Manali Patel Shares Concerns About Impact of Medicaid Work Requirement on Cancer Patients

In a recent ASCO podcast, Manali Patel, MD, assistant professor of oncology, and ASCO CEO Clifford A. Hudis elaborate on their call to action for Medicaid policy to “ensure access to high-quality cancer care for all low-income individuals.”

Recent state waiver submissions have requested changes to the employment requirements for Medicare eligibility. State waivers were originally intended as a way to potentially expand access and improve programs, but as Patel explains in the podcast, these particular revisions could leave some cancer patients without care. She also voices concern about the “administrative burden” that patient employment verification puts on physicians, “thereby reducing the already limited time physicians spend with their patients.”

Patel also says that the proposed employment stipulations fail “to promote the intended objectives of the Medicaid program… [and] directly inhibit access to high-quality cancer care.” Often, patients with Medicare coverage are at the highest risk of developing the disease and “these new provisions…can be extremely detrimental by restricting access to coverage,” for both prevention and for those with an existing diagnosis. She describes the irony of the reforms as shocking since many cancer patients are not able to work due to the “time and effort” required for treatment. In addition, given the purpose that Medicaid is intended to serve, Patel says these beneficiaries could end up experiencing even more financial burden “than patients that may be in private health plans.”

Patel goes on to list a cascade of possible consequences resulting from the new eligibility conditions, including “disruptions in care, delays in treatment, dis-enrollment in coverage—all of these gaps in care delivery” that “have been shown to directly adversely impact cancer care outcomes.” These repercussions would not only impact cancer patients, but the Medicaid program as a whole.

Patel and Hudis conclude by sharing ASCO's recommendations that any waiver amendments be transparent: “waivers should not create delays or barriers to receipt of timely and appropriate cancer care,” and “states should consider patients that are in active treatment exempt from any work requirements.” They plan to continue advocating for cancer patients through the ACT Network, and as circumstances continue to evolve, the situation will “remain at the top of our agenda.”

Listen to the full podcast here or through iTunes or Google Play.