Access to Health Care

ACS CAN advocates for policies that provide access to treatments and services people with cancer need for their care - including those who may be newly diagnosed, in active treatment and cancer survivors.

Workforce Resources:

These comments submitted to the Institute of Medicine’s Committee on the Governance and Financing of Graduate Medical Education address ways to ensure an adequate and appropriate cancer care workforce to treat cancer patients.

Private Health Insurance Resources:

These comments were submitted by ACS CAN to the U.S. Department of Health and Human Services regarding changes to the template Summary Plan Document that health insurance plans must provide to consumers.

In a letter to the National Association of Insurance Commissioners (NAIC), ACS CAN and other organziations provided specific comments to provide greater consumer protections and improvements to  the NAIC's Health Carrier Prescription Drug Benefit Model Act (Formulary Model Act). 

ACS CAN filed comments on the 2017 Notice of Benefit and Payment Parameters, including issues related to Medicare notices, standardized plan option designs, and network adequacy.

A recent American Cancer Society Cancer Action Network (ACS CAN) analysis of coverage of cancer drugs in the health insurance marketplaces created by the Affordable Care Act has found that coverage transparency has improved somewhat since 2014, but significant barriers remain for

In 2015, the American Cancer Society Cancer Action Network (ACS CAN) analyzed coverage of cancer drugs in the health insurance marketplaces created by the Affordable Care Act (ACA) and found that transparency of coverage and cost-sharing requirements were insufficient to allow cancer patients to choose the best plan for their needs.

ACS CAN filed comments supporting the Internal Revenue Services' proposed clarification requiring plans to provide coverage for physician services and inpatient hospitalization in order to qualify as minimum value coverage.

ACS CAN filed comments on the Medicare CY2016 Physician Fee Schedule, supporting CMS' proposals to establish a separate payment for collaborative care services and provide reimbursement for advanced care planning services.

ACS CAN provided comments on the proposed rule implementing changes to the Summary of Benefits and Coverage (SBC) and the Uniform Glossary in which we urged the Tri-Agencies to include a high-cost coverage example (specifically a breast cancer example) in the SBC, to require the inclusion of prem

Medicare Resources:

On January 16, 2018, ACS CAN filed comments in response to CMS’ proposed rule implementing changes to the Medicare Part C and Part D programs. ACS CAN commented on a number of proposed policies:

ACS CAN submitted comments regarding the Centers for Medicare and Medicaid Services' Survey called Innovation Center New Direction.

ACS CAN submitted comments supporting CMS' propsoal related to CMS' laboratory date of service policy.

In our comments on the CY 2018 Medicare Physician Fee Schedule proposed rule, ACS CAN expressed support for CMS’ proposed changes that would allow federally qualified health centers to provide more care coordination, and urged CMS to provide even more flexibility than proposed.

This factsheet discusses the value of screening and how it saves lives. Unfortunately, seniors on Medicare currently are responsible for a 20% coinsurance if a polyp is detected and removed during a screening colonoscopy.

The Medicare program covers 55.3 million people, including 46.3 million who qualify due to age and 9 million people who qualify on the basis of a disability.  Medicare beneficiaries - including many cancer patients and survivors - have access to an outpatient prescription drug benefit that provides them with prescription drugs needed to treat their disease or condition.  This benefit – and keeping it affordable – are crucial to any health care system that works for cancer patients and survivors.

In response to CMS’ calendar year 2017 Medicare Physician Fee Schedule proposed rule, ACS CAN filed comments supporting the proposal to expand the Diabetes Prevention Program (DPP) Model as a new Medicare preventive service because many of the interventions included in the DPP will also help bene

In response to CMS’ calendar year 2017 Medicare Hospital Outpatient Prospective Payment System proposed rule, ACS CAN filed comments suggesting changes to the Medicare and Medicaid Electronic Health Record Initiative programs and urged Medicare to develop better survey questions that seek to meas

ACS CAN, the American Heart Association, the American Diabetes Association released a joint statement providing principles for any entitlement reform proposal.

Disparities Resources:

Hispanic/Latina women have the highest incidence of cervical cancer compared to other races/ethnicities. In 2015 approximately 2,000 Hispanic/Latina women in the U.S. were expected to be diagnosed with cervical cancer and 600 were expected to die from the disease. This factsheet discusses the cervical cancer health disparities found in Hispanic/Latina women and way to reduce this disparity.

 

Breast cancer is the second leading cause of cancer deaths among women in the United States. African American women have the highest death rate of all racial and ethnic groups, and are 42 percent more likely to die of breast cancer than white women. This factsheet discusses breast cancer disparities in African American women and solutions to help reduce this disparity. 

On November 10, 2015, ACS CAN hosted the first National Summit on Health Equity in St. Louis, Missouri.

The National Institutes of Health (NIH) and the National Cancer Institute (NCI) are the foundation of our national  cancer research program and support research in every state. Today, that program is making remarkable progress in every area of discovery to improve cancer prevention, early detection, treatment, and care.

Health Care Delivery Resources:

Many patients with complex diseases like cancer find it difficult to afford their treatments – even when they have health insurance.  Current law establishes a limit on what most private insurance plans can require enrollees to pay in out-of-pocket costs.  These limits protect patients from extremely high costs and are essential to any health care system that works for cancer patients and survivors.

 

The Affordable Care Act (ACA) helps individuals with limited incomes afford their health care coverage by
providing cost-sharing subsidies (like deductibles, coinsurance, and copayments) for silver-level plans
purchased on the health insurance marketplaces. Currently, Congress and the administration are
debating whether to continue funding these cost-sharing reduction subsidies (CSRs). If CSR subsidy
funding is discontinued, health care costs could increase for all marketplace enrollees – regardless of
whether the enrollee qualifies for the CSRs.

This report explores the experiences of cancer patients with their health insurance and financial challenges through interviews with hospital-based financial navigators. The report finds that while the Affordable Care Act has brought crucial improvements to patient access to health insurance, cancer patients still face serious challenges affording their care and using their insurance benefits.

Section 1332 of the Affordable Care Act (ACA) allows states to apply for waivers to experiment with different ways of providing and paying for health care.  These waivers are often referred to as “Section 1332 waivers,” or “state innovation waivers.”  It is important for the cancer community to fully understand how Section 1332 waivers could impact cancer patients and survivors

Congressional efforts to repeal and replace the Affordable Care Act have included additional funding in an effort to stabilize state individual insurance markets.  The funding level proposed is inadequate, as discussed in more detail in this backgrounder.

Numerous provisions of H.R. 1628, the American Health Care Act (AHCA), would adversely impact access to adequate and affordable health insurance coverage for cancer patients and survivors.

On April 25, 2017, the text of an amendment to the American Health Care Act (AHCA) to be offered by Representative MacArthur (R-NJ) was released.  The amendment could undo several key protections that are critical for cancer patients and survivors – including the prohibition on pre-existing condition exclusions.

As Congress debates enacting changes to the health care market, one concept re-emerging is state high-risk pools to provide health insurance coverage for individuals who otherwise cannot obtain or afford coverage. High risk pools are not a new concept. Prior to the enactment of the Affordable Care Act (ACA) many states operated some form of high risk pool. During implementation of the ACA, a federal high risk pool was established as an interim step to the new marketplaces. The overall success of high risk pools varied. This fact sheet examines how state risk pools work and the impact on persons with cancer and cancer survivors.

The current health care law has several provisions that help ensure children with cancer have access to quality treatment and care, and that survivors of childhood cancer are able to obtain and maintain affordable health insurance.  These provisions and protections are essential in any health coverage system that intends to provide meaningful care for pediatric cancer patients and survivors.

Medicaid Resources:

A Section 1115 Demonstration Waiver gives states flexibility to design and improve upon their Medicaid programs through pilot or demonstration projects.

A Section 1115 Demonstration Waiver or Amendment gives states flexibility to design and improve upon their Medicaid programs through pilot or demonstration projects.

A Section 1115 Demonstration Waiver gives states flexibility to design and improve upon their Medicaid programs through pilot or demonstration projects.

A Section 1115 Demonstration Waiver gives states flexibility to design and improve upon their Medicaid programs through pilot or demonstration projects.

Medicaid is the health insurance safety-net program for lower income Americans. Currently, 64 million people – many of whom are cancer patients and survivors – rely on Medicaid for affordable health care coverage.

ACS CAN, the American Heart Association, the American Diabetes Association released a joint statement providing principles for any entitlement reform proposal.

ACS CAN, the American Heart Association, the American Diabetes Association released a joint statement in support of the Medicaid program, noting that any reforms should improve the value of care provided under the program and should not reduce access for Medicaid beneficiaries.

ACS CAN, the American Heart Association, the American Diabetes Association released a joint statement providing principles for any entitlement reform proposal.

ACS CAN joined together with the American Diabetes Association, American Lung Association and Families USA to highlight the importance of Medicaid for patients with chronic diseases.