Employer-sponsored health insurance coverage limitations

Results from the Childhood Cancer Survivor Study

Anne C. Kirchhoff, Karen Kuhlthau, Hannah Pajolek, Wendy Leisenring, Gregory Armstrong, Leslie L. Robison, Elyse R. Park

Research output: Contribution to journalArticle

19 Citations (Scopus)

Abstract

Purpose: The Affordable Care Act (ACA) will expand health insurance options for cancer survivors in the USA. It is unclear how this legislation will affect their access to employer-sponsored health insurance (ESI). We describe the health insurance experiences for survivors of childhood cancer with and without ESI. Methods: We conducted a series of qualitative interviews with 32 adult survivors from the Childhood Cancer Survivor Study to assess their employment-related concerns and decisions regarding health insurance coverage. Interviews were performed from August to December 2009 and were recorded, transcribed, and content analyzed using NVivo 8. Results: Uninsured survivors described ongoing employment limitations, such as being employed at part-time capacity, which affected their access to ESI coverage. These survivors acknowledged they could not afford insurance without employer support. Survivors on ESI had previously been denied health insurance due to their preexisting health conditions until they obtained coverage through an employer. Survivors feared losing their ESI coverage, which created a disincentive to making career transitions. Others reported worries about insurance rescission if their cancer history was discovered. Survivors on ESI reported financial barriers in their ability to pay for health care. Conclusions: Childhood cancer survivors face barriers to obtaining ESI. While ACA provisions may mitigate insurance barriers for cancer survivors, many will still face cost barriers to affording health care without employer support.

Original languageEnglish (US)
Pages (from-to)377-383
Number of pages7
JournalSupportive Care in Cancer
Volume21
Issue number2
DOIs
StatePublished - Feb 1 2013
Externally publishedYes

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Insurance Coverage
Health Insurance
Survivors
Neoplasms
Insurance
Patient Protection and Affordable Care Act
Interviews
Delivery of Health Care
Preexisting Condition Coverage
Aptitude
Legislation
Motivation

All Science Journal Classification (ASJC) codes

  • Oncology

Cite this

Employer-sponsored health insurance coverage limitations : Results from the Childhood Cancer Survivor Study. / Kirchhoff, Anne C.; Kuhlthau, Karen; Pajolek, Hannah; Leisenring, Wendy; Armstrong, Gregory; Robison, Leslie L.; Park, Elyse R.

In: Supportive Care in Cancer, Vol. 21, No. 2, 01.02.2013, p. 377-383.

Research output: Contribution to journalArticle

Kirchhoff, Anne C. ; Kuhlthau, Karen ; Pajolek, Hannah ; Leisenring, Wendy ; Armstrong, Gregory ; Robison, Leslie L. ; Park, Elyse R. / Employer-sponsored health insurance coverage limitations : Results from the Childhood Cancer Survivor Study. In: Supportive Care in Cancer. 2013 ; Vol. 21, No. 2. pp. 377-383.
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