Key Points:
  1. Insurance status was significantly associated with the odds of receiving definitive treatment only among patients with T4a oral cavity cancer.
  2. Patients who were Uninsured or on Medicaid are less likely to receive definitive surgical treatment.
  3. Insured patients were more likely to be male, of older age at presentation, married, and White.
  4. Characteristics associated with significantly lower odds of receiving definitive treatment included female sex; unmarried, separated, divorced, or widowed; T4b disease; Medicaid insurance; and uninsured patients.
  5. Patients with T4a disease during the post-ACA period were more likely to receive definitive treatment compared to those who received treatment pre-ACA.