Washington, D.C., February 15, 2017—Today the Centers for Medicare and Medicaid Services (CMS) released a proposed rule changing regulations for Affordable Care Act marketplace insurance plans. Of particular concern to those affected by cancer are proposed changes to special enrollment periods and essential community provider requirements that are included in available insurance plans.
A statement from Chris Hansen, president of ACS CAN, follows:
“ACS CAN recognizes the need to make changes to the marketplaces in order to maintain and increase the number of available plans. However, some of the proposed changes to special enrollment periods (SEPs) and essential community provider requirements could cause problems for cancer patients and their families who want and need to enroll in health insurance that is adequate to cover recommended prevention, treatment and follow-up care.
“Cancer patients often experience a change in their insurance status due to the nature of their disease. Whether they lose employer-sponsored coverage due to being too sick to work or relocate to be closer to caregivers or specialized cancer centers, these patients need to be able to enroll in health insurance quickly and without gaps in coverage. The proposed SEP enrollment changes would require documentation that is often challenging to quickly obtain and will likely overwhelm an already overburdened verification system. We are concerned that this change could delay a patient’s treatment and jeopardize a person’s chance of survival.
“Moreover, cancer patients and survivors need to be able to access a wide range of medical services and specialties without paying high out-of-network costs. Proposed changes to essential community provider requirements could significantly reduce the number of in-network specialized cancer providers patients can see and limit their ability to seek and afford the best possible care.
“While ACS CAN appreciates efforts to strengthen the marketplace those efforts need not weaken access to meaningful health insurance for cancer patients and survivors. We look forward to working with CMS and the administration to address these concerns throughout the rule process.”