Childhood Cancer Survivors Face Job Lock to Keep Insurance Coverage

Of the almost 400,000 childhood cancer survivors in the United States, 55% are within the prime age for labor force participation. Many of these childhood cancer survivors are reluctant to make changes in their employment because of access to health insurance, and therefore job lock is common among this population, according to a study.

A study recently published in JAMA Oncology assessed the prevalence of job lock—when individuals stay at a job to keep work-related health insurance. The researchers performed a cross-sectional survey of full-time employed adult survivors of childhood cancer and a random sample of siblings from 25 US pediatric oncology centers. All eligible participants were cancer survivors who had been diagnosed when they were younger than 21 and alive for 5 years after diagnosis.

“Survivors who are employed may be at increased risk for real or perceived ‘job lock,’” the authors noted. “In the United States, where the majority of insurance is provided via an employer, job lock may be particularly problematic for individuals with chronic health conditions.”

In order to assess job lock, the survey asked the participants if they have stayed at a job for the health insurance and recorded their current insurance status, marital status, income, and past issues with paying for healthcare.

Of the 522 eligible participants employed full-time, 394 were survivors and 128 were siblings. Job lock was found to be more prevalent among survivors than siblings. Additionally, job lock was similar among female survivors and siblings, while there was a nonsignificant difference among male survivors and siblings. Also, survivors reported having more problems paying medical bills than siblings.

Denial of health insurance was significantly more prevalent among survivors and was especially common compared with siblings when adjusted for sociodemographic factors and severe chronic diseases.

The researchers conclude that job lock is significantly prevalent among survivors. Because of proposed changes to the Affordable Care Act (ACA), there is increased concern among survivors about their insurance. Future research is necessary to analyze how the ACA changes will affect the quality of live and insurance access of childhood cancer survivors.

“The potential repeal and replacement of the ACA means that survivors who wish to change jobs, reduce work hours, or launch businesses may face fewer and more costly options to purchase insurance,” the study stated. “Replacement proposals for the ACA include waiting periods for those with a lapse in medical coverage who have preexisting conditions, which may further impede job mobility for survivors.”