This bill establishes comprehensive federal initiatives to improve care and support for the estimated 18 million American cancer survivors, with that number expected to grow to 26 million by 2040. The legislation addresses gaps in survivorship care by requiring Medicare to cover cancer care planning and coordination services, developing alternative payment models for survivorship programs, and establishing new Medicaid coverage requirements for childhood cancer survivors' healthcare transitions and fertility services for all cancer survivors. The bill also creates a Cancer Survivor Employment Assistance Program to help survivors navigate workforce challenges, funds quality-of-life improvement programs through grants to cancer centers and community organizations, and establishes a dedicated Office of Cancer Survivorship within the National Cancer Institute to coordinate research and education efforts. Most provisions take effect within 18 months to three years of enactment, with the Medicaid fertility services coverage beginning 18 months after the law passes.