Study: 1 in 3 working-age cancer survivors go into debt

Approximately one in three working-age cancer survivors went into debt after beating the disease, according to a recent study published in Health Affairs. In addition, three percent of those individuals filed for bankruptcy as a result of their high medical bills.

Matthew P. Banegas, an investigator at the Kaiser Permanente Center for Health Research, and colleagues examined survey data from 2012 for more than 4,700 cancer survivors ages 18-64. The survey included survivors from all fifty U.S. states, the District of Columbia, Puerto Rico, and the U.S. Virgin Islands.

“Given that the costs of health care are increasing faster than household incomes in the United States, there is growing concern among patients, providers, and other stakeholders about the affordability of care,” the authors wrote. “This is particularly so in the case of the working-age cancer survivor population, whose mean annual health care expenditures ($17,170 for cancer survivors within one year of diagnosis and $9,369 for cancer survivors after the first year) far exceed those of the working-age population with no history of cancer ($3,611). Furthermore, studies indicate that the proportion of working-age U.S. households facing financial hardship as a result of health care expenses remains high, regardless of insurance status.”

Banegas and colleagues listed several specific factors that impact a survivor’s likelihood of going into debt.

“Survivors ages 18–44 or 45–54 were significantly more likely to go into debt than those ages 55–64,” the authors wrote. “Also significantly more likely to go into debt were people who had lower annual incomes, compared to those in the highest annual income category ($81,000 or more); survivors who were unemployed, compared to those employed full time; people who reported two or more cancer diagnoses, compared to those with only one cancer diagnosis; and survivors who had public insurance such as Medicaid or who were uninsured, compared to those with private insurance.”

The authors also addressed the potential impact of the Affordable Care Act (ACA) on these statistics, saying the ACA does contain provisions that could prove to significantly cut down on the burden faced by cancer survivors. However, it’s not yet clear if the ACA will have a significant effect on these numbers or not.

“States’ decisions about whether or not to expand eligibility for Medicaid may affect the number of cancer survivors who could benefit,” the authors wrote. “Moreover, most working-age U.S. adults obtain health insurance through their employers and often do not meet eligibility requirements for benefiting from the ACA cost-containing provisions.”

According to Banegas et al., patients and their families should be educated about the “physical, emotional, and financial impacts of cancer” at the time of diagnosis.

The authors added that more research on the financial hardship of cancer survivors is important, because it can eventually lead to “evidence-based interventions and policies” to assist survivors with that struggle.