1. Effect of Medicaid expansion on cancer treatment and survival among Medicaid beneficiaries and the uninsured
- Author
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Primm, Kristin M, Zhao, Hui, Adjei, Naomi N, Sun, Charlotte C, Haas, Alen, Meyer, Larissa A, and Chang, Shine
- Subjects
Biomedical and Clinical Sciences ,Oncology and Carcinogenesis ,Lung ,Women's Health ,Breast Cancer ,Lung Cancer ,Cancer ,Colo-Rectal Cancer ,Digestive Diseases ,Good Health and Well Being ,Humans ,United States ,Medicaid ,Female ,Medically Uninsured ,Middle Aged ,Male ,Adult ,Patient Protection and Affordable Care Act ,Neoplasms ,Insurance Coverage ,Health Services Accessibility ,breast cancer ,colorectal cancer ,epidemiology and prevention ,non small cell lung cancer ,medicaid expansion ,survival ,Biochemistry and Cell Biology ,Oncology and carcinogenesis - Abstract
BackgroundThe Affordable Care Act expanded Medicaid coverage for people with low income in the United States. Expanded insurance coverage could promote more timely access to cancer treatment, which could improve overall survival (OS), yet the long-term effects of Medicaid expansion (ME) remain unknown. We evaluated whether ME was associated with improved timely treatment initiation (TTI) and 3-year OS among patients with breast, cervical, colon, and lung cancers who were affected by the policy.MethodsMedicaid-insured or uninsured patients aged 40-64 with stage I-III breast, cervical, colon, or non-small cell lung cancer within the National Cancer Database (NCDB). A difference-in-differences (DID) approach was used to compare changes in TTI (within 60 days) and 3-year OS between patients in ME states versus nonexpansion (NE) states before (2010-2013) and after (2015-2018) ME. Adjusted DID estimates for TTI and 3-year OS were calculated using multivariable linear regression and Cox proportional hazards regression models, respectively.ResultsME was associated with a relative increase in TTI within 60 days for breast (DID = 4.6; p
- Published
- 2024