Private Health Insurance Doesn't Protect Cancer Patients from High Costs

 

Despite having private health insurance, cancer patients are running up large debts, filing for personal bankruptcy, and even delaying or forgoing treatment because they can't afford care, a new report from the American Cancer Society and the Kaiser Family Foundation shows.

 

The report, Spending to Survive: Cancer Patients Confront Holes in the Health Insurance System, was released today at a joint press event held at the Kaiser Family Foundation building in Washington, DC. It's based on an analysis of individual calls to the American Cancer Society?s Health Insurance Assistance Service (HIAS), a service that connects cancer patients with health insurance specialists. The report features the stories of 20 people who have contacted the service.

Among the patients profiled are lymphoma survivor Michael Courtney, 41, whose employer-sponsored insurance had a pre-existing condition exclusion that caused his treatments to be postponed, and Patricia Dougherty, 58, whose out-of-network treatment for ovarian cancer led to mountains of medical debt. The report also details the cases of Catherine Guinn, 24, a lymphoma patient who was forced to continue working during her cancer treatment in order to maintain her insurance coverage, and Taylor Wilhite, 10, whose leukemia treatments are close to exhausting her family policy's $1 million lifetime maximum.

"Cancer patients too often find out that their insurance doesn't protect them when they need care the most," said John R. Seffrin, PhD, national chief executive officer of the American Cancer Society. "High out-of-pocket costs coupled with the high cost of insurance premiums can force cancer patients to incur huge debt, and to delay or forego life-saving treatments."

The report highlights five major shortcomings in the current private health insurance system:

1. High cost-sharing and caps on benefits leave cancer patients vulnerable.

2. If they become too sick to work, people with employer-sponsored coverage may not be protected from high costs.

3. Cancer patients and survivors are often unable to find adequate, affordable coverage in individual insurance markets.

4. High-risk insurance pools, which are designed to help cancer patients and others who have trouble getting insurance, aren't available in all states, and when they are available, they're often much more expensive.

5. Cancer patients who are too sick to work often find themselves without any coverage options because of long waiting periods, eligibility restrictions, and application delays.

At the press event, the Kaiser Family Foundation also unveiled a documentary entitled "The Cost of Cancer" that profiles 3 people who are struggling with the disease and its financial toll. A panel discussion will take place afterwards.

"The stories of people with cancer in this study and video documentary show what our earlier survey work found: that the insurance system often fails people when they need it most, when they get really sick," said Kaiser Family Foundation President and CEO Drew Altman, PhD.

For more information about what the American Cancer Society is doing to improve access to quality health care, see our Access to Care initiative.