{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T21:18:33Z","timestamp":1773004713975,"version":"3.50.1"},"reference-count":38,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2026,1,20]],"date-time":"2026-01-20T00:00:00Z","timestamp":1768867200000},"content-version":"vor","delay-in-days":5,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,1,15]],"date-time":"2026-01-15T00:00:00Z","timestamp":1768435200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["acsjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer"],"published-print":{"date-parts":[[2026,1,15]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The objective of this study was to examine the associations between federal and state short\u2010term limited\u2010duration (STLD) insurance plan regulations and timely cancer treatment initiation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Adults aged 18\u201364 years newly diagnosed with female breast, colorectal, or non\u2013small cell lung cancers in 2017\u20132019 were identified from the National Cancer Database. Patients were categorized into five groups on the basis of their state of residence at diagnosis: (1) the state continuously prohibited STLD plans; (2) the state stopped offering STLD plans after the 2018 federal rule; (3) the state kept the same 3\u2010month limit on STLD plans before and after the 2018 federal rule; (4) the state expanded the sale of STLD plans but imposed more stringent regulation of STLD plans; and (5) the state expanded the sale of STLD plans and did not impose additional regulation. A difference\u2010in\u2010differences (DID) approach examined the changes in the percentages of patients initiating treatment within 30 days of their cancer diagnosis before and after the 2018 federal rule.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>For all cancers combined, compared to patients living in states continuously prohibiting STLD plans, a net decrease was observed in the percentages receiving timely treatment among patients living in states continuously limiting STLD plans to 3 months (DID, \u22121.61 percentage points [ppts]; 95% confidence interval [CI], \u22122.86 to \u22120.37 ppts), in states with less stringent regulations (DID, \u22122.09 ppts; 95% CI, \u22123.33 to \u22120.84 ppts), and in states with the least stringent regulations (DID, \u22122.48 ppts; 95% CI, \u22123.52 to \u22121.44 ppts).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Limited or no state regulation of STLD plans after the 2018 federal expansion of plan coverage duration was associated with decreases in timely cancer treatment initiation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/cncr.70190","type":"journal-article","created":{"date-parts":[[2026,1,20]],"date-time":"2026-01-20T15:00:41Z","timestamp":1768921241000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Federal and state policies regulating short\u2010term limited\u2010duration insurance plans and timely cancer treatment initiation"],"prefix":"10.1002","volume":"132","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2733-2000","authenticated-orcid":false,"given":"Jingxuan","family":"Zhao","sequence":"first","affiliation":[{"name":"Surveillance, Prevention &amp; Health Services Research American Cancer Society  Atlanta Georgia USA"},{"name":"Rollins School of Public Health Emory University  Atlanta Georgia USA"},{"name":"Winship Cancer Institute of Emory University  Atlanta Georgia USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3664-5815","authenticated-orcid":false,"given":"Ilana","family":"Graetz","sequence":"additional","affiliation":[{"name":"Rollins School of Public Health Emory University  Atlanta Georgia USA"},{"name":"Winship Cancer Institute of Emory University  Atlanta Georgia USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4465-0414","authenticated-orcid":false,"given":"David","family":"Howard","sequence":"additional","affiliation":[{"name":"Rollins School of Public Health Emory University  Atlanta Georgia USA"},{"name":"Winship Cancer Institute of Emory University  Atlanta Georgia USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0644-5572","authenticated-orcid":false,"given":"K. Robin","family":"Yabroff","sequence":"additional","affiliation":[{"name":"Surveillance, Prevention &amp; Health Services Research American Cancer Society  Atlanta Georgia USA"},{"name":"Rollins School of Public Health Emory University  Atlanta Georgia USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6337-7134","authenticated-orcid":false,"given":"Joseph","family":"Lipscomb","sequence":"additional","affiliation":[{"name":"Rollins School of Public Health Emory University  Atlanta Georgia USA"},{"name":"Winship Cancer Institute of Emory University  Atlanta Georgia USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2026,1,20]]},"reference":[{"key":"e_1_2_8_2_1","volume-title":"Understanding Short\u2010Term Limited Duration Health Insurance","author":"Pollitz K","year":"2018"},{"key":"e_1_2_8_3_1","volume-title":"Short\u2010Term, Limited\u2010Duration Insurance"},{"key":"e_1_2_8_4_1","volume-title":"Marketplace Average Premiums and Average Advanced Premium Tax Credit (APTC)"},{"key":"e_1_2_8_5_1","volume-title":"Shortchanged: How the Trump Administration\u2019s Expansion of Junk Short\u2010Term Health Insurance Plans Is Putting Americans at Risk"},{"key":"e_1_2_8_6_1","volume-title":"Effects of Short\u2010Term Limited Duration Plans on the ACA\u2010Compliant Individual Market"},{"key":"e_1_2_8_7_1","volume-title":"The Potential Impact of Short\u2010Term Limited\u2010Duration Policies on Insurance Coverage, Premiums, and Federal Spending","author":"Blumberg LJ","year":"2018"},{"key":"e_1_2_8_8_1","volume-title":"The Impact of Short\u2010Term Limited\u2010Duration Policy Expansion on Patients and the ACA Individual Market","author":"Dieguez G","year":"2020"},{"key":"e_1_2_8_9_1","volume-title":"Health Insurance Coverage in the United States: 2019","author":"Keisler\u2010Starkey K","year":"2020"},{"key":"e_1_2_8_10_1","volume-title":"As ACA Marketplace Enrollment Reaches Record High, Fewer Are Buying Individual Market Coverage Elsewhere","author":"Ortaliza J","year":"2023"},{"key":"e_1_2_8_11_1","volume-title":"Health Insurance Portability and Accountability Act of 1996"},{"key":"e_1_2_8_12_1","unstructured":"Short\u2010Term Health Insurance: How It Works and Who It\u2019s For. HealthInsurance.org. 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Federal Register. Accessed April 2 2024.https:\/\/www.federalregister.gov\/documents\/2023\/07\/12\/2023\u201014238\/short\u2010term\u2010limited\u2010duration\u2010insurance\u2010independent\u2010noncoordinated\u2010excepted\u2010benefits\u2010coverage"},{"key":"e_1_2_8_34_1","unstructured":"Under\u2010Covered: How \u201cInsurance\u2010Like\u201d Products Are Leaving Patients Exposed. Partnership to Protect Coverage. 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Accessed January 31 2024.https:\/\/www.healthcaredive.com\/news\/biden\u2010short\u2010term\u2010rule\u2010uninsurance\u2010rate\/687016\/"}],"container-title":["Cancer"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/acsjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/cncr.70190","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/acsjournals.onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/cncr.70190","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/acsjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/cncr.70190","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T18:44:59Z","timestamp":1772995499000},"score":1,"resource":{"primary":{"URL":"https:\/\/acsjournals.onlinelibrary.wiley.com\/doi\/10.1002\/cncr.70190"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,15]]},"references-count":38,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2026,1,15]]}},"alternative-id":["10.1002\/cncr.70190"],"URL":"https:\/\/doi.org\/10.1002\/cncr.70190","archive":["Portico"],"relation":{},"ISSN":["0008-543X","1097-0142"],"issn-type":[{"value":"0008-543X","type":"print"},{"value":"1097-0142","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,15]]},"assertion":[{"value":"2025-07-23","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-10-27","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-01-20","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70190"}}