The number of head and neck cancer patients covered by insurance grew significantly following implementation of the Affordable Care Act (ACA), according to a new study.
“Overall, this study demonstrates an association between the ACA and increased insurance coverage for populations of head and neck cancer patients with historically limited access to care,” said the lead author of the study, Neelima Panth, MD, MPH, an otolaryngology resident at the Yale School of Medicine in New Haven, CT.
The retrospective cohort study included 131,779 patients with head and neck cancer identified through the National Cancer Database, 77,071 of whom were patients identified pre-ACA (2011 to 2013) and 54,708 post-ACA (2014 to 2015).
Dr. Panth and fellow researchers reported a 2.68 percentage point decrease in the percentage of patients without insurance from the pre-ACA period to the post-ACA period (JAMA Otolaryngol Head Neck Surg. 2019 Oct 31. doi: 10.1001/jamaoto.2019.2724. [Epub ahead of print]). This percentage point difference was highest for patients with historically limited access to treatment for head and neck cancer. For example, the study found that young adults and patients from low-income zip codes experienced the greatest change in insurance coverage pre- and post-ACA. Patients aged 18 to 34 years had the greatest reduction in uninsured rates with a 5.12 percentage point decrease, whereas patients aged 65 to 74 years had the smallest reduction in insured rates (0.24 percentage point decrease). Patients from low-income zip codes had a 3.45 percentage point decrease in uninsured rates, whereas patients from high-income zip codes had a 1.99 percentage point decrease.
“In the context of broader public health goals, this research helps us understand how expanding insurance coverage affects access to care among patients with head and neck cancer who tend to present at late stages with poor prognoses,” Dr. Panth said. “It is important for otolaryngologists to be aware of these effects so they can better advocate for their patients in an era of insurance reform.”
—Mary Beth Nierengarten