WASHINGTON (AP) — Cancer patients relieved that they can get insurance coverage because of the new health care law may be disappointed to learn that some the nation's best cancer hospitals are off-limits.
An Associated Press survey found examples coast to coast. Seattle Cancer Care Alliance is excluded by five out of eight insurers in Washington state's insurance exchange. MD Anderson Cancer Center says it's in less than half of the plans in the Houston area. Memorial Sloan-Kettering is included by two of nine insurers in New York City and has out-of-network agreements with two more.
Doctors and administrators say they're concerned. So are some state insurance regulators.
In all, only four of 19 nationally recognized comprehensive cancer centers that responded to AP's survey said patients have access through all the insurance companies in their state exchange.
Not too long ago, insurance companies would have been vying to offer access to renowned cancer centers, said Dan Mendelson, CEO of the market research firm Avalere Health. Now the focus is on costs.
"This is a marked deterioration of access to the premier cancer centers for people who are signing up for these plans," Mendelson said.
Those patients may not be able get the most advanced treatment, including clinical trials of new medications.
And there's another problem: It's not easy for consumers shopping online in the new insurance markets to tell whether top-level institutions are included in a plan. That takes additional digging by the people applying.
"The challenges of this are going to become evident ... as cancer cases start to arrive," Norman Hubbard, executive vice president of Seattle Cancer Care Alliance, said.
Advocates for cancer patients are in a quandary.
Before President Barack Obama's health care law, a cancer diagnosis could make you uninsurable. Now, insurers can't turn away people with health problems or charge them more. Lifetime dollar limits on policies, once a financial trapdoor for cancer patients, are also banned.