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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.

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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Medicare Resources:

Earlier screening for cancer is important because when detected at later stages, treatments are more limited, and outcomes are generally poorer. Medicare enrollees should have access to multi-cancer screening tests when the benefit is clinically shown.

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

The incidence of cancer increases with age and thus the Medicare program is vitally important to millions of Americans who are undergoing active cancer treatment, are cancer survivors or who have not yet developed cancer.

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.

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Costs and Barriers to Care Resources:

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.

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 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.

This report explores the experiences of cancer patients with their health insurance and financial challenges through interviews with hospital-based financial navigators. The report finds that while the Affordable Care Act has brought crucial improvements to patient access to health insurance, cancer patients still face serious challenges affording their care and using their insurance benefits.

Current federal requirements prohibit health insurance plans from denying coverage to individuals with pre-existing conditions like cancer.  These are one of several important patient protections that must be part of any health care system that works for cancer patients.

Medicaid Resources:

In 2023 10% of adults with a history of cancer in the U.S. relied on Medicaid for their health care. Access to affordable health insurance is crucial for individuals to receive necessary care, especially for those with chronic conditions like cancer. The American Cancer Society Cancer Action Network opposes cuts to the Medicaid program, as these cuts will make it harder for many people to receive preventive services and cancer screenings, cancer treatments and health care in survivorship.

ACS CAN submitted comments supporting the Rhode Island Medicaid program providing coverage to justice-involved populations and housing and nutritional supports to enrollees. 

ACS CAN submitted comments supporting Colorado's request to amend it's 1115 Medicaid waiver to establish continuous eligibility for children up to age 3, and other policies.

ACS CAN submitted comments to CMS in support of Pennsylvania's application for an 1115 Medicaid waiver to provide continuous eligibility to children, provide targeted coverage to justice-involved populations, and provide housing and nutrition supports to Medicaid enrollees.

ACS CAN submitted comments to the Centers for Medicare and Medicaid Services supporting Hawaii's proposal to provide continuous eligibility for Medicaid to children through age 6, and 2-year eligibility ages 6-19. We also supported their proposal to provide pre-release services to justice-involved individuals.

ACS CAN submitted comments to the Centers for Medicare and Medicaid Services in support of Minnesota's request to provide continuous eligibility for Medicaid to children up to age 6, and 12-month continous eligibility to 19- and 20-year-olds.