WASHINGTON, D.C. – December 1, 2010 – Adequate coverage at affordable prices is often not attainable for many Americans with cancer, testified Stephen Finan, senior director of policy for the American Cancer Society Cancer Action Network (ACS CAN), before the Senate Committee on Commerce, Science and Transportation today.
At the hearing, which focused on limited-benefit or “mini-med” plans, Finan testified that while the Affordable Care Act has made major strides in educating and empowering the consumer, there are still plans available on the market that leave people fighting a chronic disease like cancer extremely vulnerable and unaware that the insurance product they purchased is woefully inadequate.
“Many underinsured are left with the extraordinary dilemma of either incurring serious and potentially ruinous out-of-pocket financial expenses to obtain necessary treatment, or curtailing essential treatment, thereby putting their health and possibly their lives in jeopardy,” Finan said.
“If we want all Americans to have meaningful access to quality health care, we need to change the insurance market rules, provide subsidies, streamline administrative processes and greatly increase transparency and accountability.”
Finan acknowledged that requiring limited-benefit plans to comply with expanded benefits requirements immediately could result in a disproportionate hike in premiums that would be unaffordable for many low- and middle-income beneficiaries of the plans. However, he stressed the need for the Department of Health and Human Services (HHS) to take the steps necessary to require plans with waivers to improve their products between now and 2014, when an essential benefits package to be included in all plans sold on insurance exchanges will help to ensure more adequate coverage.
“A waiver this year should not be a free ride until 2014,” said Finan, who is a consumer representative to the National Association of Insurance Commissioners.
Eugene Melville, a California man who called the American Cancer Society for help when he discovered his limited-benefit plan would not cover his treatment for an oral cancer diagnosis, also testified about the financial burden and barriers to access he has faced as a result of his bare bones health plan. Melville’s employer, a national retail chain, offers a plan with a $2,000 annual benefit limit on physician visits and out-patient treatments, and a $20,000 annual limit on hospitalizations. However the hospitalization coverage does not include payment for more than $2,000 on services such as lab tests, surgical supplies and medications.
According to a national nonpartisan poll conducted by ACS CAN, more than a third of cancer patients and survivors under age 65 reported problems with insurance coverage of cancer treatment such as the plan not paying for care or less than expected, reaching the limit of what the plan would pay, or delaying or skipping treatment because of insurance issues.
ACS CAN, the advocacy affiliate of the American Cancer Society, supports the rule released by HHS last week on medical loss ratio (MLR), a calculation that for the first time offers consumers a meaningful measure to evaluate their plans. ACS CAN is calling on the administration to be even more expansive in increasing insurer disclosures and transparency in the coming months and years. Healthy competition cannot begin to exist until consumers are able to understand and compare plans, with measures of quality and value in addition to price.
FOR MORE INFORMATION, CONTACT:
Alissa Havens or Steven Weiss
American Cancer Society Cancer Action Network
Phone: (202) 661-5772 or (202) 661-5711
Email: [email protected] or [email protected]