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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 nation’s drug shortage crisis continues to affect cancer patients and survivors with 1 in every 10 (10%) reporting impacts to care, a majority of whom have had difficulties finding substitute medications (68%) and cited treatment delays (45%).

Our latest Survivor Views survey sees increases in biomarker testing since the question was last asked three years ago along with reduced cost and coverage barriers in that time. Cancer patients and survivors describe the benefits and overwhelmingly agree biomarker testing gave their providers information that improved their treatment. 

ACS CAN and partner organizations provided comments on the Medicare Drug Price Negotiation Program: Considerations for Selected Oncology Drugs.

ACS and ACS CAN provided comments to the Centers for Medicare and Medicaid Services on the list of Part D drugs selected for the price negotiation program authorized under the Inflation Reduction Act (IRA).

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.

Access to care for those who are uninsured not only ensures that serious diseases like cancer can be detected and treated earlier but also often means better patient outcomes and less costs to the individual and the larger health care system.

The American Cancer Society Cancer Action Network (ACS CAN) provided the following statement for the record at the House Energy & Commerce Health Subcommittee Hearing on Legislative Solutions to Bolster Preparedness and Response for all Hazards and Public Health Security Threats on June 13, 2023.

The American Cancer Society Cancer Action Network (ACS CAN) provided the following statement for the record at the House Energy & Commerce Oversight Hearing on Examining the Root Causes of Drug Shortages: Challenges in Pharmaceutical Drug Supply Chains on May 11, 2023.

Our latest survey finds that cancer patients and survivors would be less likely to stay current with preventive care, including recommended cancer screenings, if the provision requiring these services be covered at no cost were repealed. This survey also explores the challenges of limited provider networks and the need for patient navigation.

Prescription Drug Affordability Resources:

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.

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Private Health Insurance Resources:

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.

ACS CAN submitted comments regarding the 2020 Proposed Notice of Benefit & Payment Parameters for the individual insurance market.

ACS CAN submitted comments on the proposed 2019 CMS Program Integrity Rule.

ACS CAN submitted comments regarding a proposed rule to change Health Reimbursement Arrangements (HRAs) and other account-based group health plans.

In 2015, the American Cancer Society Cancer Action Network (ACS CAN) analyzed coverage of cancer drugs in the health insurance marketplaces created by the Affordable Care Act (ACA) and found that transparency of coverage and cost-sharing requirements were insufficient to allow cancer patients to choose the best plan for their needs.

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:

Current federal law has several provisions that help prevent individuals and families from experiencing gaps in their health insurance coverage.  Coverage gaps can delay necessary care, which is particularly detrimental to cancer patients and survivors.  Preventing gaps in coverage is a crucial patient protection that must be maintained in our health care and insurance system.

Current federal law provides life-saving coverage of cancer prevention and early detection services and programs.  These provisions are crucial to reducing the incidence and impact of cancer in the United States.  They are also crucial in helping cancer survivors remain cancer-free and lead healthy lives.

The health care law has several provisions that help prevent individuals from experiencing gaps in health insurance coverage, including the requirement that private health insurance plans allow dependents to remain on their parents’ insurance until age 26.  This provision is important for keeping survivors of childhood and young adult cancer insured, and helps to ensure young adults receive preventive services and screenings.  This provision is a crucial patient protection that must be a part of a health care system that works for cancer patients and survivors.

Consumers need access to health insurance policies that cover a full range of evidence-based health care services – including prevention and primary care – necessary to maintain health, avoid disease, overcome acute illness and live with chronic disease.  Any health care system that works for cancer patients must have standards ensuring that enrollees have access to comprehensive health insurance.

Current federal requirements prohibit most insurance plans from limiting both the lifetime and annual dollar value of benefits.  This ban is one of several important patient protections that must be part of any health care system that works for cancer patients.

 

 

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Medicaid Resources:

ACS CAN submitted comments regarding Tennessee's latest application to renew their 1115 waiver.

ACS CAN submitted comments to the Centers for Medicare & Medicaid Services regarding its 2022 Request for Information on Access to Coverage and Care in Medicaid & CHIP. Our comments address suggested improvements in Medicaid enrollment and eligibility determination, transitions of coverage, national standards for access to care, and the eventual end of the public health emergency and continuous coverage provisions.

ACS CAN submitted comments in support of the renewal of Oregon's 1115 Medicaid waiver, including the state's proposal of continuous coverage provisions for children and adults. However, ACS CAN strongly objects to the state's proposal to limit Medicaid coverage of drugs approved through the accelerated approval process, and urges CMS to reject this part of the waiver request.

ACS CAN submitted comments opposing Tennessee's proposal to fund its Medicaid program through a block grant and implement a closed formulary.

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