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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 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.

Access to care for those who are uninsured not only ensures that serious diseases like cancer can be detected and treated earlier but also often means better patient outcomes and less costs to the individual and the larger health care system.

The American Cancer Society Cancer Action Network (ACS CAN) provided the following statement for the record at the House Energy & Commerce Health Subcommittee Hearing on Legislative Solutions to Bolster Preparedness and Response for all Hazards and Public Health Security Threats on June 13, 2023.

The American Cancer Society Cancer Action Network (ACS CAN) provided the following statement for the record at the House Energy & Commerce Oversight Hearing on Examining the Root Causes of Drug Shortages: Challenges in Pharmaceutical Drug Supply Chains on May 11, 2023.

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care, including recommended cancer screenings, if the provision requiring these services be covered at no cost were repealed.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.

Ensuring your community is ready for a return to annual renewals.

Why is continuous coverage coming to an end?

Resources to help you prepare for a return to annual renewals

Annual Medicaid Renewals are back.

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.

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.

Private Health Insurance Resources:

ACS CAN submitted comments on September 16, 2020, to CMS regarding Georgia's 1332 waiver application.

Last year, the Administrative finalized a regulation that expands access to short-term, limited-duration insurance products. Short-term plans were originally intended to bridge gaps in comprehensive coverage – for instance, when an individual was between jobs and temporarily without access to an employer plan.

ACS CAN Comments on Interstate Sale of Insurance

ACS CAN submitted comments regarding the 2020 Proposed Notice of Benefit & Payment Parameters for the individual insurance market.

ACS CAN submitted comments on the proposed 2019 CMS Program Integrity Rule.

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

On March 6, 2018, ACS CAN filed comments on the proposed rule implementing changes to the Employee Retiree Income Security Act’s (ERISA’s) definition of “employer” for purposes of determining when employers may join together to form an Association Health Plan (AHP).

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

ACS CAN Comments on Short-Term Policies

Medicare Resources:

ACS CAN Comments to Seema Verma, Administrator, Centers for Medicare and Medicaid Services

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. 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.

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.

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Costs and Barriers to Care Resources:

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.

The health care law has several provisions that help prevent individuals from experiencing gaps in health insurance coverage, including the requirement that private health insurance plans allow dependents to remain on their parents’ insurance until age 26.  This provision is important for keeping survivors of childhood and young adult cancer insured, and helps to ensure young adults receive preventive services and screenings.  This provision is a crucial patient protection that must be a part of a health care system that works for cancer patients and survivors.

Medicaid Resources:

ACS CAN submitted comments opposing Tennessee's proposal to fund its Medicaid program through a block grant and implement a closed formulary.

ACS CAN comments supporting Medicaid expansion in Oklahoma, but opposing their proposal to rescind retroactive eligibility

An increasing number of states are seeking greater flexibility in administering their Medicaid programs. The Department of Health and Human Services (HHS) and the Centers for Medicare and Medicaid Services (CMS) give states the opportunity to test innovative or alternative approaches to providing health care coverage to their Medicaid populations through Section 1115 Research and Demonstration Waivers (otherwise known as "1115 waivers"). States must demonstrate that their waivers promote the objectives of the Medicaid and Children’s Health Insurance Programs (CHIP) and CMS must use general criteria to determine whether the objectives of the Medicaid/CHIP programs are met.

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