"Job Lock" Common Among Cancer Survivors and Their Partners

For many people in the US, having health insurance through their employer can affect their decision about whether to leave a job or not. Staying in a current job to maintain health insurance is called job lock. It can have a negative effect on a person’s future career path, quality of life, and family well-being. A new JAMA Oncology study found that about 1 out of 3 cancer survivors in the US reported job lock either for themselves or their spouse or partner. 

Not all employers offer health insurance coverage. Those that do offer plans vary in how comprehensive the coverage is, how much employees pay to share costs, and what healthcare providers are included in their network.

The need to maintain employer-based health insurance coverage can make it hard to freely leave a job if you or a family member has a serious health problem like cancer, said Robin Yabroff, PhD, the study’s senior researcher and ACS senior scientific director, health services research.

The study included responses from cancer survivors collected from a survey. Those who reported experiencing job lock included almost 20% of 1340 survivors and about 11% of 1593 spouses/partners. About 32% of 1094 survivors reported job loss for either themselves or their partners.

Younger cancer survivors and those who earned between 138% and 400% of the federal poverty level (FPL) were more likely to report job lock for themselves or their partners. People who have earnings in that range aren’t eligible for Medicaid.

For comparison, based on the FPL for 2020 (not one of the years studied), the yearly income range for a family of 4 is about $36,200 (138% FPL) to $104,800 (400%).

Younger cancer survivors may not have as many job opportunities with comprehensive health coverage either, Yabroff said.

The study authors said healthcare professionals, social workers, and patient navigators have opportunities to discuss employment concerns during and after cancer treatment and to connect patients and survivors with employment and health insurance counseling.

The Patient Protections and Affordable Care Act (Obamacare) includes health insurance coverage protection for people with pre-existing conditions like cancer. It’s also resulted in the creation of the Marketplace/Exchange where people can buy health insurance for themselves and their families outside of work. But, it’s too soon to tell whether these changes from the Affordable Care Act will reduce job lock over time, the authors said.