Cost and transportation barrier trends related to Affordable Care Act among cancer survivors and atherosclerotic cardiovascular disease patients

Bibliographic Data

ID24148123
AuthorsRabia Bega (The Ohio State University Wexner Medical Center and James Comprehensive Cancer Center), Qaidar Alizai (The Ohio State University Wexner Medical Center and James Comprehensive Cancer Center), Charalampos M Charalampous (0000-0003-3688-5077, The Ohio State University Wexner Medical Center and James Comprehensive Cancer Center), Areesh Mevawalla (The Ohio State University Wexner Medical Center and James Comprehensive Cancer Center), Meher Angez (0000-0002-4490-4453, The Ohio State University Wexner Medical Center and James Comprehensive Cancer Center), Rida Ejaz (The Ohio State University Wexner Medical Center and James Comprehensive Cancer Center), Lorenza Arena (The Ohio State University Wexner Medical Center and James Comprehensive Cancer Center), Jethro Wang Zih-Shuo (The Ohio State University Wexner Medical Center and James Comprehensive Cancer Center), Timothy M Pawlik (0000-0002-7994-9870, The Ohio State University Wexner Medical Center and James Comprehensive Cancer Center)
EditorsNawi Ng (0000-0003-0556-1483, University of Gothenburg: Goteborgs Universitet)
Year2026
Volume6
Issue9
Pagese0006791
Publication date2026-09-18
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenuePLOS Global Public Health (JOURNAL)
Journal identifiersISSN: 2767-3375 • E-ISSN: 2767-3375
PublisherPublic Library of Science (PLoS) (PUBLISHER)
DOI10.1371/journal.pgph.0006791
PMID42758753
OpenAlexW7213532787
LanguageEN
References cited34

The Affordable Care Act (ACA) included major coverage expansions implemented in 2014. However, its association with cost‐related barriers among people with chronic disease remains incompletely described. We analyzed trends in cost and transportation related barriers to care between cancer survivors and adults with atherosclerotic cardiovascular disease (ASCVD) in relation to ACA implementation and expansion. National Health Interview Survey (NHIS) data from 2004-2024 for adults ≥18 years reporting a history of cancer or ASCVD without cancer were obtained. Primary outcomes were overall cost‐barrier and transportation barrier. We used survey weighted interrupted time series analysis (ITSA) with prespecified policy breakpoints and survey weighted modified Poisson regression to estimate associations between policy periods and barriers, adjusting for sociodemographic covariates. The analytic sample included 106,947 respondents: 63,505 cancer survivors and 43,442 adults with ASCVD without cancer. Overall cost barriers were reported by 8.1% of cancer survivors (n = 5,264) and 10.6% of adults with ASCVD without cancer (n = 4,772; p

Atherosclerotic cardiovascular disease · Cancer · Disease · Health insurance · National Health Interview Survey · Patient Protection and Affordable Care Act · Poisson regression · Young adult · Economic and Financial Impacts of Cancer · Global Cancer Incidence and Screening · Healthcare Policy and Management