Calif legislature considering bill 2 reqre insurance cos. 2 pay 4 oral cancertherapy

[Lani]

SACRAMENTO, Calif. (KGO) -- Some cancer patients, even those with good insurance, are paying thousands of dollars a month for treatment because they're taking pills to fight their disease, instead of regular chemo. And some lawmakers in Sacramento say it's time to change that.

The American Cancer Society says cancer is the second-leading cause of death in California. There's a push for better access to treatment, by including oral chemo, in health plans.

"I've had leukemia twice... and it's very, very difficult to experience that," said Assm. Paul Cook, R-Yucaipa.

"I know what it means to spend a day in a room with a loved one going through chemo," said Assm. Gil Cedillo, D-Los Angeles.

No political party is immune to cancer , so a proposal to provide greater access to treatment won bipartisan support in the Assembly. AB1000 forces health insurance companies to cover anti-cancer pills like traditional chemotherapy. Some plans don't, requiring patients to trek to a hospital or pay out of pocket to stay home for treatment.

"They just couldn't afford it. In fact, these costs could average up to $10,000 per month in order to take their medication," said Assm. Henry Perea, D-Fresno.

Perea says expanding such access would especially benefit women greatly because a number of anti-cancer pills are used for treating breast cancer. In all, more than three dozen medications have FDA approval for different types of cancer. The Central Valley Democrat just wants insurance companies to catch up with science.

Opponents still put up a fight. Without knowing how much the federal health care reform will effect medical costs, critics say they would rather wait.

"If we continue to put mandates on insurers, the people who are paying those premiums are going to pay for it," said Assm. Dan Logue, D-Assm., the Health Committee vice chair.

Shelley Thomas lost her husband to leukemia just 18 months ago. She knows he would have rather taken oral chemo over endless trips to the hospital.

"He wanted to be at home. He knew it was not a very good diagnosis, although he was a fighter. He would have been able to spend more time with his children and me at home," said Thomas.

The bill now heads to the Senate. At least a dozen states, including those with Republican governors, have similar laws in place.

(Copyright ©2012 KGO-TV/DT. All Rights Reserved.)

[karen z]

"Opponents still put up a fight". OMG.
But it sounds like things are moving in CA.

[DeenaH]

I wonder how fast these things move along? I am in a major battle over insurance for this exact same thing right now. We changed insurance in November and were told that my Tykerb would be covered as a non-formulary (which it had been with Blue Cross). After the policy was in effect and I tried to order my Tykerb (that I have been on for a year), I found out it is on an extended drug list will cost me 10% out of pocket, and will not apply to my maximum out of pocket deductible for the year. I am outraged. Had I known that, we would have chosen to keep our old policy in spite of an increasing premium. Also, knowing that about the Tykerb would have put up a red flag as far as other drugs I knew I might be on in the future. Right now I am on Xeloda/Tykerb/Herceptin. The Xeloda costs me $315/mo and Tykerb costs me $350/mo. I pay a one time $1500 deductable for the Herceptin and it is covered at 100% for the rest of the year. It makes no sense. I don't qualify for any of the help programs because my husband makes "too much money". We have a huge mortgage due to a bad investment in real estate right before the market crashed. We owe more than our house is worth, so if we sold, we would be homeless. We have 2 little kids. Kids are expensive. We don't drive fancy cars, we shop at Costco, we rarely go on vacations. We can't afford to because of the cost of my medications and medical bills. I know there are others who are much worse off than I am, but it still isn't fair. Sorry to vent! This is such a hot button with me!

[Joan M]

Lani,

Good to hear this about Calif. I was in Albany, New York, the capitol, on advocacy day last spring with several other bc advocates to speak with legislators about the same issue.

Joan