Researchers Warn That Cheaper, Limited Health Insurance Plans May Increase Risk of Late-Stage Cancer Diagnosis

Individuals were more likely to receive a late cancer diagnosis in states that allow STLD health insurance policies, increasing the risk that the disease is untreatable by the time it is detected.

New research indicates that residents of states that allow short-term limited duration (STLD) health insurance plans face an increased risk of receiving a cancer diagnosis too late for the malignancy to be treated.

STLD plans were created to provide temporary insurance for people who are undergoing life changes, like switching jobs. They were originally intended to be temporary, lasting only three months or less. However, in 2018 the first Trump Administration loosened restrictions on STLD plans, allowing insurers to extend the duration up to 36 months.

According to findings of a new study published in the journal JAMA Network Open on March 18, holders of these kinds of cheaper health insurance policies often receive delayed cancer diagnoses, since most STLD plans do not cover crucial health benefits like cancer screenings.

A team of researchers from the American Cancer Society conducted a review of 1.3 million adults, ages 18 to 64 years old, who were newly diagnosed with cancer from January 2016 to February 2020. The study included patients across 47 states using data from the National Cancer Database.

Researchers categorized patients based on the extent to which their state’s healthcare laws aligned with federal legislation. This included states that consistently prohibited Short-Term Limited-Duration (STLD) plans, those that ceased offering them following the 2018 legislation, states that permitted these plans but imposed additional restrictions, and states that exactly replicated the federal policy without further limitations.

After the regulatory changes, enrollment in STLD plans increased by 27%, the researchers noted, also finding that the overall percentage of late-stage cancer diagnosis had seen an overall decrease over the course of the study.

However, the research team found that 604,000 subjects, nearly half of the study’s participants, came from states that had adopted the looser federal STLD policy. According to the data, those policy-holders faced a 76% increased risk of late-stage cancer diagnosis, when compared to participants who came from states where the policies had always been outlawed.

The only other group of participants to not see a relative increase in late-stage diagnoses were those from states who stopped allowing STLD policies after the 2018 changes. Those who came from any state which partially or fully allowed longer-duration STLD policies, regardless of additional restrictions, were at increased risk of being diagnosed with late-stage cancer, the researchers concluded.

They determined this data suggests STLD plans pose a risk to patients, especially those who have a higher risk of cancer.

“This large national quasi-experimental cross-sectional study found that the 2018 federal policy loosening restrictions on STLD plans was associated with an increase in late-stage cancer diagnoses in states without or with inadequate additional STLD plan regulatory protections,” the research team concluded. “Findings were consistent among cancer types with recommend screening tests (ie, female breast and colorectal cancers) and extended prior research conducted in a limited number of states, underscoring the importance of state policies and federal efforts to limit STLD plans.”