Medicaid Expansion Effects Mortality for Patients with Cancer

States that have expanded Medicaid eligibility under the Affordable Care Act have seen a decreased mortality rate in patients with diagnosed breast, lung or colorectal cancer, according to a study published in JAMA.

The primary outcome of this study was to find the effects of the Medicaid expansion on the mortality rate on patients with early breast, lung or colorectal cancer. “There has been little research into the impact of Medicaid expansion on cancer mortality [the time from initial cancer diagnosis to death]),” lead author Miranda Lam tells News Wise.

The study had a total of 523,802 patients living in Medicaid expansion states and having early diagnosis of breast (273,272), colorectal (111,720) or lung (138,810) cancer, and 234,472 patients living in non-expansion states.

Results showed that after the Medicaid expansion mortality significantly decreased in expansion states but not in non-expansion states. It was a significant decrease for patients diagnosed with lung cancer living in expansion states, they experienced the largest percentage decrease of mortality. The difference was seen primarily in patients with stage 1 to 3, when the cancer stage was adjusted to those with stage 4 there was no longer an evident difference between expansion and non-expansion states.

The data also showed no associated difference between Medicaid expansion and the mortality rate for patients living in low vs. high household income. It also showed no association between Medicaid expansion and mortality rate in patients who were black or white.

The authors suggest that a decrease in mortality in expansion states can be linked to access to screening and early-stage diagnosis. Medicaid expansion may be easing access to a better health care system for screen and timely symptom evaluation. They also note that those patients with metastatic cancer are receiving better end-of-life care in expansion and non-expansion states.

The authors also mention that it is possible that expansion states prepared for an increase in patients due to new Medicaid eligibility, so they were ready with resources and this could have had a part in the decreased mortality rate.

Overall, this study resulted in data showing there was a mortality decrease for patients with early diagnosed breast, lung and colorectal cancers after Medicaid expansion.