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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.

Private Health Insurance Resources:

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.

This analysis examines two issues of particular interest to the American Cancer Society Cancer Action Network (ACS CAN) and its members: the extent of coverage and cost-sharing for cancer drugs, and whether information on the coverage of cancer drugs can be readily obtained, compared, and understood by patients.

This report highlights the severe challenges cancer patient may face in paying for life-saving care even when they have private health insurance.

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Costs and Barriers to Care Resources:

Our latest survey finds that protecting no-cost screenings and preventive care and reducing the burden of medical debt are the most impotant priorities for cancer patients and survivors. This survey also explores the impacts of cancer on food and nutrition insecurity, with impacts felt across income groups and coverage levels.

ACS CAN teamed up with the Leukemia and Lymphoma Society and RIP Medical Debt to conduct a national survey on the impacts of medical debt and high health care costs. Read a summary of the results.

ACS CAN partnered with the Leukemia and Lymphoma Society and RIP Medical Debt to conduct a national survey on the impacts of medical debt and high health care costs. Read the full results.

Medical debt impacts many people with cancer, their caregivers and their families. This factsheet details this impact and explores policy solutions to prevent medical debt and minimize its impact on health, quality of life and financial health.

Short-term limited duration (STLD) insurance plans do not provide the kind of comprehensive insurance coverage cancer patients need.  These plans were designed only as temporary coverage and are not subject to the same Affordable Care Act (ACA) requirements as other health insurance products on the market.  As a result, an enrollee who was attracted to the plan’s lower premiums may find – if they are diagnosed with a serious illness like cancer – that the plan does not cover all of their necessary cancer treatments.  In these cases, the consumer can be left with catastrophic costs.

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.

 

A majority of cancer patients and survivors struggle to afford cancer care and over 80% have had to make financial sacrifices to cover their health care expenses. This survey also reveals ways that affordability concerns can negatively impact care and treatment, and explores issues related to prescription drug coverage and pain management options.

In these comments, ACS CAN strongly supports Congress’ and the Administration’s efforts to protect patients from surprise medical bills and we are encouraged by the important steps this interim final rule takes. Specifically, we applaud the Departments’ proposed policies related to:

High deductible health plans (HDHPs) and health savings accounts (HSAs) are becoming more common in employer-sponsored insurance and the individual and small group markets.  These types of plans have risks and features must be implemented carefully so they do not harm cancer patients, survivors or those at risk for cancer.

Medicaid Resources:

ACS CAN submitted comments opposing Tennessee's proposal to fund its Medicaid program through a block grant and implement a closed formulary.

ACS CAN comments supporting Medicaid expansion in Oklahoma, but opposing their proposal to rescind retroactive eligibility

An increasing number of states are seeking greater flexibility in administering their Medicaid programs. The Department of Health and Human Services (HHS) and the Centers for Medicare and Medicaid Services (CMS) give states the opportunity to test innovative or alternative approaches to providing health care coverage to their Medicaid populations through Section 1115 Research and Demonstration Waivers (otherwise known as "1115 waivers"). States must demonstrate that their waivers promote the objectives of the Medicaid and Children’s Health Insurance Programs (CHIP) and CMS must use general criteria to determine whether the objectives of the Medicaid/CHIP programs are met.

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