Patient Protection and Affordable Care Act Medicaid expansion and gains in health insurance coverage and access among cancer survivors

Nikpay, Sayeh; Tebbs, Margaret; Castellanos, Emily

doi:10.1002/cncr.31288

Cited by 28 publications

(19 citation statements)

References 39 publications

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“…Overall, the percentage uninsured among cancer survivors decreased from 12.8% pre‐ACA to 6.0% post‐ACA in expansion states and decreased from 18.2% pre‐ACA to 13.4% post‐ACA in nonexpansion states, with a 1.8‐ppt net decrease associated with Medicaid expansion 92 . Similar findings were reported elsewhere, with greater declines in the percentage uninsured among low‐income cancer survivors 93 …”

Section: Overview Of Research Addressing the Aca And Cancer Caresupporting

confidence: 81%

The Affordable Care Act and access to care across the cancer control continuum: A review at 10 years

Zhao

Mao

Fedewa

et al. 2020

CA A Cancer J Clinicians

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Lack of health insurance coverage is strongly associated with poor cancer outcomes in the United States. The uninsured are less likely to have access to timely and effective cancer prevention, screening, diagnosis, treatment, survivorship, and end-of-life care than their counterparts with health insurance coverage. On March 23, 2010, the Patient Protection and Affordable Care Act (ACA) was signed into law, representing the largest change to health care delivery in the United States since the introduction of the Medicare and Medicaid programs in 1965. The primary goals of the ACA are to improve health insurance coverage, the quality of care, and patient outcomes, and to maintain or lower costs by catalyzing changes in the health care delivery system. In this review, we describe the main components of the ACA, including health insurance expansions, coverage reforms, and delivery system reforms, provisions within these components, and their relevance to cancer screening and early detection, care, and outcomes. We then highlight selected, well-designed studies examining the effects of the ACA provisions on coverage, access to cancer care, and disparities throughout the cancer control continuum. Finally, we identify research gaps to inform evaluation of current and emerging health policies related to cancer outcomes. CA Cancer J Clin 2020;70:165-181.

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Section: Overview Of Research Addressing the Aca And Cancer Caresupporting

confidence: 81%

The Affordable Care Act and access to care across the cancer control continuum: A review at 10 years

Zhao

Mao

Fedewa

et al. 2020

CA A Cancer J Clinicians

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“…Studies conducted before the 2010 Affordable Care Act reported that financial burden created worry and anger when tools for lymphedema management were not covered by insurance [ 40 ]. The present study suggests that these challenges persist even after the Affordable Care Act, which has the potential to expand health insurance coverage for cancer-related care [ 41 ] and for cancer survivors [ 42 , 43 ]. For women cancer survivors with lymphedema, who continued to manage a disease long after completing cancer treatment, these challenges persisted due to ongoing needs for lymphedema care.…”

Section: Discussionmentioning

confidence: 99%

“It still affects our economic situation”: long-term economic burden of breast cancer and lymphedema

Dean

Moss

Ransome

et al. 2018

Support Care Cancer

114

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Long-term cancer survivors with lymphedema may face up to 112% higher out-of-pocket costs than those without lymphedema, which influences lymphedema management, and has lasting impact on savings and productivity. Findings reinforce the need for actions at policy, provider, and individual patient levels, to reduce lymphedema costs. Future work should explore patient-driven recommendations to reduce economic burden after cancer.

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“…Overall, the authors found that Medicaid expansion was associated with a reduction in the number of uninsured and the increased likelihood of having a personal physician. Individuals residing in expansion states fared considerably better than those in the nonexpansion states . Davidoff et al.…”

Section: Impact Of the Ppacamentioning

confidence: 99%

“…Nikpay et al. also using data from the BRFSS, explored the impact of Medicaid expansion on cancer survivors . Overall, the authors found that Medicaid expansion was associated with a reduction in the number of uninsured and the increased likelihood of having a personal physician.…”

Section: Impact Of the Ppacamentioning

confidence: 99%

“…Individuals residing in expansion states fared considerably better than those in the nonexpansion states. 34 Davidoff et al using data from the 2008-2010 MEPS, estimated that among the estimated 1.39 million uninsured cancer survivors, 30% would be Medicaid eligible under PPACA or eligible for tax credits. Among survivors residing in expansion states, 50% would be Medicaid eligible, in contrast to 8% in nonexpansion states.…”

Section: Medicaid Expansion and Creation Of The Individual Insurance mentioning

confidence: 99%

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Adolescent and young adult cancer care: Financial hardship and continued uncertainty

Parsons

Kumar

2018

Pediatric Blood & Cancer

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Since 2005, there has been a steady increase in the number of new cancer diagnoses among adolescents and young adults (AYA) in the United States (US), likely due to improved awareness and detection within this age group, as well as the possible contribution of insurance expansion under the Patient Protection and Affordable Care Act. AYAs with cancer remain highly vulnerable financially, a situation that will only worsen with proposed rollbacks in access to and affordability of healthcare. In this review, we will discuss existing aspects of financial hardship and highlight areas of uncertainty, based on the current US political climate.

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Patient Protection and Affordable Care Act Medicaid expansion and gains in health insurance coverage and access among cancer survivors

Abstract: The results of the current study suggest that the Patient Protection and Affordable Care Act Medicaid expansion has improved coverage and access for cancer survivors. Cancer 2018;124:2645-52. © 2018 American Cancer Society.

Cited by 28 publications

References 39 publications

The Affordable Care Act and access to care across the cancer control continuum: A review at 10 years

The Affordable Care Act and access to care across the cancer control continuum: A review at 10 years

“It still affects our economic situation”: long-term economic burden of breast cancer and lymphedema

Adolescent and young adult cancer care: Financial hardship and continued uncertainty

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