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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:

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

On June 24, 2022, the U.S. Supreme Court announced its decision in Dobbs v. Jackson Women’s Health Organization, eliminating the constitutional right to abortion and overruling the precedents of Roe and Casey. State actions on access to abortion services could have significant impact on cancer patients. 

Where healthcare dollars are spent compared with dollars on cancer care, 2018.

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.

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 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.

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.

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:

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:

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 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.

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.

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.

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:

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.