other than tobacco) in cigars.

In 2009, the FDA previously banned all cigarette flavors except for tobacco and menthol.

Menthol is a flavor additive with a minty taste and smell that reduces the irritation and harshness of smoking, making menthol cigarettes easier to use and more appealing to youth and young adults. Menthol interacts with nicotine in the brain to enhance nicotine’s addictive effects, which can make it harder to quit smoking. 

Modeling studies estimate that 324,000 to 654,000 smoking attributable deaths would be avoided over the course of 40 years if menthol cigarettes were no longer available.
Enforcement would apply to manufacturers, distributors, wholesalers, importers, and retailers—not consumers.

The FDA is currently reviewing the comments submitted during the public comment period and may finalize the new rules in 2023.
JUUL settles youth vaping investigation for $438.5 million

JUUL Labs recently agreed to pay $438.5 million to states to settle a two-year investigation into sales and marketing practices targeting kids and teens. 
According to the Wisconsin Department of Justice, "JUUL relentlessly marketed to underage users, [sold] a technology-focused, sleek design that could be easily concealed, and sold its product in flavors known to be attractive to underage users. JUUL also manipulated the chemical composition of its product to make the vapor less harsh on the throats of young and inexperienced users. To preserve its young customer base, JUUL relied on age verification techniques that it knew were ineffective."
While JUUL products currently remain legal, the company faces potential future action from the FDA.
New rule would lower nicotine levels in cigarettes and cigars

The FDA has announced plans to make tobacco companies reduce nicotine levels in cigarettes, cigars, and cigarillos to minimally or nonaddictive levels. The FDA is expected to formally issue the proposed rule change in May 2023, followed by a public comment and review period.  

The FDA does not have the power to ban cigarettes, but a 2009 law allows the agency to create “product standards” that make cigarettes and other tobacco products less attractive to current and potential smokers.

The new nicotine requirements would apply only to combusted forms of tobacco products, and not e-cigarettes or vaping products. 

The FDA’s announcement aligns with President Biden’s Cancer Moonshot initiative, which aims to reduce cancer death rates by 50 percent over 25 years. 
Local tobacco prevention and control updates
New state map identifies local tobacco policies
The state’s Tobacco Prevention and Control Program has created an online map of city and county tobacco policies across Wisconsin.

The map includes indoor and outdoor smoke-free air policies, as well as Marijuana Smoke Free Work Places. 
Wisconsin Wins compliance checks have resumed

After a pause during the COVID-19 pandemic, Wisconsin Wins compliance checks have resumed in communities across the state, to investigate which vendors are selling tobacco products to underage buyers.

Although federal law prohibits tobacco sales to people under 21, local enforcement is limited to state law, which prohibits sales to those under 18. Wisconsin is one of nine states that have not yet passed Tobacco 21 legislation raising the state minimum smoking age to match federal law.
Tobacco prevention programs for Wisconsin youth

The following initiatives are actively addressing tobacco use and prevention for Wisconsin teens:
  • FACT is a youth empowerment and engagement program that engages with state and local leaders on tobacco prevention.
  • N-O-T: Not on Tobacco helps young smokers quit nicotine products.
  • INDEPTH is an alternative to suspension for youth caught vaping or using tobacco, alcohol, or drugs at school.
2022 Wisconsin Cancer Summit
Don't miss the 2022 Wisconsin Cancer Summit, Oct. 19-20, in Madison!

Learn how storytelling can improve cancer health outcomes, empower patients and survivors, reduce provider burnout, and help us connect, transform, and heal.

Questions about our Policy Program? Email Amy Johnson to learn more.