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:

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.

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.

Prescription Drug Affordability Resources:

This factsheet provides basic information about the enhanced ACA tax credits.

ACS CAN has long fought for public policies that support the availability and affordability of medically necessary prescription drugs. 

Patient Assistance Programs

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.

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).

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.

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.

  •  

Medicaid Resources:

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.

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.

  •