The Oncology State Societies (OSS) Policy Town Hall, held on September 25, 2024, brought together oncology professionals, lobbyists, and state society leaders to discuss key legislative and advocacy priorities impacting oncology care across the US. The event, featuring presentations from Tammy Jackson Buckner, federal government relations expert for Michael Best Strategies, and Sarah Lanford, associate director for state advocacy at the American Society of Clinical Oncology (ASCO), highlighted the importance of collaborative efforts to improve patient care through policy change. State society leaders and lobbyists from Colorado, Nevada, North Carolina, Texas, and Wisconsin also shared their perspectives on state-level challenges and best practices for advocacy success.

Key Takeaways:

FEDERAL LEGISLATIVE LANDSCAPE

• Bipartisan Support for Cancer Issues: Despite the current political divide in Washington, District of Columbia, there remains significant bipartisan support for cancer research, Medicare funding, and initiatives like the Cancer Moonshot.
• Challenges with Insurance and Medicaid: Ongoing debates around Medicaid expansion, the Affordable Care Act, and surprise billing are central to the health care discussion on the hill. Each political party offers contrasting approaches to health care funding, impacting oncology care access and affordability.
• Pharmacy Benefit Manager (PBM) Reforms: PBM reforms are gaining traction at the local and national levels, as patients and oncologists report difficulties in accessing life-saving medications due to prior authorizations, step therapy, and other barriers.

STATE-LEVEL ADVOCACY

• Prior Authorization Reform: Many states, including Colorado, Minnesota, and Wyoming, have made significant progress in reforming prior authorization processes, reducing the burden on both patients and health care providers.
• Fertility Preservation Bills: Fertility preservation legislation, particularly for oncology patients, has made advances in Hawaii and Minnesota, although these efforts remain ongoing in several states.

2025 LEGISLATIVE PRIORITIES

• PBM Transparency: Several states are preparing for continued efforts to increase transparency and regulate PBMs, especially regarding reimbursement practices for physician-administered drugs.
• Biomarker Testing: Efforts are ongoing to educate and pro-pose legislation in states that have not yet passed the model bill. There is a push to expand biomarker testing legislation beyond oncology to include other diseases, emphasizing the need for comprehensive coverage without restrictive criteria.
• Access to Care in Rural Areas: A recurring theme was the challenge of ensuring oncology patients in rural areas have equitable access to care, especially considering ongoing workforce shortages.

STRATEGIES FOR SUCCESS

• Harness the Power of Patient and Physician Stories: Lawmakers are moved by real-world stories that illustrate the impact of policy on individuals. Personal stories humanize complex legislative issues, such as access to biomarker testing and the impact of PBM policies on patient outcomes.
  • In Action: In Wisconsin, the Wisconsin Association of Hematology and Oncology (WAHO) collected and shared patient testimonies about the negative impact of copay accumulators and PBM practices which helped shift lawmakers’ positions on PBM reform bills.
• Coalition Building for Effective Lobbying: State societies stressed the importance of coalition building, especially with state medical societies, patient advocacy groups, and other health care organizations, to create a unified voice on key issues like PBM reform, white bagging bans, and biomarker testing.
  • In Action: In Colorado, the Rocky Mountain Oncology Society (RMOS) partnered with advocacy groups like the American Cancer Society to advance biomarker testing legislation, which helped increase political momentum behind the bill.
• Utilizing Local Lobbyists: Engaging lobbyists who under-stand the local legislative landscape and have established relationships with lawmakers is critical for advancing oncology- related policies. A local lobbyist can make it easier to navigate political complexities and push forward legislation.
  • In Action: The Nevada Oncology Society (NOS) and the Rocky Mountain Oncology Society (RMOS) recently hired lobbyists who had existing relationships with local policy-makers. This helped to bridge gaps between the states’ medical societies and legislative priorities.
• Collaborating with Other States for Best Practices: Several states, like Minnesota and Wyoming, have successfully implemented prior authorization reforms or copay accumulator bans. Collaborating and sharing these successful models across state societies can help guide advocacy efforts in other regions.
  • In Action: The success of prior authorization reforms in Minnesota served as a model for advocacy groups in other states working toward similar goals.
• Engage Lawmakers Early and Build Long-Term Relationships: Regular engagement with legislators, not just during the legislative session, ensures that oncology advocates stay on their radar. Developing personal, long-term relationships with key lawmakers increases the likelihood that they will champion oncology-related issues.
  • In Action: In Texas, the Texas Society of Clinical Oncology (TxSCO) maintains ongoing engagement with legislators, meeting regularly and building relationships that allow them to influence health care policy in the state.
• Taking Incremental Wins: Advocacy efforts often take multi-ple legislative sessions to yield significant change. Accepting smaller, incremental victories, such as limited reforms, can lay the foundation for larger future successes. Legislators are more likely to support smaller changes initially, which can be built upon in subsequent sessions.
  • In Action: In Nevada, a biomarker testing bill was passed with a limited scope (only oncology), but advocates view it as a stepping stone for broader coverage expansion in future sessions.

The town hall concluded with a call to action for state society members to actively participate in advocacy efforts, leveraging their expertise and patient stories to drive change at the state and federal levels. The outlook for 2025 presents opportunities to address ongoing health care challenges through proactive legislative strategies.

Learn more about or join the policy committee by emailing Lu Anne Bankert at lbankert@accc-cancer.org.

Made possible by support from:

The Oncology State Societies at ACCC is a network of 23 State Chapters that are managed by—and collaborate with—the Association of Cancer Care Centers (ACCC) and are members of the American Society of Clinical Oncology State/Regional Affiliate Program. State Society members receive select benefits from ACCC and valuable state-specific resources to help them stay ahead of the shifting health care landscape and the challenges that directly impact the high-quality care their patients deserve. For more information, visit accc-cancer.org/state-societies or call 301.984.9496. Follow us on Twitter @OSSatACCC.

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