Heart on the Hill - October 2018

American Heart Association Joins Other Patient Groups in Support of ACA Patient Protections

In February, Republican attorneys general from 20 states filed a lawsuit against the federal government challenging the constitutionality of the Affordable Care Act (ACA). The lawsuit, filed in the U.S. District Court of Northern Texas, argues that because Congress repealed the requirement that individuals must obtain health insurance (also called the individual mandate), the ACA is unconstitutional. States that joined the lawsuit include Texas, Wisconsin, Alabama, Arkansas, Arizona, Florida, Georgia, Indiana, Kansas, Louisiana, Maine, Mississippi, Missouri, Nebraska, North Dakota, South Caroline, South Dakota, Tennessee, Utah, and West Virginia.

The case, also referred to as referred to as Texas v. U.S., poses a serious threat to the ACA’s patient protections. If the ACA is ruled unconstitutional, nearly 20 million people enrolled in marketplace plans could lose their health coverage. Provisions that guarantee coverage for people with pre-existing conditions, prevent people from being charged more for coverage because of their health status or gender, and ensure that plans cover essential health benefits could be eliminated.

The association understands that individuals and families with cardiovascular disease, stroke and other pre-existing conditions rely on these and other protections to help them obtain access to comprehensive, affordable health coverage. That’s why the association, along with 10 other patient organizations, joined an amicus (or friend-of-the-court) brief urging the court to uphold the ACA and acknowledge the clear intent by the Congress to provide access to life-saving health care for millions of Americans.

The AHA also has weighed in on another federal lawsuit that threatens patient access to comprehensive care. The association and other patient groups joined an amicus brief in the case of Association for Community Affiliated Plans v. United States, which seeks to invalidate the administration’s recently finalized rule on short-term, limited-duration insurance (short-term) plans.

The association opposes the expansion of short-term plans because they are not required to provide all of the essential health benefits or offer the same patient protections as ACA-compliant plans. Under the rule finalized this summer, insurers selling short-term plans would be allowed to charge women more, exclude coverage for pre-existing health conditions, retroactively rescind coverage and engage in other discriminatory practices.

The suit is led by the Association for Community Affiliated Plans (ACAP) and was joined by the National Alliance on Mental Illness (NAMI), AIDS United, the American Psychiatric Association (APA), Little Lobbyists, Mental Health America and the National Partnership for Women & Families.

Contact: Katie Berge

Senators Introduce Legislation that Falls Short of Protecting Patients

A group of Republican senators has introduced the Ensuring Coverage for Patients with Pre-Existing Conditions Act (S.3388), which they assert will protect patient access to health coverage if the ACA is struck down in the courts. Led by Senator Thom Tillis (R-NC), the legislation would not provide the full range of patient and consumer safeguards included in the ACA and could have serious implications for insurance markets and the millions of patients who rely on them.

In September, the association, in coordination with 32 other patient organizations, sent a letter to lawmakers expressing our concerns about the legislation and our willingness to work with Congress to develop alternative that would fully protect patients if the law is struck down in the courts.

Contact: Katie Berge

An Unclear Path Forward for the Farm Bill

This summer, the Senate and House passed starkly different versions of the farm bill. The Senate legislation preserves access to benefits for vulnerable populations, including children, the elderly and the disabled and strengthens the integrity and accountability of the Supplement Nutrition Assistance Program (SNAP).

Unfortunately, the House legislation would cut benefits and kick millions of people off SNAP. The House version would also reduce funding for nutrition -education and undermine the integrity of the Fresh Fruit and Vegetable Program (FFVP). While there is language in both bills supporting the Food Insecurity Nutrition Incentives (FINI) program and improving the Electronic Benefits Transfer (EBT) system, neither bill goes far enough in addressing improving diet quality.

After more than a month of negotiations, a House-Senate conference committee was unable to reach consensus and the authorization expired Sept. 30. Mandatory programs, including SNAP, will continue, but discretionary programs, like FINI, will require an extension of current funding to avoid running out of money.

Key lawmakers continue to negotiate a final product,  and have also began discussions for an extension of current farm bill law coupled with funding for discretionary programs. However, a long-term solution for the farm bill remains elusive and a path forward will very likely be determined by the outcome of the November election.

The association will continue to advocate for policies that provide access to healthy and affordable food during these ongoing negotiations.

Contact: Kristy Anderson

NIH Funding Boost a ‘Triumph’ for Patients

In late September, President Trump signed a bill into law that funds the U.S. Departments of Labor, Health and Human Services, Education and other federal agencies for fiscal year 2019. This marks the first time in 22 years that Congress has sent the Labor-HHS bill to the president’s desk  before the October 1 fiscal year deadline.

This legislation allocates funding for research-focused institutions, including the National Institutes of Health (NIH) and the Centers for Disease Control and Prevention (CDC).

In a triumph for patients, the law increases NIH funding by $2 billion, or 5.4 percent. It is the fourth straight year Congress has increased the research budget at NIH.

Unfortunately, important programs at the Centers for Disease Control and Prevention (CDC), including the Division for Heart Disease and Stroke Prevention, Million Hearts 2022 and WISEWOMAN received level funding.

Robust, predictable, and sustained funding for the NIH and CDC opens an abundance of possibilities for curing and preventing cardiovascular disease.

Contact: Claudia Louis

Agricultural Appropriations Negotiations Continue on Capitol Hill

In recent months, the Senate and House Appropriations Committees passed their respective agriculture funding bills. Both bills included language the association opposes related to voluntary sodium targets and the Supplemental Nutrition Assistance Program (SNAP) retailer stocking standards rule.

The House bill further undermines nutrition policies by including language related to the Dietary Guidelines for Americans (DGAs) and nutrition facts labels. On the positive side, both bills contained funding for the upcoming update to the DGAs.

Lawmakers were unable to reconcile the two bills before September 30, the end of the federal fiscal year. However, Congress passed an extension of current law through December 7 to ensure that funding for these programs continue. The House and Senate will consider this bill again when they return after the November elections.

The association believes Congress must make nutrition a priority. We will continue to push for agriculture appropriations legislation that strongly supports robust nutrition policies.

Contact: Kristy Anderson

A Healthy, Well-Rounded Education Includes Physical Activity

Last month, Congress passed the Labor, Health and Human Services, and Education funding bill which includes Title IV, Part A education grants, also known as the Student Support and Academic Achievement grants.

Title IV, Part A is a grant program authorized under the Every Student Succeeds Act, which provides grants to all Title I schools for well-rounded education, safe students, and technology improvements for the school; physical education is eligible under all three criteria. The grant program received a slight boost this year, up from $1.1 billion in FY 2018 to $1.17 billion in FY 2019.

However, this funding is still below the authorized levels of $1.65 billion. The association will continue to advocate for full funding for this vital program, so participating schools can provide children with a healthy, well-rounded education.

Contact: Kristy Anderson