U.S. states that adopted the Affordable Care Act’s Medicaid expansion in January 2014 have earlier colon cancer diagnoses, enhanced access to care, and improved colon cancer surgical care than states that didn’t implement the expansion, researchers reported in Journal of the American College of Surgeons. Additionally, patients in the expansion states were more likely to have minimally invasive procedures and fewer urgent surgeries.
Researchers used data from 2011–2012 (pre-expansion) and 2015–2016 (postexpansion) in the National Cancer Database to compare 4,438 patients with invasive colon cancer from 19 states that implemented expansion in January 2014 with 6,017 patients in 19 nonexpansion states. They found that the days to treatment were longer and the proportion of patients treated in fewer than 30 days was lower among patients with stages I–III colon cancer in nonexpansion states than in expansion states.
Additionally, patients traveled farther for care in expansion states, which the researchers theorized was because patients who lived greater distances from hospitals could now obtain care because of coverage, and patients in expansion states who had end-stage colon cancer were more likely to receive palliative care services.
“Our findings suggest that Medicaid expansion has enabled more previously uninsured people to see a primary care physician and get screened for colon cancer,” the researchers said. “These findings highlight the importance of improving health insurance coverage and can help guide future policy efforts.”