Percentage of uninsured, newly diagnosed patients with cancer declines after ACA

The percentage of uninsured, nonelderly patients with newly diagnosed cancer fell substantially after implementation of the Affordable Care Act, study data showed.

“We found that uninsured rate among newly diagnosed nonelderly cancer patients decreased in both Medicaid expansion and non-expansion sates following the Affordable Care Act. However, the decrease was more pronounced in low-income patients residing in the expansion states,”  Ahmedin Jemal, DVM, PhD, vice president of surveillance and health services Research at American Cancer Society, told HemOnc Today.  “Further, we found that in the expansion states, more patients were diagnosed at early stage for some cancer types after the ACA.”

The researchers used the National Cancer Data Base to estimate the absolute and relative change in the percentage of uninsured patients aged 18 to 64 years who had newly diagnosed cancer between 2011 and the third quarter of 2013 compared with the second to fourth quarters of 2014. The researchers calculated the differences in absolute change between states that expanded Medicaid and states that did not, as well as changes in early-stage diagnosis and insurance in the top 15 of 17 cancers occurring in both men and women.

The percentage of uninsured, newly diagnosed patients decreased across all income categories in states that expanded and did not expand Medicaid. However, the decrease appeared more significant among low-income patients who lived in states that expanded Medicaid (9.6% to 3.6%; total change, –6%; 95% CI, –6.5 to –5.5) compared with those in nonexpansion states (14.7% to 13.3%; total change, –1.4%; 95% CI, –2 to –0.7) for an adjusted difference in decreases of –3.3% (95% CI, –4 to –2.5).

The largest decrease occurred in patients with cancers related to smoking- or infection-related cancers. The researchers reported “a small but statistically significant shift” toward diagnosis of early-stage lung, colorectal, breast and pancreatic cancers, as well as melanoma, among patients who lived in states that expanded Medicaid.

“Among low-income nonelderly adults with newly diagnosed cancer — the most vulnerable patients — we observed that the percent uninsured decreased substantially in Medicaid expansion states while remaining persistently high in nonexpansion states after implementation of the major ACA components in 2014,” the researchers wrote. “The findings could inform ongoing health care reform and reinforce the continued need for additional expansion of access to care, especially for low-income populations.” – by Andy Polhamus

Disclosures: Jemal reports no relevant financial disclosures. Please see the study for a complete list of all other authors’ relevant financial disclosures.