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Taking the easy layup: Why brain cancer patients depend on it


As the NBA playoffs wind on, we may well find some parallels between the common basketball axiom of ‘not passing on an open, or easy, layup’ and Congress’ current approach toward cancer-related legislation. While receiving due credit for coming together in 2016 to pass the sweeping and complex 21st Century Cures Act, recent congresses are showing a penchant for passing up on the easy layup, opting instead for the proverbial “three-pointer” of large, high-profile legislation. And this is truly beginning to beleaguer cancer patients and patient advocates.

Currently, two non-controversial, bipartisan bills, which would greatly benefit brain tumor and other cancer patients, languish in the 115th Congress. Both pieces of legislation have been introduced in previous congresses and face no constituency that is staunchly opposed their enactment. Indeed, they are ‘no brainers’ (pun not intended).

{mosads}The difficulties of getting a bill passed – particularly passed quickly – with a myriad of national interests to balance is not lost on us. Yet, the following two acts have paid their figurative dues, have been given enough time for consideration, and now demand action.

The Childhood Cancer Survivorship, Treatment, Access and Research (STAR) Act, first introduced in July of 2015 during the 114th Congress (H.R.3381, Rep. Michael McCaul (R-Texas) and S.1883, Sen. Jack Reed (D-R.I.)), contains a number of vital provisions which would help stimulate more effective pediatric cancer research and lead to better outcomes for our most vulnerable patients. The STAR Act requests no new spending, and merely authorizes a number of amendments to NIH and NCI policy. The STAR Act is especially critical for pediatric brain tumor patients, after a 2016 CDC study found that this disease had recently supplanted leukemia for the dubious distinction of the deadliest childhood cancer.

After garnering 270 cosponsors, the House passed the STAR Act on Dec. 6, 2016. There was hope the Senate could follow suit before the close of the session. However, time ran out on the 114th Congress before enough urgency could be mustered in the upper chamber, despite the support of prominent Sens. Marco Rubio (R-Fla.) and Charles Schumer (D-N.Y.) and 20 other cosponsors. However, Senate HELP Committee staffers provided strong signals to advocates that it would take up the STAR Act swiftly in the 115th Congress. And while the STAR Act was quickly re-introduced in both chambers by early February, 2017 (S.292 Sens. Shelley Moore Capito (R-W.Va.)/Reed/Christopher Van Hollen (D-Md.)/Johnny Isakson (R-Ga.), H.R.820 Reps. McCaul/Jackie Speier (D-Calif.)/Mike Kelly (R-Pa.)/G.K Butterfield (D-N.C.)), there has been no additional action taken beyond a flurry of cosponsors again lending their names to the bill.

Alas, the ACA and AHCA seem to have sucked up all of the oxygen from the respective committees needed in each chamber to advance the legislation. As a result, kids with cancer (including pediatric brain tumors, which now account for three out of every 10 pediatric cancer deaths and have never seen a therapy developed specifically for them) continue to be forced to wait in line.

For many adults with brain cancer, so-called oral chemotherapy parity legislation is of crucial importance. These bills would require health plans, particularly ERISA plans, to cover chemotherapy prescribed in pill-form equitably to chemotherapy that is delivered intravenously. Brain cancer patients’ main treatment option is a chemotherapy known as temozolomide. Temozolomide is virtually always prescribed in pill-form, which has allowed some plans to cover the therapy under its prescription drug benefits, instead of as a major medical expense like traditional intravenous chemotherapy. Unfortunately, this often subjects patients to financially crushing co-pay or co-insurance fees. The bills requirements are not considered mandates, as it only applies to plans that already cover similar chemotherapy.

Dating even further back than the STAR Act’s introduction, this legislation originated in 2013 during the 113th Congress as The Cancer Drug Coverage Parity Act (H.R.1801, Rep. Brian Higgins (D-N.Y.)) and the Cancer Treatment Parity Act (S.1879, Sen. Al Franken (D-Minn.)). Yet, despite racking-up 92 cosponsors in the House during the 113th Congress, and then 123 in the House (H.R.2739, Rep. Leonard Lance (R-N.J.)) and 21 in the Senate (S.1566, Sen. Mark Kirk (R-Ill.)) during the 114th Congress, two full sessions have passed without as much as a committee vote in either chamber.

The Cancer Drug Coverage Parity Act was reintroduced in the House (H.R.1409, Reps. Lance and Higgins) this past March for the 115th Congress, but now without even a companion bill in the Senate, this legislation also remains on the ‘outside looking in’ on the floor schedule.

The future of national healthcare policy, whether the ACA remains the law of the land, whether it is revised, or whether it is repealed and replaced (by the AHCA or some other proposal), is an essential debate we must have as a country. There is no denying it’s primacy. In fact, we’ve weighed-in ourselves to ensure critical protections remain that are necessary for the costly care brain tumor patients incur. But that does not mean that Congress should pass up open layups. There is little excuse for not putting points on the board via simple, yet critical and potentially-live saving, bipartisan legislation.

In addition to taking three-pointers, Congress needs to hit the easy layups. Brain cancer patients are depending on it.

David F. Arons, JD, is the Chief Executive Officer of the National Brain Tumor Society. He recently served on the Cancer Moonshot’s Blue Ribbon Panel of advisors and currently chair’s the National Cancer Institute’s Council of Research Advocates. 

The views expressed by this author are their own and are not the views of The Hill.

Tags Al Franken Chuck Schumer Jack Reed Johnny Isakson Marco Rubio Mark Kirk Shelley Moore Capito

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