Open AccessThe Affordable Care Act and access to care across the cancer control continuum: A review at 10 years
Author(s) -
Zhao Jingxuan,
Mao Ziling,
Fedewa Stacey A.,
Nogueira Leticia,
Yabroff K. Robin,
Jemal Ahmedin,
Han Xuesong
Publication year - 2020
Publication title -
ca: a cancer journal for clinicians
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 62.937
H-Index - 168
eISSN - 1542-4863
pISSN - 0007-9235
DOI - 10.3322/caac.21604
Subject(s) - medicaid , patient protection and affordable care act , health care , health insurance , medicine , cancer screening , survivorship curve , continuum of care , health equity , family medicine , environmental health , business , cancer , nursing , public health , political science , population , law
Lack of health insurance coverage is strongly associated with poor cancer outcomes in the United States. The uninsured are less likely to have access to timely and effective cancer prevention, screening, diagnosis, treatment, survivorship, and end‐of‐life care than their counterparts with health insurance coverage. On March 23, 2010, the Patient Protection and Affordable Care Act (ACA) was signed into law, representing the largest change to health care delivery in the United States since the introduction of the Medicare and Medicaid programs in 1965. The primary goals of the ACA are to improve health insurance coverage, the quality of care, and patient outcomes, and to maintain or lower costs by catalyzing changes in the health care delivery system. In this review, we describe the main components of the ACA, including health insurance expansions, coverage reforms, and delivery system reforms, provisions within these components, and their relevance to cancer screening and early detection, care, and outcomes. We then highlight selected, well‐designed studies examining the effects of the ACA provisions on coverage, access to cancer care, and disparities throughout the cancer control continuum. Finally, we identify research gaps to inform evaluation of current and emerging health policies related to cancer outcomes.