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Policy Archive

FORCE Fights for Our Community, COVID Relief

Insurance Coverage & Barriers

July 29, 2020 - The coronavirus pandemic has touched all aspects of American life, from education and employment to travel, hobbies and health care. For people with or at high risk of cancer, there are unique challenges. In addition to financial and familial stress, medical appointments have gone virtual, screenings and surgeries canceled or rescheduled, and some treatments moved to the home setting to reduce risk for people with compromised immune systems.

Here at FORCE, we understand the struggles of our community and have been working tirelessly to help address those needs. In addition to moving our support and educational programs to virtual formats, we have been very active in advocating for policies that provide relief.

Enacted in early March, we strongly supported the Coronavirus Preparedness and Response Supplemental Appropriations Act that provided $8.3 billion in emergency funding for federal agencies to respond to the COVID outbreak. The package included small business loans and allowed for temporarily waiving Medicare restrictions and requirements for telehealth services. This was followed by the Families First Coronavirus Response Act. Passed in mid-March, this legislation guaranteed free coronavirus testing, established paid leave, improved unemployment insurance, expanded food security programs and increased federal Medicaid funding.

At the end of March, the Coronavirus Aid, Relief, and Economic Security (CARES) Act was enacted. This $2 trillion relief bill included $1,200 for each American making $75,000 a year or less, added $600 a week to unemployment benefits for four months, made $500 billion in loans or investments to businesses, states and municipalities, and more. The package also paved the way for nonprofit organizations to seek paycheck protection loans to help them sustain the vital work they do in the community.

The Paycheck Protection Program and Health Care Enhancement Act, passed in late April, was a $484 billion relief bill that went to replenish the Paycheck Protection Program (PPP) for small businesses and to public health measures such as virus testing and hospital funding. In July, another bill extended the PPP through August 8th.

What's Next?

With the crisis continuing and extra unemployment benefits ending late last week, we are joining efforts to ask for another stimulus package that includes:

Oral Chemo Parity
The pandemic has highlighted differences in what patients have to pay for oral cancer drugs in contrast to what they pay for IV chemotherapy. Cancer patients today are covered under antiquated insurance benefits which require them to pay more out-of-pocket costs for treatments delivered by pill instead of IV. This discrepancy in cost-sharing means many cancer patients face greater financial barriers to oral anticancer drugs. We are asking Congress to include the Cancer Drug Parity Act in its next legislative package to help cancer patients and their families as they navigate treatment during this difficult time.

90-day Supply of Medications
Early in the pandemic, the Centers for Disease Control (CDC) recommended keeping a 90-day supply of medications on hand; however, many insurers only allow a 30-day supply of medications in a single fill. Recognizing the issue, Congress included a policy change in the CARES Act requiring Medicare Part D and Advantage plans to allow a 90-day supply of medication. What about people who don't have Medicare? We're urging Congress to require Medicaid and private insurers to allow 90-day medication supplies as well. We are also asking that all health insurers be required to limit copays and cost-sharing to the amount of a medication 30-day supply or to establish policies that reduce out-of-pocket costs for patients.

Improved Access to Health Care
We are encouraging Congress to create a 60-day special enrollment period under the Affordable Care Act. Eleven states and DC have already launched special enrollment periods to meet the urgent increased need for health coverage. The federal government, which oversees the individual exchange for 38 other states, has not. The state you live in should not determine your access to health care, especially at this time of national crisis.

We are also supporting increased funding for state Medicaid programs to assist the people who have or will lose their employer-sponsored health insurance; many lack the resources to buy other health coverage and will be turning to Medicaid. We are also encouraging Congress to authorize the Department of Labor to allow individuals to extend their employer-sponsored health coverage after they lose their job and to provide subsidies to lessen the financial strain.

Personal Protective Equipment Supply
Finally, like many providers, oncologists and cancer centers across the country are running low on personal protective equipment (PPE). We hope Congress will prompt the federal government to do significantly more to facilitate the timely manufacturing and distribution of ventilators and PPE.

Stay tuned for updates on how and when Congress acts. And, visit our Hereditary Cancer During COVID-19 webpage for useful resources, webinars and support.

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News Briefs

4/3/2024 - Submitted comments to Senator Cassidy and the HELP Committee in response to an RFI regarding oversight of clinical diagnostic tests, known as in vitro diagnostics (IVDs) and laboratory-developed tests (LDTs).

3/15/2024 - Joined the Coalition to Increase Access to Cancer Care (CIACC) in comments to House leadership on efforts to strengthen the Employee Retirement Income Security Act (ERISA) and emphasize the need to pass the Cancer Drug Parity Act.

3/1/2024 - Provided feedback to CMS on the Medicare Advantage Advanced Notice and accompanying Part D Redesign Program provisions aimed at reducing and managing beneficiary out-of-pocket costs in the Medicare Part D program.

2/29/2024 - Wrote sponsors to endorse the BENEFIT Act, which would require the FDA to include in the benefit-risk assessment framework of a new drug application how patient experience data was considered in the review process.

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