ArticlePLOS global public health2026
Cost and transportation barrier trends related to Affordable Care Act among cancer survivors and atherosclerotic cardiovascular disease patients.
Article in PLOS global public health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The Affordable Care Act (ACA) included major coverage expansions implemented in 2014. However, its association with cost‑related barriers among people with chronic disease remains incompletely described. We analyzed trends in cost and transportation related barriers to care between cancer survivors and adults with atherosclerotic cardiovascular disease (ASCVD) in relation to ACA implementation and expansion. National Health Interview Survey (NHIS) data from 2004-2024 for adults ≥18 years reporting a history of cancer or ASCVD without cancer were obtained. Primary outcomes were overall cost‑barrier and transportation barrier. We used survey weighted interrupted time series analysis (ITSA) with prespecified policy breakpoints and survey weighted modified Poisson regression to estimate associations between policy periods and barriers, adjusting for sociodemographic covariates. The analytic sample included 106,947 respondents: 63,505 cancer survivors and 43,442 adults with ASCVD without cancer. Overall cost barriers were reported by 8.1% of cancer survivors (n = 5,264) and 10.6% of adults with ASCVD without cancer (n = 4,772; p < 0.001). In adjusted models, the prevalence of overall cost barriers in 2022-2024 was lower than in 2004-2009 among both cancer survivors (aPR 0.63; 95% CI: 0.56-0.71) and adults with ASCVD without cancer (aPR 0.73; 95% CI: 0.65-0.82). In ITSA, cancer survivors had an immediate decrease in overall cost barriers at the 2022 breakpoint (-1.98 percentage points; p = 0.006). No substantial 2022 level change in overall cost barriers was observed among adults with ASCVD without cancer. Transportation barriers were higher in the post-pandemic period among years with available data, particularly among adults with ASCVD without cancer, but transportation ITSA findings were exploratory since data were unavailable in 2019-2021. Overall cost related barriers declined among U.S. cancer survivors and ASCVD patients, with the largest improvements observed in the most recent period. Nevertheless, increases in transportation-related delays underscore persistent structural barriers and highlight the need for targeted interventions to improve care accessibility.
Identifiers
What Socratic holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.