Pre-Existing Condition Resolution; Teen Vaping; Drug Pricing Talks

January 21, 2019 by Chris Pirschel ONS Staff Writer/Producer, and Alec Stone MA, MPA, Former ONS Director of Government Affairs and Advocacy

Debates like the one facing the constitutionality of the Affordable Care Act (ACA) are what American democracy is built on. Checks and balances for each branch of government—often with authority undulating back to state governments—provide numerous opportunities for policy issues to change and develop through legislative, regulatory, and judicial review. Recently, U.S. Senator Patty Murray (D-WA) and Senator Maria Cantwell (D-WA) have reintroduced a resolution that authorizes Senate Legal Counsel to defend Americans (https://www.murray.senate.gov/public/index.cfm/newsreleases?ContentRecord_id=868F1572-FA98-4B0C-B2DA-57AF39BCDC03) with preexisting conditions against a Republican Attorneys General lawsuit facing the ACA.

The Senate committee’s recent resolution defending preexisting conditions is just another form of the ongoing democratic process. National polling indicates that most Americans are in favor of preexisting condition coverage (https://voice.ons.org/advocacy/pre-existing-conditions-overcharging-prescription-drugs-opposing-medicare-for-all). The lawsuit seeking to strip this legislative right is petitioning the court to recognize that the basis of the ACA was the individual mandate (https://voice.ons.org/advocacy/government-shutdown-aca-ruled-invalid-medicare-for-all-push), and, without that, the rest of the law is therefore unconstitutional. It’s a dangerous game for both sides with the health of the American public in the middle. The lawsuit will likely make its way to the Supreme Court and back to Congress. This debate is still a long way from over.

Data outlining the effect of traditional tobacco use on teenagers spans decades. However, the effects of vaping are still relatively unknown. According to recent reports (https://www.cnn.com/2019/01/17/health/vaping-ecigarettes-kids-teens-brains-fda/index.html), vaping could impact the young adult population in totally different ways than tradition tobacco use. The vaping problem seems to be growing. Recently, the U.S. Food and Drug Administration made headlines by accusing the e-cigarette manufacturer Juul (https://voice.ons.org/advocacy/short-term-insurance-plans-fda-curbs-youth-vaping-drug-cost-legislations) of foregoing its promise to curb teen vaping. Juul has been in the news for creating nicotine pods that are flavored and marketed in ways that make them more appealing to younger smokers.

With an uptick in usage by kids, vaping has jumped to the top of the smoking cessation policy agenda. Originally intended as a step-down therapy, e-cigarettes have expanded in the youth marketplace in a field that was previously seeing a decrease in users. If the medical community can demonstrate that vaping has the negative impact many believe it does, then a concerted effort may help state and federal regulators strengthen oversight of the new technology. Tobacco control and smoking cessation are key policy issues for ONS (https://www.ons.org/make-difference/ons-center-advocacy-and-health-policy/position-statements/isncc-tobacco-position), a specialty area where oncology nurses can lead the way and share their expertise with legislators (https://voice.ons.org/news-and-views/oncology-nurses-are-vital-to-tobacco-control-and-smoking-cessation-efforts-worldwide).

The Trump administration—along with Democrats in the House—recently suggested a drug pricing plan that would base U.S. medication costs on what pharmaceutical companies are charging patients in other countries (https://voice.ons.org/advocacy/short-term-insurance-plans-fda-curbs-youth-vaping-drug-cost-legislations). According to the White House, this would effectively level the playing field. However, some Republicans are skeptical of the tactic and concerned about the influence (https://thehill.com/policy/healthcare/425709-hhs-secretary-meets-with-senate-finance-republicans-on-drug-pricing) that other companies and foreign countries might have by being able to manipulate the American market. Ultimately, many elected officials believe that there must be a reasonable basis found to justify the costs of life-saving drugs.

If the pharmaceutical industry doesn’t step in soon, this new Congress—filled with outspoken officials who aren’t waiting for incremental change—could take more draconian measures to curb the soar costs. Oncology nurses are vital to the conversation (https://voice.ons.org/advocacy/get-involved) and can share the experiences of patients with cancer suffering the burden of financial toxicity (https://voice.ons.org/news-and-views/financial-toxicity-and-its-burden-on-cancer-care).

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