Cancer survivors ages 18 to 64 faced fewer financial barriers to health care after the Affordable Care Act was implemented than they did before the landmark law took effect, University of Michigan researchers found.
In fact, they believe the ACA helped the financial burden (problems related to the cost of medical care) for younger cancer survivors fall to its lowest estimated levels in 20 years.
"There has been a lot of talk about the ACA affecting people who don't have the Medicare safety net," said Christopher Su, M.D., a clinical fellow in the division of hematology and oncology at Michigan Medicine and the first author of the paper. "We were able to drill down to that and show that it did make a difference to younger cancer survivors."
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Su and his team analyzed data from more than 20,000 Americans who responded to the National Health Interview Survey, a long-running series of interviews conducted by a part of the Centers for Disease Control and Prevention that collects data on everything from chronic conditions to vaccinations.
They found that younger cancer survivors were less likely to delay treatment because of cost and didn't have as much trouble paying for medications or dental care from 2014 to 2018. This was the five-year period after several key features of the ACA -- including the Health Insurance Marketplace, through which individuals, families and small businesses can compare and purchase health insurance plans -- went into effect.
In contrast, cancer survivors 65 and older didn't experience much of a change in their ability to afford health care post-ACA, likely because so many were on Medicare.
"When the major provisions of the Affordable Care Act came into play, all the measures of affordability came down for the younger survivors," Su said, "but they actually stayed the same for the Medicare population."
When the researchers traced these measures back over the past two decades, they saw that, between 2015 and 2017, all had dropped to their lowest points since 1999 for adult cancer survivors younger than 65. Essentially, younger cancer survivors were more likely to be able to afford their health care than at any other time since the 21st century began.
"At the end of the day, the ACA really benefits people who are vulnerable," Su said, "who are at high risk, who, for whatever reason, need to come to get medical care a lot and the medical care that they get is expensive. I think we can say that cancer patients fit this definition."