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Invited Commentary
November 2018

Is Improved Insurance Coverage a Fleeting Opportunity?

Author Affiliations
  • 1Department of Otolaryngology–Head and Neck Surgery, Oregon Health and Science University, Portland
  • 2Center for Health Systems Effectiveness, Oregon Health and Science University, Portland
JAMA Otolaryngol Head Neck Surg. 2018;144(11):1058-1059. doi:10.1001/jamaoto.2018.1953

The data from the Surveillance, Epidemiology, and End Results (SEER) database analyzed by Cannon et al1 in this issue of JAMA Otolaryngology–Head & Neck Surgery are highly relevant as the future of the Patient Protection and Affordable Care Act (ACA) becomes progressively more fragile. The authors provide objective data on improved rates of health care coverage after implementation of the ACA among patients with head and neck cancer. Reviewing the evolving payer mix is an important metric when assessing access to care. The decline in uninsured patients with head and neck cancer from 6.2% in 2013 to 3.0% in 2014 is a significant improvement. This finding does not mean that increased coverage is inexpensive, uniformly successful, or synonymous with improved patient adherence to treatment and healthier living. Although SEER survival outcomes data are not yet available for comparison of the periods before and after implementation of the ACA, this article is an important catalyst in our specialty for future study of the influence that major health policy change has on patients with head and neck cancer.