Cancer Professionals and Patients Anxious About Changes in Obamacare

Oncology professionals are concerned about the ability of their patients to access cancer screening and treatment under the American Health Care Act proposed by House Speaker Paul Ryan, according to a survey conducted in March at the National Comprehensive Cancer Network’s  Annual Conference.

A majority of those surveyed believed that anticipated changes to the Patient Protection and Affordable Care Act (Obamacare) would have a negative impact on their practices and on cancer research. More than 70 percent noted that patients have voiced concern about the anticipated repeal and replacement of Obamacare, nearly two-thirds of whom have demonstrated increased levels of distress.

The survey was conducted during the period of congressional debate over the American Health Care Act (AHCA), which was withdrawn the afternoon of March 24 when it became clear there were not enough votes to pass the legislation. Responding to the survey were 76 oncology professionals, including physicians, academic and community; nurses; physician assistants; pharmacists; industry professionals; payers and patient advocates. Republicans in the House continue to discuss ways to repeal or change the law.

“The American Health Care Act is tabled and the ACA remains in place, but concerns about access to cancer screening, care, and research funding remain. Today, patients are in limbo, not knowing what action the federal and state governments will take,” said Robert W. Carlson, MD, Chief Executive Officer of NCCN. “NCCN agrees there are ways to improve the current health care system for Americans with cancer, the clinical professionals who care for them, and payers. However, we are concerned for Americans with cancer that affordability, coverage of products and services in cancer treatment, and overall access will be impeded by allowing health insurers to set their own rates, or by providing states the ability to experiment with Medicaid coverage, without appropriate patient protections.”

The NCCN survey found:

• Fifty-five percent of respondents reported that the anticipated large-scale changes to federal health care policy would likely have a negative impact on their practice, research programs or patient outcomes. Eleven percent anticipated a positive impact, and 34 percent anticipated a neutral, or mixed impact.

•  When asked to select from a list of outcomes they anticipated would occur with changes to health care policy, those who anticipated a negative impact (55%) indicated:                         

•   Fewer patients will have access to health insurance (71%) • High deductibles will limit patient access to care (69%) • Cancer screening rates will decline due to higher co-pays and deductibles (63%) • Patients’ pre-existing conditions could be excluded from coverage (57%) • Federal funding for cancer research will decline (56%) • There will be less support for mental health services (50%)

Those who expected a positive impact (11%) indicated:

•   With increased competition for insurers operating across state lines, health insurance premiums and co-pays will go down for more patients, leading to improved access to care (50%) • Allowing medications to be imported will create more competition and reduced drug prices (50%) • Patient health savings accounts will lead to increased price transparency for medical procedures and medications, causing health care costs to drop (38%)

•  When asked, “What kind of impact do you believe changes in federal health care policy will have on your patients’ ability to afford cancer care?” 66 percent of respondents said the impact would be negative; nine percent said positive; and 25 percent said the impact would be neutral.

•   And, to the question, “To your knowledge, are your patients affected by health insurance policy and the possible repeal and replacement of the Affordable Care Act?” respondents answered:   

• Yes, patients have expressed concern and demonstrated greater levels of distress (50%) • Yes, patients have expressed concern but no evidence of health impact (21%) • No, I have not seen any effects (29%) 

“President Trump included three key elements in his approach to health coverage reform: repairing necessary aspects of the ACA, ensuring greater access, and lowering the total cost of care,” Dr. Carlson said. “We are ready to share our Network’s expertise with lawmakers to deliver a value-based health policy to ensure that all Americans with cancer have access to high-quality, effective, and efficient cancer care.”

Read Dr. Carlson’s March 21, 2017 letter to Congress outlining NCCN’s concerns about the health policy proposal and patient access to care here.

Information from a news release provided by the National Comprehensive Cancer Network.