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:

 

Federally Qualified Health Centers (FQHCs) are an integral part of the health care safety-net, providing access to affordable primary care services for nearly 26 million uninsured or underinsured Americans many of whom have cancer. The centers are non-profit, community-directed, and serve high need rural and urban communities that face obstacles to health care, including cost and lack of insurance, as well as geographic and language barriers. FQHCs provide access to quality preventive and primary care services that are critical for cancer patients, survivors, and those who will be diagnosed with cancer.

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.

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.

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:

The Affordable Care Act (ACA) expanded access to health insurance through reforms of the private health insurance market, including income-related premium support and cost-sharing subsidies and establishment of Health Insurance Marketplaces.

Information about prescription drug formularies

It is critically important for cancer patients to be able to access clear, consistent, and comparable information on prescription drug coverage, including coverage of physician-administered drugs, in order to choose a health plan. Prior to the Affordable Care Act (ACA), such information was not widely available, but various ACA provisions aim to improve the comprehensiveness, comparability, and transparency of health plan benefits.

In this 2014 white paper, ACS CAN examined the extent of coverage and cost-sharing for cancer drugs in silver Marketplace plans in selected states and whether information on the coverage of cancer drugs can be readily obtained, compared, and understood by patients.

Utilization management is a collection of treatment review and cost reduction techniques used by health insurers and health plans.

ACS CAN filed comments to the Department of HHS on the proposed rule regarding data collection and support standards related to the collection of data for Essential Health Benefits.

In a letter to President Obama, ACS CAN and other consumer groups urged the Adminstration to promptly, effectively, and fully implement the Summary of Benefits and Coverage rule.

In a letter to HHS Secretary Sebelius, ACS CAN and other organizations urged HHS to provide additional specific information on proposed state benchmark plans.

In a letter to Congress, ACS CAN and other organizations urged the rejection of legislation that would undermine the critical consumer benefits provided by the ACA's minimum loss ration requirements.

Medicare Resources:

Letter in support of Medicare coverage for CAR-T therapies.  

ACS CAN submitted comments on the Medicare Part C and D Rule.

Approximately 1.7 million new cancer cases are expected to be diagnosed in 2018.[1] Age is one of the most important risk factors for cancer, with one half of cancer cases occurring in people over the age of 65.

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.

Health Care Delivery Resources:

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.

The Affordable Care Act (ACA) expanded access to health insurance through reforms of the private health insurance market, including income-related premium support and cost-sharing subsidies and establishment of Health Insurance Marketplaces.

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.

The Children's Health Insurance Program (CHIP) is an integral part of the safety-net for lower-income children and their families. CHIP provides access to quality, affordable, and comprehensive health care coverage to nearly nine million lower income children up to age 19 in the U.S. – many of whom have been affected by cancer.

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.