Improving Access to Adequate and Affordable Health Insurance

The health insurance issues facing cancer survivors bring into sharp focus the gaps and limitations of health insurance in the United States. All Americans are at risk of becoming a cancer survivor and finding themselves without access to adequate and affordable health insurance. Cancer survivors, like other Americans with serious, chronic health conditions, face significant barriers to coverage because of their health status. In particular, access to individual health insurance may be denied to residents in many states if they have a history of cancer. Cancer survivors may also face surcharged premiums for coverage because of their cancer history, depending on where they live and the type of coverage they seek. The improvements in the care of cancer survivors envisioned by the committee can not be achieved without health insurance that is accessible, adequate, and affordable.

Health insurance provides protection from the very high costs of cancer care. Most cancer survivors have health insurance through the federal Medicare programs because they are aged 65 and older. Nevertheless, 11 percent of adult cancer survivors under the age of 65 are uninsured and, for these individuals, the costs of cancer care can be financially devastating. These younger uninsured cancer survivors report access to care problems due to concerns about cost—51 percent report delays in obtaining medical care; 44 percent report not getting needed care; and 31 percent report not getting needed prescription medicine. The financial problems posed by cancer loom larger, because even those with health insurance can have trouble paying for prescription drugs and other types of care.

The IOM Committee on the Consequences of Uninsurance, in its 2004 report, Insuring America’s Health, recommended that the President and Congress develop a strategy to achieve universal insurance coverage and to establish a firm and explicit schedule to reach this goal by 2010 (IOM, 2004).

Recommendation 9: Federal and state policy makers should act to ensure that all cancer survivors have access to adequate and affordable health insurance. Insurers and payors of health care should recognize survivorship care as an essential part of cancer care and design benefits, payment policies, and reimbursement mechanisms to facilitate coverage for evidence-based aspects of care.

Cancer survivors need continuous access to health insurance that covers their health care needs. Policy makers should act to ensure that cancer survivors and others with serious chronic health conditions can obtain



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