Obamacare may have expanded the number of Americans with health insurance, but it has not eased the financial burden of healthcare, particularly for those with cancer, a new analysis shows.

Virginia Commonwealth University School of Pharmacy who tracked U.S. health records since 2011 – the year after the Affordable Care Act was passed and signed into law – found that nearly 29 percent of cancer survivors are financially burdened as a result of their cancer diagnosis and/or treatment.

The findings, published online in CANCER, a peer-reviewed journal of the American Cancer Society, also revealed that such hardships can have lasting physical and mental effects on cancer survivors that can compromise their survival and recovery.

"Our results suggest that policies and practices that minimize cancer patients' out-of-pocket costs can improve survivors' health-related quality of life and psychological health," said researcher Norman Carroll.

"Reducing the financial burden of cancer care requires integrated efforts, and the study findings are useful for survivorship care programs, oncologists, payers, pharmaceutical companies, and patients and their family members."

To reach their conclusions, Carroll and his colleagues analyzed the medical records, including financial expenditures on care, of 19.6 million cancer survivors. They considered financial burden to be present if the medical bills forced the patients to borrow money, declare bankruptcy, or make other financial sacrifices to cover their healthcare costs.

The results:

• Nearly one in three cancer survivors reported at least one financial problem resulting from cancer diagnosis, treatment, or lasting effects of that treatment.
• More than one in five worried about paying large medical bills.
• About 11.5 percent were unable to cover the cost of medical care visits.
• Some 7.6 percent reported borrowing money or going into debt.
• Roughly 1.5 percent declared bankruptcy and 8.6 percent reported other financial sacrifices.

The researchers said the findings underscore the need for oncologists to consider selecting treatments that are less expensive but similar in effectiveness, discuss treatment costs with patients, and involve patients in making decisions about their therapy.