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 costs are a significant burden on cancer patients and survivors, sometimes even leading patients to miss or delay taking prescribed medications. The latest Survivor Views survey explores the role copay assistance programs can play in reducing this burden, and also addresses patient navigation and digital therapeutics.
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.
Many cancer patients take multiple drugs as part of their treatment – often for many months or years. While drugs are not the only costly part of cancer treatment, finding ways to reduce these costs for patients and payers will significantly reduce the overall cost burden of cancer.
This Survivor Views survey examined access to and affordability of cancer care. Survivors report insurance-related barriers to obtaining prescriptions, and lower-income respondents in particular have difficulty affording them. 24% of respondents have received a surprise medical bill, 60% of which were more than $500.
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).
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.
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.
An increasing number of states are seeking greater flexibility in administering their Medicaid programs. The Department of Health and Human Services (HHS) and the Centers for Medicare and Medicaid Services (CMS) give states the opportunity to test innovative or alternative approaches to providing health care coverage to their Medicaid populations through Section 1115 Research and Demonstration Waivers (otherwise known as "1115 waivers"). States must demonstrate that their waivers promote the objectives of the Medicaid and Children’s Health Insurance Programs (CHIP) and CMS must use general criteria to determine whether the objectives of the Medicaid/CHIP programs are met.
