Cancer patients less likely to face 'catastrophic' care costs under ACA, study finds

The Affordable Care Act protects cancer patients from losing insurance, but they still face potentially catastrophic health costs, a new study has found. Screenshot courtesy
The Affordable Care Act protects cancer patients from losing insurance, but they still face potentially catastrophic health costs, a new study has found. Screenshot courtesy

Sept. 8 (UPI) -- Adults with cancer are less likely to experience catastrophic care expenses under the Affordable Care Act than they were before implementation of the law, a study published Wednesday by JAMA Network Open found.

They are also less likely to lose or change healthcare coverage during their illness, thanks to the law, also known as Obamacare, the data showed.


Compared with the period immediately before the ACA's passage, 2005 to 2009, cancer patients covered by health plans under the law between 2014 and 2018 had a 3% lower risk for experiencing catastrophic care expenses.

The ACA also reduced cancer patients' risk for being uninsured -- or lacking healthcare coverage -- by more than 4%.

Compared to the public, however, cancer patients still faced a higher risk for catastrophic health expenses -- which refers to costs exceeding 10% of a patient's annual household income -- making it difficult for them to keep up with expenses, according to the researchers.

"Non-elderly patients with cancer in the U.S. continue to cope with a complex insurance marketplace and high risks of catastrophic health expenses, despite the well-intentioned policy reforms of the ACA," researchers from Duke University in Durham, N.C., wrote.


"In particular, low-income patients with cancer with private insurance coverage may face lower risks of periods of uninsurance, but under-insurance is associated with high risks of catastrophic health expenses," they said.

Signed into law in 2010 and fully implemented by 2014, the ACA was designed to enable consumers to purchase healthcare coverage at a reduced cost, thereby reducing the ranks of the uninsured in the United States.

The law also stipulated that insurers could not deny coverage based on pre-existing conditions, meaning those with chronic or long-term conditions were more likely to remain insured.

For this study, the Duke researchers analyzed data on more than 6,000 adults with cancer in the United States annually from 2005 to 2018 and compared them with similar numbers of people without the disease.

Most of the study participants were in their late forties or early fifties, the researchers said.

Over the study period, 5% of cancer patients lost their health insurance and 15% were uninsured, the data showed.

Among those without cancer, 8% lost their coverage and 24% did not have insurance.

However, 12% of cancer patients incurred catastrophic health expenses, not including insurance premiums, while 6% of those without the disease did so.


Including insurance premium costs, 27% of cancer patients experienced catastrophic health expenses, compared to 16% of those without cancer, the data showed.

Nearly 82% of cancer patients from low-income families, and with full-year private coverage, were at high risk for catastrophic health expenditures, the researchers said.

"Oncologists should be cognizant of the financial strains that cancer places on patients and families, even when insured," the researchers wrote.

"Further health reforms to cover the remaining uninsured individuals and to increase plan generosity are needed to adequately protect the population of individuals with cancer," they said.

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