Medicaid Expansion Associated with Lower Death Rates for Three Major Cancers

In states that have expanded Medicaid availability as part of the Affordable Care Act (ACA), mortality rates for three major forms of cancer are significantly lower than in states that have not expanded their Medicaid, according to a study published in JAMA Network Open.

“There has been little research into the impact of Medicaid expansion on cancer mortality [the time from initial cancer diagnosis to death],” says the lead author of the new study, Miranda Lam, MD, MBA, of Dana-Farber, Brigham and Women’s Hospital, and Harvard T.H. Chan School of Public Health via a press release. “It’s been thought that expansion might improve mortality by fostering earlier detection, earlier stage of diagnosis, and improved access to treatment. On the other hand, it could worsen mortality by creating an influx of newly covered patients that strains hospitals’ resources.”

In this study, researchers obtained data from the National Cancer Database to track 523,802 patients across the country who were newly diagnosed with breast, lung, or colorectal cancer from 2012 through 2015. Subsequently, mortality rates for these patients were compared in states that expanded their Medicaid programs and those that did not.

“We found that Medicaid expansion was associated with a significant decrease in mortality compared to states without such expansion,” Dr. Lam said. The expansion group had a 2% decline in hazard of death from the pre- to the post-expansion period. The non-expansion group, by contrast, showed no change in mortality.

Dr. Lam added, “Increased Medicaid coverage may remove barriers to accessing the healthcare system for screening and timely symptom evaluation, and that can translate into better outcomes for patients.”