As 2017 begins, ONS is hard at work supporting several new policies that could shape health care in the coming months and years. Although the election season has ended, ONS’s ongoing advocacy for oncology nurses and patients with cancer continues.
The Palliative Care and Hospice education and Training Act
ONS has continued to work on advancing the Palliative Care and Hospice Education and Training Act (PCHETA). PCHETA would provide education and training opportunities in palliative care to nurses and other healthcare providers; establish a national campaign to inform patients, families, and healthcare professionals about the benefits of palliative care; and direct the National Institutes of Health (NIH) to expand research programs to improve the delivery of palliative care to patients with serious illnesses.
The 21st Century Cures Act
ONS joined hundreds of stakeholder groups in supporting the 21st Century Cures Act, which President Obama signed into law in December 2016. Important provisions in this act are increased funding for NIH and authorization for the funding of Vice President Biden’s Cancer Moonshot Initiative. The act also will deliver new, cutting-edge medications to the market in a more efficient manner.
Updates to the Centers for Medicare and Medicaid Services
Although repeal of the Affordable Care Act (ACA) has been discussed on Capitol Hill, the Centers for Medicare and Medicaid Services (CMS) continue to implement programs established as part of the Medicare Access and CHIP Reauthorization Act of 2015—the Merit-Based Incentive Payment System and Alternative Payment Models—under a unified framework known as the Quality Payment Program. ONS continues to be a voice for oncology nursing and quality care as these updates to CMS continue to be implemented.
The Affordable Care Act
With a new administration preparing to take office, the ACA may be repealed and replaced. For many oncology nurses and patients with cancer, the following issues will be important as the new administration decides on its plan of action regarding healthcare reform.
- No lifetime limits for insurance plans: This ACA provision prohibits insurance companies and healthcare plans from defining a lifetime dollar amount to which they’ll spend on a person’s treatment. In the past, once these limits were hit, the insurance company wasn’t required to pay for treatment (U.S. Department of Health and Human Services [HHS], n.d.).
- Preventive services without copayment: The ACA requires a number of preventive health services to be covered free of charge by healthcare plans, including screening and interventions for adults, pregnant women, and children. Screenings for colorectal cancer and cervical cancer, breast cancer mammography, access to immunizations, obesity counseling, and tobacco cessation are just a few of the preventive measures covered under ACA (HHS, n.d.).
- Eliminating pre-existing condition limitations: In the past, health plans could limit or refuse coverage to individuals with pre-existing conditions such as asthma, diabetes, or cancer. The ACA prohibits this practice, allowing patients with past conditions to be covered under any health plan (HHS, n.d.).
- Closing the Medicare drug prescription gap: The ACA includes benefits that will help close the Medicare prescription drug coverage (Part D) gap, making prescriptions more affordable for older adults who rely on Medicare. Discounts through Medicare Part D are up to 55% for brand name prescriptions. With many cancers affecting older populations, the access to affordable medications has become an important concern in cancer care (CMS, n.d.).
- Coverage for Clinical Trial Participation: Under a mandate added to the ACA in January 2014, insurers cannot deny qualified individual participation to approved clinical trials. This provision allows more individuals to participate in approved clinical trials without the worry that insurers will limit or deny their coverage.
ONS recognizes the importance of oncology nursing’s voice at the national level and is actively advocating for its members and patients with cancer. Just as ONS has worked with the current administration, we will continue to work with the incoming administration to enact positive changes for oncology nurses, patients with cancer, and health care and health policy in the United States.