As millions of seniors and other enrollees select their 2021 Medicare health benefits during annual open enrollment, a new report details just how confusing the program’s appeals process can be should a patient need to appeal a claim denial for health care services or prescription drugs.
House Passed Health Bill Risks Pricing Cancer Patients, Survivors Out of Insurance Market
Pre-Existing Condition Protections Could be Meaningless as Insurers in Some States Would be Permitted to Charge Sick People More for Less Comprehensive Coverage
Today the House of Representatives passed a health care bill that could leave cancer patients, survivors and those at risk for the disease unable to access or keep quality health insurance. The bill would create a coverage patchwork whereby patients with pre-existing conditions could be charged more for their coverage while simultaneously weakening the rules for what health services will be covered.
A statement from Chris Hansen, president of the American Cancer Society Cancer Action Network (ACS CAN) follows:
“The bill passed by the U.S. House today risks placing millions of Americans into a system in which they could be unable to afford their health coverage.
“Allowing patients to be charged more for coverage based on their health status risks making pre-existing condition protections virtually meaningless. A return to medical underwriting, combined with seriously weakened standards for what constitutes good coverage through the erosion of Essential Health Benefits, sets up a situation whereby payers can cherry-pick their customers and leave patients with serious conditions like cancer with few if any affordable insurance options.
“High-risk pools have not historically been an adequate safety-net. These programs have been unsustainable and underfunded. High-risk pool enrollees were often charged unaffordable premiums—usually 150-200% higher than the average standard rate—and faced potentially long waiting periods and strict coverage limitations; circumstances that are unacceptable for cancer patients and survivors who need immediate treatment and consistent follow-up care.
“Additionally, it is unclear how weakening the essential health benefits standards will affect cancer patients’ access to new therapies and key patient protections like the cap on out-of-pocket costs and the prohibition of lifetime and annual limits, both of which are applied only to essential health benefits. This bill could seriously weaken these key protections, jeopardize access to new therapies and leave cancer patients—both in the individual and employer-based market—vulnerable to higher out-of-pocket costs.
“There is no denying that current law needs improvement, however focusing on lower premiums for healthy people at the expense of the millions of Americans with pre-existing health conditions, including more than 16 million cancer survivors, is wrong.
“We call on the Senate to reject this legislation and stand ready to work with all lawmakers to develop policies that improve the law and encourage a strong health insurance market that provides affordable and comprehensive coverage options for those with serious diseases like cancer.”