Health coverage, access to care, and financial barriers for adults with a cancer history early in ACA implementation

The Affordable Care Act (ACA) has the potential to improve health care coverage and access for adults with cancer.  This analysis provides an early look following the implementation of the ACA’s major coverage provisions at the characteristics and health care experiences of adults who have ever been diagnosed with cancer (excluding skin cancer).  We use data from the Health Reform Monitoring Survey (HRMS), a quarterly internet-based survey that is representative of US households.  The September 2014 (Quarter 3) HRMS included an oversample of adults who have been diagnosed with cancer (n=1,143). We compare the demographic and socioeconomic characteristics of adults with cancer to other adults as well as their health insurance status, health care affordability challenges, and access to and use of health care.  We describe the characteristics of adults with cancer who have access and affordability challenges. We find that adults with a cancer diagnosis are more likely to have coverage with high deductibles of $1,000 or more (45.4% vs 38.6%) and report having medical debt and family out of pocket spending of $4,000 or more in the past year (14.9% vs 7.8%). Adults with a cancer history who have no usual source of care (USOC) other than a hospital emergency department are more likely to be low-income, uninsured, and unmarried compared to those with a USOC.  Adults with cancer who reported health care affordability issues are more likely to have moderate family income and to have a diagnosis for an ambulatory care sensitive condition.