Data on Cancer Discussed by a Researcher at Washington University School of Medicine (Association of state policies regulating short-term limited-duration insurance plans and cancer stage at diagnosis): Cancer

2023 JUN 15 (NewsRx) -- By a News Reporter-Staff News Editor at Insurance Daily News -- Investigators publish new report on cancer. According to news originating from St. Louis, Missouri, by NewsRx correspondents, research stated, “1589: In 2018, federal regulations expanded access to short-term limited duration insurance (STLD) plans. STLD plans generally limit coverage of medical services and have no cost-sharing caps, which can delay a cancer diagnosis.”

Funders for this research include None..

The news journalists obtained a quote from the research from Washington University School of Medicine: “Furthermore, uptake of STLD plans can destabilize individual insurance markets, leading to increased prices and subsequent barriers to care for comprehensive insurance plan enrollees. Several states introduced legislation prohibiting and/or limiting STLD plans, but it is unclear whether STLD plans or policies restricting their proliferation have affected cancer stage at diagnosis. Individuals ages 18-64 years with staged first primary malignancies diagnosed 2016-2019 were identified from the Surveillance, Epidemiology, and End Results (SEER) database. Difference-in-differences (DID) analyses evaluated changes in early-stage (stages 0 [breast and bladder only] through II) diagnoses from pre- (2016-2017) to post- STLD expansion (2019; 2018 was excluded as washout/phase-in period) between states with policies prohibiting and/or limiting STLD plans vs. states with no policies regulating STLD plans. In some states limiting but not prohibiting STLD plans, insurers stopped selling STLD plans; we conducted additional analyses by state STLD plan availability in 2019. Linear probability models utilized cluster-robust standard errors (clustered at state level) and adjusted for fixed state and year effects, sociodemographic covariates, and cancer site. Sensitivity analyses excluded states that expanded and/or substantially changed Medicaid eligibility during the study period. The plausibility of the parallel trends assumption was tested in adjusted models restricted to the pre-policy period (2016-2017) and was satisfied for all analyses. 398,190 individuals were included. In adjusted DID analyses, early-stage diagnoses increased 0.95 percentage points (95% CI = 0.53 to 1.38, p<.001) in states that prohibited vs. did not regulate STLD plans, but there was no relative change in early-stage diagnoses in states with other policies limiting STLD plans (p=.25). Relative to states where STLD plans remained available, there was a nonsignificant increase in early-stage diagnoses in states where legislation stopped the sale of STLD plans, with greater evidence for an increase after excluding states with Medicaid eligibility changes (1.03, 95% CI = 0.71 to 1.35, p<.001). There were no differential changes in early-stage diagnoses by state group in falsification tests limited to individuals >65 years-old, who were Medicare-age-eligible.”

According to the news reporters, the research concluded: “State legislation prohibiting and/or leading to the cessation of STLD plans was associated with an increased rate of early-stage cancer diagnoses. Alternatively, the proliferation of STLD plans was associated with a differential decreased rate of early-stage cancers.”

For more information on this research see: Association of state policies regulating short-term limited-duration insurance plans and cancer stage at diagnosis. Journal of Clinical Oncology, 2023,41(16_suppl). The publisher for Journal of Clinical Oncology is American Society of Clinical Oncology (ASCO).

A free version of this journal article is available at https://doi.org/10.1200/jco.2023.41.16_suppl.1589.

Our news editors report that additional information may be obtained by contacting Justin Michael Barnes, Department of Radiation Oncology, Washington University School of Medicine, St. Louis, MO, United States. Additional authors for this research include Anne C. Kirchhoff, Robin Yabroff, Fumiko Chino.

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