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.
How Much Does Cancer Cost? New Report Examines Expected Patient Costs for Common Cancer Diagnoses
Washington, D.C.—The American Cancer Society Cancer Action Network (ACS CAN) today released its first report examining the costs of treating cancer, and specifically the out-of-pocket portion patients face. The report, released at the organization’s annual national policy forum, found U.S. cancer patients paid nearly $4 billion in out-of-pocket costs in 2014 and the disease cost the country $87.8 billion in cancer-related health care spending.
The report examines costs for three of the most common cancers—breast, lung and colorectal; under three types of insurance—employer-sponsored, Medicare and an individual exchange plan. The total patient costs, including premiums, deductibles, co-pays and co-insurance, range from nearly $6,000 a year on an employer-sponsored plan to a little more than $10,000 on an exchange plan. Most of these costs accrue right as a person is diagnosed, leaving patients with significant payments due in a short amount of time.
Moreover, these out-of-pocket costs can be compounded if a patient needs to seek out-of-network care or needs a treatment that is not covered by their insurance plan.
“For cancer patients and their families the costs of cancer care are truly staggering,” said Chris Hansen, ACS CAN president. “This report makes clear the importance of insurance coverage, but also offers insight into the extent even insured patients struggle to afford treatment. If we are going to continue reducing cancer-related death and suffering, we must ensure that these patients and survivors have access to quality health insurance that meets their needs and is affordable to buy and to use,” said Hansen.
Key report findings include:
- A lower-premium insurance plan may not actually save cancer patients money in the long run. Such plans often have high-cost sharing and cancer patients are high utilizers of care.
- Even with insurance, cancer patients often face unpredictable or unmanageable costs including high co-insurance, high deductibles, having to seek out-of-network care, and needing a treatment that is not covered by their plan.
- Limits on out-of-pocket costs significantly lowered patients’ expenses in two of the three insurance scenarios. Without these limits, patients’ costs would have sky-rocketed.
The report comes as Congress and the administration continue to consider possible changes to the nation’s health care system. In a worst case scenario, those changes could alter important insurance market reforms including, allowing insurers to charge people more based on their health status and history, enabling plans to deny people coverage based on a pre-existing condition and significantly altering the health services insurance plans must cover; all of which are critical to providing patients with affordable access to quality insurance.
Cancer is one of the leading causes of death and disease in the United States. Nearly 1.7 million Americans are expected to be diagnosed this year and more than 15 million Americans alive today have a cancer history.
Read the full Costs of Cancer report.
About ACS CAN
ACS CAN, the nonprofit, nonpartisan advocacy affiliate of the American Cancer Society, supports evidence-based policy and legislative solutions designed to eliminate cancer as a major health problem. ACS CAN works to encourage elected officials and candidates to make cancer a top national priority. ACS CAN gives ordinary people extraordinary power to fight cancer with the training and tools they need to make their voices heard. For more information, visit http://www.acscan.org/