Cancer Policy News from the Wisconsin Cancer Collaborative | July 2021
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Gov. Evers signs next state budget
Gov. Tony Evers has signed into law an $87 billion, two-year budget that will set the funding levels for nearly all state programs. 

The new budget went into effect at the beginning of July and will run through the end of June 2023. It provides funding for multiple cancer-related programs, including the Wisconsin Well Woman Program, which offers preventive health screening services to women with little or no health insurance coverage; tobacco prevention and control efforts; and other programs that serve patients, families, and health care providers on the cancer care continuum. 
Gov. Evers’ original budget proposal included the expansion of the Medicaid program, the creation of a medical marijuana program, raising the age to purchase tobacco to 21 years, and funding for a state-run ACA insurance marketplace. Those items were removed by the state legislature’s Joint Committee on Finance in the spring. 
Bill regulating PBMs signed into law
A bipartisan bill designed to bring more transparency to the prescription drug supply chain was signed into law by Gov. Evers earlier this spring. The bill does so by increasing the regulation of pharmacy benefit managers, commonly known as PBMs.

PBMs are companies that manage prescription drug benefits by working with drug manufacturers, pharmacies, and insurers to set drug costs and influence patient access to prescription drugs.   

The new law prohibits PBMs from using gag clauses in contracts to prevent pharmacists from informing patients of more affordable options for their medications. The law also prevents PBMs from charging more from patients with insurance, in the form of larger copays, than what is charged to patients without insurance. 

PBMs will be required to give patients a 30-day written notice if there are changes to their drug formulary, or if a drug they are taking is reassigned to a benefit level with higher cost sharing. 

Under the new law, PBMs must be licensed by the state Office of the Commissioner of Insurance. PBMs also will be required to submit annual reports on the amount of rebates they receive from pharmaceutical companies and the percentage they pass on to patients as savings.
State lawmakers introduce Tobacco 21 bills
Lawmakers in the Wisconsin State Senate and Assembly have introduced companion bills that would increase the purchase age for tobacco and vapor products from 18 years to 21 years. 

Both bills (AB 348 and SB 355) are very similar to the bills that were considered in both chambers in 2020, but stalled in the legislature as a result of COVID-19. The federal age for purchasing tobacco and vapor products was increased to 21 years in 2019, but state officials cannot enforce the federal age restriction without changing state law, leaving enforcement to federal officials.

Although the new state bills restrict the purchase of vapor products regardless of nicotine content, they do not require the licensure of vapor shops, as mandated for tobacco sellers, and they don’t define “non-nicotine” products. The omission of these provisions creates problems for enforcement by state officials. 

The bills also place the penalty for underage tobacco and vapor sales on the customer, instead of on the retailer.

You can follow the progress of AB 348 and SB 355 online.

The Wisconsin Cancer Plan 2020-2030 encourages policies that restrict youth access and use of cigarettes, other commercial tobacco products, and e-cigarettes. See Chapter 2: Risk Reduction to learn more.
US Supreme Court upholds Affordable Care Act
The United States Supreme Court dismissed a challenge to the Affordable Care Act (ACA), preserving the 10-year-old law that provides millions of Americans with health care coverage. This was the third attempt by ACA opponents to strike the law.

At issue was whether a law passed by Congress in 2017 that removed the individual mandate to purchase health insurance meant the law should be struck down. In a 7-2 decision written by Justice Stephen Breyer, the Supreme Court held the states that brought the lawsuit did not have standing, meaning the states could not demonstrate they had experienced harm from the federal government as a result of the law.

Had the Supreme Court ruled in favor of the states bringing the suit, cancer prevention and treatment provisions in the ACA would have ended, such as coverage of preventive screenings, prohibiting lifetime limits of coverage, ensuring coverage for preexisting conditions, and coverage of young adults on their parents’ policies. 

The Wisconsin Cancer Plan 2020-2030 highlights the importance of maintaining protections against lifetime limits in insurance coverage, ensuring health care insurance for cancer patients with preexisting conditions, and increasing access to health insurance coverage. See Chapter 1: Health Equity and Chapter 4: Treatment to learn more.
USPSTF releases new guidelines for colorectal and lung cancer screening
The United States Preventive Services Task Force (USPSTF), an independent panel of experts in preventive and evidence-based medicine, has updated the guidelines for colorectal cancer and lung cancer screenings. 

Now, average risk adults should begin colorectal cancer screenings starting at age 45 instead of 50. Colorectal cancer is the nation’s third leading cause of cancer deaths, and data show that reducing the screening age to 45 would prevent more deaths from the disease.  

In Wisconsin, the Medicaid program will be incorporating the new age guidelines, and the Office of the Commissioner of Insurance notified insurers in the state of the change that requires many health insurance plans to comply with the updated recommendation.

The USPSTF also lowered the age when lung cancer screening should begin. People with a history of smoking about a pack of cigarettes a day for 20 years should get annual low-dose CT scans beginning at age 50, instead of 55. The new recommendation applies to current smokers and those who have quit within the past 15 years. 

Both updated screening recommendations received a B rating from the USPSTF. This means that under the Affordable Care Act, most private insurers must cover the service without cost-sharing. Although not required, Medicare generally follows the panel’s recommendations, as well. 

The Wisconsin Cancer Plan 2020-2030 includes strategies to increase awareness of recommended cancer screenings and improve access to screening services. See Chapter 3: Early Detection and Screening to learn more. 
How to find cancer-related legislation in Congress
Every two years, members of Congress introduce dozens of bills that would affect the lives of cancer patients and the prevention of cancer. These bills range from tax parity of tobacco products, eliminating cost sharing for cancer screenings under Medicare, the affordability of prescription drugs, and coverage of genetic counseling services. 

You can find and track current bills related to cancer by visiting and typing “cancer” in the search box.
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