Abstract
This study examined racial/ethnic differences in health/life insurance denial due to cancer among cancer survivors after the passage of the Affordable Care Act (ACA). Behavioral Risk Factor Surveillance System data were obtained from 2012–2020. The dependent variable asked: “Were you ever denied health insurance or life insurance coverage because of your cancer?” Cancer survivors were included if they were diagnosed with cancer after the Affordable Care Act (N = 14,815). Unadjusted and adjusted logistic regressions for age, sex, income, and employment provided odds ratios of insurance denial due to cancer across racial/ethnic groups: Non-Hispanic White, Black, and Other/mixed race; and Hispanic. Statistically significant differences (p < 0.05) were found between those who were denied or not denied insurance across sex, age, race/ethnicity, income, and employment. Adjusted regressions found significantly higher odds ratios of insurance denial for Blacks (OR: 3.00, 95% CI: 1.77, 5.08), Other/mixed race (OR: 2.16, 95% CI: 1.16, 4.02), and Hispanics (OR: 2.13, 95% CI: 1.02, 4.42) compared to Whites. Differences were observed across sex, income, and employment. Cancer survivors report racial/ethnic disparities in health and life insurance denial due to their cancer despite policy changes. This may be harmful for those who are already financially vulnerable due to their cancer diagnosis and exacerbate racial/ethnic cancer disparities.
Highlights
Cancer is the second leading cause of death in the United States and over 16.9 millionAmericans living today have a history of cancer [1]
This study aims to fill these gaps in knowledge by analyzing annual survey data on health or life insurance denial due to a cancer diagnosis collected by the Behavioral
The purpose of this study was to examine the association between race/ethnicity and health or life insurance denial due to a cancer diagnosis among those respondents diagnosed after the Affordable Care Act (ACA)
Summary
Cancer is the second leading cause of death in the United States and over 16.9 millionAmericans living today have a history of cancer [1]. Cancer is the second leading cause of death in the United States and over 16.9 million. Health insurance plays a significant role in cancer prevention and survival [4]. The. Affordable Care Act (ACA) focused on decreasing the number of people without health insurance and on reducing racial/ethnic health disparities [5]. The ACA made health insurance available to millions of Americans through several provisions, including the expansion of Medicaid eligibility for individuals with low incomes, establishment of health insurance marketplaces with subsidies to those who qualify, extension of coverage for dependents to age 26, and elimination of insurance coverage restrictions for individuals with pre-existing conditions [6]. Gains in health insurance coverage from the ACA have been largest for Americans under the age of 65 who are not eligible for Medicare.
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