Nina Niu Sanford, M.D. Assistant ProfessorUT Southwestern Department of Radiation OncologyDallas TX 75390

Cancer Survivors: Insurance Patterns Before and After Affordable Care Act Interview with:

Nina Niu Sanford, M.D. Assistant ProfessorUT Southwestern Department of Radiation OncologyDallas TX 75390

Dr. Sanford

Nina Niu Sanford, M.D. 
Assistant Professor
UT Southwestern Department of Radiation Oncology
Dallas TX 75390 What is the background for this study? What are the main findings?

Response: The background for this study is that we know cancer survivors are at risk for uninsurance or underinsurance and the most commonly cited reason for this is cost of insurance.  However, there have been no prior studies assessing from the patient perspective the reasons for not having insurance.

In addition, there has been further recent controversy over the Affordable Care Act, including threats from the current administration to dismantle it.  Thus assessing the impact of the ACA among at risk populations including cancer survivors is timely. What should readers take away from your report?

Response: ​First, that the ACA was successful in decreasing rates of being uninsured among cancer survivors – from 10.6 to 6.2%, with greatest gains seen in groups specifically targeted by the ACA including young individuals, minorities and those below the poverty threshold.

Second, although cost was the most commonly cited reason for not having insurance, other reasons, notably employment-related, were also common among cancer survivors. What recommendations do you have for future research as a result of this work?

Response: Further research is needed to assess the quality of healthcare coverage for cancer survivors before and after ACA implementation – i.e. are these individuals able to afford medications, see providers on a timely basis, obtain necessary follow-up tests and scans.

In addition, studies are needed to investigate whether improved healthcare coverage translates to better health outcomes, including cancer-specific outcomes and quality of life.

No disclosures 


Sanford NN, Lam MB, Butler SS, et al. Self-reported Reasons and Patterns of Noninsurance Among Cancer Survivors Before and After Implementation of the Affordable Care Act, 2000-2017. JAMA Oncol. Published online May 15, 2019. doi:10.1001/jamaoncol.2019.1973 

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Last Updated on May 19, 2019 by Marie Benz MD FAAD