Confirming previous research, a new study has found that the Affordable Care Act (ACA) led to more cancer diagnoses -- and more detection of early-stage disease -- in the states that used the ACA to expand insurance coverage than in the states that didn't. The results were published December 21 in the American Journal of Public Health.
Previous studies have shown that Medicaid expansion under the ACA led to better access to care for nonelderly adults, but researchers from multiple centers wanted to explore its impact specifically on cancer diagnosis. They conducted a county-level analysis of overall cancer diagnosis in nine states that expanded Medicaid (California, Connecticut, Hawaii, Iowa, Kentucky, Michigan, New Mexico, New Jersey, and Washington) and four states that didn't (Alaska, Georgia, Louisiana, and Utah).
States that starting in 2014 used provisions of the ACA to expand access to Medicaid saw their rate of overall cancer diagnosis go up by an average of 3.4%, compared with states that didn't expand Medicaid access. What's more, the rate of early-stage diagnosis went up by 6.4%, according to the study.
In further analysis, the researchers found that the increase in early-stage diagnoses was driven by cancers found in individuals ages 35 to 54 and cancers that are amenable to screening. They believe this finding is consistent with the increase resulting from the expansion of health insurance and access to care under the ACA. For overall diagnoses, the growth was driven by increases among those ages 45 to 54 and patients with prostate cancer.
The findings suggest that public health insurance may improve cancer detection, which is associated with better patient outcomes, including reduced mortality, the researchers concluded.
