Dear Hepatitis Health Action Members:
As a policy intern for Project Inform, I volunteered to reach out to our community of viral hepatitis advocates to encourage them to join our campaign. I started with an outreach effort inviting support group facilitators, members, and friends and colleagues to join this action group. The results of that effort have been immensely productive.
We are now over 100 members and a lot of interest is circulating around how health care reform legislation can improve the lives of people living with and at risk for hepatitis B and/or C. With the help of our advocacy partners, we successfully organized our first webinar. The feedback has been tremendously positive.
However, as you may know there is a continual battle to defend and implement this law and we need your help. In order to make an impact, we need more members engaged in this work. Great movements can happen in numbers so please join us in reaching out to friends of friends, families, and communities alike that may benefit from this group. Ask them to join our Facebook group and our listserv. People can sign up by emailing firstname.lastname@example.org.
Thank you for taking the moment to read this piece. Stay informed and make sure others are too!
Relatively little is known about the health insurance status of people living with hepatitis C and its impact on access to treatment. A new study in the respected journal Hepatology examined these issues using data from the National Health and Nutrition Examination Survey (NHANES), a large household survey overseen by the Centers for Disease Control and Prevention (CDC).
Here’s the abstract for the study:
Hepatology. 2010 Dec 17. doi: 10.1002/hep.24131. [Epub ahead of print]
Insurance status and treatment candidacy of hepatitis C patients: Analysis of population-based data from the United States.
Stepanova M, Kanwal F, El-Serag HB, Younossi ZM.
Center for Liver Diseases at Inova Fairfax Hospital, Falls Church, VA; Betty and Guy Beatty Center for Integrated Research, Inova Health System, Falls Church, VA.
Successful treatment with antiviral therapy could potentially reduce morbidity and mortality in patients with hepatitis C virus (HCV) infection. However, at the population level, these benefits may be offset by a limited number of patients who have access to antiviral treatment. Using data from the National Health and Nutrition Examination Survey conducted in 2005-2008, we analyzed the health insurance status and treatment candidacy of HCV-positive (HCV+) individuals. A total of 10,582 subjects were examined; of those, 1.16% had detectable HCV RNA and were defined as HCV+. The HCV+ patients were less likely to be insured than HCV-negative individuals (61.2% versus 81.2%; P = 0.004). Among those with health insurance, HCV+ patients were less likely to have private insurance, whereas the coverage by Medicare/Medicaid and other government-sponsored plans was similar to the rest of the population. In multivariate analysis, HCV infection was an independent predictor of being uninsured even after adjustment for demographic disparity of the HCV+ cohort (odds ratio, 0.43; 95% confidence interval, 0.24-0.78). Of all HCV+ patients, 66.7% were eligible for anti-HCV treatment. However, only 54.3% of HCV+ treatment candidates had any type of insurance coverage. Finally, only 36.3% of HCV+ patients were potentially eligible for treatment and had health insurance. Conclusion: A high proportion of HCV+ patients are currently uninsured, and many have publicly funded health insurance. Among those who could be candidates for treatment, the rate of insurance coverage is even lower. These findings can have important implications for health insurance coverage of these patients under the new health care reform legislation in the United States.
The study had several other significant findings:
- People with hepatitis C were more likely to report histories of substance use (alcohol, smoking, marijuana, opiates or methamphetamine)
- People with hepatitis C were nearly three times more likely to report a visit to a mental health specialist in the past year
- People with hepatitis C were more likely to report depression, arthritis, and chronic obstructive pulmonary disease (COPD)
- A history of cocaine, heroin, or methamphetamine use was independently associated with uninsurance.
In their discussion of the results of the study, the authors conclude:
We also found that HCV+ individuals without health insurance were more likely to report history of alcohol abuse and were less likely to be educated than insured. It is plausible that the high prevalence of social comorbidity and lack of education may still hamper treatment acceptance and initiation among individuals after they are diagnosed with HCV infection. To make any impact on the burden of HCV and to cover the gap between efficacy and effectiveness, not only more individuals need to be screened for and diagnosed with HCV, but more focus is needed on HCV-related social services and education—comprehensive HCV care that may be best delivered through medical homes using the chronic care model approach….
…In conclusion, a high proportion of HCV+ individuals in the United States are currently uninsured, and many have publicly funded health insurance. Among those who could potentially be candidates for treatment, the rate of insurance coverage is even lower. Although newer treatment regimens with direct acting antivirals may increase efficacy, it will certainly increase the costs of antiviral treatment in HCV—thus further limiting access to treatment for the uninsured/underinsured. This issue of access to care for HCV patients is critical and must be considered by policy makers. We believe that our results can have important implications for health insurance coverage of HCV-infected patients and should be considered under the new health care reform legislation.
Health Care Reform Is Under Attack Again
Tell Your Representative to Oppose Defunding of Health Reform Implementation
The Affordable Care Act (ACA), landmark health care reform legislation signed into law last year, has great potential to improve the lives of people living with and at risk for hepatitis B and/or hepatitis C. Starting in 2014, many low-income, uninsured people will be able to get health care and treatment through an expanded Medicaid program and those with higher incomes now have access to private insurance because the ACA eliminated the ‘pre-existing conditions’ clauses enabling everyone to access health insurance regardless of their health status. The benefits of the ACA are only just beginning but will increase over the next few years, helping more people with hepatitis B and C to get the care and treatments they need.
However, this legislation is under attack by Republicans in the House of Representatives who want to repeal the bill and deny millions of uninsured people the chance to have regular health care. Even though their efforts to fully repeal the legislation failed in the Senate, they are now attempting to block funding in this year’s spending bill for activities to implement health reform. Without this funding, implementation could become stalled – meaning it will be even longer before people in need get care and treatment to stay healthy and productive.
Your help is needed this week to defend against this latest attack on health reform!
What you can DO:
Please call your U.S. House Representative before Thursday, February 17th. We are hearing directly from Congressional staff that phone calls are the most effective form of communication.
Call the Capitol Switchboard toll-free at 1-888-876-6242 and ask to be connected to your Representative. When you reach your Representative’s office, tell whoever answers the phone that you are a constituent and that you would like to speak to the staff person who handles health care issues. Whether you speak to the staff person live or leave a voicemail, tell him/her:
“My name is _______________ and I live in (city/state). I am calling to urge Representative ____________ to vote against any attempts to take funding away from implementing the Affordable Care Act. I firmly support the Affordable Care Act because it will help many uninsured people with viral hepatitis get the health care and treatment they need to be healthy and productive. I urge you to support full implementation of this important legislation.”
Thank you for taking the time to make a difference! Please spread the word.
Stay involved with Hepatitis Health Action!
· Join Hepatitis Health Action’s Facebook group to participate in discussions with other advocates and share your ideas and strategies.
· Follow this blog blog for Hepatitis Health Action news and commentary.
Hepatitis Health Action is a new campaign led by viral hepatitis advocates working to make sure that health care reform addresses hepatitis B and C.
Welcome to the launch of Hepatitis Health Action: The Hepatitis Community Responds to Health Care Reform! Hepatitis Health Action is a new campaign led by viral hepatitis advocates working to make sure that health care reform addresses hepatitis B and C.
Health care reform has the potential to increase access to health care and treatment for many people with hepatitis B and C who are currently uninsured or who are having trouble getting their current insurance provider to pay for necessary services and care. Health care reform could also be a new source of funding for viral hepatitis prevention programs and hepatitis B and C screening.
Most new benefits won’t become available until 2014, but there is a lot of activity going on right now to establish what care and treatment services will be covered under Medicaid expansion and new private insurance exchanges. We must be ready to respond and provide input as a community when these decisions are being made. This new campaign will make sure our voices are heard. The more we get involved, the more likely it is that health care reform will meet the needs of people living with or at risk for hepatitis B and C.
Hepatitis Health Action will:
1. Provide information about health care reform legislation, how it affects the viral hepatitis community, and the process that the government is taking to implement the law.
2. Collect input on viral hepatitis concerns during “public comment” periods offered by the government as it makes decisions on benefits and services provided through health care reform.
3. Send Action Alerts with ways to communicate with your members of Congress and other public officials to defend health care reform from being repealed or weakened.
4. Advocate for funding in the bill to be directed to viral hepatitis prevention programs.
5. Build a movement to make sure that people living with and at risk for hepatitis B and C are not forgotten when crucial decisions are made.
Get involved with Hepatitis Health Action!
• Join Hepatitis Health Action’s Facebook group, where you can participate in discussions with other advocates and share your ideas and strategies.
• Follow Hepatitis Health Action’s blog here for news and commentary.
Thanks for joining with us in this campaign!Together, we will make sure that health care reform works for people with hepatitis B and C!
Hepatitis B Fellow, Association of Asian Pacific Community Health Organizations (AAPCHO)
Policy Director, Harm Reduction Coalition
Director of Public Policy, Project Inform and Steering Committee Member, National Viral Hepatitis Roundtable
Policy Intern, Project Inform