Georgia's Online Cancer Information Center

Cancer patients get better coverage, care in states that expand Medicaid, study says

1/14/2024, USA Today

study published last week sought to measure how pivotal insurance coverage is for people with cancer. The study led by American Cancer Society researchers compared cancer patients in states that expanded Medicaid under the Affordable Care Act with patients in states that did not.

In states that expanded Medicaid, about 1 in 5 college- or working-age adults diagnosed with cancer were insured by Medicaid, the government health insurance program for low-income families and the disabled. Just 2% of cancer patients in these states were uninsured as of 2019, the last year included in the study.

By comparison, 8.1% of cancer patients in non-expansion states were uninsured as of 2019.

Oregon, New Mexico and Kentucky had the highest share of cancer patients who gained coverage from Medicaid. Among states that did not expand Medicaid, Texas had the highest number of people who were uninsured when they were diagnosed with cancer, followed by Florida and Georgia.

The study said Medicaid expansion increased cancer screening and early diagnosis, provided better care for cancer patients and decreased racial disparities among cancer patients.

Expanded Medicaid coverage 'is saving lives'

Lisa Lacasse is president of the American Cancer Society Cancer Action Network, the advocacy arm of the American Cancer Society. Lacasse said Medicaid expansion means that more people get access to health care and they face better odds of surviving cancer.

"In short, expanding this health insurance program is saving lives,” Lacasse said in a statement.

In all, the study examined 6.4 million cancer cases among adults 18 to 64 whose insurance status was known when they were diagnosed. The study included data from 48 states and the District of Columbia. Kansas and Minnesota were excluded because of lack of consent from state registries or data quality issues. The study did not include minors or Medicare-age adults 65 and older.

States trim Medicaid rolls following pandemic enrollment boom

The study only examined Medicaid coverage leading up the the COVID-19 pandemic. Millions of Americans gained Medicaid health insurance during the COVID-19 pandemic when the federal government provided billions in federal aid to states.

States took the funding on the condition that they would not remove people from Medicaid until the public health emergency ended last year. The temporary measure was meant to ensure Americans didn't lose coverage during the pandemic, but it lasted more than two years. With the end of the public health emergency last year, states began winnowing their Medicaid rolls as they resumed eligibility checks. More than 14 million Americans have been removed from Medicaid so far because they no longer qualified or because of procedural reasons such as failing to complete renewals, according to KFF, a nonprofit organization focused on health policy.

Some of the steepest drops in post-pandemic enrollment are in the 10 states that have not expanded Medicaid, including Texas and Florida.

A KFF analysis found about 1 million people chose Affordable Care Act and individual insurance plans outside the marketplace from April through September last year. Some of those signups likely included people who were disenrolled from Medicaid, the analysis said.

Those former Medicaid recipients contributed to the record number of Obamacare signups announced this week by the Biden administration. As of Dec. 23, more than 20 million Americans signed up for ACA marketplace insurance coverage, and that figure continues to increase with enrollment open through Jan. 16. Some state exchanges have extended enrollment through the end of the month.

Generous federal subsidies under the Inflation Reduction Act also likely contributed to the record signups, KFF said.

Still, even with ACA marketplace enrollment breaking though the 20 million market for the first time, far more Americans are covered by Medicaid insurance. Medicaid also offers more robust coverage with minimal cost-sharing requirements such as copayments, coinsurance and deductibles that are common with ACA plans.

Dr. Xin Hu, the American Cancer Society study's lead author and an assistant professor in public health sciences at the University of Virginia School of Medicine, said the study shows "many patients with cancer may face challenges with care access and continuity, especially following the unwinding of COVID-19 pandemic protections for Medicaid coverage.”

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