Health Insurance Coverage Among Adolescent and Young Adult Cancer Survivors Receiving Health Care before and During the COVID-19 Pandemic

J Adolesc Young Adult Oncol. 2025 Aug;14(4):372-377. doi: 10.1089/jayao.2024.0115. Epub 2025 Feb 10.

Abstract

We investigated insurance coverage among adolescents and young adults (AYA) with cancer before and during the COVID-19 pandemic. AYAs diagnosed with cancer 15-39 years of age were identified using Utah Cancer Registry records and linked with University of Utah electronic health records. Poisson models calculated incidence rate ratios (IRRs) of health insurance coverage during pre-pandemic (11/4/2017-3/5/2020; n = 2,140) and pandemic (3/6/2020-7/6/2022; n = 1,894) periods. Prior to the pandemic, insurance gaps were higher (pre-pandemic = 16.40%, pandemic = 13.73%; IRR = 0.84, 95%CI = 0.71-0.98); more AYAs had continuous public insurance during the pandemic (pre-pandemic = 8.60%, pandemic = 10.98%; IRR = 1.28, 95%CI = 1.05-1.56). Research is needed on the durability of pandemic relief programs on insurance coverage among AYA cancer survivors.

Keywords: COVID-19; adolescent and young adult; cancer survivors; health insurance coverage; insurance gaps; pandemic.

MeSH terms

  • Adolescent
  • Adult
  • COVID-19* / epidemiology
  • COVID-19* / virology
  • Cancer Survivors* / statistics & numerical data
  • Female
  • Humans
  • Insurance Coverage* / statistics & numerical data
  • Insurance, Health* / statistics & numerical data
  • Male
  • Neoplasms* / economics
  • Neoplasms* / epidemiology
  • Neoplasms* / therapy
  • Pandemics
  • SARS-CoV-2 / isolation & purification
  • Utah / epidemiology
  • Young Adult