1. Legislative Asks

2. Michigan’s Health Insurance Exchange It is a fundamental principle of the American Cancer Society that everyone should have meaningful public or private health insurance. Meaningful health insurance is adequate, affordable, available and administratively simple

3. Adequate health insurance means: ✔ Timely access and coverage of the complete continuum of quality, evidence-based healthcare services (i.e., rational, science-based, patient- centered), including prevention and early detection, diagnosis, and treatment ✔ Supportive services should be available as appropriate, including access to clinical trials, chronic disease management, and palliative care ✔ Coverage with sufficient annual and lifetime benefits to cover catastrophic expenditures

4. Available health insurance means: ✔ Coverage will be available regardless of health status, or claims history ✔ Policies are renewable ✔ Coverage is continuous ✔ Choice in plans

5. Affordable health insurance means: ✔ Costs, including premiums, deductibles, co-pays, and total out-of-pocket expenditure limits, are not excessive and are based on the family’s or individual’s ability to pay ✔ Premium pricing is not based on health status or claims experience

6. Administratively simple health insurance means: ✔ Clear, up-front explanations of covered benefits, financial liability, billing procedures, and processes for filing claims, grievances, and appeals are easily understood and timely, and required forms are readily comprehensible by consumers, providers and regulators ✔ Consumers can reasonably compare and contrast the different health insurance plans available and can navigate health insurance transactions and transitions

7. Michigan Health Insurance Exchange We need to let our legislators know how cancer patients could benefit from a properly designed Exchange We need to let them our legislators know that we care and are paying attention

8. Legislative Status

9. Legislative Ask #1: Design the state’s Health Insurance Exchange to be Adequate, Affordable, Available, and Administratively Simple.

10. The Challenge we face For the first time in human history, 2/3 of an adult population, and 1/3 of their children are overweight or obese.

11. The Serious Threat to Our Next Generation Mortality: An obese child will likely die up to 14 years younger than one of healthy weight, and obesity in teenagers can be as deadly as smoking cigarettes. Obese children are twice as likely to die by the age of 55 than one of healthy weight. Cost: The average yearly medical cost of an obese child is up to five times than a child of healthy weight.

12. Childhood Obesity Since 1970….. Rates in ages 2-5 have tripled Rates in ages 6-11 have quadrupled Rates in ages 12-19 have tripled Rates in 16 year olds from families with income just above the poverty level surged 233% Highest obesity rates are in areas of highest poverty rates –Adults earning $50,000/yr are at 24% JAMA, Oct 9, 2002 JAMA, May, 24/31, 2006

13. Effects on the Entire Society Academic performance –Kids with healthy weights miss less school, better focused, better academics, fewer behavioral problems¹ Healthcare costs –Obesity-related medical costs are 10% of all annual medical spending, 50% on Medicare and Medicaid² Economic productivity –Businesses are more reluctant to re-locate in areas where the workforce, particularly the future workforce, is unhealthy

14. Schools are an essential part of the solution Through strong school-based policies – including nutrition standards and quality health education and physical education - schools can help students adopt and maintain healthy eating and physical fitness. –The Center for Disease Control reports that PE classes are disappearing from schools nationwide, and as a result schools are increasing the amount of time children’s bodies remain relatively stationary. –Researchers have found that children who were not engaged in a PE program at school gained 1 inch more around the waist and 2 pounds more overall than those that were involved in PE curriculum. –More and more, children’s free time is consumed with sedentary activities like watching television and playing computer games. There is a direct correlation between high levels of “screen time” and obesity.

15. Physical and Health Education ACS supports legislation strengthening K-8 health education and physical education requirements in Michigan schools, outlining specifics for frequency and quality (e.g., standards-based curriculum and certified physical education teachers), of classes. –Nearly 75 percent of state schools already meet adequate requirements for health education and physical education and we need to get the other 25 percent up to that level. –Our proposals, when compared to the recommended guidelines from leading health and education organizations and those adopted by other states, are modest but would be a big step forward to strengthening our already weak state law.

16. No Substitutions  Substitutions and waivers to “opt” students out of physical and health education, through sports, band or other areas, are not acceptable. The focus is not simply for kids to be active, but to be learning how to be active now and for the rest of their lives. Those learning skills are not part of other curriculums or sports clubs.

17. PE (1) for grades K to 5, to provide at least 30 minutes of physical education at least two days each week for the entire school year. (2) for grades 6 to 8, to provide at least 45 minutes of physical education every school day for at least one semester.

18. HE (1) for grades K to 5, require at least 15 hours of health education each school year. (2) for grades 6 to 8, require at least 50 hours of health education each school year.

19. Legislative Status

20. Legislative Ask #2 Support legislation to strengthen K-8 health education and physical education requirements in Michigan schools

21. Dare we ask for more?

22. Review #1 - Design the state’s Health Insurance Exchange to be Adequate, Affordable, Available, and Administratively Simple #2 - Support legislation to strengthen K-8 health education and physical education requirements in Michigan schools #3 -