Health Care Blog

This Is The Affordable Care Act: Giving Women at High Risk for Breast Cancer Access to Free Chemoprevention Medication

More than 20 years ago, my personal involvement in the fight against breast cancer started after four of my friends were diagnosed with the disease in the same year. After one of those friends lost her battle, I saw just what a ruthless adversary breast cancer could be. Far too many of us have lost a loved one to breast cancer or seen a colleague or friend endure painful treatments to fight the disease. 

That is why I am so pleased that today the Administration is making clear that most health insurance plans must soon cover chemoprevention medications like tamoxifen and raloxifene that can reduce the risk of breast cancer for women who have an increased chance of developing the disease. In addition, these health plans will have to cover the medications at no cost to these women.

Women who are at high risk of developing breast cancer face many questions. Now, if their doctor recommends that the benefits of this treatment outweigh the risks, one question women across the country won’t have to ask is whether they can afford it. 

This is just one more way the Affordable Care Act is helping fight breast cancer. Already, the ACA ensures that about 47 million women have access to free mammograms every year or two, that insurance companies can no longer deny coverage or increase premiums due to pre-existing conditions like breast cancer, and new health plans can no longer set an annual or lifetime cap on someone’s health insurance benefits – meaning women diagnosed with breast cancer will not max out their insurance benefits while seeking treatment.

New Health Insurance Options, New Consumer Protections in the New Year

Today is a new day for the millions of Americans who finally have the security that comes from quality, affordable health coverage. And those who already have health insurance will have better, more reliable coverage than ever before. From now on, insured Americans won't be forced to put off a check-up or worry about going broke if they get sick.

While there is much more work to be done, beginning today, no family will be denied coverage because of a pre-existing condition like high blood pressure or asthma. Women can no longer be charged more than men for the same coverage. No American will have to worry that losing a job means you can't get health coverage. And small businesses may qualify for more financial help to pay for new affordable coverage options for their employees.

The challenges in our health care system were decades in the making and won't be solved overnight, but now more than 6 million Americans have been enrolled in Marketplace or Medicaid coverage and are getting peace of mind, knowing that they can get the care they need without losing everything they've worked and saved for.

New Benefits and Consumer Protections Begin Today

• Protections for People with Pre-Existing Conditions: Up to 129 million Americans with pre-existing conditions no longer have to worry about being denied health coverage or charged higher premiums because of their health status.
• New Insurance Options: Many previously uninsured Americans have new health insurance options through private health plans in the Marketplace or Medicaid in States that have opted to expand it. Nearly 6 in 10 of Americans who were uninsured could pay $100 or less per month for coverage.
• No More Annual Caps on Health Benefits: Millions of Americans no longer have to worry about having their health benefits cut off after they reach an annual dollar limit on benefits.
• Comprehensive Coverage: Health plans in the individual and small group markets are now required to cover ten categories of essential health benefits – including emergency services, maternity and newborn care, mental health and substance use disorder services, and prescription drug coverage. As a result of these new protections, approximately 60 million people will gain expanded mental health and substance use disorder benefits and/or parity protections.