Statement of Principles on Medicaid (cuts & expansions) 

Statement of Principles on Access to Cancer Clinical Trials

Statement of Principles on Access to Oral Chemotherapy Drugs

Statement of Principles on Medicaid (cuts & expansions)

Medicaid is one of the largest health insurance programs in the country providing coverage to low-income families, children, older adults, and people with disabilities.  Jointly funded by state and federal government, Medicaid has become the largest source of general revenue spending on health services.  In an effort to meet the costs of Medicaid many states which are struggling financially have looked to program restructuring.  This restructuring may include cutting eligibility or service coverage, adding recipient cost sharing, reducing pharmacy benefits, or cutting or freezing provider payments all of which reduce access to health care for the county's neediest populations.

With over fifty million beneficiaries, cuts to state Medicaid programs has the potential to significantly affect the United States patient population along with the family members involved.  Decreased access to care will create not only an unhealthy nation but an unhealthy economy as those with life-threatening illnesses cannot meet the necessary costs.  National Patient Advocate Foundation is critically concerned about cuts to state Medicaid programs.  We strongly support expansions of state Medicaid programs and will strive to protect patients' rights to gain access to, and reimbursement for, quality health care.

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Statement of Principles on Access to Cancer Clinical Trials

National Patient Advocate Foundation lends its support for providing patients access to cancer clinical trials in an effort to progress cancer treatments and prolong the lives of many patients faced with this particular disease.  Currently there are fewer than 5% of adult cancer patients participating in clinical trials due in part to lack of insurance coverage.  While these trials are innovative and often offer the best and in some cases the only chance of survival, health plans may categorize the care as "experimental" and significantly limit or deny any type of coverage.

With 10 million Americans living with cancer and another 1.5 million that will be diagnosed by the end of the year, progressive approaches must be utilized to ensure that patients are offered the best possible care. By offering coverage of routine care costs such as doctor visits, hospital stays, clinical laboratory tests, and x-rays, health plans will increase access to trials for many patients across the United States therefore contributing to the future of medicine and offering patients the best therapeutic techniques available.  National Patient Advocate Foundation will work to pass state legislation requiring health plans to pay the cost of routine medical care received as a participant in a clinical trial.

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Statement of Principles on Access to Oral Chemotherapy Drugs

Intravenously administered chemotherapy has been the standard cancer treatment since 1962; however, in the past five years sales of oral chemotherapy drugs have substantially risen.  Developed to improve patients' quality of life, provide a more convenient and less invasive method of therapy, and offer an alternative for patients who have failed to respond to other treatments, oral chemotherapy could potentially reduce resource utilization and health care system costs, improve drug safety, and enhance patient satisfaction.

Evidence suggest oral chemotherapy is a more comfortable way to treat cancer with, in certain cases, more effectiveness and less adverse reactions than seen with I.V.  chemotherapy and therefore viewed by patients to be the more favorable of the two treatment options.  However, many insurance plans have discriminated against oral chemotherapies as seen by non-coverage, limited quantities, or high co-pays as compared to intravenously administered chemotherapies which are generally covered in a much more comprehensive manner.  Financial factors rather than seeking options which yield best quality of life has therefore dominated patients' treatment choices up to this point.

In 2007, the 74th Oregon Legislative Assembly passed a bill pertaining to health insurance coverage of oral chemotherapy.  Senate bill 8 states, "a health benefit plan that provides coverage for cancer chemotherapy treatment must provide coverage for a prescribed, orally administered anticancer medication...no less favorable than intravenously administered or injected cancer medications that are covered as medical benefits."  The National Patient Advocate Foundation is a proponent of this bill and will work within states to pass similar legislation so that all patients may have access to the best possible treatments while reducing negative financial impacts.

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