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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.

Access to Health Care Resources:

The Affordable Care Act (ACA) has helped individuals with pre-existing conditions like cancer access comprehensive health insurance and afford their care. But the law is at risk of being dismantled.

This Survivor Views survey examined access to and affordability of cancer care. Survivors report insurance-related barriers to obtaining prescriptions, and lower-income respondents in particular have difficulty affording them.  24% of respondents have received a surprise medical bill, 60% of which were more than $500.

This Survivor Views survey examined cancer symptoms and side effects, including pain, and use of palliative/ supportive services. Cancer survivors report many physical and emotional side effects during and after treatment, but use of solutions to address those symptoms is lagging.  Survivors prescribed opioids often encounter barriers to obtaining them.

ACS CAN responded to the reopening of the Centers for Medicare and Medicaid Services (CMS) coverage decision for NGS testing panels.

ACS CAN comments to Steven Mnuchin and Seema Verma on Iowa's 1332 Waiver

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.

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.

ACS CAN filed extensive comments expressing deep concern with the proposed Medicare Part B Drug Payment Model and noting that in its proposed form the Part B Drug Model Model failed to protect cancer patients' access to life-saving medications.

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.

Costs and Barriers to Care Resources:

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.

Cancer patients are particularly vulnerable to spikes in their health care costs because many expensive diagnostic tests and treatments are scheduled within a short period of time, so cancer patients spend their deductible and out-of-pocket maximum quickly. These costs can be difficult to manage over the course of a year, and most monthly budgets simply can’t afford these large bills. 

Most patients experience spikes in their health care costs around the time of a cancer diagnosis as they pay their deductible and out-of-pocket maximum. For patients on high deductible plans, this spike can mean bills due for several thousands of dollars within one month.

The U.S. spent approximately $183 billion on cancer-related health care in 2015. This represents a signification portion of the total health care spending in the U.S. And it is expected to keep growing. By 2030 cancer-related health care spending is expected to reach nearly $246 billion.

The Affordable Care Act (ACA) has helped individuals with pre-existing conditions like cancer access comprehensive health insurance and afford their care. But the law is at risk of being dismantled.

This report explores the experiences of cancer patients with their health insurance and financial challenges through interviews with hospital-based financial navigators. The report finds that while the Affordable Care Act has brought crucial improvements to patient access to health insurance, cancer patients still face serious challenges affording their care and using their insurance benefits.

Current federal requirements prohibit health insurance plans from denying coverage to individuals with pre-existing conditions like cancer.  These are one of several important patient protections that must be part of any health care system that works for cancer patients.

Current federal law has several provisions that help prevent individuals and families from experiencing gaps in their health insurance coverage.  Coverage gaps can delay necessary care, which is particularly detrimental to cancer patients and survivors.  Preventing gaps in coverage is a crucial patient protection that must be maintained in our health care and insurance system.

Current federal law provides life-saving coverage of cancer prevention and early detection services and programs.  These provisions are crucial to reducing the incidence and impact of cancer in the United States.  They are also crucial in helping cancer survivors remain cancer-free and lead healthy lives.

Medicaid Resources:

What does unwinding continuous coverage have to do with Medicaid expansion?

  • During the pandemic, Congress put in place continuous coverage protections to ensure that Medicaid enrollees were able to keep their health coverage without needing to re-enroll.

ACS CAN strongly opposes any attempt by the federal government or states to condition Medicaid coverage on work or community engagement.

ACS CAN opposes per capita caps, block grants, and other capped funding structures for the Medicaid program, as they endanger access to care.

Cancer patients and survivors must balance reducing their health care costs with ensuring they have comprehensive coverage of services, treatments, and care providers.

ACS CAN submitted comments strongly supporting several policy changes that will make it easier to apply for, enroll in, and maintain enrollment in Medicaid and CHIP.

ACS CAN submitted comments regarding Tennessee's latest application to renew their 1115 waiver.

ACS CAN submitted comments to the Centers for Medicare & Medicaid Services regarding its 2022 Request for Information on Access to Coverage and Care in Medicaid & CHIP. Our comments address suggested improvements in Medicaid enrollment and eligibility determination, transitions of coverage, national standards for access to care, and the eventual end of the public health emergency and continuous coverage provisions.

ACS CAN submitted comments in support of the renewal of Oregon's 1115 Medicaid waiver, including the state's proposal of continuous coverage provisions for children and adults. However, ACS CAN strongly objects to the state's proposal to limit Medicaid coverage of drugs approved through the accelerated approval process, and urges CMS to reject this part of the waiver request.