In 1965, the monthly cost of cancer care was $100. By 2013, that number had risen to nearly $10,000. The skyrocketing cost of cancer drugs has, in part, played a major role in limiting access to care for patients with cancer. But money isn’t the only barrier: Location of treatment centers, lack of transportation, socioeconomic challenges, along with myriad cultural differences can play into the ways patients do—or don’t—access care.

When President Obama announced the National Cancer Moonshot Initiative during his State of the Union address in January 2016, he set lofty goals for oncology professionals. One of those goals called for increased access to and participation in clinical trials. Clinical trial data are integral in getting cutting-edge treatments to market, where they can help improve cancer care. However, many patients aren’t fully educated about the efficacy of these new forms of treatment and what these trials entail.

When the new state-based health insurance marketplaces open on October 1, 2013, as part of the Affordable Care Act, choice of insurance will be added to the long list of difficult decisions patients with cancer will face during their diagnosis and treatment.