Top Cancer Centers Often Not Included In Obamacare


With insurers in the plans set up under the Affordable Care Act shrinking their provider networks and cutting the number of plans that offer out-of-network coverage, many of those living with cancer are being left out of access to the best available treatment.

An example of this is Memorial Sloan Kettering Cancer Center in New York City. NPR reported the center participates in New York’s Essential Plan, designed for lower income people on the state’s exchange, but doesn’t participate in any of the regular plans. In short, having a modest salary that isn’t at poverty level is proving to be detrimental for many.

This could potentially mean the difference between life and death. A 2015 study, published in the journal Cancer, found that adult patients between the ages of 22 and 65 who were newly diagnosed with one of several types of cancer — breast, colorectal, lung, pancreatic, gastric or bile duct — were 20 percent to 50 percent more likely to die from the disease if they were initially treated at a place other than an NCI-designated comprehensive cancer center.

But there are generally are other factors aside from survival rates that contribute to a patient’s decision about where to go for care. Dr. Robert Carlson, CEO of the National Comprehensive Cancer Network, said these factors often include non-medical costs such as transporation and housing.

“Most patients, if offered the option to go to a major cancer center — especially if it involves traveling — will decline it,” Carlson said.

But those who want to access a cancer center for treatment and are concerned about cost should speak to the facility directly. Many try to work with patients to enable their treatment.

“We understand that each patient has a unique financial situation and we work with our patients, especially those in active treatment, to ensure they receive the care needed and that their treatment is uninterrupted,” said Ruth Landé, senior vice president for patient care revenue at Memorial Sloan Kettering. “We have patient financial services representatives available to assist patients who do not have health insurance or whose insurance may not cover all charges.”