Bill would bring chemotherapy treatment equity
Insurance companies treat different forms of chemotherapy differently
Even if you’ve never been diagnosed with cancer, you probably have an image of what treatment looks like. A patient hooked up to an IV, maybe having lost some of their hair. They’re tired and nauseous, and struggle to hold on to their sense of who they were before cancer. Until recently, this was the only way to fight the disease.
Today, many cancers can be treated differently, in a way that is less invasive, less time-consuming, more convenient. And for some patients, oral chemotherapy –cancer treatment in pill form– is the only treatment option. What most people don’t know, however, is that insurance covers these two kinds of chemotherapy very differently.
Thankfully, in Connecticut, there’s a partial solution to that problem: Connecticut, along with 42 other states, has passed legislation that ensures that all cancer treatments have the same cost-sharing implications for the patient. While state-level legislation is important, the only protection for every American is to pass this type of legislation on the federal level. Doing so will remedy the gap for people living in Connecticut who have insurance that is regulated on the federal level, and for millions of other Americans, too.
As a co-sponsor of S. 741, Sen. Chris Murphy is on the forefront of making sure all Americans have access to the cancer treatments their doctors prescribe without having to worry about insurance coverage. Similar legislation was also just filed in the U.S. House of Representatives.
The difference between the coverage of these different cancer treatments lies in the way they are classified by insurance policies. The traditional IV treatment has long been categorized as part of a patient’s medical benefit —much like a doctor’s visit or hospital stay. There may be a small co-pay, but it’s minimal. Oral chemotherapy, however, falls under the prescription drug plan, which has a different set of rules when it comes to how much patients have to shoulder out of their own pockets.
Murphy has long been a champion of protections for women’s health, as well as the Affordable Care Act, and he’s repeatedly stated that a person shouldn’t go broke because they get sick. That’s exactly what this bill addresses, by ensuring that all cancer treatments are covered equally, and with similar out-of-pocket costs for the patients. It’s simply not right to make patients who have insurance pay more because of the type of cancer they have, or because the treatment their doctor thinks gives them the best shot at a good outcome comes in pill form.
S. 741 will ensure that no cancer patient or their oncologist has to make a treatment decision on anything other than what is the best chance for fighting their disease. We commend Sen. Murphy for leading the fight to pass this critical patient protection.
Lori van Dam is the CEO of Susan G. Komen New England.
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