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.

Access to Health Care Resources:

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.

Since passage of the health care law in 2010 there have been significant changes in health insurance that have protected patients.  This fact sheet provides information on how changes to the health care market have directly affected the United States.

This ACS CAN report focuses specifically on the costs of cancer borne by patients in active treatment as well as survivors.  It examines the factors contributing to the cost of cancer care, the type of direct costs patients pay, and the indirect costs associated with cancer.

Reducing the cancer burden depends on access to meaningful health coverage for all Americans. ACS CAN created an infographic to help illustrate the difference between having access to affordable, adequate coverage and facing barriers to care when facing a cancer diagnosis.

wAmericans who want health insurance but do not have access through a group (like an employer or union) or through a government program (like Medicare or Medicaid) must buy insurance in the individual market.  Current law provides tax credits that help certain individuals purchase this insurance.  The House “American Health Care Act” proposal would dramatically change the tax credits available for purchasing individual market insurance.

ACS CAN submitted this letter to the Secretary of the Department of Health and Human Services about the 2018 Notice of Benefit and Payment Parameters proposed rule.

If you are enrolled in Medicare you have the opportunity – between October 15, 2016 and December 7, 2016 – to renew your existing Medicare Prescription Drug Plan (also known as Medicare Part D).

If you are a person living with cancer or a cancer survivor making sure that the health insurance plan you choose covers the prescription drugs you need is particularly important.

Between November 1, 2016 and January 31, 2017, you may have the opportunity to renew your existing health insurance plan or buy a new plan through the insurance marketplaces.

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:

ACS CAN submitted comments on the ACA market stabilization rule.

In 2014 and 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). We found that high cost-sharing requirements and shortcomings in the transparency of drug formularies imposed significant barriers that could make it difficult for cancer patients to choose and enroll in the plan best suited to their needs. In this updated analysis, which examines 2017 formulary data in Alabama, California, Colorado, Nevada, New Jersey, and Texas, we found coverage transparency has improved since 2015. However, significant barriers remain for cancer patients.

ACS CAN submitted this letter to the Secretary of the Department of Health and Human Services about the 2018 Notice of Benefit and Payment Parameters proposed rule.

A policy analysis and consumer recommendations for State Policymakers, Consumer Advocates, and Health Care Stakeholders.

As the National Association of Insurance Commissioners (NAIC) updated its Managed care Plan Network Adequacy Model Act (Network Adequacy Model Act), ACS CAN filed comments urging the NAIC to adopt policies that would ensure that health plan networks  are sufficient to provide enrollees with acces

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.

Medicare Resources:

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.

If you are enrolled in Medicare you have the opportunity – between October 15, 2016 and December 7, 2016 – to renew your existing Medicare Prescription Drug Plan (also known as Medicare Part D).

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 filed comments on the implementation of the Medicare and CHIP Reauthorization Act.

ACS CAN filed extensive comments expressing deep concern with the proposed Medicare Part B Drug Payment Model and noting that in its proposed form the Part B Drug Model Model failed to protect cancer patients' access to life-saving medications.

ACS CAN filed comments on the Advance Notice of Methodological Changes for calendar year 2017 for Medicare Advantage  capitation rates, Part C and D payment polici

Passing the Removing Barriers to Colorectal Cancer Screening Act (H.R. 1220 and S. 624) would eliminate unexpected costs, and remove the financial disincentives that prevent people from getting their cancer screening.

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.

Health Care Delivery Resources:

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.

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.

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.

Much of the public debate regarding health care reform concerns government-funded health insurance like Medicaid and exchanges, but changing health care laws will also affect the health insurance many Americans get through their employers.  Therefore, any changes to current law must not make it harder for cancer patients and survivors to obtain, afford or use their job-based health insurance.

Medicaid Resources:

The U.S. Senate is currently considering the Better Care Reconciliation Act (BCRA) legislation that could potentially jeopardize the Medicaid program. ACS CAN opposes the BCRA because it threatens access to Medicaid’s health care coverage for millions of lower income cancer patients, survivors, and those at risk for the disease.

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.

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.

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