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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 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 upheaval to the U.S. economy caused by the pandemic has resulted in many Americans losing their jobs and their employer-provided health insurance. Mid-year coverage disruptions are costly because cancer patients like Franklin who have already met their deductible and maximums near the beginning of the year must pay another deductible and reach their new maximum out-of-pocket amount when they start their new insurance plan.

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.

Prescription Drug Affordability Resources:

Patient Assistance Programs

Prescription drug costs are a significant burden on cancer patients and survivors, sometimes even leading patients to miss or delay taking prescribed medications. The latest Survivor Views survey explores the role copay assistance programs can play in reducing this burden, and also addresses patient navigation and digital therapeutics.

A majority of cancer patients and survivors struggle to afford cancer care and over 80% have had to make financial sacrifices to cover their health care expenses. This survey also reveals ways that affordability concerns can negatively impact care and treatment, and explores issues related to prescription drug coverage and pain management options.

Many cancer patients take multiple drugs as part of their treatment – often for many months or years. While drugs are not the only costly part of cancer treatment, finding ways to reduce these costs for patients and payers will significantly reduce the overall cost burden of cancer.

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.

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).

For an individual with specific health care needs – like cancer patients and survivors – the drugs covered by a health plan and corresponding cost sharing for each drug is important information when choosing health insurance. However, to make an informed choice, formulary information must be disclosed to the individual.

Private Health Insurance Resources:

More than 2 million Americans will be diagnosed with cancer this year and more than 18 million Americans living today have a history of cancer. Having comprehensive and affordable health insurance coverage is a key determinant for surviving cancer.

More than 1.9 million Americans will be diagnosed with cancer this year and more than 18 million Americans living today have a history of cancer.[1] For these individuals finding the right doctor is one of the most important factors in t

Every person regardless of their race, color, national origin, gender identiy, sexual orientation, age or disability deserves to be given equal access to timely, quality, comprehensive health care without discrimination.

On Thursday, March 30, 2023, Judge O’Connor released a final opinion on remedies in Braidwood Management vs.

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 regarding marketplace insurance plans and requirements for plan year 2023. 

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.

Medicare Resources:

On Monday, April 29th, ACS CAN submitted comments in response to CMS' Medicare Prescription Payment Plan model notices. 

 

This ACS CAN chartbook provides cancer-specific data related to Medicare, including basic information about the program, a discussion of its components, characteristics of enrollees, coverage of services – specifically those related to prevention and screening – program expenditures and enrollees

ACS CAN is making cancer a top priority for public officials and candidates at the federal, state, and local levels.

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.

As Congress debated the Inflation Reduction Act (IRA) we strongly advocated for both an annual cap on total Part D out-of-pocket costs and a mechanism that would allow an enrollee the option to pay the required cost-sharing in capped monthly installments.

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

On Tuesday, September 6, 2022, American Cancer Society Cancer Action Network filed comments on the calendar year (CY) 2023 Medicare Physician Fee Schedule proposed rule. 

ACS CAN's comments focused on the following:

Costs and Barriers to Care Resources:

Medical debt impacts many people with cancer, their caregivers and their families. This factsheet details this impact and explores policy solutions to prevent medical debt and minimize its impact on health, quality of life and financial health.

Our latest survey finds that about half of cancer patients and survivors (49%) have incurred medical debt to pay for their cancer care and another 13% expect to incur medical debt as they begin or continue their treatment. Nearly all of those (98%) had health care coverage at the time they accumulated medical debt. This survey also explores the broad health and financial implications of medical debt, how medical debt deepens inequites, and the alarming rate of cancer related medical debt among younger respondents with early diagnoses.

Our latest survey finds that protecting no-cost screenings and preventive care and reducing the burden of medical debt are the most impotant priorities for cancer patients and survivors. This survey also explores the impacts of cancer on food and nutrition insecurity, with impacts felt across income groups and coverage levels.

ACS CAN partnered with the Leukemia and Lymphoma Society and RIP Medical Debt to conduct a national survey on the impacts of medical debt and high health care costs. Read the full results.

ACS CAN teamed up with the Leukemia and Lymphoma Society and RIP Medical Debt to conduct a national survey on the impacts of medical debt and high health care costs. Read a summary of the results.

Short-term limited duration (STLD) insurance plans do not provide the kind of comprehensive insurance coverage cancer patients need.  These plans were designed only as temporary coverage and are not subject to the same Affordable Care Act (ACA) requirements as other health insurance products on the market.  As a result, an enrollee who was attracted to the plan’s lower premiums may find – if they are diagnosed with a serious illness like cancer – that the plan does not cover all of their necessary cancer treatments.  In these cases, the consumer can be left with catastrophic costs.

Many patients with complex diseases like cancer find it difficult to afford their treatments – even when they have health insurance.  Current law establishes a limit on what most private insurance plans can require enrollees to pay in out-of-pocket costs.  These limits protect patients from extremely high costs and are essential to any health care system that works for cancer patients and survivors.

 

A majority of cancer patients and survivors struggle to afford cancer care and over 80% have had to make financial sacrifices to cover their health care expenses. This survey also reveals ways that affordability concerns can negatively impact care and treatment, and explores issues related to prescription drug coverage and pain management options.

In these comments, ACS CAN strongly supports Congress’ and the Administration’s efforts to protect patients from surprise medical bills and we are encouraged by the important steps this interim final rule takes. Specifically, we applaud the Departments’ proposed policies related to:

Medicaid Resources:

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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