Cancer survivors’ access to medical care and ability to afford medication increased after implementation of the Affordable Care Act (ACA), according to research published in JAMA Oncology.1

An estimated 15 million people in America have a history of cancer. Survivors, furthermore, require long-term follow-up and tend to need more medical care than those without a cancer history. Survivors can, however, face difficulty with access to care and affording medications.

For this study, researchers evaluated whether cancer survivors face more difficulty accessing and affording care than do controls, and whether implementation of the ACA affected any difficulty accessing medical care in this population. Data from 30,364 participants (15,182 survivors and 15,182 controls) in the National Health Interview Survey were included. Changes in access to care from 2010 to 2016 were evaluated.

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Of included participants, 57.4% were women, and the mean age was 63.5 years. Survivors were more likely to have health insurance (94.8% vs 92.2%; P < .001) and to have insurance with government sponsorship (44.3% vs 38.8%; P < .001).

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Survivors were, however, more likely to have delays in care (odds ratio [OR], 1.38), forego medical care (OR, 1.76), and/or be unable to afford medications (OR, 1.77). Coinciding with implementation of the ACA, these difficulties significantly decreased each year.

The authors concluded that “our findings suggest that survivors’ struggles to access and afford medical care decreased during our observation period, coincident with implementation and expanding coverage under the ACA, although we cannot attribute this to any specific ACA provision.”


  1. Nipp RD, Shui AM, Perez GK, et al. Patterns in health care access and affordability among cancer survivors during implementation of the Affordable Care Act. JAMA Oncol. 2018 Mar 29. doi: 10.1001/jamaoncol.2018.0097 [Epub ahead of print]