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ABSTRACT. The aim of this study was to identify ongoing barriers to obtaining breast cancer care following the Affordable Care Act (ACA) implementation in California. While the ACA successfully expanded access to health insurance and breast cancer care, numerous population subgroups remain uninsured, and others may lack adequate coverage for treatment and management of their breast cancer. In this study, we assessed barriers and challenges to accessing breast cancer care in California through a synthesis of the peer reviewed literature, gray literature (news media, reports and policy brief, social media), a legislative policy scan, and a series of key informant/stakeholder interviews. We triangulated our findings to identify main themes that illustrated barriers that women experience in receiving timely breast cancer care. We found five key types of barriers: 1) Health system barriers, (2) Insurance barriers, (3) High costs, (4) Individual and cultural characteristics, and (5) Language. Women diagnosed with breast cancer encountered challenges due to narrow provider networks, delays in insurance authorization for treatment, and lack of culturally and linguistically appropriate services. The issues and key barriers identified in this report can help policy makers hone in on the issues facing women with breast cancer in California and help reduce the marked disparities in treatment they are currently facing.

Keywords: breast cancer; barriers to care; insurance; California; health disparities; Affordable Care Act

How to cite: Ponce, Ninez A., Beth Glenn, Riti Shimkhada, A.J. Scheitler, and Michelle Ko (2017). “An Examination of the Barriers to Breast Cancer Care in California,” American Journal of Medical Research 4(2): 73–126.

Received 22 February 2017 • Received in revised form 1 June 2017
Accepted 2 June 2017 • Available online 22 June 2017

doi:10.22381/AJMR4220174

NINEZ A. PONCE
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Department of Health Policy and Management,
Center for Health Policy Research &
Center for Global and Immigrant Health,
Fielding School of Public Health,
The University of California, Los Angeles
(corresponding author)
BETH GLENN
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Fielding School of Public Health,
The University of California, Los Angeles
RITI SHIMKHADA
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Center for Health Policy Research,
The University of California, Los Angeles
A.J. SCHEITLER
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Center for Health Policy Research,
The University of California, Los Angeles
MICHELLE KO
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Department of Public Health Sciences,
The University of California, Davis

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