Affordable Care Act
The 115th Congress has set one of its priorities as repealing and replacing the Affordable Care Act. This will impact many living with and at risk for lung cancer. We are following this issue closely and working with Members of Congress to ensure your needs are still met no matter the outcome. See our official statement on this issue below.
LCA POSITION ON “REPEALING AND REPLACING” THE AFFORDABLE CARE ACT
In view of the continued interest to repeal the Patient Protection and Affordable Care Act (ACA), signed into law in 2010, LCA urges the Trump Administration and Congress to maintain the patient protections that are so important to cancer patients, survivors and all Americans.
LCA is deeply concerned that without simultaneously enacting a replacement plan that maintains and improves existing coverage and access to quality care, millions of Americans who are vulnerable due to pre-existing, chronic and serious lifelong conditions will lose comprehensive care.
We strongly urge Congress to not risk possible critical advancement in disease prevention and detection and treatments under the ACA without having in place a very strong and specific plan that ensures continued progress and patients’ ongoing access to comprehensive and affordable healthcare.
We recognize that there are many ideas about how best to reform healthcare and all segments of the system that includes the insurance and drug industries, the medical community and health care consumers, but LCA believes the main goal of healthcare reform should be to assure that all Americans have the ability to obtain high quality, comprehensive, affordable health care that meets their individual needs, thus allowing them to enjoy good health, functional independence and live as a productive participant within their communities.
LCA is calling on lawmakers to preserve critical protections for the lung cancer community that includes more robust research, accelerated preventive services and new breakthrough drug therapies, and commitment that patient needs are front and center in efforts underway to transform our healthcare delivery system. We encourage the inclusion of patient perspectives in the provisions of any legislative proposals and on behalf of the lung cancer community we advocate for the following:
Patient Valued Care Delivery System
The health care law should be patient centered. As we continue the transition from the traditional fee-for-service health care delivery system model – to a “value” based care model – we must ensure that “value” is defined by the patient not third party interests.
Access to Quality Care
The health care law should preserve patient and physician decision making about what treatments are “medically necessary” for and valued by the patient and should include access to all appropriate cancer care specialists, palliative care, support services and new lifesaving drugs and therapies.
The health care law should allow for portability of health insurance so that health needs shift to the individual and away from the employer. Once an individual is accepted into a healthcare plan and continues to make the necessary premium payments, portability would allow the individual to continue obtaining healthcare services through that plan even when they leave the job or state in which they obtained the plan.
The health care law must recognize that each of us has individual needs, unique characteristics and personal preferences that factor into our health care decisions and that do not fit neatly into one-size-fits-all models and assessments that drive certain clinical decisions on benefits, cost and effectiveness of treatments. Therefore, as we continue to transform healthcare delivery, we must ensure a people-centered health care system that works to match the right care deemed necessary by the individual and their physician, no matter where the individual works or lives.
Preventive Services for Lung Cancer
The health care law must recognize that in order to reduce lung cancer mortality, early detection and research must be linked to prevention efforts in a “continuum of care.”
The health care law must not reverse essential health benefits that includes newly approved preventive services for lung cancer screening, as this would deny life-saving benefits to the tens of thousands at risk for the disease.
The health care law should streamline and expedite the federal structure and process responsible for review and implementation of new preventive services to ensure benefits reach people more rapidly and efficiently. The system must be reformed to be more adaptive and agile when called upon to transition from scientific breakthrough to a national public health implementation plan.
The health care law should continue to support, reward and incentivize prevention, wellness and earlier intervention strategies to reverse costly and late stage management of disease.
Equitable and Affordable Insurance Coverage
The health care law should not allow insurance companies to limit the amount of money they will spend on a patient during their lifetime.
The health care law must prohibit high premiums based on health status and annual or lifetime limits on benefits to protect patients from being denied further coverage after they have met the set limits.
The health care law should allow for continued use of tax advantaged health savings accounts to give people additional financial tools and continued flexibility to best manage their own individualized health care planning and needs.
The health care law should prohibit insurance companies from denying coverage due to pre-existing conditions. This is a discriminatory practice and poses grave financial and emotional harm to people in need of critical care.
Medicare Drug Coverage
The health care law must maintain Medicare prescription drug coverage and not revert back to gaps in coverage for our seniors. We cannot go back to facing a “doughnut hole” in coverage.
LCA will oppose legislation that allows for a loss of insurance coverage, cuts in benefits and increases in medical costs for our community and our most vulnerable populations. We will continue to strive for a patient-centered system that brings choice and access to high quality care in an affordable and equitable way.
For more information on this and to share your opinion, please contact our Director of Health Policy, Elridge Proctor