The report--which comes just a few weeks before the Supreme Court hears a case that could invalidate the Affordable Care Act (ACA) and significantly alter how Americans get health care and what they pay for it--examines the costs associated with several kinds of cancer through various common insurance types including: a large employer-sponsored plan, a small employer high deductible plan, an individual marketplace plan, a short-term limited duration (STLD) plan and Medicare.
The analysis found a wide range in total patient costs, especially between the ACA-compliant plans and the non-compliant non-comprehensive STLD option. When premiums, deductibles, co-pays and co-insurance were calculated, patients with comprehensive or ACA-complaint coverage paid between
"This report shows just how important it is that patients have access to affordable, comprehensive health coverage," said
Key report findings include:
* Having insurance coverage and the type of coverage is critical. Benefit design determines how much a patient pays and how and when they'll pay it. High deductible health plans may have lower monthly premiums, but force patients to pay much higher costs all at once when they get sick, which can be challenging for patients and may lead to delayed tests or treatment.
* Out-of-pocket limits protect cancer patients, who rely heavily on their insurance benefits to treat their disease. Such patients often hit their maximum spend quickly and once reached do not have to pay cost sharing for in-network covered services.
* STLD plans put patients at risk for extreme costs as they do not have to cap patient out-of-pocket spending, can have even higher deductibles, and do not have to cover specific essential services.
Other findings include that changing insurance plans mid-year can cause spending spikes and higher total costs--a scenario more people may be experiencing due to coronavirus-related layoffs--and that the type of cancer, treatment plan, and treatment duration can cause huge variation in how much patients pay. The patient profiles do not account for out-of-network services, surprise medical bills, transportation and other expenses patients often incur.
The report details numerous policy proposals lawmakers should implement to ensure patient access to affordable, comprehensive health coverage and address the high costs of cancer. A recent survey (https://www.fightcancer.org/releases/survey-coronavirus-health-care-delays-and-anxiety-persist-cancer-patients-and-survivors) of cancer patients and survivors found access to comprehensive health care that covers all necessary services--during the pandemic and beyond--is patients' and survivors' top health-related priority (51%), followed by the availability of such coverage should someone's job change (20%).
"We need lawmakers to do everything they can to ease the financial stress cancer patients experience and ensure they're able to get quality, affordable care," said Lacasse. "That means working together to protect and strengthen the current health care law."
Cancer is one of the leading causes of death and disease in
* * *