Advocacy The Honorable Mitch McConnell, Senate Majority LeaderThe Honorable Charles Schumer, Senate Democratic LeaderThe Honorable Nancy Pelosi, Speaker of the HouseThe Honorable Kevin McCarthy, House Republican Leader Dear Speaker Pelosi and Leaders McConnell, Schumer, and McCarthy: Thank you for your efforts to help our nation respond to and resolve the COVID-19 emergency. As you plan for a fourth COVID package, I am writing on behalf of Susan G. Komen to share our policy priorities to ensure that breast cancer patients, survivors and their co-survivors are protected. Komen is the world’s leading nonprofit breast cancer organization representing the millions of women and men who have been diagnosed with breast cancer. Komen has an unmatched, comprehensive 360-degree approach to fighting this disease across all fronts—we advocate for patients, drive research breakthroughs, improve access to high quality care, offer direct patient support and empower people with trustworthy information. Komen is committed to supporting those affected by breast cancer today, while tirelessly searching for tomorrow’s cures. We advocate on behalf of the estimated 279,100 women and men in the United States who will be diagnosed with breast cancer and the more than 42,690 who will die from the disease in 2020 alone. The COVID-19 related policies that you have already enacted will help our nation’s families and businesses, including nonprofits, adjust to these difficult times. As you develop additional COVID-19 relief packages in the coming weeks, we appreciate the opportunity to share additional policies for your consideration that will ensure that breast cancer patients, survivors and their co-survivors are protected: Implement Chemotherapy ParityPlease include the Cancer Drug Parity Act (H.R.1730/S.741), bipartisan legislation that could significantly assist cancer patients in maintaining their treatment regimens while staying home. Cancer patients are particularly vulnerable to COVID-19 due to having compromised immune systems and oncology care providers are increasingly encouraging their patients to stay home as much as possible. When medically appropriate, they are also transitioning patients onto oral or self-administered forms of chemotherapy rather than intravenous chemotherapy administered in a healthcare facility. Unfortunately, due to antiquated insurance benefit design, the switch from an IV to an oral form of the same treatment could lead to patients having a significant cost-sharing burden, precisely at a time when many Americans are experiencing economic hardship. Implementing this policy solution will benefit millions of Americans with cancer and their families, as well as the oncology medical professionals who treat them. Declare Clinical Trials for Treatments for Life-Threatening Conditions to be EssentialWhile we understand the need for health care facilities to postpone non-essential services to maintain capacity for people with urgent health care needs, we have been extremely concerned about reports that clinical trials for investigational cancer treatments have been postponed. Clinical trials often afford breast cancer patients, especially those with metastatic breast cancer (MBC), the best options to treat their cancers. Given the mortality associated with MBC and the lack of clinical treatment options, if a clinical trial were to be delayed or stop accruing new patients for even a few months during the COVID-19 emergency, it could have serious consequences or even be fatal. We ask Congress to declare clinical trials for life-threatening conditions to be essential services that should continue during the pandemic. Additionally, we know the drug development process takes years and worry about the long-term impact the current disruption will have on cancer therapies for the years to come. Open Healthcare.gov EnrollmentWe were disappointed in the Administration’s decision not to initiate a special enrollment period for the healthcare.gov marketplace in the wake of the COVID-19 pandemic. We encourage you to direct the Department of Health and Human Services (HHS) to immediately initiate a 60-day special enrollment period under the Affordable Care Act (ACA) and undertake an educational campaign to ensure the public is aware of the special enrollment period. Eleven states and D.C. have taken the initiative to create special enrollment periods, allowing thousands in urgent need of coverage to enroll. Since the federal government oversees exchange functions in the rest of the country, a federal special enrollment period must be established to ensure that anyone seeking coverage can have access. Where you live should not determine your ability to access health care, especially at this time of national crisis. Address Surprise Medical BillingKomen joins with many organizations in the patient advocacy community to urge you to include a policy to address surprise medical billing in the fourth package. Surprise medical billing causes uncertainty and financial hardship for Americans every day. It is especially cruel to allow this practice for any service during a time when so many Americans are experiencing financial difficulties and when the circumstances of the pandemic may require patients to seek care out-of-network. We urge Congress to enact legislation to permanently end all surprise medical billing and to protect patients from financial harm as part of broader bipartisan efforts to address the COVID-19 pandemic. Expand Paid LeaveAs another step to promote financial protections for Americans, we join with our colleagues in the patient advocacy community to ask Congress to expand eligibility for the paid family and medical leave program to include individuals determined by the Centers for Disease Control and Prevention (CDC) to be at high risk for adverse complications from COVID-19 and working members of their households. As noted above, cancer patients are particularly vulnerable to COVID-19 and Komen seeks to ensure that cancer patients and their families can stay home without jeopardizing their jobs or financial security. This policy will allow those at highest risk to remain home for the duration of the COVID-19 pandemic and will help ensure their health and safety. Ensure Non-Profit SustainabilityWe sincerely appreciate the policies that you have implemented to help ensure the financial security of the non-profit sector. Like many non-profits, Komen is concerned about the impact that the COVID-19 emergency will have on our operations and ability to serve our patient community. We ask that the next bill strengthen protections for non-profits, including additional provisions to: ensure non-profit access to credit; to strengthen charitable giving incentives; to treat self-funded non-profits fairly with respect to unemployment insurance; and to increase emergency funding for non-profits partnering with state and local governments to serve their communities. ConclusionKomen thanks you for your leadership and your efforts to respond to the effects of COVID-19. We encourage you to pursue additional policy options in future relief packages to protect breast cancer patients, survivors and co-survivors. We look forward to working with you throughout this process. If you have any questions please do not hesitate to reach out to Molly Guthrie, Director of Public Policy and Advocacy, at mguthrie@komen.org Sincerely, Victoria A.M. WolodzkoSenior Vice President, MissionSusan G. 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