UPDATE: In 2021, the Metastatic Breast Cancer Access to Care Act was introduced in the 117th Congress. It is now S. 1312 in the Senate and H.R. 3183 in the House of Representatives. The two bills are identical.
Timely access to treatment is critical for individuals dealing with any number of medical conditions. Metastatic breast cancer is no exception.
The Metastatic Breast Cancer Access to Care Act would waive the lengthy waiting periods that currently prevent individuals with advanced breast cancer from receiving timely access to care.
Metastatic breast cancer (MBC) is breast cancer that has spread from the breast to another part of the body, most often the bones, lungs, liver or brain. The average life expectancy of an individual with MBC is three years. Although there is no cure, treatments have extended survival for women and men with MBC. But for some individuals dealing with MBC, not being able to work, and thus not having health insurance, presents a major problem in getting access to care.
Ellen Duffy was one such individual. Ellen was a 47-year old registered nurse in Waterloo, Iowa who was diagnosed with breast cancer. Before she completed her initial treatment, it was discovered that the breast cancer had spread to her bones. Given her illness, Ellen was unable to work at either of her two jobs and after one year both of her employers let her go, which left her with no job and no health insurance.
Ellen applied for Social Security disability, but she still had to wait over 2 years to become eligible for Medicare and didn’t live long enough to receive it. Ellen was single, never married, and lived her final year very sick and in constant fear of losing her home because she could not pay her bills.*
How the System Works Now
What happened to Ellen should never happen to anyone. But unfortunately, the way our system currently works puts many individuals in this type of situation. Someone with a medical condition that prevents them from being able to work and obtain health insurance can apply for Social Security Disability Insurance benefits. Once they receive approval for that, whatever their age, they can then apply for health insurance coverage through Medicare, a government funded health insurance program that is generally for individuals age 65 and over.
But with all approvals in hand, the individual must still wait 5 months for the Social Security disability status to become active, and then another 2 years before their Medicare coverage is available to them.
Cutting the Red Tape
There are bills currently before both houses of congress that would cut this red tape. The House bill, H.R. 2178, and the Senate bill, S. 1374, are both entitled the Metastatic Breast Cancer Access to Care Act. This legislation waives the 24 month waiting period for Medicare eligibility and the 5 month waiting period for Social Security Disability Insurance benefits for individuals with MBC.
The legislation was developed by the National Breast Cancer Coalition (NBCC), working with key supportive members in Congress. Both bills have bipartisan support and NBCC advocates are working to continue to build that support. You can find more information on NBCC’s website and see whether your representative and senators have signed on to support the bill.
Please let your representatives in Congress know that you support these bills and urge them to take action to get this important legislation passed into law.
*Source: National Breast Cancer Coalition
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