What the Future of Cancer Care May Hold Under President-Elect Joe Biden

Former Vice President Joseph R. Biden Jr. is now the President-elect after crossing 270 Electoral College votes after the commonwealth of Pennsylvania was called for the now president-elect, winning the 2020 presidential election. In January he will be sworn in as the 46th president of the United States of America, which could offer a different path for the future of cancer care – in particular with the Affordable Care Act and the Cancer Moonshot Initiative.

As Biden enters the White House, here is what people can expect regarding health care, and in particular, cancer care.

Addressing the Affordable Care Act

President-elect Biden was a part of former President Barack Obama’s administration and helped facilitate the Affordable Care Act, also known as “Obamacare”, which was signed into law in 2010. Throughout the 2020 campaign, Biden ran on keeping the act as law and possibly expanding its offering.

However, as the Supreme Court is set to hear arguments in the landmark California v. Texas case, the fate of the Affordable Care Act is in jeopardy, potentially leaving thousands of patients with cancer without insurance as the affordability of cancer care becomes increasingly more challenging. According to the American Cancer Society, the ACA has had a dramatic impact on the number of patients with cancer who have been insured in the past 10 years and has helped to increase the number of screenings for early detection. The previous position of the Trump administration was to repeal Obamacare.

“When you look at the policy changes that have been made through that cancer lens, you see some policies that are troubling and somewhat crippling of the important patient protections that were included in the law,” said Keysha Brooks-Coley, vice president of Federal Advocacy and Strategic Alliances at the American Cancer Society Cancer Action Network (ACS CAN), in an interview with CURE® when discussing the Trump administration’s desire to undercut the ACA. Whereas, the Biden administration seeks to keep the act in place and look to quickly pass legislation if the act is repealed in court.

Read More: Patients with Cancer Stand to Lose if Supreme Court Repeals ‘Obamacare’

However, that does not mean the debate around the ACA will subside, as Republicans are on track to retain their majority in the Senate and have even shrunk the Democrats’ lead in the House of Representatives. This means they will still have a say in any potential measures for the Biden administration to expand the ACA and the Medicaid option under it. Moreover, Democrats would become further entrenched in keeping the ACA as it is, as Republicans are offering no replacement plan if it were to be repealed.

“Vice President Biden, when he was Senator Biden, basically was known for going across the aisle, but this has been a very contentious election,” said Ted Okon, executive director of the Community Oncology Alliance (COA), in an interview with CURE®. “And it's particularly going to be tough in terms of what we do with the ACA, because letting it sit there, when everybody believes, ‘oh, this is the best thing in the world’, no, it isn't. There is a fallacy to it, it does need to be made better.”

Okon lauded the ACA for expanding coverage for patients with cancer but described that they are still not sufficiently covered for cancer care, especially as the cost of care continues to rise. The majority of plans under the ACA are low premium with high deductibles, he explained, which makes it difficult for prolonged cancer care and can result in paying too much of the initial bill. An initial bill that continues to grow steeper as drug prices increase for cancer treatments, an issue that organizations like the ACS CAN and COA believe Congress and a new administration must work to address.

Expanding the Cancer Moonshot Initiative

Despite an unprecedented number of new cancer therapies and further research into developing them, research funding is still a central issue for many cancer organizations. The Trump administration’s proposed fiscal budget for 2021 did not include a high enough research budget for both the National Institutes of Health and National Cancer Institute (NCI), according to Brooks-Coley. In turn, she added, this has led to the ACS working directly with members of Congress to advocate for additional funding.

“The investment in cancer research is something that we know has to have sustainable funding, it has to be increased every year to make sure that important research continues,” explained Brooks-Coley. “From our perspective, with everything that's been going on with COVID, a lot of research has had to stop. And so, ACS CAN has been engaged in advocating for even more increased funding for the National Institutes of Health, specifically in stimulus packages to help have some of those important research projects start back up.”

President-elect Biden has said he would seek to pass another stimulus package right away, which could potentially include more funding for cancer research.

“From statements that we've heard him make on the campaign trail and information that the campaign has put out, it shows signs that he would want to continue to stay steady the course and continue to look at cancer research funding, and other key policies that impact cancer patients and survivors as a priority,” explained Brooks-Coley.

Moreover, cancer research under the Biden administration could have a broader goal, as the President-elect has campaigned on trying to find a cure for cancer during his administration through the Cancer Moonshot initiative. The initiative, which was spearheaded by Biden when he was Vice President, led to the passing of the 21st Century Cures Act to fund the program and allocate $1.8 billion in funds for cancer research and the NCI.

“I actually attended a meeting in the White House with a number of different cancer organizations trying to get this sort of Cancer Moonshot off the ground,” Okon added. “It's going to be very interesting to see how (former) Vice President Biden, who now becomes president-(elect) Biden, balances the idea of not only not harming the cancer ecosystem, but launching his cancer moonshot, while at the same time dealing with some of the issues that prior administrations have dealt with.”

“Next year is actually the 50th anniversary of the signing of the National Cancer Act, and it will be an opportunity to look back and see what the great discoveries that have been made over the past 50 years have done,” Brooks-Coley added. “We've come a long way, but we have to stay steady the course to continue to move forward, to move through and not move backwards.”

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