Last week the American Cancer Society Cancer Action Network released the 2014 version of their annual “How Do You Measure Up?,” (HDYMU) a progress report on state legislative activity to reduce cancer incidence and mortality. Since Nevada’s lawmakers only meet every other year, Nevada hasn’t seen much progress from the 2013 report to now. However, we think it’s great to take a look at what has changed with the rollout of the insurance provisions of the Affordable Care Act as well as how Nevada now stacks up against other states.
Here’s a look at a few key areas from the HDYMU report:
Tobacco Control Program Funding: Red. Nevada’s ranking hasn’t changed, nor has the meager $1 million the state spends on funding tobacco prevention and cessation programs. (That’s just 3.1% of the $32.5 million the CDC recommends Nevada spend on such programs and a little more than 1.3% of what the tobacco industry spends to market their products in the state.) What has changed is that several states have increased their tobacco prevention funding, including Oklahoma and Maine, both of which moved from the report’s “yellow” ranking up to “green” with funding reaching 50% or more of the CDC recommended levels. Our neighbors in Arizona and Oregon also bumped up their funding.
Indoor Tanning Device Restrictions: Green. Nevada was the fourth state in the nation to enact a law prohibiting minors under 18 from using indoor tanning devices under any circumstances, earning a “green” rating in the 2013 HDYMU report alongside California, Illinois, Vermont, and Texas. What’s exciting is that three more states have turned “green” by banning indoor tanning for minors under 18, including Hawaii, Minnesota, and Louisiana. While several others have turned from “red” to “yellow” for implementing some restrictions for minors and tanning, we encourage more states to strengthen their laws to prohibit youth from any indoor tanning activities.
Access to Care
Tobacco Rating: Red. This is a new category in the report added as the Affordable Care Act’s new insurance rules and guidelines rolled out. One provision of the law is that insurers on the marketplace can charge tobacco users up to 50% higher premiums than they charge non-tobacco users. States have the ability to reduce or eliminate that penalty, thus removing financial barriers to insurance coverage and enabling equal access to health insurance coverage for tobacco users. Nevada has left the policy intact, allowing companies to charge those higher premiums. Public health professionals believe the surcharge should be eliminated to allow tobacco users access to the cessation assistance many health plans now cover, as well as screening and early treatment options that may reduce healthcare spending in the long run.
State Appropriation for Breast and Cervical Cancer Screening Programs: Black. Nevada’s ranking in this category hasn’t changed, with no state funding going to support breast and cervical cancer screening programs. The CDC’s National Breast and Cervical Cancer Early Detection Program, known as Women’s Health Connection in Nevada, receives no funding from the state and is just one of four state programs working under that circumstance. While the state’s Medicaid expansion and the ACA’s marketplace, which requires these cancer screenings to be covered with no cost-sharing, provides coverage for many more women in the state, there are still under- and uninsured women in need of these services. Additionally, if funded at a higher level Women’s Health Connection would be able to not only screen more women in need but provide additional outreach and education, navigation, and assistance to those women who do screen positive for cancer.
Palliative Care: Yellow. Currently the bulk of U.S. states rank “yellow” when it comes to palliative care and pain issues, but we anticipate major changes in these state rankings in the coming years. The report defines palliative care as specialized medical care that focuses on providing the best possible quality of life for a patient and his or her family by offering relief from the pain, stress and other symptoms of a serious illness. It can include counseling, symptom management, extended communication, and care coordination across healthcare settings. Palliative care can not only reduce healthcare costs, but improve outcomes for patients and ease the stress of treatment. Given these benefits, it’s apparent why palliative care is a rapidly growing field. As more medical centers and physicians embrace palliative care models watch for policy to shift and for more states to turn “green” in this rating.