Younger cancer survivors more likely to afford their health care since the 21st century began

July 15, 2021

Younger cancer survivors — those between ages 18 and 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.

Christopher Su, MD, 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 the younger group of 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 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.

In addition, the number of younger cancer survivors without health insurance dropped, and Medicaid enrollment for this group increased after the ACA became law.

Yet the results do point to another way that the ACA has helped adult cancer survivors younger than 65, who often rely on their jobs for health insurance and can face difficult decisions when they’re not able to work because of illness and long-term treatment.

“The younger working population doesn’t have pensions,” Su said. “Most don’t have a rainy-day fund stored away for them if they get cancer. They’re still trying to work, still trying to put bread on the table. But the ACA made it easier to sign up for Medicaid, to sign up for a health insurance plan that’s affordable to them, and now they have a better umbrella to fall back on for their health care expenses without jeopardizing their already precarious finances because cancer put them out of work or reduced the time that they could be working.”

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