Medicaid Expansion Enhances Long-Term Survival Rates in Cancer Patients

In a significant development, recent research indicates that Medicaid expansion has a positive impact on the long-term survival of individuals diagnosed with cancer. The study, published in the journal Cancer Discovery, analyzed data from over 1.4 million adult cancer cases across North America, comparing survival outcomes from before and after many states adopted Medicaid expansion under the Affordable Care Act (ACA).

Medicaid expansion, initiated in 2014, allowed states to extend eligibility to adults earning up to 138% of the federal poverty level. This policy change has already been associated with increased insurance coverage, easier access to cancer screening services, and improved short-term survival rates. However, its influence on longer-term outcomes, such as five-year survival among cancer patients, was previously less understood.

Using a difference-in-differences approach, researchers examined data from 26 states that adopted Medicaid expansion and compared it with 12 non-expansion states during 2007–2008 and 2014–2015. The analysis revealed that Medicaid expansion was linked to notable improvements in survival rates, especially among vulnerable populations such as those living in rural and high-poverty areas. Specifically, cancer patients in expansion states experienced an increase of 2.55 percentage points in cause-specific survival and 3.03 points in overall survival. Additionally, non-Hispanic Black individuals saw a survival improvement with a difference of 1.05 points, while non-Hispanic Whites experienced increases of 0.37 and 0.57 points in cause-specific and overall survival, respectively.

The findings underscore the importance of Medicaid expansion in prolonging the lives of cancer patients, emphasizing the need for policymakers to maintain or extend such programs. The research also highlights that broader access to health coverage can lead to better early detection, treatment, and long-term outcomes in cancer care.

Limitations of the study include potential confounding factors such as increased insurance coverage across the board due to the ACA and exclusions of individuals lacking complete sociodemographic data. Nonetheless, the evidence presented advocates strongly for ongoing efforts to expand Medicaid in states that have yet to adopt these policies, aiming to improve cancer survival outcomes nationwide.

This research is part of ongoing efforts to evaluate healthcare policies' effects on cancer outcomes and is accessible through Cancer Discovery, DOI: 10.1158/2159-8290.CD-25-1244. It was conducted with the support of the American Association for Cancer Research.