March 2017 VOL 8, NO 3

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The RoundTable: Insight From Expert Navigators

What Would an ACA Repeal Mean for Patients with Cancer? A Commentary

Mandi Pratt-Chapman, MA
Director of the Institute for Patient-Centered Initiatives & Health Equity
and Associate Center Director for the GW Cancer Center, Washington, DC

The Affordable Care Act (ACA) provides important protections for patients with cancer and cancer survivors. President Obama’s signature health reform legislation ensured that people with preexisting conditions, such as cancer, could not be denied health insurance coverage or be charged more than healthy people for their insurance. Furthermore, the ACA made it illegal to limit health insurance through lifetime caps because the care of a patient with cancer was too expensive. It is also illegal to drop a patient with cancer or a cancer survivor from a health insurance policy because of their cancer diagnosis.

On January 13, 2017, the House of Representatives voted to approve a budget plan to end important provisions of the ACA, even though there is no consensus on a replacement plan. Opponents of the ACA are trying to repeal parts of the ACA through a budget reconciliation approach, because budget resolutions require fewer votes than other legislative actions. Parts of the health reform law that are most at risk are federal support for Medicaid expansion, federal subsidies for exchange plans in the Marketplace, and the individual and employer requirements to maintain health insurance.

The ACA’s requirement for all Americans to purchase health insurance keeps costs down by spreading risk (the cost of treatment) across the whole population. This is what makes consumer protections possible, such as not being denied health insurance and not being dropped from insurance. Elimination of individual and employer responsibilities to have health insurance would destabilize the health insurance market and increase costs of health insurance broadly.

For patients with cancer, repeal of the ACA would be catastrophic. Health reform expanded health insurance coverage for 20 million Americans, the majority of whom had been uninsured for more than 3 years. Repeal of the ACA would eliminate healthcare coverage for 10 million more Americans than were uninsured before the ACA and expunge $140 billion in federal healthcare support for those who need it most.

Your Time to Act

As a patient advocate, now is your time to act. Contact your congressperson and senator today and tell them:

  1. If they repeal the ACA, a replacement plan must be in place, and must ensure that those who have gained insurance will maintain their coverage
  2. Repealing the ACA will cost the nation billions of dollars; efforts should instead focus on reducing healthcare costs, improving quality of care, and increasing the primary care workforce
  3. The important consumer protections under the ACA must be retained
  4. Health reforms should focus on keeping people healthy and ensuring free preventive care services.

You can easily find your congressperson online:
Contact your senator:
Contact your representative:


American Cancer Society: Six Ways the Affordable Care Act Is Helping Cancer Patients.
American Cancer Society: What Does the Affordable Care Act Mean for People with Cancer?
Families USA: Protect America’s Health Coverage

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