ASCO Members Take a Stand on Access to Care for Low-Income Individuals

In a paper published in the Journal of Clinical Oncology, medical oncologists have delineated their recommendations to improve cancer care and provide better access to quality care for those patients with financial issues and on Medicaid. Based on the principles that Medicaid patients should have equal access to high-quality cancer care delivered by cancer specialists, as do patients on private insurance, the committee formulated several policy recommendations. Some key points include:

1. Expand insurance coverage for those below the federal poverty level in all 50 states.
2. Extend clinical trial protections included in the Affordable Care Act (ACA) to patients with Medicaid coverage, and dissolve state lines to allow patients access to these trials.
3. Eliminate artificial barriers between current Medicaid beneficiaries and newly eligible beneficiaries, and apply ACA final-rule mandates for cancer screening and diagnostic follow-up without copay for all Medicaid beneficiaries.
4. Complete coverage of genetic testing for patients deemed at high risk, defined by published guidelines.
5. 340B reform, back to its original intent: to incentivize care for the uninsured, underinsured, and patients with Medicaid coverage, regardless of care setting.
6. Policies to help oncology practices to serve as medical homes.

Medicaid reform has been a topic of debate for a long time, and the authors think that post-ACA, the disparities in cancer care will worsen. The authors emphasize that while Medicaid is fraught with a million faults, and healthcare providers and their financial administrators do not favor Medicaid’s low reimbursement rates compared to Medicare, we have to accept that Medicaid is the lifeline for patients. The only option, therefore, is for all stakeholders to contribute their voice to the discussion—provide their thoughts and recommendations, as did ASCO, to help reform care delivery so it’s a win-win for both the patient and the oncology care provider.