Story at a glance
- Cancer is the fourth leading cause of death among young adults in America.
- Young adults are also more likely to lack health insurance.
- New data show expanding Medicaid under the Affordable Care Act was associated with significant benefits in two-year cancer survival outcomes among young adults.
Expanded Medicaid coverage under the Affordable Care Act (ACA) is linked with better survival outcomes for young Americans newly diagnosed with cancer, research shows.
The two-year survival benefit was most pronounced among individuals who identify as Hispanic or Black and those with breast cancer or stage IV cancers.
Writing in the Journal of Clinical Oncology, researchers explained how previous studies linked Medicaid expansion with improved insurance coverage and early cancer diagnosis among young adults.
Young adults typically have the highest uninsured rate compared with other age groups.
In the current study, authors assessed data from more than 345,000 patients between the ages 18 and 39 who were diagnosed with cancer from 2010 to 2017. Researchers calculated changes in twp-year overall survival in states that did expand Medicaid and those that did not. They also looked at pre-expansion survival rates in states that adopted the policy.
Among all young adult patients, two-year overall survival increased more in expansion states than in non-expansion states. In states that expanded Medicaid, two-year survival rose from 90.39 percent pre-expansion to 91.85 percent after the expansion.
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Around 83,700 young adults received new cancer diagnoses in 2020. Historically, this age group has not experienced the same survival improvements over time compared with pediatric and older patients, authors explained, due in large part to a lack in health insurance. In addition, exclusion of young adults from most age-based screening guidelines has resulted in a lack of cancer studies on this population.
Under the ACA, states could expand their Medicaid programs to cover adults earning incomes up to 138 percent of the Federal Poverty Level. Since 2010, the majority of states have adopted the policy, while 11 have not.
Holdouts include Texas, Wyoming, Kansas, Wisconsin, Tennessee, Mississippi, Alabama, Georgia, Florida, South Carolina and North Carolina.
Previous research has linked Medicaid expansion with other health benefits, including a slowing of suicide rates and lower maternal mortality.
Improving insurance coverage for low-income patients can help improve access to care for young adults with cancer, researchers stressed.
“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 study author Sharon Castellino in a release.
Castellino is a researcher at Winship Cancer Institute of Emory University, director of the Leukemia and Lymphoma Program at the Aflac Cancer and Blood Disorders Center of Children’s Healthcare of Atlanta, and a pediatrics professor at the Emory University School of Medicine.
“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 said.
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