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:

Medicaid is a safety-net health program administered by the states and jointly financed by the states and the federal government. States have used the broad flexibility historically allowed in Medicaid to create many eligibility, coverage, and financing policies that meet the diverse needs of their populations and satisfy state budgets. Thus, benefits have varied considerably by state. 

Medicaid is currently a safety net system that does not serve nearly half of those living under the poverty line. Complex rules limit eligibility to people who fall into certain categories, such as pregnant women, children, the disabled, some parents, and women with breast and cervical cancer.

The U.S. Preventive Services Task Force (USPSTF) is an independent panel of experts charged with reviewing the scientific evidence for clinical preventive services and developing evidence-based recommendations about their delivery.

Approximately 160 provisions in the final health care legislation will directly impact the millions of Americans who have or will face cancer. The following is a list of the most important provisions for the cancer community:

In this 2009 report, the American Cancer Society and the Kaiser family Foundation highlighted the issues cancer patients and survivors face as they try to find and maintain affordable coverage that enables them to access the care they need.

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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:

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.

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.

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

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.

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:

Current federal requirements provide crucial protections that ensure health insurance coverage is comprehensive, not arbitrarily limited, available to all and more affordable.  These protections are especially important for cancer patients, survivors, and those at risk for cancer.  This fact sheet contains a list of the most important provisions in current law for the cancer community.

Provides information on health insurance options, tax credits and subsidies in every state. Consumers may be able to submit an application for health insurance directly through this site.

Provides information about enrolling in Medicare, including Part D prescription drug coverage, what Medicare covers, and how to contact Medicare with questions

Resources and information from the American Cancer Society about understanding health insurance, particularly for cancer patients and survivors.

The American Cancer Society operates a call center available to all cancer patients and their families, that includes resources and specialists who can help patients with questions about health insurance, enrolling in a plan, and issues accessing care.

In 2015 ASCO unveiled a draft framework for assessing value of cancer drugs, requesting feedback.  ACS CAN expressed concern with the approach and provided constructive feedback for improving the final framework.

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 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.

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.

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.