Georgia’s state lawmakers concluded the 2014 General Assembly session on March 20, 2014, and several bills were passed in the state House and Senate which await the Governor’s signature that impact cancer issues in the state of Georgia. Bills passed were protection of cancer patients’ access to pain medication while continuing to monitor abuse; out-of-pocket costs for oral chemotherapy being too expensive; low income and uninsured women sit on waiting list for mammograms too long; tobacco industry having too much control in Georgia; and state lawmakers deciding whether to lesson the Governor’s power to decide on expanding Medicaid.
Monitoring abuse while offering Georgia’s cancer patients’ access to pain medication is set in motion for Governor Deal to pass it or deny it. The Georgia Pain Initiative (GPI) worked with Georgia lawmakers to establish a comprehensive Prescription Drug Monitoring Program (PDMP) in 2011, which was implemented by the Georgia Drugs and Narcotics Agency. In large part, this led to Georgia going from a “D” grade to an “A” grade in pain management. This year the program was in jeopardy of losing its federal funding if the state of Georgia did not allow for interstate data sharing through the National Association of Boards of Pharmacies’ PMP Inter-Connect program. Through the leadership of Senator Buddy Carter the general assembly passed legislation (Senate Bill 134) which would allow Georgia to share data collected through the PDMP with other states, thereby returning federal dollars back to the state program. This will ensure that Georgia can continue to offer pain medication to those with chronic illnesses while continuing to monitor for abuse in the system.
High costs for oral chemotherapy was next bill introduced, with the Georgia General Assembly passing legislation, House Bill 943, to require that a health benefit policy provide coverage for intravenously administered or injected chemotherapy for the treatment of cancer that provides coverage no less favorable for orally administered chemotherapy. Since cost-sharing requirements for patients are structured differently for oral anticancer treatments than those administered intravenously, then oral treatments often have significantly higher out-of-pocket costs. The Georgia Senate is being pressured to decrease the cap amount from $200 to $50 per month, and per prescription. Avalere Health’s 2011 report showed as much as 10 percent of patients abandoning their treatment if the out-of-pocket costs were more than $100, with 25 percent walking away if their expenses were $500 or more.
“American Cancer Society announces that nearly 30% of the new therapies in the research pipeline coming in oral form, oral anticancer treatment is the future of cancer care. To level the playing field for all cancer patients, Georgia should reject the $200 out-of-pocket costs and implement a $50 cap, ensuring that no matter how a drug is administered, cancer patients can have access to the best possible care at a price they can afford.”
Low income and uninsured women along with state budget costs means that women stay on the waiting list for mammograms too long so if the bill passes it means that these women will get treated for cancer earlier, or receive testing without having to wait for long periods of time.
Kirk Miller, from American Cancer Society announced, “Georgia’s Breast and Cervical Cancer Program (BCCP) provides free pap tests to women aged 21 to 64 and mammograms to women aged 40 to 64 who are uninsured, underinsured, and have income below 200% of the federal poverty level. The Affordable Care Act will provide women with greater access to preventive cancer screenings and treatment; however gaps will still remain for women who are uninsured or underinsured. Since Georgia will not be participating in the Medicaid expansion, more than 266,000 women will not gain access to any affordable health care coverage in 2014.”
Funding plans for the 2015 budget remains at the same level as years before, but if bill goes through it means a quicker response rate for women in Georgia.
“States have an opportunity to provide millions of currently uninsured people nationwide with lifesaving health coverage through Medicaid, and public sentiment in various areas of the country is decidedly in favor of states using available federal dollars to pay for it,” said Chris Hansen, president of ACS CAN, the advocacy affiliate of the American Cancer Society. “If states make that choice, families across the country will have the security of knowing they have access to proven cancer screenings and treatments they otherwise could not afford.”
Governor Deal turned away hundreds of millions of dollars in federal funds to provide low-income Georgians access to health care coverage through the state Medicaid program as provided under the federal health care law. In an effort to further limit the possibility that Georgia would implement this optional provision of the federal health care law, the General Assembly passed legislation, House Bill 990, that prohibits the Governor from expanding eligibility for the state Medicaid program without legislative approval from the House and Senate. The passage of this legislation would have allowed low-income state residents (those earning less than $11,670 per year) to gain access to comprehensive health care coverage, by expanding eligibility for the state Medicaid program. As a result of this new state law, more than 500,000 Georgians will continue to be denied access to affordable and comprehensive health care coverage.
Year after year of the tobacco industry having a strong-hold over the Georgia policies, the Georgia General Assembly, despite the concerns of health advocacy and cancer organizations, passed legislation; house Bill 251, to deny the sales of electronic cigarettes to minors under the age of 18. This was a tobacco industry supported bill that creates a separate product definition for e-cigarettes and other electronic smoking devices, raising serious concerns for how these products are taxed and can be regulated.
Georgia spends less than 1% of its tobacco sales tax revenue on tobacco control- and with the Master Settlement Agreement that was the 1998 agreement between tobacco companies and the states it meant the tobacco industry has had a lock-hold on Georgia policy for years. While the CDC recommends for comprehensive tobacco control programs in Georgia, the 2015 funding levels in the Governor’s budget hasn’t reflected these recommendations- and hinders the state’s ability to reduce youth and adult smoking rates.
If this bill goes through, if Georgia Governor Deal signs it into existence it means that e-cigarettes will be defined as tobacco products. If the bill passes, e-cigarettes will be under local and state evidence-based prevention and control measures.