Medicare Part D will continue to give patients access to certain cancer drugs, according Centers for Medicare and Medicaid Services’ (CMS’s) final ruling issued May 16, 2019. The final rule does not allow for utilization controls like step therapy and prior authorizations for patients who are already in an established treatment regimen; does not restrict drugs that have had certain price increases over a specified time period; and does not restrict new formulations of an existing protected class drug.

Patients with cancer are living longer, embarking on complex treatment regimens, and experiencing more complications associated with care. As a result, a large volume of patients with cancer require urgent or emergency visits throughout their disease trajectory. Although the need remains constant, what has evolved over time are the chief complaints that bring patients in, the care associated with complications, and new options to lower the burden and cost of care.    

Efforts to curb the national opioid epidemic have taken shape in several ways, including redefined prescription guidelines. However, many insurers are now refusing to cover certain pain medications like the ones commonly prescribed to patients with cancer. For years, ONS has been meeting with congressional offices to advocate that access to prescription opioids for cancer survivors should be exempt from the strict limits assigned to other diagnoses. It’s always been a successful strategy, because ONS helps policy leaders understand that patients with cancer often struggle with issues related to severe pain management, quality of life, and end-of-life care.

On January 3, 2019, the newly elected, Democrat-controlled House of Representatives introduced legislation to reopen the federal government and end the current shutdown. It’s not about the money, which is usually the case; it’s about the blame. The border wall funding—in whatever capacity—is politically driving the shutdown. But Senator Mitch McConnell (R-KY) doesn’t want to take up a Democrat-sponsored bill that he knows the president will veto. Democrats want that to happen to force the president to either accept the blame for the shutdown or to cave without funding for the wall and reopen the government.

Although the Democrats have yet not formally taken control of the House of Representatives, many are primed and passionate about holding the Trump administration accountable after the November midterm elections. Through involvement in committees and as incoming chairs of powerful oversight panels, lawmakers are questioning officials about healthcare policy.

With more than 70% of Americans supporting expanded Medicare, the single-payer Medicare for All rallying cry has gained significant support among progressives and moderates alike. A recent editorial report makes the case for its adoption with strong evidence from an economic point of view. During the November 2018 midterm election campaign, many incumbent Republicans—some of whom previously voted to repeal and replace the Affordable Care Act—now promised to uphold sections of the law, including protections for pre-existing conditions as their most important campaign commitment.

To Rally Voters, Democrats Focus on Health Care as Their Closing Argument

Although many states are already collecting early votes, Tuesday, November 6, 2018, will tell the full tale of the midterm elections. Many Democrats are emphasizing their focus on health care in the final days and hours before the election. By most measurable public opinion poll, health care remains the most important domestic issue for voters.

Fighting the cost of soaring prescription medications is a winning issue with tremendous bipartisan support. And reigning in exorbitant drug prices means patients will be the real winners. Recently, President Trump lauded his administration’s work to fight against high prescription drug costs, citing new efforts to reduce other countries from taking advantage of drug pricing.

Addressing the high cost of prescription medications has been an ongoing focus for the Trump administration. Its latest move, requiring drug companies to list their product’s market price on consumer ads, is an added level of transparency that didn’t exist before. Whether the decree will have an impact remains to be seen, but it may add some trust to the process.

During a recent speech at the 2018 Medicaid Management Care Summit, Centers for Medicare and Medicaid Services (CMS) Administrator Seema Verma expressed a continued commitment to Medicaid’s legacy of supporting Americans in need.

For months, bipartisan lawmakers have worked together to build an opioid package aimed to tackle the nation’s abuse epidemic. After rounds of revisions and finally making it through both chambers of the House and Senate, the legislation is on its way to the president’s desk. The bill focuses funding efforts on addiction recovery programs and cracking down on the illegal medication trafficking.

Millions of Americans depend on the Affordable Care Act (ACA) marketplace for their health insurance. In the past, costs have been unstable, seeing insurance premiums rise and competition flee. However, new reports estimate that Americans who receive health coverage from ACA will only see moderate increases to their premiums for 2019. During earlier repeal and replace efforts of Obamacare—otherwise known as ACA—the healthcare marketplace was volatile for consumers. Some insurers pulled out of the marketplace, leaving those that remained able to sharply increase premiums.

A new cross-government program is underway to improve veterans’ access to clinical cancer trials. Together with the National Cancer Institute (NCI), the Department of Veterans Affairs (VA) Interagency Group to Accelerate Trials Enrollment launched in 12 VA facilities in summer 2018.

Under the Affordable Care Act (ACA), each state has the right to create its own basic healthcare system within its own jurisdictions. Currently, only New York and Minnesota have made such systems available to residents who are just over the limit to qualify for Medicaid. Those individuals receive their health care from the state—until the Trump administration eliminated certain aspects of ACA that provided federal funding for these programs. After suing to overturn the administration’s ruling, the Department of Health and Human Services announced a settlement that would pay close to half a billion dollars to New York and Minnesota to support the affected plans.

A cancer diagnosis at a young age can lead to serious hardship after completing treatments and moving into survivorship. Such was the case for Matthew Zachary after his cancer diagnosis at age 21. An interesting component to Zachary’s story—and that of many others like him—is that despite the higher number of insured Americans after the Affordable Care Act, costs and complications still plague patients. Access to health care can be a double-edge sword. It means more people are seeing providers, but it doesn't mean that people can afford those treatments.

On May 22, the U.S. House of Representatives passed S.B. 292, the Childhood Cancer Survivorship, Treatment, Access, and Research (STAR) Act. The legislation will improve efforts to identify and track childhood cancer incidence, improve quality of life for childhood cancer survivors, ensure pediatric expertise at the National Institutes of Health by requiring the National Cancer Advisory Board to have at least one pediatric oncology expert on its board, and identify opportunities to increase childhood cancer research to better treat the 10,270 children diagnosed with cancer in the United States every year.   

On February 4, 2018, The Center for Disease Control and Prevention’s (CDC’s) annual World Cancer Day will aim to raise cancer awareness and support in a unified, global effort. The CDC’s efforts focus on cancer research and prevention, as well as improving services to patients with cancer, understanding and sharing common sentiments related to cancer, and mobilizing the global community against the disease.

On November 3, 2017, the House of Representatives passed HR 3922, the Championing Healthy Kids Act, which reauthorizes the Children’s Health Insurance Program (CHIP) program for an additional five years. The act also reauthorizes public health programs. Previous funding for the CHIP program had expired September 30, 2017.

The Affordable Care Act (ACA), better known as Obamacare, is likely here to stay. After previous attempts to repeal and replace the nation’s healthcare legislation, the Senate has finally moved on to other issues. However, this hasn’t stopped President Trump from attempting to undercut some of the financial components of the ACA. Recently, former Health and Human Services (HHS) secretaries from both the Democrats and Republicans urged Trump to support ACA subsidies that could affect the cost of more than 10 million American’s healthcare plans.

“Congress is working together on a nonpartisan issue that will have a profound effect on the lives of all Americans. H.R. 6, the 21st Century Cures Act, will bring our health care innovation infrastructure into the 21st Century, delivering hope for patients and loved ones and providing necessary resources to researchers to continue their efforts to uncover the next generation of cures and treatments,” Chairman Fred Upton (R-MI) and Representative Diana DeGette (D-CO) discussed their vision for the 21st Century Cures initiative in April 2014.