Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

ACA Dependent Coverage Expansion Impact Assessed

Cancer; ePub 2017 Sep 22; Alvarez, Keegan, et al

The option to cover older children under the Affordable Care Act (ACA) has increased insurance coverage for some but not all patients with cancer, according to a retrospective, population-based analysis involving >11,000 young people. Participants ranged between 22 and 30 years of age and were hospitalized for cancer between 2006 and 2014. Investigators looked at influences linked with having private insurance, including implementation of the ACA. Among the results:

  • Blacks and Hispanics were less likely than whites to have private insurance pre-ACA.
  • Patients between 22 and 25 years of age were 20% more likely to have private insurance post-ACA.
  • Private insurance increased among this age group from 65% pre-ACA to 69% post-ACA for those living in medium-income areas.
  • It rose from 80% to 82% for those living in high-income areas.
  • It increased from 73% to 86% for Asians in this younger group who lived in high-income areas.
  • Private insurance decreased for all Hispanics aged 22 to 25 years between the 2 time periods.


Alvarez E, Keegan T, Johnston E, et al. The Patient Protection and Affordable Care Act Dependent Coverage Expansion: Disparities in impact among young adult oncology patients. [Published online ahead of print September 22, 2017]. Cancer. doi:10.1002/cncr.30978.

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