We have been hearing about the Affordable Care Act (ACA) for quite a while. However, many are still confused as to what this law is trying to accomplish and how it will benefit various populations of patients across the United States. This fourth issue of Conquering the Cancer Care Continuum™ provides readers with a comprehensive overview of the ACA as seen from the eyes of an oncology nurse, an insurance payer, and a pharmacist. I think these different viewpoints offer great value and will provide new insights into the potential impact of this legislation on both patients and healthcare professionals.
Everyone applauds the goals of improving access to care, developing more quality measures by payers (such as penalties for hospitals with high readmission rates), addressing the “doughnut hole,” and eliminating preexisting conditions, which have been a known barrier to care for a long time. As millions of people obtain insurance coverage, the healthcare system will be potentially flooded with new patients who may have neglected cancers that now are presented to us for evaluation and treatment. The law also provides for free screenings (for cancers that have methods for screening) with the goal of prevention or early detection. Once cancer is diagnosed, however, care is not necessarily going to be totally free. This remains an issue of confusion for individuals who are just now getting into an insurance program. What has been probably long overdue, and we hope will result in better quality of care, is a requirement that patients receive information that is linguistically and culturally sensitive for them.
Many parents who were planning on having an empty nest once their children finished college are now experiencing these young adults returning home after graduation. In some cases, these adult children are jobless. If they do find employment, there is a good chance that their jobs will not include insurance benefits. Therefore, the ACA also provides a means for “children” up to the age of 26 years to remain on their parents’ insurance plan.
As more oncology drugs are converted from intravenous to oral routes of administration, the need for access to these new drugs, education about how to self-administer them, and the need to adhere to the treatment plan as intended becomes crucial. We will all watch, some from a distance and others in the thick of things, as the ACA continues its work in providing insurance coverage with the hope that no one is without insurance benefits going forward.
