Childhood Cancer Survivors Still Face Health Care Affordability Issues Despite ACA

Despite the passing of the Affordable Care Act (ACA), health care affordability and medical nonadherence remains a problem for childhood cancer survivors (CCS), a new study showed.

After the passing of the ACA, more than 10% of CCS still reported having difficulty affording healthcare and foregoing care because of cost.

“Medicaid expansion in all states would likely continue to improve healthcare access and affordability among CCS,” study authors wrote. “CCS are at greater risk for chronic health conditions, requiring additional care, have higher out-of-pocket medical costs, and lower average incomes than their peers, all of which likely contribute to the disparity.”

Study researchers used data from the National Health Interview Survey and identified 309 CCS in a pre-ACA cohort and 324 CCS in a post-ACA cohort. Included CCS were aged 21 to 65 years and were matched with controls without a history of cancer.

Prior to ACA, CCS were 39% more likely to be uninsured compared with their peers (P=0.046). However, there was no differences in the likelihood of being uninsured after ACA.

After ACA, the number of CCS that reported difficulty in affording healthcare significantly decreased as did the proportion that had to skip care due to cost. Despite these reductions, 13% of CCS still reported being uninsured.

“For these people, affordability of healthcare and medical nonadherence are a larger concern,” the researchers wrote. “Among CCS, lack of insurance coverage is associated with lower rates of ongoing medical care, cancer-related medical visits, and cancer screening, and decreased utilization of dental services.”

In addition, 13% of CCS reported forgoing needed care because of cost. More than one-third (36%) reported difficulty paying for health care.

Based on these results, the researchers recommended additional research to help elucidate the causes of these issues and to find potential solutions.