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.
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.
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 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).
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.
In 2015, the American Cancer Society Cancer Action Network (ACS CAN) analyzed coverage of cancer drugs in the health insurance marketplaces created by the Affordable Care Act (ACA) and found that transparency of coverage and cost-sharing requirements were insufficient to allow cancer patients to choose the best plan for their needs.
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.
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.
