exchange plans Archives - NCCS - National Coalition for Cancer Survivorship

NCCS Joins 28 Patient and Consumer Groups Urging the Administration to Implement a Special Enrollment Period for Healthcare.gov

April 1, 2020/in Cancer News, Cancer Policy Blog, NCCS News Access to Care, Affordable Care Act, COVID-19, Financial Toxicity, Health Equity, Pre-Existing Conditions, Quality Cancer Care NCCS News /by actualize

The Trump administration decided against opening a special enrollment period for Healthcare.gov, which would allow uninsured individuals to purchase plans outside of the open enrollment period.

NCCS joined with 28 patient and consumer groups to urge the administration to implement a special enrollment period as the nation fights to protect its citizens from the COVID-19 virus. The Affordable Care Act does allow for people who have lost employer-sponsored health insurance to enroll, which is important to the nearly 10 million people who filed unemployment claims in March.

An excerpt from the statement:

As research shows again and again, access to comprehensive health insurance means access to timely, medically-necessary health care. If someone without health insurance today contracts the COVID-19 virus, they may be forced to make the difficult decision to not be tested and treated due to fears about the cost of care. That puts our entire society – particularly the people with that we represent – at risk. All Americans need immediate, reliable access to quality, affordable health insurance.

Read the Full Statement

Download the Statement »

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NCCS Concerned That Proposed ACA Rule Changes Could Raise Costs for Patients and Disrupt Treatment

March 4, 2019/in Cancer News, Cancer Policy Blog, CMS, HHS, NCCS News, Policy Comments Access to Care, Affordable Care Act, Financial Toxicity, Health Equity NCCS News, Policy Comments /by actualize

NCCS and member organizations of the Cancer Leadership Council (CLC) submitted comments to the Department of Health and Human Services (HHS) in response to the agency’s Notice of Benefits and Payment Parameters for 2020. The Notice contains rules and provisions that will apply to the individual market (the Affordable Care Act marketplace), and small group health insurance markets. The letter states NCCS’ concerns about specific provisions that may threaten cancer patients’ access to quality health care.

Below are the specific provisions for which NCCS provided comments:

NCCS urges CMS to reject any movement away from automatic re-enrollment for consumers in ACA marketplace plans. Automatic re-enrollment makes enrollment in health insurance more convenient and is consistent with private insurance practices.
NCCS opposes making post-enrollment assistance optional for ACA navigators, as cancer care is complex and patients benefit from assistance in utilizing their insurance to pay for their care.
NCCS opposes mid-year formulary changes that may change the cost-sharing for certain drugs. These formulary changes may put cancer patients at risk of disruption of their treatment plan and loss of access to the drugs recommended by their care team.
NCCS cautions against the proposed change to the manner in which the premium adjustment factor is calculated. This could result in consumers facing higher maximum cost-sharing amounts and higher premiums. We urge CMS to retain the current methodology for calculation of premium adjustment factor and thereby retaining important protections for consumers.

Read the full letter below.

Download the letter in PDF

CANCER LEADERSHIP COUNCIL

A PATIENT-CENTERED FORUM OF NATIONAL ADVOCACY ORGANIZATIONS
ADDRESSING PUBLIC POLICY ISSUES IN CANCER

February 19, 2019

Seema Verma
Administrator
Centers for Medicare & Medicaid Services
Department of Health and Human Services
Hubert H. Humphrey Building
200 Independence Avenue, SW
Washington, DC 20201

RE: CMS-9926-P, Patient Protection and Affordable Care Act; HHS Notice of Benefit and Payment Parameters for 2020

Dear Administrator Verma:

The undersigned organizations represent people with cancer who need adequate and affordable insurance to ensure access to quality and timely cancer care. We are writing to share our concerns about provisions of the Notice of Benefit and Payment Parameters for 2020 that may threaten cancer patients’ access to quality care. We urge reconsideration of certain provisions of the proposal.

Automatic Re-Enrollment

The Centers for Medicare & Medicaid Services (CMS) does not propose ending automatic re-enrollment in 2020 but asks for comment on terminating the policy of automatic re-enrollment of consumers in exchange plans, beginning with plan year 2021. We urge the agency to reject any movement away from automatic enrollment. As the agency states, automatic re-enrollment makes enrolling in health insurance more convenient for the consumer and is consistent with private insurance practices. In our experience, the assurance that consumers will be enrolled in a plan at the end of open enrollment affords a protection that is important to cancer patients.

Some of our organizations offer assistance to patients as they evaluate their plan options, to help those patients select coverage adequate for their cancer care needs. We know firsthand that this selection process is not easy and materials about plan options are not always useful. As the agency notes, enrollment materials should be designed to be consumer-friendly so that consumers understand the value of the plans they are considering. CMS signals a commitment to assisting with that design. We also support the efforts of CMS to “explore ways to increase the interoperability of patient-mediated health care data across health care programs, including in coverage purchased through the Exchanges.” Even if there is success in improving the materials available to consumers to support solid plan selection, we do not think that success would justify elimination of automatic re-enrollment.

The agency suggests that automatic re-enrollment makes consumers less aware of their plan options, blocks action to update their coverage and premium tax credit eligibility, and leads to unrecoverable federal spending if premium assistance is miscalculated. We agree that all these shortcomings of the enrollment process should be addressed. However, we do not believe that eliminating automatic re-enrollment would solve these problems.

The Role of Navigators

The proposed rule would make the provision of post-enrollment assistance by navigators in the federally facilitated exchanges an optional activity. We understand that reductions in funding
for navigators have placed strains on the system. However, we believe the solution is to provide adequate resources for navigators instead of reconsidering the allowable activities of navigators.

In our experience, cancer patients face significant difficulties in understanding their health insurance coverage and how to use it most effectively to pay for quality cancer care. Cancer
patients confront challenges related to network limits, coverage and payment standards for different elements of cancer care, and formulary issues. All these issues may affect the choices and options for care available to them. Cancer care is typically complex and interdisciplinary, and patients benefit from assistance in utilizing their insurance to pay for their care. We urge a
continuation of the requirement that navigators provide post-enrollment assistance.

Mid-Year Formulary Changes

CMS proposes to permit plans to make mid-year formulary changes to introduce new generic drugs to their formularies. Plans would be permitted to move the brand name drug for which a new generic drug is added to the formulary to a higher tier or drop the brand name drug from the formulary. Plan enrollees would be given a 60-day notice regarding mid-year formulary changes.

Mid-year formulary changes may put cancer patients at risk of disruption of their treatment plan and loss of access to the drugs recommended by their care team. We recommend that several patient protections be incorporated into this proposal. Patients who are utilizing a brand name drug for which a generic is introduced should not be required to switch to the generic drug without the recommendation of their care team. In connection with other drug pricing proposals discussed or advanced by this administration, this protection has been recommended. We urge that it be included in this proposal. The plan should also provide at least 90 and preferably 120 days of notice of a formulary change. For patients already utilizing a brand name drug, this would be a lesser protection than permitting them to remain on current therapy. However, this 90-day or 120-day timeline should be included for all consumers, to permit them to plan their treatment with full knowledge of the current formulary. There must also be an efficient exceptions process, in the situations where a health care provider believes that the brand name should be utilized in place of the generic added to the formulary.

Calculation of Premium Adjustment Factor

The agency has proposed to change the manner in which the premium adjustment factor is calculated. Under the agency proposal, National Health Expenditure Account (NHEA) estimates for all types of health insurance (except Medigap plans) would be included in the calculation. This contrasts to the premium adjustment factor calculation of past years, which has been based on employer-sponsored insurance rates. The agency suggests that the change in the calculation will more closely reflect the premium trends for all individuals in the private insurance market since 2013.

It seems that the agency is making this change in the calculation to save federal funds and because it has determined to forgo policy changes to address so-called silver loading in 2020. We are concerned about the proposed calculation of premium adjustment factor, because of its significant financial effects on consumers and because it would result in a loss of insurance coverage. CMS details the impact of the proposed changes in the premium adjustment factor calculation, including: 1) a higher maximum annual limitation on cost-sharing, 2) higher employer shared responsibility payment amounts, and 3) fewer employed individuals qualifying for the Advanced Premium Tax Credit, or APTC. In addition, CMS anticipates that the Department of the Treasury and the Internal Revenue Services will adopt the same premium measure, which would result in a decrease in the premium tax credit for which consumers would qualify and increase the contribution that consumers must make. The agency also predicts that the premium adjustment factor calculation will result in premium increases for exchange plans, in turn causing healthier enrollees not to purchase insurance on the exchanges.

Although the agency goal of reducing federal expenditures may be realized through this revised premium adjustment factor calculation, the corresponding impact on consumers will be significant and negative, as they face higher maximum cost-sharing amounts and higher premiums, in some cases resulting in decisions to forgo coverage.

We understand that the agency has considered a change to calculating the premium adjustment factor in the past but has rejected the change. We urge the agency to follow this example for 2020, by retaining the current methodology for calculation of premium adjustment factor and thereby retaining important protections for consumers.

If the change in the calculation is an indirect way of addressing silver loading, we recommend instead that the agency pursue a solution to payment of cost-sharing reductions and then address silver loading. We object to the change in the premium adjustment factor calculation because of the adverse effects of the change on consumers.

We appreciate the opportunity to comment on the proposed Notice of Benefit and Payment Parameters for 2020. We look forward to changes in the final notice, so that it more clearly reflects the needs of consumers who are seeking insurance coverage that protects their access to quality health care.

Sincerely,

Cancer Leadership Council
CancerCare
Cancer Support Community
The Children’s Cause for Cancer Advocacy
Fight Colorectal Cancer
International Myeloma Foundation
Leukemia & Lymphoma Society
LUNGevity Foundation
Lymphoma Research Foundation
National Coalition for Cancer Survivorship
Ovarian Cancer Research Alliance
Prevent Cancer Foundation
Susan G. Komen

Cancer Leadership Council
2446 39th Street NW, Washington, D.C. 20007 · Phone: 202-333-4041 · www.cancerleadership.org

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NCCS Strongly Objects to New CMS Waiver Options That Seek to Further Undermine the ACA

November 29, 2018/in Cancer News, Cancer Policy Blog, NCCS News Access to Care, Affordable Care Act, Financial Toxicity, Health Care Coverage, Health Equity, Pre-Existing Conditions NCCS News /by actualize

Silver Spring, MD – The National Coalition for Cancer Survivorship (NCCS) issued the following statement regarding today’s announcement by the Trump administration outlining options states can pursue to circumvent the Affordable Care Act (ACA). Today’s announcement of these policy options follows previous Centers for Medicare and Medicaid Services (CMS) guidance that outlined broad authority to the states to design their health care systems through a “waiver” of key ACA requirements and provides states with more specific options for avoiding ACA standards.

Shelley Fuld Nasso, CEO of NCCS, stated:

“The National Coalition for Cancer Survivorship (NCCS) advocates on behalf of nearly 16 million cancer survivors today, and 1.7 million newly diagnosed each year. Today’s waiver option is a serious threat to cancer survivors. First, by encouraging the purchase of junk insurance plans, the Trump administration will undermine the insurance markets that millions of people with cancer and other pre-existing conditions currently rely on. Although CMS describes the proposal as a flexible and consumer-based approach, it is in fact another threat to people with cancer and other serious and chronic illnesses, which would leave them in costly and unsustainable insurance markets. It is the latest attack on those with pre-existing conditions.

“Second, to redirect federal assistance currently used to purchase quality health plans in the ACA to instead be used to purchase junk insurance would undermine another of the ACA’s most important safeguards. By directing federal assistance to these and other skimpy insurance options, CMS is encouraging states to provide insurance options that will largely be inadequate for anyone newly diagnosed with cancer who need comprehensive insurance coverage.

“The Trump administration describes the options as ones that empower patients and provide states flexibility. However, these guidance documents would encourage states to design systems that would make adequate and affordable insurance for cancer patients almost impossible in the individual insurance markets. The options for state health plans released today confirm that the Trump administration is threatening the viability of the ACA and the insurance marketplaces in the states. Again, the ACA should set a baseline of quality and affordable health care for everyone and should not depend on what state you live in.

“NCCS will express its strenuous objections to the waiver guidance during the open comment period, even though the Trump administration made clear that it is moving ahead with the waiver plan even before the comment period ends. We will also urge the states to resist the encouragement from CMS to move away from ACA plans and toward junk insurance. Finally, we will collaborate with other organizations representing the needs of patients in efforts to block this most recent effort to undermine the ACA.”

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NCCS Statement on HHS Final Rule for Short-Term, Limited Duration Health Plans

August 1, 2018/in Cancer Policy Blog, CMS, HHS, NCCS News, Policy Comments Access to Care, Affordable Care Act, Health Care Coverage, Pre-Existing Conditions NCCS News, Policy Comments /by actualize

The National Coalition for Cancer Survivorship (NCCS) issued the following statement regarding the Trump administration’s announcement of the final rule on short-term, limited-duration health insurance plans:

“NCCS is deeply concerned that the administration’s new rule on short-term, limited-duration plans, called ‘junk insurance’ by health insurance experts, will harm cancer patients and survivors by providing inadequate coverage for cancer care and by driving up premiums for comprehensive plans that cover the health care needs of those with cancer. While the administration touts the affordability of these plans, affordability comes at the expense of coverage. Encouraging the use of short-term plans breaks the promise of the administration and Members of Congress to protect people with pre-existing conditions.

“Millions of cancer survivors were relieved when Congress rejected efforts to repeal the Affordable Care Act (ACA) last year, but now the administration is again eroding the ACA protections. Short-term plans do not have to cover people with pre-existing conditions and are not required to offer benefits such as maternity care, prescription drugs, or preventative care. These plans will not help people with a history of cancer or people who will be diagnosed with cancer. Additionally, these barebones plans will attract young and healthy individuals, leaving older and sicker individuals in the individual market. Premiums in the individual market will go up and choices may go down. People with cancer and cancer survivors who rely on the individual market for insurance will find that adequate and affordable insurance is beyond their reach.

“NCCS is concerned that individuals will buy short-term plans thinking they are getting a good deal until the moment they need health care services, or worse, face a diagnosis of cancer, when they will be stuck with enormous out-of-pocket costs. These plans are NOT a substitute for the comprehensive health coverage that the ACA ensures. By expanding and promoting short-term limited-duration plans, the administration is taking patients back to the days when insurance companies denied individuals who are sick and excluded coverage for the care that cancer survivors need.”

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ACA Update | December 8, 2017 – As Tax Bill Negotiations Continue, Sen. Collins’ Legislative Demands Not Likely to Be Acted on This Year

December 8, 2017/in Cancer News, Cancer Policy Blog Access to Care, Affordable Care Act, Pre-Existing Conditions NCCS News /by actualize

Prior to the Affordable Care Act (ACA), cancer survivors were at the mercy of the health care system, often forced to pay exorbitant premiums or simply denied coverage altogether. Today, America’s 16 million cancer survivors benefit from the ACA’s patient protections that are critical to providing them with quality, affordable, and accessible health care coverage. NCCS is actively engaged in advocating to ensure this unprecedented access for cancer patients and providers continues.

It has been a little over a week since the Senate passed their tax reform bill. As the chambers continue to negotiate the differences between the House and Senate versions, a great deal of uncertainty remains as to the final product, especially as it pertains to health care provisions in the bill. Senator Collins (R-ME) voted in support of the bill with the condition that two stabilization bills pass before the year ends in order to off set the negative impacts of repealing the individual mandate. One bill, known as Alexander-Murray, would temporarily restore cost-sharing subsidies to insurers. The second, Collins-Nelson, would fund a two-year reinsurance program helping health plans cover particularly expensive patients. However, health policy experts are not convinced that these two stabilizing bills would truly mitigate the impact of repealing one of the most important pieces of the Affordable Care Act. In fact, the nonpartisan Congressional Budget Office estimates that repealing the mandate would lead to 13 million people losing their coverage and premiums could rise by 10 percent. It would put more pressure on an already unsteady Obamacare market as it could lead to an exodus of healthy people and cause insurers to raise prices to cover the cost.

The health care community is united in opposition to repeal of the individual mandate, including the American Academy of Family Physicians, American Medical Association, America’s Health Insurance Plans, American Hospital Association, Blue Cross Blue Shield Association of America, and the Federation of American Hospitals.

As Bloomberg News reported, it is by no means clear that either of the health care bills Collins bargained for will get anywhere in the House, where conservatives regard the measures with disdain. While the negotiations around the tax bill are shaky, now is a key time to make sure Members of Congress know that the public doesn’t want to repeal the individual mandate. Please call your Members today at (844) 257-6227 and tell them tax reform should not come at the expense of cancer patients.

While this year’s ACA open enrollment is outpacing years past, final numbers are expected to be lower since the Administration has cut the time of enrollment in half. 4.5 million Americans can get covered at NO premium. They must just apply by 12/15. If you, or a friend or family member needs to sign up for health insurance, visit getamericacovered.org today!

What Caught Our Eye: ACA Open Enrollment Info, Tax Bill Eliminates Medical Expense Deduction, A Young Med Student’s Lymphoma Story

November 3, 2017/in Cancer News, Cancer Policy Blog Access to Care, Affordable Care Act NCCS News /by actualize

What Caught Our Eye (WCOE), November 3, 2017
What Caught Our Eye is our week-in-review blog series, where we recap the cancer policy articles, studies, and stories that caught our attention.

Affordable Care Act

It’s Open Enrollment Season! Do You Know Your Health Insurance?

It’s officially “open enrollment season” and that means millions of Americans are about to dive into an alphabet soup of insurance choices. To help with this problem, Merck collaborated with health literacy experts to design a simple online guide to buying and using health care insurance that uses entertaining and interactive tools to teach consumers about insurance options that make sense for their families’ needs.
Go to the online guide »

“Get America Covered”

Why #GetCovered? Without health insurance, a trip to the emergency room could cost you more than a month’s rent. https://t.co/idN4K8F2GU pic.twitter.com/iek0wCDngm

— Get America Covered (@GetUSCovered) October 31, 2017

If you have coverage through HealthCare.gov, a state run ACA Marketplace, or off-Marketplace coverage, the headlines this year likely have filled you with anxiety. Was health care repealed, is your coverage at risk, are premiums going to be higher? Rest assured: the Marketplace is opening for business on Wednesday, November 1, 2017, and if you enroll you can count on your coverage through the end of 2018.
Read More »

“How Premiums are Changing in 2018”

Gold v Silver: In some counties, ACA marketplace consumers can get more generous coverage for lower premiums in 2018 https://t.co/y75lvqP7w6 pic.twitter.com/dINAPwM4E4

— KFF (Kaiser Family Foundation) (@KFF) November 2, 2017

From Kaiser Family Foundation — Premiums are rising significantly in many counties across the country, in part due to the decision of the Trump Administration to cease payments to insurers for cost-sharing reductions. Insurer participation also declined in many areas, leaving more counties with only one insurer, which likely contributed to the high rate of premium growth.
Read More »

“Insurer “Gravy Train” May Actually Help a Lot of People”

Actually, most customers will be unharmed by Trump’s subsidy cutoff and some will be better off, @sangerkatz finds. https://t.co/eTbQue9nc8

— Peter Baker (@peterbakernyt) October 19, 2017

By Margot Sanger-Katz, New York Times — Early in October, President Trump announced that he would stop making cost-sharing reduction (CSR) payments, but now it looks as if the ACA won’t collapse without them – how could that be? Insurers and states found a way to avoid it.
Read More »

Cancer Policy

“GOP tax bill would eliminate medical expense deductions”

GOP tax bill would eliminate medical expense deductions https://t.co/d2lBsTrkL4 pic.twitter.com/tj3i1ZlQYr

— The Hill (@thehill) November 2, 2017

By Nathaniel Weixel — The House Republican tax bill would eliminate the ability for individuals to deduct qualified medical expenses, a provision that could have major implications for households with extremely high health-care costs.

Under current law, the IRS allows individuals to deduct qualified medical expenses that exceed 10 percent of a person’s adjusted gross income for the year. The bill would repeal that itemized deduction, effective in 2018.
Read More »

Cancer Care

“Cancer Diagnosis Galvanizes a Medical Student”

I was really emotional as I reported this story of a young medical student who learned he had lymphoma — and… https://t.co/3lQKri5QF0

— Lucette Lagnado (@LucetteLagnado) October 21, 2017

By Lucette Lagnado, Wall Street Journal — How a support network—and a special bond with his doctor—helped a 22-year-old med student fight lymphoma.

Ari Bernstein was 22 years old and five months into his first semester at Albert Einstein College of Medicine when he learned he was sick. Sometime last November, he began noticing his neck was sore, and felt a lump at the base of his neck. When he had it checked in December, it turned out to be the tip of a roughly seven centimeter mass wrapped around his heart and trachea.
Read More »

“After Battling Cancer, She Spreads the Word on Genetic Testing”

Many thanks to @BostonGlobe and @GlobeWest for this opportunity to share my #BRCA story and Oneinforty's messages:https://t.co/pfcGxXkLRw

— Oneinforty (@oneinforty) October 27, 2017

By Steve Maas, Boston Globe — Lauren Corduck had been haunted by the fear of breast cancer. Her grandmother died of it at 56, and an aunt had it twice. Corduck had undergone annual mammograms since she was in her 20s. Last December, prodded by a friend, she received genetic counseling.
Read More »

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What Caught Our Eye: ACA Premiums; Excessive Cancer Care; Saving Lives With Policy; Horrifying Hospice Care; Cancer Drug Efficacy; and More

October 27, 2017/in Cancer News, Cancer Policy Blog Access to Care, Affordable Care Act, Health Care Coverage, Palliative Care, Quality Cancer Care, Survivorship Care NCCS News /by actualize

What Caught Our Eye (WCOE), October 27, 2017
What Caught Our Eye is our week-in-review blog series, where we recap the cancer policy articles, studies, and stories that caught our attention.

Affordable Care Act

“When Silver Costs More Than Gold: How Trump’s Actions Have Scrambled Insurance Prices”

https://twitter.com/sangerkatz/status/923863096711614464

Via New York Times — The rates for next year’s Obamacare plans are out, and they show how President Trump’s actions have scrambled the insurance marketplace. Usually, plans known as gold have higher monthly premiums but lower out-of-pocket costs than “silver” plans, which have tended to cost less each month and have been the most popular plans.

But this month, Mr. Trump carried out a longstanding threat and ended certain subsidies for insurers. To compensate for the lost funding, insurers increased the prices of their plans — heavily in the silver category and less so in others.
Read More »

“CBO: Congress waited too long to avoid Obamacare premium increases for 2018”

CBO: Congress waited too long to avoid Obamacare premium increases for 2018 https://t.co/CtgG8pAL7r

— Michael Hiltzik (@hiltzikm) October 25, 2017

Via L.A. Times — There’s good news and bad news in the Congressional Budget Office’s analysis of the bipartisan Senate deal to save some Obamacare provisions from President Trump and his wrecking crew.

The good news is that the so-called Alexander-Murray compromise, named after its godparents, Sens. Lamar Alexander (R-Tenn.) and Patty Murray (D-Wash.), would accomplish its goal of reducing premiums and would even cut the federal deficit, without raising the number of Americans without health coverage.
Read More »

“Share The News (Because Trump Won’t): ACA Open Enrollment Starts Soon”

New post: Open Enrollment For #ACA Starts Soon – Share The News via @forbes https://t.co/S2UZoAxRCP #health #insurance pic.twitter.com/w3WhEY1UDB

— Judy Stone (@DrJudyStone) October 26, 2017

Via Forbes Opinion — Trump and the GOP are doing their best to undermine the Affordable Care Act (aka Obamacare) and cause it to fail. One of their means of sabotage is by removing outreach and educational efforts, which are vital in getting people to enroll for health care.
Read More »

Policy News

“How a change in hospital policy saved thousands of lives”

https://twitter.com/sarahkliff/status/922508630188023808

Podcast from Vox.com — Sarah Kliff’s new podcast series, “The Impact” on Vox.com, examines how policy impacts lives. In this episode, she describes how two hospitals responded when children in their care died of central line infections. One examined its practices and made changes to reduce infections. The other did not.
Listen Online »

“Trump health official Seema Verma has a plan to slash Medicaid rolls. Here’s how”

Seema Verma's plan for reversing the expansion of Medicaid, state by state. https://t.co/zT9ESg8RMa via @statnews

— Casey Ross (@caseymross) October 26, 2017

By — With a broad overhaul of Obamacare stalled in Washington, one of President Trump’s top health care leaders is drawing the outlines of sweeping changes to Medicaid that could pare enrollments and cut costs without congressional approval.

Seema Verma, director of the federal Centers for Medicare and Medicaid Services, is promising to give states an “unprecedented level of flexibility” to design their Medicaid programs as they see fit. In an appearance in Cleveland this week, she pledged to reduce scrutiny of state requests for waivers from federal rules meant to preserve access and quality standards.
Read More »

“Actually, Many New Cancer Drugs May Be Helpful And Worth Trying”

Actually, Many New Cancer Drugs May Be Helpful And Worth Trying, by @ESchattner –https://t.co/RAvDF7RQsK via @Forbes

— Elaine Schattner MD, MA (@ESchattner) October 24, 2017

Via Forbes.com — You might have heard that many new cancer medicines offer little benefit. This month, the BMJ published a review finding that for most cancer drugs approved by the European Medicines Agency between 2009 and 2013, there was neither published evidence that they extend overall survival nor improve patients’ quality of life. In 2015, JAMA reported similar observations for oncology drugs approved by the U.S. FDA between 2008 and 2012. Both papers focused on evidence from randomized clinical trials.

…

Perhaps the literature fails to capture the clinical benefit of many oncology drugs. This could happen for several reasons. One is the under-appreciation that progression-free survival (PFS) can be truly helpful, permitting many people with advanced cancer to more comfortably go about their lives. Another is that randomized clinical trials (RCTs) may not be designed or statistically powered to reveal true benefits in small fractions of patients.

Coping with Cancer

“‘No One Is Coming’: Hospice Patients Abandoned At Death’s Door”

Instead of hospice care for a dying loved one, they were left to their own devices. REALLY. https://t.co/r9cQoPONZS @JoNel_Aleccia @mmbaily

— Catherine SaintLouis (@cslwrites) October 26, 2017

Via Kaiser Health News — As her husband lay moaning in pain from the cancer riddling his body, Patricia Martin searched frantically through his medical bag, looking for a syringe.

She had already called the hospice twice, demanding liquid methadone to ease the agony of Dr. Robert Martin, 66. A family practice physician known to everyone as “Dr. Bob,” he had served this small, remote community for more than 30 years.
Read More »

“So Much Care It Hurts: Unneeded Scans, Therapy, Surgery Only Add To Patients’ Ills”

Overscanning. Overtreating. Overburdening patients with breast cancer. A VERY smart read from @LizSzabo at @KHNews: https://t.co/9JfjWtFih1

— Clifton Leaf (@CliftonLeaf) October 25, 2017

Via Kaiser Health News — When Annie Dennison was diagnosed with breast cancer last year, she readily followed advice from her medical team, agreeing to harsh treatments in the hope of curing her disease. “You’re terrified out of your mind” after a diagnosis of cancer, said Dennison, 55, a retired psychologist from Orange County, Calif.

In addition to lumpectomy surgery, chemotherapy and other medications, Dennison underwent six weeks of daily radiation treatments. She agreed to the lengthy radiation regimen, she said, because she had no idea there was another option.
Read More »

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ACA Update | October 23, 2017 – Bipartisan ACA Stabilization Bill an Important Step Forward

October 23, 2017/in Cancer News, Cancer Policy Blog Access to Care, Affordable Care Act, Pre-Existing Conditions NCCS News /by actualize

Prior to the Affordable Care Act (ACA), cancer survivors were at the mercy of the health care system, often forced to pay exorbitant premiums or simply denied coverage altogether. Today, America’s 16 million cancer survivors benefit from the ACA’s patient protections that are critical to providing them with quality, affordable, and accessible health care coverage. NCCS is actively engaged in advocating to ensure this unprecedented access for cancer patients and providers continues.

For months, Senators Lamar Alexander (R-TN) and Patty Murray (D-WA) have been working on a market stabilization bill that would fund the cost-sharing reduction (CSR) payments for the Affordable Care Act (ACA) and include other provisions to keep insurers in the markets. The stabilization bill was tabled when the Graham-Cassidy legislation was being considered, but now that efforts to repeal the ACA have stalled, Senators Alexander and Murray this week released the text of their bipartisan compromise. So far, 24 Senators have co-sponsored the bill, with a dozen of those co-sponsors being Republican Senators.

The Alexander-Murray bill would:

Guarantee CSR payments through 2019.
Restore a significant portion of the Administration’s cuts to ACA outreach and enrollment assistance.
Expand eligibility for “catastrophic plans”.
Make changes to 1332 waivers that allow states to modify certain provisions of the ACA.

https://twitter.com/dylanlscott/status/920676149130399744

The Alexander-Murray bill rebukes the Administration’s efforts to undermine the ACA by funding the CSR payments through 2019 and restoring $106 million of the funding for enrollment outreach over the same time period. In exchange for these stabilization policies, states will have more flexibility to shape their own health care systems.

As Vox explains, states would have to jump through fewer hoops for ACA waivers and approvals would be streamlined. The bill allows state flexibility regarding waivers, but retains critical patient protections, as states would not be allowed to waive essential health benefits or discriminate based on pre-existing conditions. Dylan Scott of Vox writes, “Looking ahead to 2019, the deal would undoubtedly provide more stability to the ACA markets, which were reaching an equilibrium before Trump intervened. The cost-sharing payments would be guaranteed, and plans would know that tens of millions of dollars would be spent on Obamacare outreach.”

Since the release of the bill text, America’s Health Insurance Plans (AHIP), American Hospital Association (AHA), the U.S. Chamber of Commerce, and the American Academy of Family Physicians have announced support of the legislation stating that patients and consumers benefit from more affordable health care and additional choices in a stable individual health insurance market. A bipartisan group of governors have announced their support for the bill, as have many advocacy and patient groups.

NCCS believes the Alexander-Murray agreement is an important step forward in moving Congress toward bipartisan action on health care and away from damaging efforts to repeal the ACA and taking coverage away from millions of people. The bill rebukes the Administration’s efforts to undermine the ACA and would help to stabilize the marketplace. NCCS and nearly 30 cancer advocacy organizations, representing patients, physicians, nurses, and social workers have joined together to support the legislation.

Please contact your Members of Congress and ask them to support the Alexander-Murray bipartisan stabilization bill by calling our hotline at (844) 257-6227.

For more information on how you can get involved, check out our #ProtectOurCare page »

Follow NCCS on Twitter to stay updated on developments: @CancerAdvocacy.

ACA Update | October 13, 2017 – Trump Administration Cuts Off Cost-Sharing Payments, Signs Executive Order to Undermine the ACA

October 13, 2017/in Cancer News, Cancer Policy Blog Access to Care, Affordable Care Act, Pre-Existing Conditions NCCS News /by actualize

Prior to the Affordable Care Act (ACA), cancer survivors were at the mercy of the health care system, often forced to pay exorbitant premiums or simply denied coverage altogether. Today, America’s 16 million cancer survivors benefit from the ACA’s patient protections that are critical to providing them with quality, affordable, and accessible health care coverage. NCCS is actively engaged in advocating to ensure this unprecedented access for cancer patients and providers continues.

After the actions President Trump took this week, there’s no question the Administration is actively working to undermine the Affordable Care Act (ACA). Yesterday, the President signed an Executive Order making sweeping changes to the ACA that would hurt patients and disrupt the ACA marketplace and he announced the Administration would halt cost-sharing reduction (CSR) payments. NCCS is alarmed by the efforts to undermine the ACA and calls on Congress to act immediately to ensure the funding of cost-sharing reductions. Read our statement on these actions here.

The Executive Order attempts to unwind the law through Administration action, since Americans and Congress rejected legislative repeal efforts. The order will allow insurance companies to sell cheaper, “junk” plans that are exempt from Obamacare requirements. These changes could expand coverage options for healthy customers, but would raise costs for individuals who need more comprehensive coverage, or potentially leave them without coverage options at all. The Order would allow insurance companies to sell short-term health plans and association plans for small businesses, and in some cases, individuals. Association plans exist today but the Executive Order would exclude them from ACA regulations that require all plans meet a minimum standard and cover essential health benefits.

The Executive Order, much like the ACA repeal bills that Congress considered this year, would be terrible for Americans with pre-existing conditions and leave millions with insurance policies that do not cover essential services like prescription drugs, hospital visits, or critical treatments. The new, less regulated insurance plans would be attractive to healthy people, while at the same time making it difficult for individuals with pre-existing conditions to find comprehensive health care coverage. This Order would be harmful to the 1.7 million Americans diagnosed with cancer this year and the millions who will be diagnosed in the future. As the 16 million Americans living with cancer well know, we are all only temporarily healthy.

Later in the day, President Trump took another action that would disrupt the marketplace and make it more difficult for low-income Americans to purchase health insurance through the exchanges. The administration announced it will immediately halt cost-sharing reduction (CSR) payments. The $7 billion in annual subsidies help around 7 million low-income Americans to afford their deductibles and co-pays. While the Administration has called the CSR payments a “bailout,” this characterization is inaccurate. The payments are made to insurance companies, who then pass them along to medical providers.

The Congressional Budget Office says that ending CSR payments will result in 1 million more Americans uninsured, premiums will rise by 20% and the deficit would rise by $194 billion. As the Washington Post reports, the uncertainty about what Trump would do has already driven premium prices higher for 2018 – in some states, increases topping 50 percent. Now it’s going to get worse. And NPR reports that pulling CSR payments not only hurts the low income Americans who depend on the subsidies, the decision will also hurt middle-class individuals who earn too much to qualify for help paying their premiums.

To be clear, these actions will have a combined effect of “sabotaging” the Affordable Care Act. The replacement will be “Trumpcare,” a system that will not offer adequate health care to Americans and that will instead put many at risk. The National Coalition for Cancer Survivorship (NCCS) strongly opposes the decision to pull CSR payments and the Executive Order to allow substandard health plans and we will be an active and aggressive participant in the regulatory process, to make sure that the needs of those with cancer and other serious illnesses are reflected and that their access to affordable and adequate health insurance is protected.

You can help us advocate for cancer survivors by contacting your senators to ask them to publicly state support for funding CSR payments and bipartisan legislation to ensure payment. Call our hotline # to be connected to your Members of Congress: (844) 257-6227

For more information on how you can get involved, check out our #ProtectOurCare page »

Follow NCCS on Twitter to stay updated on developments: @CancerAdvocacy.

NCCS Position Statement on Actions to Undermine ACA

October 13, 2017/in Cancer News, Cancer Policy Blog, NCCS News Access to Care, Affordable Care Act, Financial Toxicity, Health Care Coverage, Health Equity, Pre-Existing Conditions NCCS News /by actualize

October 13, 2017

The National Coalition for Cancer Survivorship (NCCS) is alarmed by the actions President Trump took this week to undermine the Affordable Care Act. These decisions are likely to destabilize the individual insurance market and put affordable and adequate health insurance out of reach for millions of Americans. The health and well-being of cancer patients and millions of additional Americans are under threat as a result of these actions, as many will be unable to afford insurance coverage. Those at greatest risk for limited access to affordable coverage are those with pre-existing conditions.

These actions, and their potential effects on cancer patients, include:

Directing federal departments to revise rules and regulations to encourage the marketing and purchase of association health plans and short-term limited duration insurance. These efforts will harm cancer patients – and all Americans except those who are healthy today – by separating the healthy and the sick into risk pools, thereby collapsing the individual market. These efforts will also result in the marketing and purchase of bare bones “junk” insurance policies that are inadequate for any Americans with health issues. Those who purchase these junk plans today while healthy will be left with wholly inadequate insurance if they are diagnosed with cancer.
Refusing to fund the cost-sharing reductions that ensure that low-income Americans have assistance with deductibles and cost-sharing. This decision will immediately cause increases in premiums in the individual market, but the subsequent effects will likely be the withdrawal of insurers from the marketplace and potentially the collapse of insurance markets. Many consumers will be unable to obtain insurance coverage at all and many more will be unable to find affordable coverage. These $7 billion in annual subsidies to health insurers allow around 7 million low-income Americans to afford coverage. The Congressional Budget Office says that ending CSR payments will result in 1 million more Americans uninsured, premiums will rise by 20% and the deficit would rise by $194 billion. As the Washington Post reports, the uncertainty about what Trump would do has already driven premium prices higher for 2018.

NCCS will intensify its efforts in opposition to proposals that will bifurcate the pool of Americans in the individual market, as we think these efforts do not achieve the goals of providing Americans more affordable insurance and a wider range of insurance options. Instead, these efforts threaten the individual insurance market. We also call on Congress to act immediately to ensure the funding of cost-sharing reductions. This is a modest but absolutely critical step for stabilizing the insurance markets.

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