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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 nation’s drug shortage crisis continues to affect cancer patients and survivors with 1 in every 10 (10%) reporting impacts to care, a majority of whom have had difficulties finding substitute medications (68%) and cited treatment delays (45%).

Our latest Survivor Views survey sees increases in biomarker testing since the question was last asked three years ago along with reduced cost and coverage barriers in that time. Cancer patients and survivors describe the benefits and overwhelmingly agree biomarker testing gave their providers information that improved their treatment. 

The American Cancer Society (ACS) and the American Cancer Society Cancer Action Network (ACS CAN) along with partners appreciate the opportunity to comment on the Patient Navigation provisions of CY2024 Medicare Physician Fee Schedule.

Our latest survey finds that cancer patients and survivors would be less likely to stay current with preventive care, including recommended cancer screenings, if the provision requiring these services be covered at no cost were repealed. This survey also explores the challenges of limited provider networks and the need for patient navigation.

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

Telehealth visits that enable providers to deliver clinical services from a distance using options like video conferencing and remote monitoring can provide cancer patients and survivors with a convenient means of accessing both cancer care and primary care.

ACS CAN conducted a survey of 315 oncology providers examining barriers providers face in performing recommended cancer biomarker testing. The survey found that providers face challenges such as lab turnaround time, patient concerns about out-of-pocket-costs, and insurance coverage of biomarker tests.

This Survivor Views survey finds that cancer patients and survivors continue to face pandemic-related health care delays one year later, including disruptions to screenings and difficulties accessing care.

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. 

Prescription Drug Affordability Resources:

Biological drugs, commonly referred to as biologics, are a class of drugs that are produced using a living system, such as a microorganism, plant cell, or animal cell. Like all drugs, biologics are regulated by the United States Food and Drug Administration (FDA).

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Private Health Insurance Resources:

ACS CAN submitted comments regarding a proposed rule to change Health Reimbursement Arrangements (HRAs) and other account-based group health plans.

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Medicare Resources:

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

The incidence of cancer increases with age and thus the Medicare program is vitally important to millions of Americans who are undergoing active cancer treatment, are cancer survivors or who have not yet developed cancer.

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Costs and Barriers to Care Resources:

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 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.

Current federal requirements prohibit most insurance plans from limiting both the lifetime and annual dollar value of benefits.  This ban is one of several important patient protections that must be part of any health care system that works for cancer patients.

 

 

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Medicaid Resources:

Learn how the new HHS interim final rule implementing Medicaid work requirements will impact people with cancer and their caregivers.

Medicaid is a critical source of health insurance and coverage for more than 77 million Americans, including people with cancer who rely on the program for prevention, timely detection, treatment, and survival. The 2025 budget reconciliation bill makes significant changes to key Medicaid funding mechanisms like state-directed payments and provider taxes, which are expected to reduce states’ ability to finance their Medicaid programs. This factsheet outlines what these changes mean, the projected financial impact on states, and consequences for patient access to cancer care.

ACS CAN submitted comments to CMS opposing Montana's 1115 waiver application to implement work requirements and premiums in their Medicaid program.

ACS CAN opposes policies that condition Medicaid enrollment on work or reporting of work. 

ACS CAN opposes Utah’s proposal to implement work requirements in its Medicaid program, and we urge CMS to reject the amendment request.

ACS CAN supports this demonstration application and urges the Centers for Medicare and Medicaid Services to approve it.

While ACS CAN supports South Carolina expanding Medicaid, we oppose the current proposal for a severely limited expansion with work requirements and an enrollment cap. We urge CMS to reject this proposal.