Changes in Health Insurance Coverage Associated With the Affordable Care Act Among Adults With and Without a Cancer History
Advanced Search
Select up to three search categories and corresponding keywords using the fields to the right. Refer to the Help section for more detailed instructions.

Search our Collections & Repository

All these words:

For very narrow results

This exact word or phrase:

When looking for a specific result

Any of these words:

Best used for discovery & interchangable words

None of these words:

Recommended to be used in conjunction with other fields

Language:

Dates

Publication Date Range:

to

Document Data

Title:

Document Type:

Library

Collection:

Series:

People

Author:

Help
Clear All

Query Builder

Query box

Help
Clear All

For additional assistance using the Custom Query please check out our Help Page

i

Changes in Health Insurance Coverage Associated With the Affordable Care Act Among Adults With and Without a Cancer History

Filetype[PDF-458.83 KB]


  • English

  • Details:

    • Alternative Title:
      Med Care
    • Description:
      Background:

      The Affordable Care Act (ACA) improved health care coverage accessibility by expanding Medicaid eligibility, creating insurance Marketplaces, and subsidizing premiums. We examine coverage changes associated with ACA implementation, comparing adults with and without a cancer history.

      Methods:

      We included nonelderly adults from the 2012 to 2015 National Health Interview Survey. Using information on state Medicaid policies (2013), expansion decisions (2015), family structure, income, insurance offers, and current coverage, we assigned adults in all 4 years to mutually exclusive eligibility categories including: Medicaid-eligible pre-ACA; expansion eligible for Medicaid; and Marketplace premium subsidy eligible. Linear probability regressions estimated pre-post (2012–2013 vs. 2014–2015) coverage changes by eligibility category, stratified by cancer history.

      Results:

      The uninsured rate for cancer survivors decreased from 12.4% to 7.7% (P < 0.001) pre-post ACA implementation. Relative to income > 400% of the federal poverty guideline, the uninsured rate for cancer survivors decreased by an adjusted 8.4 percentage points [95% confidence interval (CI), 1.3–15.6] among pre-ACA Medicaid eligible; 16.7 percentage points (95% CI, 9.0–24.5) among expansion eligible, and 11.3 percentage points (95% CI, −0.8 to 23.5, with a trend P = 0.069) for premium subsidy eligible. Decreases in uninsured among expansion-eligible adults without a cancer history [9.7 percentage points (95% CI, 7.4–12.0), were smaller than for cancer survivors (with a trend, P = 0.086)]. Despite coverage gains, ~528,000 cancer survivors and 19.1 million without a cancer history remained uninsured post-ACA, yet over half were eligible for Medicaid or subsidized Marketplace coverage.

      Conclusions:

      ACA implementation was associated with large coverage gains in targeted expansion groups, including cancer survivors, but additional progress is needed.

    • Pubmed ID:
      29438192
    • Pubmed Central ID:
      PMC6105312
    • Document Type:
    • Collection(s):
    • Main Document Checksum:
    • File Type:

    You May Also Like

    Checkout today's featured content at stacks.cdc.gov