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Study shows Affordable Care Act benefited adults with head, neck cancers

Analysis of a national database reveals that numbers of uninsured people with hard-to-treat cancers declined by 3 percent after law's implementation.

By Brian P. Dunleavy
A new study shows more people with head and neck cancer had health insurance and greater access to care as a result of the Affordable Care Act's insurance exchanges. Photo by Healthcare.gov
A new study shows more people with head and neck cancer had health insurance and greater access to care as a result of the Affordable Care Act's insurance exchanges. Photo by Healthcare.gov

Oct. 31 (UPI) -- The Affordable Care Act remains a source of debate -- both in Washington and around American dinner tables -- but the law seems to have enabled more people to purchase health insurance, which is particularly important for those with expensive and difficult-to-treat diseases like cancer.

A study published Thursday in the journal JAMA Otolaryngology-Head & Neck Surgery suggests that the ACA, the controversial Obama-era law that sought to reduce the cost and availability of health insurance, has made a difference for those with head and neck cancers, a particularly hard to treat form of the disease.

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The findings show the law has resulted in an uptick of head-and-neck cancer patients with health insurance-meaning: more of them can afford the cost of their care.

"Our study suggests that the ACA was successful in increasing coverage among patients with head and neck cancer, a subgroup of patients with cancer whose disease treatment can be particularly complex and costly," wrote the authors.

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"Previous studies, including ours have shown that head and neck cancer is one of the most expensive cancers to treat," study co-author Nosayaba Osazuwa-Peters, an assistant professor and director of epidemiology and population health research at St. Louis University School of Medicine, told UPI.

"And unfortunately, a significant proportion of head and neck cancer patients come from backgrounds of lower socioeconomic status, and less than half of these patients present with early-stage disease," he said. "This is not entirely due to lack of insurance; however, studies after studies including ours have shown that individuals without insurance or those under-insured are more likely to present with advanced-stage disease, which is typically more complicated to treat, and which has worse prognosis."

For their analysis, the researchers reviewed information on more than 130,000 adults diagnosed with malignant head and neck cancer from the National Cancer Database, a hospital-based cancer registry, from 2011 to 2015. The ACA was signed into law in 2010 and took effect in 2014.

The authors compared health insurance coverage among head and neck cancer patients both pre- and post-ACA implementation. They found that the numbers of uninsured decreased by nearly 3 percent after the law was enacted, with the largest reduction, of 5.1 percent, coming among head and neck cancer patients between 18 and 34 years of age.

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They also noted a 3.5 percent reduction in uninsured status in low-income zip codes, an indication the law was successful in targeting those who couldn't afford healthcare coverage, they wrote.

"One of the most important aspects of the ACA was the requirement that patients could not be denied coverage or charged inappropriately higher rates based on pre-existing conditions," Osazuwa-Peters said.

"Unfortunately, this only works when a large enough pool of healthy patients also have insurance coverage," Osazuwa-Peters continued. "Hence, recent policy changes, including the elimination of the individual mandate and the introduction of health plans that only cover a limited number of services, are expected to lead to insurance plans that cover a higher risk population, which may increase costs for those higher-risk patients, including patients with cancer."

Open enrollment for 2020 coverage under the ACA begins on Friday.

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