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Blair Horner: Health Care Reform Takes a Big Step Forward


Last week, the U.S. Supreme Court upheld the federal health care reform law which is critical to improving access to quality, affordable health care for people with cancer and their families.

The ruling is a victory for cancer patients and survivors nationwide, who for decades have been denied health coverage, charged far more than they can afford for lifesaving care, and forced to spend their life savings on necessary treatment, simply because they have a pre-existing condition.

In New York, nearly three million people are uninsured.  In Albany County, an estimated 25,000 residents are uninsured.  Lack of health coverage means a serious illness can be financially catastrophic and potentially deadly. 

Almost halfof uninsured women in New York between age 40 and 64 did not have a mammogram in the past two years compared to about a quarter of those with insurance.  Nearly 75 percent of uninsured adults in New York between age 50 and 64 had not had a colonoscopy or sigmoidoscopy compared to about half of those insured.  About 2 in 5 uninsuredadults in New York reported they were unable to see a doctor in the last 12 months when they needed care because they couldn’t afford it.

With help from the Affordable Care Act, more New Yorkers will have access to, and use, these life-saving tests.

The decision ensures the implementation of critical patient protections, including those that:

·         Prohibit insurance companies from denying coverage to people with a pre-existing condition such as cancer.

·         Require insurers to provide people with cancer and others with easy-to-understand summaries about their coverage.

·         Require health plans in the individual market to offer essential benefits needed to prevent and treat a serious condition such as cancer.

The ruling also preserves other vital provisions that are already expanding access to care by:

·         Offering proven preventive services such as mammograms and colonoscopies at no cost to patients.

·         Eliminating arbitrary dollar limits on coverage that can suddenly terminate care for people with cancer.

·         Prohibiting insurance companies from unfairly revoking coverage when a person receives a diagnosis.

     Creating online marketplaces (aka health exchange) in every state where patients can easily compare quality health plans and choose the one that is best for them.

New York policymakers must move forward to meet the federal deadline of having virtually all eligible people covered by health insurance by January 1, 2014. Two decisions must be made soon:

·         The health insurance exchange is the marketplace where the uninsured and small businesses will purchase their health insurance.  Gov. Cuomo used his executive powers to create the exchange. Lawmakers must act quickly to give the exchange the resources and the power to aggressively bargain with insurers to secure affordable and consumer-friendly plans and to establish a self-sustaining financing mechanism.

·         Consumers using the insurance “marketplace” in the exchange will choose among plans that offer, at the least, an approved minimum benefits package.  The decision on what plan is best is up to the states. New York must choose its plan by the end of the summer.

The federal law is not perfect, but it represents an improvement in the ability of patients to access lifesaving care.  New Yorkers must monitor implementation of the law to ensure it meets the needs of all patients and allows them to focus on what’s most important: getting well. 


Blair Horner is the Vice President for Advocacy for the American Cancer Society, Eastern Division. His commentary does not necessarily reflect the views of the American Cancer Society.

 The views expressed by commentators are solely those of the authors, and do not reflect the views of this station or its management.