Women diagnosed with breast cancer in states that expanded Medicaid eligibility under the Affordable Care Act experienced significantly better survival rates compared to those in non-expansion states, according to a recent study published in the medical journal JAMA Network Open. The research, conducted by a team from Howard University, the University of Alabama, Henry Ford Hospital in Michigan, and other institutions, analyzed data from approximately 1.6 million women aged 40 to 64 diagnosed between 2006 and 2021.
The study compared the survival rates of women in states that expanded Medicaid eligibility, which began in 2014, with those in states that did not. Of the women studied, about 58% resided in expansion states while 42% lived in non-expansion areas. The findings indicated that Medicaid expansion was associated with lower mortality rates across various demographics, including disease stage, race, ethnicity, and neighborhood income.
Significant Impact on Mortality Rates
Particularly noteworthy was the decline in deaths among women whose breast cancer had metastasized to other organs, representing the most advanced disease stage. The greatest relative improvements were observed among Hispanic women, who were 19% less likely to die from breast cancer if they lived in states that expanded Medicaid. This marked difference could be attributed to many Hispanic women lacking insurance prior to the expansion, as noted by Dr. Oluwasegun Akinyemi, director of the Clive O. Callender Outcomes Research Center at Howard University and coauthor of the study.
In contrast, Black women, who historically face higher breast cancer mortality rates despite fewer diagnosed cases, benefited less from Medicaid expansion. This disparity is partly due to the fact that many Black women are diagnosed at later stages and disproportionately reside in southern states that have not opted to expand Medicaid, including Alabama, Florida, Georgia, Mississippi, South Carolina, Tennessee, and Texas. Other non-expansion states include Kansas, Wisconsin, and Wyoming.
Income Disparities and Treatment Access
The researchers also examined mortality rates in relation to neighborhood income levels. Women living in high-income areas, as well as those receiving immunotherapy treatment, demonstrated lower mortality rates. This observation suggests that enhanced healthcare coverage promotes greater access to effective treatments.
The implications of these findings come at a critical time, especially following legislative developments. In July 2023, President Donald Trump signed a tax and spending bill that may cut federal Medicaid funding by over $900 billion over the next decade. This move could potentially result in approximately 15 million individuals losing their Medicaid coverage, according to estimates provided by the Center on Budget and Policy Priorities.
Overall, this study highlights the significant influence of Medicaid expansion on breast cancer survival rates and underscores the need for continued advocacy for healthcare accessibility, particularly for vulnerable populations.
