Study Shows Medicaid Expansion Rejected by GOP Increased Cancer Survival in Other States

As Congress prepares to boot millions of people off of Medicaid, landmark research published this week revealed that expansion of the government healthcare program--which some GOP decision-makers have blocked in their states--is tied to higher cancer survival for adults under 40.

"Our study shows a survival benefit of Medicaid expansion under the Affordable Care Act for young adult patients with cancer."

"Cancer is a leading cause of death in young adults diagnosed between ages 18-39 years--and it is increasing. Approximately 83,700 young adults were newly diagnosed in 2020," Emory University noted in a statement about the new study, which was led by researchers at the school's Winship Cancer Institute as well as the American Cancer Society.

Published Monday in the Journal of Clinical Oncology, the first-of-its-kind research relied on a sample of 345,413 adults ages 18-39 from across the United States.

"Using nationwide cancer registry data, our study shows a survival benefit of Medicaid expansion under the Affordable Care Act for young adult patients with cancer, particularly among racial and ethnic minority groups and patients at risk for poor prognosis," said lead author Xu Ji, a researcher and assistant professor at Emory as well as a member of the Aflac Cancer and Blood Disorders Center of Children's Healthcare of Atlanta.

The researchers found that along with notably benefiting patients of color in terms of two-year survival, state-level Medicaid expansion was associated with better outcomes for patients with female breast cancer and stage IV cancers.

"The impact of these data is enormous for young adults who often come to diagnosis late due to the lack of cancer screening guidelines in their age group," said Dr. Sharon Castellino, an Emory researcher and professor who also directs the Leukemia and Lymphoma Program at the Atlanta healthcare center.

"Access to medical care for early detection and cancer treatment is afforded by Medicaid expansion programs and is critical to our advancement of care in this young population who often fall between the gaps in our healthcare system," she added.

Senior author Xuesong Han, scientific director of health services research at the American Cancer Society and a researcher and adjunct professor at the university, stressed in a statement that "the current study adds to accumulating evidence of the multiple health benefits of Medicaid expansion, reinforcing the importance of expanding Medicaid in all states."

The Hillreported that "previous research has linked Medicaid expansion with other health benefits, including a slowing of suicide rates and lower maternal mortality."

After a bitter battle, Congress passed and then-President Barack Obama signed the Patient Protection and Affordable Care Act (ACA) in 2010. Also known as Obamacare, it has survived several legal challenges. However, while the law was intended to expand Medicaid across the country, a U.S. Supreme Court decision allows states to decide whether to do so.

The District of Columbia and 38 states have expanded their Medicaid programs. South Dakota is planning for expansion next year. Eleven states have so far declined: Alabama, Florida, Georgia, Kansas, Mississippi, North Carolina, South Carolina, Tennessee, Texas, Wisconsin, and Wyoming.

The new research comes as federal lawmakers are working to pass a nearly $1.7 trillion, 4,155-page omnibus government funding package. The legislation would roll back a Covid-19 pandemic-related provision that blocks states from kicking most enrollees off of Medicaid.

If the bill passes and is signed into law by President Joe Biden, as is expected in the days ahead, millions of people could lose their Medicaid coverage as early as April. While enrollees must first be notified, Robin Rudowitz, director of Medicaid at Kaiser Family Foundation, warned this week that "there is likely to be people who fall through the cracks."

Democrats, who are set to lose control of the House next month, reportedly warmed to the GOP's push for the rollback because the savings will partly go toward a year of both postpartum coverage in states that don't offer it and continuous coverage for children.