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Does Having Health Insurance Improve Breast Cancer Survival Rates?

Although most of us could probably surmise that having health insurance increases the chances of surviving a major illness, researchers at Loyola University Chicago recently put the theory to the test. In a June 2017 study in the journal Cancer Epidemiology, researchers found that more patients were diagnosed with stage 1 breast cancer after the Affordable Care Act took effect, widening the population able to obtain health insurance. These cancers were found early when they are most treatable, thereby improving survival rates.

[See: A Tour of Mammographic Screenings During Your Life.]

The study examined patient records from more than 470,000 breast cancer patients between the ages of 50 and 74 who were covered by private insurance or Medicare and were newly diagnosed. The study compared diagnosis rates between 2007 and 2009, before the ACA went into effect, and the period between 2011 and 2013 after the ACA took effect. Researchers found that stage 1 breast cancer diagnoses increased 3.6 percentage points after the ACA went into effect, rising from 54.4 percent to 58.0 percent. This was directly correlated with a decrease in stage 2 and stage 3 diagnoses, indicating that more people were being diagnosed earlier after they were covered by the ACA. African- Americans and Latinos saw the biggest increase in early stage diagnosis, which further supports the hypothesis that previously uninsured or underinsured patients were receiving coverage that enabled them to access the care they needed.

Because the ACA eliminated copayments and reduced other out-of-pocket costs for 45 preventive care services, including mammograms, getting these screening services became more affordable and more patients were able to access them, the researchers report. And this in turn is likely to lead to improved breast cancer survival rates.

The Cost of Care

Being diagnosed with any serious or chronic disease is an expensive endeavor in the United States today. A 2016 study in the journal American Health & Drug Benefits reports “the costs were higher for patients whose cancer was more advanced at diagnosis,” with “the average costs per patients allowed by the insurance company in the year after diagnosis” being $60,637 for stage 0, $82,121 for stages 1 and 2, $129,387 for stage 3 cases and $134,682 for a stage 4 breast cancer diagnosis.

In essence, the earlier the disease is found, the cheaper it is to treat, but it’s still going to be expensive. Many people — especially those who do not have insurance or have inadequate health insurance — struggle to pay for these treatments. Any portion of the treatment not covered by insurance must be paid for by the patient, and these expenses can add up.

Jackie Weber, senior manager of practice operations at UF Health Cancer Center — Orlando Health, says that having insurance is important and a key to better outcomes when dealing with a breast cancer diagnosis. Weber, who is a breast cancer survivor herself, says, “I feel like I’m a good example of having insurance and things going well because I do have insurance. We do know even though we do our best to try to get access for screening mammograms, if a woman doesn’t have insurance she’s not likely to have the follow-up diagnostics ” she needs when something suspicious shows up on the mammogram. So for all the free screenings that various organizations offer, if those who are screened can’t pay for the next steps in care, their prognosis is grim.

In her case, Weber has just surpassed the three-year anniversary of her diagnosis with triple negative, a very aggressive form of breast cancer, that was caught early. She underwent several rounds of chemotherapy, a lumpectomy and radiation treatments. She’s currently cancer-free, and her prognosis is great because she was able to get the care she needed early on.

[See: 7 Innovations in Cancer Therapy.]

In other cases, however, women delay seeking care because they can’t afford it, and then will seek emergency room treatment when the issue becomes too painful or unwieldy to ignore. “Their cancer could be so advanced by then that it could be very difficult for them to fight it or survive it,” but if they’d had insurance or another means of paying for care, they could have been treated earlier when their chances of survival were better, Weber says.

“Most plans these days offer great coverage for routine care, and that’s what can detect things,” she says. But not all plans are as robust in covering follow-up diagnostics and treatments. So even though some patients will have health insurance, it may not be enough to meet their needs.

If this describes you, don’t panic. There are other resources that may be available to help you. Breastcancer.org offers a comprehensive list of potential sources of funding for breast cancer patients who need coverage. Philanthropic organizations may also be able to help. The AVON Foundation supports the CancerCare program that offers financial assistance for underserved women with breast cancer. The Susan G. Komen foundation also lists a range of programs that can help cover aspects of treatment for some patients.

“There are many avenues to go down,” Weber says. “The American Cancer Society is the biggest, broadest umbrella.” The ACS offers financial assistance to patients who need it, and locally, Weber says many communities also have funds or grants available to patients who need help. “There are a lot of things out there, but it requires research,” she says. A member of your care team should be able to point you in the right direction if you’re struggling to make ends meet after a breast cancer diagnosis.

In addition to assistance paying for treatment, transportation to the hospital and other services, Weber says her team seeks to help patients by lowering the cost of treatment. “We work with drug companies all the time to lower the cost of chemo drugs. They can be phenomenal in working with us.” She says some companies also offer copay assistance programs for patients. This can be especially helpful for people who are covered by health insurance plans that offer the basics but come with hefty deductibles or large copays that can be out of reach for low-wage workers or the unemployed.

[See: What Not to Say to a Breast Cancer Patient.]

“We don’t hear a lot of good things about drug companies usually,” Weber says, “but when it comes to cancer patients, they’re very patient-focused and will try everything they can to try and cure someone and improve their quality of life.”

She says any and all of this assistance starts with the patient alerting a member of the care team to the financial burden they may be experiencing. Therefore, it’s important to talk with your doctor or patient navigator if you’re having trouble financially. Most hospitals will work with patients to set up payment plans or to seek out other funding sources to cover the cost of treatment. But having insurance to begin with is the best option. “Patients are so much more set up for success when they have that insurance plan and that comfort and can go and get care,” Weber says. “Having insurance is a blanket of safety that gives [patients] the freedom to be able to take care of themselves and seek out care ahead of illness. If I hadn’t been able to get that mammogram with my type of cancer I don’t know that I would have survived.”

More from U.S. News

7 Innovations in Cancer Therapy

What Not to Say to a Breast Cancer Patient

A Tour of Mammographic Screenings During Your Life

Does Having Health Insurance Improve Breast Cancer Survival Rates? originally appeared on usnews.com

Don’t Settle for Student Loans to Pay for Online Education

Online college programs are becoming a more popular choice for prospective students, with one study finding that more than 6 million students enrolled in at least one online course in fall 2015. The popularity of these courses can be attributed in part to their flexibility with working adults' schedules, students' ability to progress more quickly through online programs and, oftentimes, cheaper tuition. [See 10 low-cost online bachelor's programs for out-of-state students.]Online degrees can be beneficial to many college students, but some studies have shown online learners complete their programs at lower rates than students at traditional brick-and-mortar campuses. Individuals with student loans but no degree comprise two-thirds of defaulted borrowers. Though these numbers are not encouraging, just like for traditional programs, there are ways to reduce how much you'll need to borrow for an online program to ensure you won't become one of these statistics. Don't just settle on borrowing student loans to cover the whole cost of your program and living expenses. Instead, start thinking about how to cut costs and cover your balance in different ways, such as the following. -- Grants and scholarships: Even though you are taking an online course, you can still apply and receive grants and scholarships. But your first step should be to complete the Free Application for Federal Student Aid, commonly referred to as the FAFSA, which will allow you to receive a Pell Grant if your expected family contribution is low enough. The EFC criteria and award amounts are adjusted annually, but the 2017-2018 academic year awards range from $606 to $5,920, which could significantly lower the amount you borrow annually. Your next step is to apply for scholarships. You can start by checking online scholarship search engines, such as the Salt Scholarship Search, College Board's BigFuture and Peterson's. But don't forget to take advantage of local organizations and your school's financial aid office. Both may offer scholarships that you can't find with a national scholarship search. [Review these 10 sites to kick off your scholarship search.]For instance, organizations like the Elks Club, Knights of Columbus or the Rotary Club typically offer scholarships annually to local students. Just because you're going to school online doesn't mean you're ineligible. Visit your local library for scholarship listings, and ask around town. You might be surprised how many local organizations offer scholarships. While these scholarships typically aren't large, every little bit counts. Each dollar you receive in a scholarship is a dollar you don't have to borrow and pay interest on. -- Work-study: Another option for online students may be work-study awards. Not all students enrolled in online programs are eligible, but students at some schools -- including, for example, SUNY Empire State College and Liberty University -- are. Work-study awards are not given upfront like scholarships and grants. In most cases, they are an offer to earn up to the awarded amount if you secure an eligible work-study job. While there is a misconception that all work-study jobs must be on campus, students can work for off-campus, nonprofit or public employers as long as the work is in the public's interest. You may be able to work for a for-profit employer if the job is relevant to your course of study. No matter who the outside employer is, it will need to have an established agreement with your college for you to receive work-study funds. Remember, to be eligible for federal financial aid, you must be enrolled and pursuing a degree or certificate. If you're not working toward a credential, Pell Grants and work-study won't be option, but you may still be able to take advantage of private scholarships -- just be sure to read the eligibility criteria carefully. [Explore what to know about financial aid in online programs.]-- Pay as you go: One of the great benefits to enrolling online is the flexible schedule, which can allow you to complete your college coursework around your responsibilities. But prospective students often overlook using their part- or full-time job earnings as an option for paying for college. Almost 80 percent of college students in 2015 worked at least part time while attending classes, according to the National Center for Education Statistics. By budgeting and thinking strategically about your college costs, you can likely reduce your dependence on student loans by paying a portion out of pocket. Many -- but not all -- online programs are less expensive than traditional programs and often have shorter payment periods. Six, eight or 10 weeks are common course durations. Because of the frequency of payments in an online setting, you may be well-placed to pay as you go and possibly avoid borrowing altogether. Attending college online and avoiding student loans may be challenging, but if you are willing to put in the effort, you can limit the amount you need to borrow. More from U.S. News Q&A: Understanding Student Loan Discharge Eligibility Student Loan Refinancing Isn't Right for All Borrowers
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