Deborah J. Cornwall
works with the Cancer Action Network, the legislative advocacy affiliate of the American Cancer Society, and is the author of "Things I Wish I'd Known: Cancer Caregivers Speak Out"
Cancer strikes without regard to political parties. One in two men and one in three women will hear the dreaded words, "You have cancer." In fact, 75 percent of households will find themselves caring for a cancer patient. No matter their politics, 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 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 caregivers, every hour spent agonizing about insurance and finances is an hour not used to support a patient's primary needs: sustaining normalcy, maintaining hope, and restoring health.
The 2012 election results provide certainty that the ACA will be implemented, freeing caregivers to focus on providing care and support. The 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 coverage will be available even for those who change jobs, and coverage must be approved or continued regardless of gender or preexisting conditions like cancer. No one will need to worry about an insurer canceling 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 treatable and survivable. Effective Jan. 1, 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 "doughnut hole") will be narrowed over time and eliminated by 2020.
Longer coverage for children. Children up to age 26, even those with cancer, can maintain coverage under their parents' health insurance policies.
No lifetime (now) or annual limits on payments (by 2014), so 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 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. Clinical trials represent treatments that are working their way out of the research pipeline into early commercialization. For patients facing certain life-threatening cancers, trials can represent the key to longer life and potential survival.
The mechanics for implementation of the ACA are still being developed by states and insurance carriers, so much remains to be defined and communicated over the months ahead.
However, two uncertainties remain as Congress confronts fiscal-cliff deficit reductions. Mandated budget cuts scheduled to take effect Jan. 1 if Congress doesn't reach agreements would jeopardize federal (National Institutes of Health) funding for cancer research, clinical trials, and breast and cervical cancer screening programs for low-income, uninsured, and underinsured women. In addition, action is still needed on provisions for maintaining adequate drug reimbursements to office-based physicians who administer drug treatments covered by Medicare Part B.
In spite of these two uncertainties, a sigh of relief is appropriate for cancer-affected families. Their focus now can be on managing their loved ones' treatment processes, supporting them in their day-to-day living, and maintaining their hope for a cancer-free future. These focal points are the core of what effective cancer caregiving is all about.