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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:

What does unwinding continuous coverage have to do with Medicaid expansion?

  • During the pandemic, Congress put in place continuous coverage protections to ensure that Medicaid enrollees were able to keep their health coverage without needing to re-enroll.

ACS CAN provided the following comments to the Centers for Medicare and Medicaid Services on the Medicare Drug Price Negotiation Program: Initial Memorandum, Implementation of Sections 1191 – 1198 of the Social Security Act for Initial Price Applicability Year 2026.

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

On June 24, 2022, the U.S. Supreme Court announced its decision in Dobbs v. Jackson Women’s Health Organization, eliminating the constitutional right to abortion and overruling the precedents of Roe and Casey. State actions on access to abortion services could have significant impact on cancer patients. 

This Survivor Views survey finds that cancer patients and survivors continue to face pandemic-related health care delays one year later, including disruptions to screenings and difficulties accessing care.

Where healthcare dollars are spent compared with dollars on cancer care, 2018.

Telehealth visits that enable providers to deliver clinical services from a distance using options like video conferencing and remote monitoring can provide cancer patients and survivors with a convenient means of accessing both cancer care and primary care.

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.

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:

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:

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.