Medicaid Expansion Linked with Reduced Racial Disparities

Medicaid expansion available to states through the Affordable Care Act was associated with reduced Black-White racial disparities associated with receipt of timely treatment for advanced cancer, according to the results of a recent study.

“The Affordable Care Act was designed to improve health care access, equity, and outcomes and to reduce costs in the United States,” the researchers wrote. “Although reports of the ACA’s effects on socioeconomic disparities in health care utilization and outcomes have been mixed, Medicaid expansion has been associated with increased health insurance coverage and earlier disease-stage diagnosis among patients with cancer.”

Looking at more than 30,000 patients (12.3% Black), researchers found that without Medicaid expansion, Black patients were significantly less likely to receive timely treatment compared with White patients (43.7% vs. 48.4%; P<.001).

As of February 2019, 34 states and Washington D.C. had implemented Medicaid expansion. More than twice as many Black patients reported Medicaid coverage compared with White patients (18.7% vs. 8.1%), regardless of Medicaid expansion status.

With Medicaid expansion, the difference in receipt of timely treatment diminished and was no longer statistically significant (49.7% vs. 50.5%; P=0.605).

“Evaluation of health care policy impact is critical to determining if desired goals are met and to inform the design of future policy,” the researchers wrote. “Future research is needed to fully understand the factors influencing timing of treatment initiation to ensure equity and improve access to care for all patients with cancer.