Affordable Care Act Associated with Reduced Cancer Mortality, According to ASCO Presscast

                Approximately 589 cancer deaths could have been prevented in 2017, had all states expanded their Medicaid programs under the Patient Protection and Affordable Care Act (ACA), according to a ‘difference of differences’ study discussed during the recent ASCO presscast, in advance of the 2020 virtual ASCO meeting starting May 29.

Cancer mortality has been declining overall. Between 1999 and 2017, It declined from 64.7 to 46.0 per 100,000 in those 27 states (plus the District of Columbia) that expanded Medicaid, and from 69 to 51.9 per 100,000 in states that did not expand their Medicaid programs under the ACA, according to abstract 2003, “Changes in cancer mortality rates after the adoption of the Affordable Care Act.”

“Twenty million people gained insurance through this legislation,” explained lead author Anna Lee, MD, MPH. “There were an estimated 785 less cancer deaths in states that expanded,” said Lee, who is also a radiation oncology fellow at Memorial Sloan Kettering Cancer Center in New York.

In the study, age-adjusted mortality rates per 100,000 between 1999 and 2017 were gathered from the National Center for Health Statistics. Absolute change in cancer mortality among patients younger than 65 was calculated from 2011 to 2013 and then from 2015 to 2017.

Hispanic patients appeared to reap the greatest benefit from Medicaid expansion, the study suggested.

African-American patients had the highest overall cancer mortality, but are improving at a greater rate than other populations. “This may be why we were unable to find a differential benefit for Medicaid expansion in this population,” noted Lee.