After Obamacare What Comes Next for Cancer Patients

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Tuesday, Nov 15, 2016 by Brian English

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In the wake of Donald Trump’s surprising win on election day, people everywhere are wondering how the President-Elect’s policies will effect their healthcare. Trump has long listed the repeal of Obamacare as the top priority of his first 100 days in office. In fact, it’s been rumored that Trump has actually talked about convening a special session of Congress on January 20, 2017 – the very day he takes the oath of office – in order to repeal the Affordable Care Act (ACA).

Trump Obama

All of which leaves a lot of cancer patients wondering … now what? In the event that Obamacare is actually repealed, what replaces it? How will it impact care? Trump has claimed to have a “better plan” ready to go, but no specific details have been discussed. Would the end of Obamacare have a devastating or beneficial effect on the untold thousands cancer patients nationwide?

In these early days after the election, Trump has hedged a bit on removing the law in its entirety. But clearly, major changes are on the way; Obamacare is going to alter radically, or disappear completely to be replaced with some other system. In a recent article in the Philadelphia Inquirer, 32-year-old breast cancer patient Jessica Karabian said she fears that if the ACA were to be repealed and replaced with another syste, it could “hasten her death.”

“My greatest concern is that [health insurance] will go back to what it was before Obamacare, and that Trump will unravel all the progress,” Karabian said. “If my supplement is dropped, I can't afford treatment and I die. I'm afraid this will give me even less time than I already have.”

The two key elements of Obamacare that impact cancer patients are the fact that it guarantees that patients with pre-existing conditions can’t be denied coverage, and that there is no limit to the lifetime dollar amount of coverage. Critically, the ACA imposes these provisions on both individual health policies and employer-sponsored plans.

Jean Sachs, CEO of Living Beyond Breast Cancer , a Pennsylvania-based patient advocacy and support organization, says that many patients were posting their fears on the organization’s social media sites on the Wednesday after the election.

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“Women living with metastatic cancer are frantic and scared,” Sachs says. “So many of them couldn’t get insurance if they didn’t have the ACA. Trump had a lot of rhetoric, but now, what does that mean?”

Even if Trump takes immediate action, it could take some time – perhaps months – for changes to make any significant impact on patients. One immediate option that Trump would have would be to cut off any funds that are earmarked to offset the losses of insurance carriers that are part of the healthcare exchange marketplace.

WhatNexters have mixed opinions on the value of Obamacare and the potential impact of its repeal.

“Obamacare was definitely not working for my family,” writes BoiseB on the WhatNext forums. “My daughter is getting all her healthcare through a Catholic Clinic and Hospital, and my son has to prove that he is low income so that he doesn't have to pay the fine.”

DoreenLouise also has concerns. “I worry that the pre-existing clause may be taken away,” she writes. “And then what will happen if I am unable to have insurance through my employer who is a small business with less than 10 employees.”

Like the majority of Americans, BuckeyeShelby gets her insurance from her employer, and actually works for a third party administrator of ACA policies, which gives her a unique perspective. She writes that of the three states that her company administered the ACA policies for, two of them have already “thrown in the towel and given it over to the Feds.”

“It's sad seeing people lose their coverage or have to scramble to try to find something else. I believe in the aims of "Obamacare,” she writes. “But there are problems with it as well. I hope the Donald has a real plan, but I am not holding my breath. I sincerely hope that hundreds of thousands of people will still have coverage when the dust settles.”

Vice President-Elect Gov. Mike Pence, as head of Trump’s transition team provided the closest glimpse of what may lie ahead. Pence said that expansion of tax-exempt health savings accounts would be part of the plan, and that individuals would be able to deduct health-insurance premium payments on their tax returns. Additionally, Pence said that a new healthcare law would allow Americans to purchase insurance across state lines, and allow each state to manage its own Medicaid funding.

In spike of Trump’s claims, whatever happens is unlikely to happen soon. “I am not concerned at all,” writes LiveWithCancer.Obamacare needs work. “I believe it will be better than it is now, but I don't expect anything to happen overnight.”

How do you expect the change in administration to affect your health insurance? Please comment below.

[gmasurvivor]

Pre-existing conditions must be covered whatever happens. In 1998 I was diagnosed with LCIS in my left breast. In 2002 I changed jobs. My new insurer sent me a letter stating that if I were to get breast cancer in my left breast, I would not be covered. I was in shock. I tried to fight it, but tô no avail. In 2008, I was diagnosed with breast cancer in my right breast. I guess some would say I got lucky.

[Ibelong]

My hope is that the preexisting conditions and no life time caps stay in place as is. I hope that funding is also made available to offset the high cost of supplemental insurance for disabled persons under age of retirement. Supplemental health insurance is costly. Medicare part D and its donut hole must be closed and prescription cost need to come down. I have a targeted therapy that cost me over $600, the price pharmaceutical company places on it is greater than $24,000 for 21 pills. I am grateful for programs that help cover those costs.