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Trends in Insurance Status Among Patients Diagnosed With Cancer Before and After Implementation of the Affordable Care Act.

Publication ,  Journal Article
Moss, HA; Havrilesky, LJ; Zafar, SY; Suneja, G; Chino, J
Published in: J Oncol Pract
February 2018

PURPOSE: The Affordable Care Act (ACA) aimed to increase insurance coverage through key provisions such as expansion of Medicaid eligibility and enforcement of an individual mandate. The objective of this study is to examine the impact of the ACA on insurance rates among patients newly diagnosed with colon, lung, or breast cancer. METHODS: Using the SEER database, patients younger than age 65 years diagnosed with colon, lung, or breast cancer between 2008 and 2014 were identified. Insurance rates were examined before versus after passage of the ACA (2011) and before (2011 to 2013) versus after (2014) Medicaid expansion in nine expansion states and five nonexpansion states. Difference-in-differences models were used to estimate the differential impact of ACA in expansion compared with nonexpansion states. RESULTS: A total of 414,085 patients with known insurance status were diagnosed with colon, lung, or breast cancer between 2008 and 2014. For all cancer types, there was a significant increase in patients enrolled in Medicaid after 2011 in expansion states. Between 2011 to 2013 and 2014, in patients living in states with Medicaid expansion, the uninsured rates decreased by ≥ 50% among patients with a new diagnosis of lung and colon cancer (6.5% in 2011 to 2013 to 3.1% in 2014 and 6.8% in 2011 to 2013 to 3.4% in 2014, respectively; P < .001); the uninsured rate decreased to a lesser degree for patients with breast cancer (2.7% in 2011 to 2013 to 1.6% in 2014; P < .001). This decrease in the rate of uninsured patients was absent in patients living in nonexpansion states. CONCLUSION: The ACA resulted in expanded insurance coverage for patients diagnosed with colon, lung, and breast cancer. However, the impact was only observed in states that increased their Medicaid eligibility.

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Published In

J Oncol Pract

DOI

EISSN

1935-469X

Publication Date

February 2018

Volume

14

Issue

2

Start / End Page

e92 / e102

Location

United States

Related Subject Headings

  • United States
  • SEER Program
  • Oncology & Carcinogenesis
  • Neoplasms
  • Neoplasm Staging
  • Medicaid
  • Male
  • Insurance, Health
  • Insurance Coverage
  • Humans
 

Citation

APA
Chicago
ICMJE
MLA
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Moss, H. A., Havrilesky, L. J., Zafar, S. Y., Suneja, G., & Chino, J. (2018). Trends in Insurance Status Among Patients Diagnosed With Cancer Before and After Implementation of the Affordable Care Act. J Oncol Pract, 14(2), e92–e102. https://doi.org/10.1200/JOP.2017.027102
Moss, Haley A., Laura J. Havrilesky, S Yousuf Zafar, Gita Suneja, and Junzo Chino. “Trends in Insurance Status Among Patients Diagnosed With Cancer Before and After Implementation of the Affordable Care Act.J Oncol Pract 14, no. 2 (February 2018): e92–102. https://doi.org/10.1200/JOP.2017.027102.
Moss HA, Havrilesky LJ, Zafar SY, Suneja G, Chino J. Trends in Insurance Status Among Patients Diagnosed With Cancer Before and After Implementation of the Affordable Care Act. J Oncol Pract. 2018 Feb;14(2):e92–102.
Moss, Haley A., et al. “Trends in Insurance Status Among Patients Diagnosed With Cancer Before and After Implementation of the Affordable Care Act.J Oncol Pract, vol. 14, no. 2, Feb. 2018, pp. e92–102. Pubmed, doi:10.1200/JOP.2017.027102.
Moss HA, Havrilesky LJ, Zafar SY, Suneja G, Chino J. Trends in Insurance Status Among Patients Diagnosed With Cancer Before and After Implementation of the Affordable Care Act. J Oncol Pract. 2018 Feb;14(2):e92–e102.

Published In

J Oncol Pract

DOI

EISSN

1935-469X

Publication Date

February 2018

Volume

14

Issue

2

Start / End Page

e92 / e102

Location

United States

Related Subject Headings

  • United States
  • SEER Program
  • Oncology & Carcinogenesis
  • Neoplasms
  • Neoplasm Staging
  • Medicaid
  • Male
  • Insurance, Health
  • Insurance Coverage
  • Humans