Reconciliation Package Improves Health Care Affordability for Cancer Patients

Caps Medicare Patients’ Part D Drug Costs, Extends Increased Marketplace Tax Credits

July 28, 2022

WASHINGTON, D.C.--Congress reached a significant budget deal that includes key provisions that will improve affordability of health care coverage for many cancer patients, survivors and their loved ones. The reconciliation package includes language to help Medicare enrollees afford their outpatient prescription drugs by capping out-of-pocket costs for prescriptions for those with Part D plans and the option to spread expenses over the plan year, rather than requiring potentially thousands of dollars in co-insurance in one month. The legislation also extends increased tax credits for Marketplace plan premiums, giving millions of Americans a reprieve to continue affording their plans. Unfortunately, the deal does not include a permanent extension of the credits and does not address the Medicaid coverage insurance gap in 12 states that have yet to expand access, leaving more than 2 million Americans without a viable health insurance option.

The following is a statement from Lisa Lacasse, president of ACS CAN:

“Based on current legislative text, ACS CAN applauds Congress for prioritizing health and taking this important step to address affordability issues in Medicare and Marketplace plans. Capping Medicare Part D prescription drug costs for individuals, often on a fixed income, will mean more cancer patients and survivors have timely access to the treatment they need. Cancer drugs can be incredibly expensive, so also allowing Medicare enrollees to pay their out-of-pocket costs throughout the year rather than up front will offer critical financial relief and allow patients to focus on their treatment, rather than worrying about how they will pay for it.

“Extending the increased subsidies for Marketplace plans for three years will provide continued relief for the millions of Americans who have seen their monthly premiums significantly decline or have been able to afford private insurance for the first time. For individuals facing a cancer diagnosis and all those at risk of developing the disease, this action could save their lives. Though, absent a permanent extension of the increased credits, patients and survivors – many of whom are still undergoing treatment or survivorship care that spans several years – will face sky-rocketing premiums when the extension expires; therefore ACS CAN will continue to work with all members of  Congress to make the increased credits permanent.

“Unfortunately, the reconciliation package does nothing to address the Medicaid coverage gap that denies more than 2 million Americans access to the lifesaving health coverage they need in 12 states that have yet to expand access to insurance through Medicaid, despite recent polling that shows an overwhelming majority of voters support closing the gap. Of the individuals stuck in the coverage gap, 60% are people of color, the majority of whom live in the South. This is a serious health equity issue and one our lawmakers should not ignore any longer.

“American Cancer Society research has time and again shown that having access to health insurance is linked to earlier diagnosis of cancer when the disease is more treatable, and individuals are more likely to survive. Where you live should not determine if you live, but this will remain a reality as long as the Medicaid gap exists. ACS CAN has worked tirelessly in states urging them to increase access to their Medicaid programs for more than a decade – including our current work in North Carolina to urge lawmakers to expand Medicaid when they return to finish their session and our efforts to educate South Dakotans on the importance of expansion ahead of a ballot vote on the issue in November.

“ACS CAN urges Congress to continue its work on this critical legislation— specifically to find a way to include closing the Medicaid coverage gap for the 2 million people in the 12 remaining non-expansion states—along with the Medicare Part D provisions and the extension of the Marketplace tax credits. Combined, these provisions would represent a significant improvement in the affordability and accessibility of health care for millions of cancer patients, survivors and their families. ACS CAN will continue to monitor the bill’s progress on behalf of all those effected by cancer.”


Media Contacts

Allison Miller
Director, Media Advocacy
Washington, D.C.
Alissa Crispino
Vice President, Advocacy Communications & Policy
Washington, D.C.