Centers for Medicare and Medicaid Services (CMS) issued guidance allowing states to require “able-bodied” adults to work, participate in job training or volunteer in order to receive Medicaid health benefits. As part of the guidance, CMS exempts those who are deemed, “medically frail,” however the guidance does not clearly define who would be considered medically frail.
ACS CAN Expert Testifies About Proposed Health Care Changes in Graham-Cassidy Bill
Senate Finance Committee Holds Hearing on Legislation to Dramatically Altering Patient Access to Adequate, Affordable Insurance Coverage
Washington, D.C. — September 25, 2017 — Changes to the nation’s healthcare system as proposed in the pending Graham-Cassidy health legislation could leave millions of cancer patients and survivors without access to adequate, affordable health insurance coverage, according to Dick Woodruff, senior vice president of federal advocacy for the American Cancer Society Cancer Action Network (ACS CAN).
During a Senate Finance Committee hearing, Woodruff told committee members the bill essentially rolls back the patient protections implemented under current law, including those for people with pre-existing conditions. While plans would still be prohibited from denying someone coverage based on their health history, in states that applied for waivers, insurers could instead be free to charge people more for their coverage based on their health status.
“For an individual in active cancer treatment or a cancer survivor, the health plan could have no limit on the amount of the monthly premium,” said Woodruff. “Products could be unaffordable for individuals who required—or were anticipated to require—high cost treatments.”
States could also apply to change what services plans are required to cover, putting current guaranteed essential health benefits (EHB), including coverage for hospitalization, physician services, specialty cancer care and prescription drugs at risk.
“Insurance should cover the major health needs of cancer patients and survivors,” said Woodruff. “Eliminating EHB requirements would encourage insurers to streamline ‘basic’ policies that do not include explicitly defined comprehensive benefits, thus putting cancer patients and survivors at risk of inadequate treatment, and could jeopardize access to necessary preventive care, treatment and follow-up care.”
Woodruff added that because current law ties a prohibition on lifetime or annual benefit limits to the EHB requirements, the Graham-Cassidy proposal could once again bring back coverage caps, increasing the chances that a cancer diagnosis or other serious condition could leave patients financially devastated.
The bill would also make coverage much less affordable for many by ending guaranteed premium subsidies and cost-sharing payments that help low and moderate income Americans afford private coverage, and by slashing Medicaid funding.
Medicaid serves as a vital safety-net and provides coverage to more than 2.3 million Americans with a history of cancer, including one-third of all pediatric cancer patients at the point of diagnosis.
“For low-income Americans, the changes proposed by Graham-Cassidy could be the difference between an early diagnosis when outcomes are better and costs are less or a late-stage diagnosis where costs are higher and survival less likely,” said Woodruff.
Woodruff urged senators to reject the Graham-Cassidy legislation and instead resume bipartisan work to improve the health care law that was being done by Senators Lamar Alexander and Patty Murray.
“ACS CAN stands ready to work with the Committee and all Members of Congress to develop and implement policies that will improve the health care system for the millions of individuals who are in active cancer treatment and cancer survivors,” said Woodruff.
To read the full written testimony: http://bit.ly/2fpEMNF