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National Win for Student Loan Borrowers Diagnosed With Cancer + Other State Updates

In an effort to keep you up to date on proposed and actual changes to our health care system and other hot topics in the law, here is our federal and state update:

National News:

  • The U.S. Department of Education (DOE) has finally released a form to apply for student loan assistance, based on a law that passed last year (P.L. 115-245). Federal direct student loan borrowers who are undergoing active cancer treatment may defer repaying those loans for the duration of treatment and for 6 months afterward. Interest does not accrue on those loans. Click here to complete the form.
  • The U.S. Department of Agriculture, issued a proposed rule that changes the eligibility for the Supplemental Nutritional Assistance Program (SNAP), more commonly known as food stamps. Nearly 38 million Americans get assistance with buying food through SNAP. The proposed changes will remove 3 million people from the program, by lowering the household income level to be eligible for these benefits.
  • Health care sharing ministries are membership organizations, where members agree to share one another’s health care costs. Members typically make monthly payment stop cover expenses of other members; however, these ministries are not health insurance, they do not have to comply with consumer protections in the ACA, and there are no guarantees that all medical bills will be covered. Over the last few weeks, insurance agencies in a few states have warned consumers about these ministries, based on complaints that they have been receiving from consumers.Washington State Insurance Commissioner Mike has ordered Aliera, which operates Trinity Healthshare Inc., to halt operations in Washington, alleging the firm was selling health insurance illegally and engaging in deceptive business practices.

California:

  • California’s Governor signed a new budget, which included a number of benefits for seniors and people with health needs, including:
  • In 2020, the federal poverty level (FPL) for seniors and people with disabilities who are eligible for Medi-Cal (CA’s Medicaid program) will go up from 100% to 138% of FPL. This means that approximately 27,000 more seniors and people with disabilities will be eligible for Medi-Cal.
  • For people who get services through Medicaid’s In-Home Support Services (IHSS) program, the budget restored a previous 7% cut to funding, through December 31, 2021
  • In 2020, optical, audiology, podiatry, speech therapy, and incontinence creams and washes will be covered by Medi-Cal for the first time since 2009. But coverage is only guaranteed through December 31, 2021.
  • Unfortunately, the budget did not restore recession-era cuts to the State Supplementary Program (SSP) for Supplemental Security Income (SSI).

Connecticut:

Governor Ned Lamont signed a bill that creates a paid family and medical leave program that will provide up to 12 weeks of paid leave when workers need to take time away to care for themselves or a seriously ill family member, or to welcome a new child. Workers at employers of all sizes will be able to take this leave, after working for an employer for three months. This program will begin in 2022.

Delaware:

Governor John Carney signed a bill that protects patients from step therapy exceptions imposed by insurance companies and a bill that prohibits insurers and pharmacy benefit managers from charging patients a co-pay if the medication retail cost is cheaper.

Maine:

Governor Janet Mills signed into law three bills to expand health consumer protections in the state:

  • Provides step therapy exceptions and establishes a set of timelines for determining patient appeals.
  • Establishes prior authorization review timelines. If the timelines are not met, the coverage is automatically granted.
  • The Peer Medical Review bill, requires an appellate review on an adverse coverage decision to be conducted by a licensed health care practitioner who is board certified in the same practice area as the adverse decision.

New Hampshire:

Republican Governor Chris Sununu signed a bill, which codifies many of the ACA’s consumer protections as New Hampshire state law.  Vermont’s Republican Governor, Phil Scott, signed similar legislation this summer.

New Jersey:

Questions swirling around the workplace implications of medical marijuana use by employees and applicants in New Jersey have finally been answered, as New Jersey Governor Phil Murphy recently amended The New Jersey Compassionate Use Medical Marijuana Act. In its original draft, the law stated that it did not require an employer “to accommodate the medical use of marijuana in any workplace.” As you can imagine, this proves to be controversial for anyone using medical marijuana to treat the pain that arises from cancer treatment.

  • The law as amended has been renamed the Jake Honig Compassionate Use Medical Cannabis Act. The two important amendments include:
  • Adverse Employment Actions Prohibited: Prohibits employers from taking any “adverse employment action” against an employee who is a “registered qualifying patient” based “solely on the employee’s status as a registrant with the commission.” A “registered qualifying patient” is an individual who both (1) has been authorized by a health care provider for the medical use of cannabis, and (2) has registered with the state’s Cannabis Regulatory Commission.
  • Right To Explain Drug Test Results: If an employee tests positive for marijuana after a drug test, they will now have the opportunity to explain these positive test results and provide proof of authorization by a health care professional to use medical marijuana.

New Jersey:

A state appeals court has ruled that New Jersey can move ahead with a new law allowing terminally ill patients to seek life-ending drugs, overturning a lower court’s temporary hold on the law.

Oregon:

Oregon has become the eighth state to approve a paid family and medical leave bill. Oregon Governor, Kate Brown signed into law H.B. 2005, which creates a state insurance fund that provides workers paid family and medical leave. The bill would provide workers:

  • 12 weeks paid leave to deal with family, medical, or domestic violence issues.
  • Women with pregnancy complications would get an additional two weeks.
  • Individuals who earn 65% or less of the state’s average weekly wage would receive a 100% wage replacement. A formula would be used to determine exactly how much those individuals would receive.
  • Benefits will not be paid out under this program until 2023.

Governor Brown also signed legislation that removes the 15-day waiting period previously required under the state’s death with dignity law. For more information on death with dignity laws, read this blog.  

Texas:

Beginning this month, Dallas employers are now required to provide their employees with paid sick time. Austin and San Antonio have also approved paid sick leave laws, but the laws are being challenged in court.  The Dallas ordinance requires one hour of paid sick leave for every 30 hours an employee works. Workers are able to accrue up to 64 hours of paid sick leave each year. For employers with fewer than 15 workers, the amount would be capped at 48 hours, or six paid sick days.

Samantha Skelton
ss@triagecancer.org