A study assessing the impact of the Affordable Care Act (ACA) revealed that the ACA significantly reduced the number of uninsured individuals diagnosed with cancer, according to a research letter published in JAMA Oncology.1

Researchers collected data from 858,193 patients who received a first-time cancer diagnosis between 2010 and 2014 from the National Cancer Institute’s Surveillance, Epidemiology, and End Results program (SEER). They evaluated the unadjusted change in percentage of uninsured patients from pre-ACA 2010 to 2013 and 2014 — the year the ACA was implemented — and further analyzed the data stratifying for tumor location, cancer stage, race and ethnicity, and county poverty rate.

Overall, the rate of uninsured patients decreased from 5.73% in 2010-2013 to 3.81% in 2014, representing a relative change of 33.51%.

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One of the largest decreases in uninsured diagnoses was observed among patients with distant disease at diagnosis, with an absolute difference of -3.03% (95% CI, -3.32 to -2.74), suggesting that uninsured patients may not seek treatment until advanced disease develops.

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The greatest change in uninsured diagnosis rates was observed in Hispanic patients, with an absolute difference of -3.82 (-4.18 to -3.47).

States with Medicaid expansion status had an absolute difference of -2.38% (95% CI, -4.0 to -0.8; P = .007), while rates stayed stable in all other states.

The study shows that the number of uninsured patients with newly diagnosed cancer decreased by nearly 33% in the ACA’s inaugural year.

The authors concluded that “research should examine effects of coverage on cancer diagnoses, treatment, and outcomes. Policy changes that reduce Medicaid funding or weaken protections for individuals with preexisting conditions could be particularly harmful for patients with cancer.”


  1. Soni A, Sabik LM, Simon K, Sommers BD. Changes in insurance among cancer patients under the Affordable Care Act. JAMA Oncol. 2017 Oct 19. doi: 10.1001/jamaoncol.2017.3176 [Epub ahead of print]