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Employer-sponsored health insurance coverage limitations: results from the Childhood Cancer Survivor Study

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Supportive Care in Cancer Aims and scope Submit manuscript

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.

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Acknowledgments

This study was supported by the Lance Armstrong Foundation and National Cancer Institute (U24-CA55727).

Author information

Authors and Affiliations

  1. Center for Children’s Cancer Research, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA

    Anne C. Kirchhoff

  2. Cancer Control and Population Sciences Research Program, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA

    Anne C. Kirchhoff

  3. Department of Pediatrics, University of Utah, 2000 Circle of Hope, Salt Lake City, UT, 84112, USA

    Anne C. Kirchhoff

  4. Massachusetts General Hospital, 100 Cambridge Street, Boston, MA, 02114, USA

    Karen Kuhlthau, Hannah Pajolek & Elyse R. Park

  5. Fred Hutchinson Cancer Research Center, 1100 Fairview Avenue North, Seattle, WA, 98109, USA

    Wendy Leisenring

  6. University of Washington, Seattle, WA, USA

    Wendy Leisenring

  7. St. Jude Children’s Research Hospital, 262 Danny Thomas Place, Memphis, TN, 38105-3678, USA

    Greg T. Armstrong & Leslie L. Robison

Authors
  1. Anne C. Kirchhoff
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  2. Karen Kuhlthau
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  3. Hannah Pajolek
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  4. Wendy Leisenring
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  5. Greg T. Armstrong
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  6. Leslie L. Robison
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  7. Elyse R. Park
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Corresponding author

Correspondence to Anne C. Kirchhoff.

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Kirchhoff, A.C., Kuhlthau, K., Pajolek, H. et al. Employer-sponsored health insurance coverage limitations: results from the Childhood Cancer Survivor Study. Support Care Cancer 21, 377–383 (2013). https://doi.org/10.1007/s00520-012-1523-7

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  • DOI: https://doi.org/10.1007/s00520-012-1523-7

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