How the ACA Will Affect Cancer Care

The 2012 election results provide certainty that the Affordable Care Act will be implemented, freeing cancer caregivers to focus on providing patient care and support. The passage of the Affordable Care Act will ensure that all Americans will have the following:

  • Health insurance coverage: Access to insurance coverage will be available even for those who change jobs, and coverage must be approved or continued regardless of gender or pre-existing conditions like cancer. No one will need to worry about an insurer cancelling coverage or being charged more when they receive a cancer diagnosis (effective January 1, 2014).
  • Earlier cancer detection: Effective January 1, 2013, the act provides for reduced or no-cost preventive and screening services for breast, colorectal, and prostate cancer, three of the most prevalent cancers.
  • More Extensive Medicare Drug Coverage: The Medicare Part D prescription cap in coverage (known as the “donut hole”) will be narrowed over time and eventually eliminated (by 2020).
  • Longer coverage for children (including those with cancer): Children up to the age of 26 can continue to maintain coverage under parents’ health insurance policies.
  • No lifetime limits (now) or annual limits on payments (by 2014): Patients won’t have to postpone treatments for fear of costs being incurred after an arbitrary limit has been reached.
  • Coverage for Clinical Trials: Beginning January 1, 2014, coverage will be provided for anyone who is eligible to participate in a clinical trial that is appropriate to treat the patient’s condition. For patients facing certain life-threatening cancers, trials can be the key to a longer life.

As states and insurance carriers work out the mechanics for implementation, much remains to be defined and communicated over the months ahead. Mandated budget cuts are scheduled to take effect January 1 if Congress doesn’t reach prior agreements. These cuts would jeopardize National Institutes of Health funding for cancer research, clinical trials, and breast and cervical cancer screening programs for low-income, uninsured, and under-insured women. In addition, action is still needed on provisions for maintaining adequate drug reimbursements to office-based physicians who administer drug treatments covered by Medicare Part B.  In spite of these two uncertainties, a sigh of relief is timely and appropriate for cancer-affected families. Their focus now can be on managing their loved ones’ treatment, supporting them in their day-to-day living, and maintaining their hope for a cancer-free future. These focal points are the core of what effective cancer caregiving is all about.

Deborah J. Cornwall is an advocate for cancer patients and their families, working with the legislative advocacy affiliate of the American Cancer Society. She is also the author of “Things I Wish I’d Known: Cancer Caregivers Speak Out,” a new book based on interviews with 86 cancer caregivers and dozens of patients and survivors. For more information, visit

Last Updated 05/25/2022

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