Cancer strikes without regard to politics. One in two men and one in three women will hear the dreaded words: “You have cancer” and 75 percent of households will care for a cancer patient at some point. No matter their political persuasion, cancer patients and caregivers will benefit from the next stages of Affordable Care Act (ACA) implementation.
Cancer poses a plethora of challenges–physical, psychological, emotional, social, logistical, and financial–to both cancer patients and their families. The costs of unreimbursed medical care, even for people who have health insurance, caused 62 percent of personal bankruptcies in 2007, according to a study by Harvard researchers. For patients’ family caregivers, every hour spent agonizing about insurance and financial issues is an hour that’s not supporting the cancer patient’s primary needs: sustaining normalcy, maintaining hope and restoring health.
The future of the ACA has been in limbo since its passage in 2010, leaving cancer families wondering if future treatments would be covered, for how long, and with what financial impact on the rest of the family. Family caregivers bear the brunt of the financial stresses associated with a cancer diagnosis while the patient is otherwise engaged, often fighting for his or her life. Regardless of the outcome for the cancer patient, research has found that severe and prolonged cancer care giving can measurably shorten a caregiver’s life.
The passage of the Affordable Care Act was intended to ensure access to quality care with maximum quality of life, minimum administrative complexity and significantly reduced financial stress. It will ensure that all Americans will have:
• Health insurance coverage. Access to insurance coverage will be available even for those who change jobs, and coverage must be approved or continued regardless of gender or pre-existing conditions. No one will need to worry about an insurer cancelling coverage or ? effective Jan. 1, 2014 ? being charged more when they receive a cancer diagnosis.
• Earlier cancer detection. The earlier cancer is detected, the more likely it is to be survivable. Effective Jan. 1, 2013, the act provides for reduced or no-cost preventive and screening services for breast, colorectal, and prostate cancer, three of the most prevalent cancers.
• More extensive Medicare drug coverage. The Medicare Part D prescription cap in coverage (known as the “donut hole”) will be narrowed over time and eventually eliminated (by 2020).
• Longer coverage for children. Children up to the age of 26 can continue coverage under parents’ health insurance policies.
• No lifetime limits (now) or annual limits on payments (by 2014). Patients won’t have to postpone treatments for fear of costs being incurred after an arbitrary limit has been reached.
• Coverage for clinical trials. Beginning on Jan. 1, 2014, coverage will be provided for anyone eligible to participate in a clinical trial that is appropriate to treat the patient’s condition, which can results in longer life and potential survival.
Uncertainties remain that are important to cancer families as Congress confronts the “fiscal cliff,” mandated budget cuts that are scheduled to take effect Jan. 1 if Congress doesn’t resolve the financial stalemate. Under that scenario funding would be jeopardized for cancer research, clinical trials and breast and cervical cancer screening programs.
In spite of the uncertainties, cancer-affected families can now focus on managing their loved ones’ treatment, supporting their living and maintaining their hope for a cancer-free future—the core of effective care giving.
Deborah J. Cornwall is the author of ‘Things I Wish I’d Known: Cancer Caregivers Speak Out.’