ArticleJNCI cancer spectrum2022
Narrowing Insurance Disparities Among Children and Adolescents With Cancer Following the Affordable Care Act.
Article in JNCI cancer spectrum, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed.
- Health Insurance as a Mediator of Neighborhood Deprivation and Pediatric Cancer Survival: An Analysis of State Cancer Registry Data.Cancer medicine · 2026Article
- The lasting impact of the ACA: how Medicaid expansion reduces outcome disparities in AYAs with leukemia and lymphoma.Hematology. American Society of Hematology. Education Program · 2024Article
- Health insurance among survivors of childhood cancer following Affordable Care Act implementation.Journal of the National Cancer Institute · 2024Article
- A Scoping Review to Identify Community- and Societal-Level Strategies Evaluated from 2013 to 2023 for Their Potential Impact on Child Well-Being in the United States.Children (Basel, Switzerland) · 2024Article
- Survival in Young Adults With Cancer Is Associated With Medicaid Expansion Through the Affordable Care Act.Journal of clinical oncology : official journal of the American Society of Clinical Oncology · 2023Article
- Moving Beyond Patient-Level Drivers of Racial/Ethnic Disparities in Childhood Cancer.Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology · 2022Article
- American Cancer Society's Report on the Status of Cancer Disparities in the United States, 2025.CA: a cancer journal for cliniciansArticle
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Authors and funding
6 authors.
Funding
Abstract
Despite advances toward universal health insurance coverage for children, coverage gaps remain. Using a nationwide sample of pediatric and adolescent cancer patients from the National Cancer Database, we examined effects of the Affordable Care Act (ACA) implementation in 2014 with multinomial logistic regressions to evaluate insurance changes between 2010-2013 (pre-ACA) and 2014-2017 (post-ACA) in patients aged younger than 18 years (n = 63 377). All statistical tests were 2-sided. Following the ACA, the overall percentage of Medicaid and Children's Health Insurance Program-covered patients increased (from 35.1% to 36.9%; adjusted absolute percentage change [APC] = 2.01 percentage points [ppt], 95% confidence interval [CI] = 1.31 to 2.71; P < .001), partly offset by declined percentage of privately insured (from 62.7% to 61.2%; adjusted APC = -1.67 ppt, 95% CI = -2.37 to -0.97; P < .001), leading to a reduction by 15% in uninsured status (from 2.2% to 1.9%; adjusted APC = -0.34 ppt, 95% CI = -0.56 to -0.12 ppt; P = .003). The largest declines in uninsured status were observed among Hispanic patients (by 23%; adjusted APC = -0.95 ppt, 95% CI = -1.67 to -0.23 ppt; P = .009) and patients residing in low-income areas (by 35%; adjusted APC = -1.22 ppt, 95% CI = -2.22 to -0.21 ppt; P = .02). We showed nationwide insurance gains among pediatric and adolescent cancer patients following ACA implementation, with greater gains in racial and ethnic minorities and those living in low-income areas.
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