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Medicaid expansion led to earlier breast, colon, lung cancer diagnosis

The study authors also observed that there were no delays in treatment for these patients -- a concern opponents of Medicaid expansion had prior to its implementation. Photo by jossuetrejo_oficial/Pixabay
The study authors also observed that there were no delays in treatment for these patients -- a concern opponents of Medicaid expansion had prior to its implementation. Photo by jossuetrejo_oficial/Pixabay

Feb. 19 (UPI) -- People with breast, colon and lung cancer are more likely to have healthcare coverage and receive a timely diagnosis thanks to expansions of Medicaid under the Affordable Care Act, a new analysis has found.

New research assessing the impact of changes in eligibility allowed under the ACA, also known as Obamacare, published Wednesday in JAMA Network Open, shows those residing in states that opted to expand Medicaid services were typically diagnosed with cancer earlier, which has been linked with improved prognosis.

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Although costs for diagnostic and treatment services were more likely to be covered for Medicaid beneficiaries, the analysis found no evidence that they were started on cancer care any earlier following expansion.

Conversely, the authors also observed that there were no delays in treatment for these patients -- a concern opponents of Medicaid expansion had prior to its implementation.

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"Medicaid expansion was associated with positive impact on insurance status and stage for patients with newly diagnosed common screenable cancers, without leading to treatment delays," Samuel U. Takvorian, an instructor at the University of Pennsylvania Perelman School of Medicine, told UPI.

The findings of Takvorian and his colleagues are only the latest to tout the benefits of Medicaid expansion on the diagnosis and treatment of a variety of health conditions among beneficiaries. The studies suggest that expansion -- based on raising the maximum income allowed for beneficiaries -- has reduced overall healthcare costs by improving care, even though it has increased the price tag for the federal program.

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For the new study, Takvorian and his colleagues reviewed records from the National Cancer Database, from 2011 through 2016, which covers the years before and after passage of the ACA. They focused on adults between 40 and 64 years of age who had a new diagnosis of invasive breast, colon or non-small cell lung cancer.

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More than 925,000 cancer patients were included in the final analysis, 48 percent of whom lived in states that expanded Medicaid under the ACA, while the remainder lived in states that had not. Of all participants, nearly 59 percent had a new diagnosis of invasive breast cancer, nearly 15 percent had been diagnosed with colon cancer and more than 26 percent had been diagnosed with non-small cell lung cancer.

The authors found that, compared with non-expansion states, the percentage of uninsured patients decreased more in expansion states -- 2.3 percent versus 1.8 percent. In addition, the percentage of early-stage cancer diagnoses grew more in expansion states, by 1.8 percent, than in non-expansion states, by 1.4 percent.

Conversely, among the 848,329 patients who underwent cancer-directed therapy within 365 days of diagnosis, the percentage treated within 30 days declined from 52.7 percent before Medicaid expansion to 48 percent after in expansion states. In non-expansion states, this percentage declined from 56.9 percent to 51.5 percent.

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"Our study showed neither improvement nor decrement in the rate of timely cancer-directed treatment associated with Medicaid expansion," Takvorian said. "Given our hypothesis that Medicaid expansion might lengthen wait times and thus worsen the rate of timely treatment, we viewed this finding as reassuring that this policy did not have the unintended consequence of delays in treatment."

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