Justin M Barnes1,2, Derek S Brown2,3, Jenine K Harris3, Allison A King2,4,5,6, Kimberly J Johnson7,8. 1. Saint Louis University School of Medicine, St. Louis, MO, USA. 2. Siteman Cancer Center, Washington University in St. Louis, St. Louis, MO, USA. 3. Brown School, Washington University in St. Louis, St. Louis, MO, USA. 4. Program in Occupational Therapy, Washington University School of Medicine, St. Louis, MO, USA. 5. Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St. Louis, MO, USA. 6. Department of Pediatrics, Division of Hematology/Oncology, St. Louis Children's Hospital, Washington University School of Medicine, St. Louis, MO, USA. 7. Siteman Cancer Center, Washington University in St. Louis, St. Louis, MO, USA. kijohnson@wustl.edu. 8. Brown School, Washington University in St. Louis, St. Louis, MO, USA. kijohnson@wustl.edu.
Abstract
PURPOSE: To evaluate the impact of the Affordable Care Act Dependent Care Provision by sociodemographic and economic characteristics in young adult cancer patients. METHODS: The National Cancer Database (NCDB) and the Surveillance, Epidemiology, and End Results (SEER) 18 database were queried for young adult cancer cases diagnosed during 2007-2014. Using a difference-in-differences approach, we examined insurance coverage in different subgroups of policy-eligible 19-25 year-olds versus policy-ineligible 27-29 year-olds from the pre- (2007-2009) to post- (2011-2014) Dependent Care Provision period. RESULTS: Across subgroups and study populations, insurance coverage increased significantly following the Provision enactment in the policy-eligible versus policy-ineligible group across most subgroups (range in NCDB: 1.83 to 6.38% for low and mid-low education areas, respectively; range in SEER: 1.43 to 6.18 for Non-Hispanic Others and Hispanics, respectively). Heterogenous impacts were observed by sex with a larger impact in males (NCDB: 5.14%, 95% CI 3.59-6.69; SEER: 4.46, 2.12-6.8) than females (NCDB: 2.51%, 95% CI 1.39-3.62; SEER: 2.50, 0.82-4.18). We observed no other statistical evidence for Dependent Care Provision subgroup heterogeneity except for a smaller impact in individuals from low education areas in NCDB. CONCLUSIONS: Our results indicate a positive Dependent Care Provision impact on insurance coverage in young adults with cancer across subgroups, with evidence for a smaller impact in females relative to males and in low relative to high education areas.
PURPOSE: To evaluate the impact of the Affordable Care Act Dependent Care Provision by sociodemographic and economic characteristics in young adult cancerpatients. METHODS: The National Cancer Database (NCDB) and the Surveillance, Epidemiology, and End Results (SEER) 18 database were queried for young adult cancer cases diagnosed during 2007-2014. Using a difference-in-differences approach, we examined insurance coverage in different subgroups of policy-eligible 19-25 year-olds versus policy-ineligible 27-29 year-olds from the pre- (2007-2009) to post- (2011-2014) Dependent Care Provision period. RESULTS: Across subgroups and study populations, insurance coverage increased significantly following the Provision enactment in the policy-eligible versus policy-ineligible group across most subgroups (range in NCDB: 1.83 to 6.38% for low and mid-low education areas, respectively; range in SEER: 1.43 to 6.18 for Non-Hispanic Others and Hispanics, respectively). Heterogenous impacts were observed by sex with a larger impact in males (NCDB: 5.14%, 95% CI 3.59-6.69; SEER: 4.46, 2.12-6.8) than females (NCDB: 2.51%, 95% CI 1.39-3.62; SEER: 2.50, 0.82-4.18). We observed no other statistical evidence for Dependent Care Provision subgroup heterogeneity except for a smaller impact in individuals from low education areas in NCDB. CONCLUSIONS: Our results indicate a positive Dependent Care Provision impact on insurance coverage in young adults with cancer across subgroups, with evidence for a smaller impact in females relative to males and in low relative to high education areas.
Entities:
Keywords:
Affordable care act; Cancer; Dependent coverage; Young adult
Authors: Michael Roth; Amy Berkman; Clark R Andersen; Branko Cuglievan; J Andrew Livingston; Michelle Hildebrandt; Archie Bleyer Journal: Oncologist Date: 2022-03-04 Impact factor: 5.837
Authors: M Larissa Avilés-Santa; Laura Hsu; Tram Kim Lam; S Sonia Arteaga; Ligia Artiles; Sean Coady; Lawton S Cooper; Jennifer Curry; Patrice Desvigne-Nickens; Holly L Nicastro; Adelaida Rosario Journal: Front Public Health Date: 2020-08-28