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Trumpcare Versus Obamacare: What It Means for Patients With Cancer

Before you start to applaud the dissolution of Obamacare, you need to take into consideration what will happen to cancer patients and survivors.
PUBLISHED February 28, 2017
Kathy LaTour is a breast cancer survivor, author of The Breast Cancer Companion and co-founder of CURE magazine. While cancer did not take her life, she has given it willingly to educate, empower and enlighten the newly diagnosed and those who care for them.
Before you start to applaud the dissolution of Obamacare, you need to take into consideration what will happen to cancer patients and survivors who stand to lose the most according to many who are exploring potential changes suggested by the republicans.

One significant fact that is seldom pointed out is that the laws set out in the Affordable Care Act, also called Obamacare, reflect changes in all insurance – not just the companies in the marketplace.

Cancer is an expensive disease, and high medical bills is one of the top reasons individuals declare bankruptcy in the U.S. But for many, Obamacare has provided protections that have meant reasonable coverage, if not cure.

First, for those young people diagnosed with cancer before they have their own career started, the ability to stay on their parents' plans until age 26 has provided significant financial support. And when these young people look for their own insurance, the industry cannot take their cancer diagnosis into account in considering them for coverage. Before the ACA, insurance companies were allowed to refuse coverage to anyone with a preexisting health condition. This left those with cancer or those who provided insurance to a family member with cancer unable to change jobs or only seek employment with large companies that could provide coverage. 

Before Obamacare, women paid up to $1 billion more than men each year for identical health plans, according to obamacarefacts.com. The ACA makes it illegal to discriminate based on gender. Yes, healthy young men have been charged more on Obamacare to offset the costs of their mothers, wives, sisters, etc. 

Aside from tobacco use, wellness program requirements in the small group market, family size and geography, all other factors, such as pre-existing conditions, health status, claims history, duration of coverage, gender, occupation, small employer size, and industry are no longer used by insurance companies to increase the premiums for those seeking insurance.   

Some of the things that can no longer be taken into consideration in getting insurance are of critical importance to cancer patients. These include medical conditions including both physical and mental, the number of times claims have been filed in the past, how much health care a person has received. a person’s medical history, genetic information, evidence of insurability that includes conditions arising from domestic violence and disability.

As the Trumpcare plans begin to replace Obamacare, watch that these areas of critical importance to cancer patients and survivors stay with us. Notice from the above list that the ACA covers genetic information as one of the things that cannot be considered to deny coverage. This is critical for us as more research gives us more information about personalized care based on genetics. To be asked if we carry one of the gene mutations to be insured would be, to use a word Trump likes, a disaster.

And don’t forget drugs. The ACA required a 50 percent discount on brand-name drugs for Medicare patients beginning in 2011. By 2020, the government would pay to provide up to 75 percent discount on brand-name and generic drugs, eventually closing the coverage gap.

As it becomes clear that cancer can return and cause other problems in the future of the patient, we must also continue demanding no lifetime limits on insurance. It will be easy to hit millions of dollars without such limits with the new, ever increasing drug and treatment costs. 

Even with the limits placed by the ACA, cancer patients often declare bankruptcy. Now the 1.6 million Americans who will be diagnosed with cancer this year and the 15.5 million who have already been diagnosed may be concerned that they will be in financial straits more than they already are. Many have long-term and late effects from treatment. Others are on disability or can no longer practice their profession due to cancer or its treatment.

According to a 2013 study in the American Journal of Clinical Oncology, for Americans newly diagnosed with cancer, the annual economic burden was $16,000 per person. Cancer bills have been a leading cause of personal bankruptcy in the U.S and a third of survivors report ongoing financial burdens after cancer. Often this is a result of stopping work, which 85 percent of cancer patients report.

The ACA has not removed all the financial issues for cancer patients, but it has made a good start. It needs tweaking, we all agree, as the premiums have continued to rise. But let’s not throw out the baby with the bath water. Trump is a well-known negotiator, so let’s see him get the insurance companies to set their costs and stick with them. It’s not the design of Obamacare that is the problem, it is the insurance companies upping the costs. 

Think about what you have heard about Obamacare. It's the skyrocketing premiums that are the problem. So, Donald, Leave the ACA as it is and do what you do so well to get the insurance companies to stick to the lower premiums they promised.    
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