Expanded Health Coverage May Improve Cancer Outcomes, Study Says

A new study from researchers at Dana-Farber/Brigham and Women’s Cancer Center (DF/BWCC) and Harvard Medical School found some interesting information regarding medical care and the Affordable Care Act, aka Obamacare.

First, researchers found that adults who lack health insurance are more likely to be diagnosed in advanced stages of cancer and have a higher risk of death. Now, that seems like a “no kidding” type of finding. People who lack health insurance clearly will not be getting the preventative care, tests, and checkups needed for early cancer detection. But the study also found that the ACA may improve cancer outcomes in young adults as it expands coverage to many who have been uninsured, says the study’s first author Dr. Ayal Aizer of the Harvard Radiation Oncology Program. Cancer patients will also benefit from the ACA requirement that insurers cover individuals with pre-existing conditions.

Aizer and senior author Dr. Paul Nguyen, an oncologist at DF/BWCC, published the study, which examined relationships between insurance status and several cancer outcomes, in the Journal of Clinical Oncology on Monday. Aizer said that the study was aimed at exploring the ACA’s potential impact on cancer outcomes.

“We found that patients who have insurance coverage do better on every measure,” Aizer said in a statement.

According to the report:

Those who had insurance coverage were less likely to come to medical attention when their cancer had metastasized, or spread beyond the original site. The results showed that 11.3 percent of covered individuals had metastatic disease when they were diagnosed, compared with 18.5 percent of uninsured patients. That amounted to a 16 percent greater adjusted likelihood of having a potentially curable cancer.

Insured patients were about twice as likely to receive “definitive therapy” – radiation or surgery – for their disease. And, strikingly, the insured were 20 percent more likely to survive.

For the study, researchers analyzed records of 39,447 cancer patients ages 20 to 40 years whose medical, demographic, and insurance information was stored in a National Cancer Institute-sponsored database.

According to the report, the 93 percent of patients were insured, while 7 percent lacked health insurance. Those without coverage tended to be younger, male, non-white, and unmarried. They were also, according to the report, “likely to be from regions of lower median income, educational level, and population density.”

“Overall, the ACA is going to improve health coverage for young people, but we can’t forget about some young people who may feel they can’t afford the premiums,” Nguyen said in a statement. The authors wrote in their article that “extra consideration will need to be given to ensure that at-risk patients can obtain insurance coverage under the ACA.”

Premium costs for some young adults who purchase insurance in the individual market are expected to rise substantially. Such individuals often lack employer-sponsored health plans. The higher costs are partly because the coverage under the ACA is required to be more comprehensive than many existing plans, and because the premiums paid by young, healthy people are helping to subsidize lower costs for older adults.

On the other hand, the ACA extends young adults’ coverage under their parents’ health plans until age 26, and federal subsidies will pay part of the premium costs of low-earning consumers.