Share

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 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 upheaval to the U.S. economy caused by the pandemic has resulted in many Americans losing their jobs and their employer-provided health insurance. Mid-year coverage disruptions are costly because cancer patients like Franklin who have already met their deductible and maximums near the beginning of the year must pay another deductible and reach their new maximum out-of-pocket amount when they start their new insurance plan.

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 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.

This Survivor Views survey examined cancer symptoms and side effects, including pain, and use of palliative/ supportive services. Cancer survivors report many physical and emotional side effects during and after treatment, but use of solutions to address those symptoms is lagging.  Survivors prescribed opioids often encounter barriers to obtaining them.

ACS CAN responded to the reopening of the Centers for Medicare and Medicaid Services (CMS) coverage decision for NGS testing panels.

This ACS CAN report focuses specifically on the costs of cancer borne by patients in active treatment as well as survivors.  It examines the factors contributing to the cost of cancer care, the type of direct costs patients pay, and the indirect costs associated with cancer.

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.

  •  

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.

  •  

Costs and Barriers to Care Resources:

ACS CAN submitted comments to the Consumer Financial Protection Bureau strongly supporting the proposal to prohibit medical debt from appearing on credit reports.

Medical debt impacts many people with cancer, their caregivers and their families. This factsheet details this impact and explores policy solutions to prevent medical debt and minimize its impact on health, quality of life and financial health.

Our latest survey finds that about half of cancer patients and survivors (49%) have incurred medical debt to pay for their cancer care and another 13% expect to incur medical debt as they begin or continue their treatment. Nearly all of those (98%) had health care coverage at the time they accumulated medical debt. This survey also explores the broad health and financial implications of medical debt, how medical debt deepens inequites, and the alarming rate of cancer related medical debt among younger respondents with early diagnoses.

Our latest survey finds that protecting no-cost screenings and preventive care and reducing the burden of medical debt are the most impotant priorities for cancer patients and survivors. This survey also explores the impacts of cancer on food and nutrition insecurity, with impacts felt across income groups and coverage levels.

ACS CAN partnered with the Leukemia and Lymphoma Society and RIP Medical Debt to conduct a national survey on the impacts of medical debt and high health care costs. Read the full results.

ACS CAN teamed up with the Leukemia and Lymphoma Society and RIP Medical Debt to conduct a national survey on the impacts of medical debt and high health care costs. Read a summary of the results.

Short-term limited duration (STLD) insurance plans do not provide the kind of comprehensive insurance coverage cancer patients need.  These plans were designed only as temporary coverage and are not subject to the same Affordable Care Act (ACA) requirements as other health insurance products on the market.  As a result, an enrollee who was attracted to the plan’s lower premiums may find – if they are diagnosed with a serious illness like cancer – that the plan does not cover all of their necessary cancer treatments.  In these cases, the consumer can be left with catastrophic costs.

Many patients with complex diseases like cancer find it difficult to afford their treatments – even when they have health insurance.  Current law establishes a limit on what most private insurance plans can require enrollees to pay in out-of-pocket costs.  These limits protect patients from extremely high costs and are essential to any health care system that works for cancer patients and survivors.

 

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.