Medicaid Expansion in Southern U.S. States and Breast Cancer

By: Michael S. Stabile, BS
Posted: Tuesday, February 28, 2023

Medicaid-expanded states appear to experience an increase in Medicaid-insured, treatment, and earlier-stage diagnoses (decrease in distant-stage diseases) among patients with breast cancer in comparison with non-Medicaid–expanded states, according to a study published in the Journal of American College of Surgeons. More specifically, Medicaid expansion in the South seems to be effective in providing earlier, more comprehensive treatment to patients with breast cancer.

“Whether results [of the impact of Medicaid expansion among 32 expanded states] apply to Southern states that share similar geopolitical perspectives remains elusive,” explained Quyen D. Chu, MD, MBA, FACS, of the Orlando Health Cancer Institute, Florida, and colleagues. “We aimed to assess the impact of Medicaid expansion on breast cancer diagnosis and treatment in eight Southern states in the United States.”

A total of 21,974 (uninsured or Medicaid) patients, aged 40 to 64 and diagnosed with invasive breast cancer, were identified from the North American Association of Central Cancer Registries’ CiNA Public Use Data Set from 2011 to 2018. Medicaid-expanded states (Louisiana, Kentucky, Arkansas) were compared with non-Medicaid–expanded states (Tennessee, Alabama, Mississippi, Texas, Oklahoma).

In Medicaid-expanded states, there were increased odds of Medicaid-insured patients by 43%, with an increase of Medicaid patients by 10.6% (Arkansas, Kentucky) after Medicaid expansion. Odds of distant-stage disease decreased by 7%, with an overall 2.3% (Arkansas, Kentucky) fewer patients being diagnosed and an increase in odds of receiving treatment. Conversely, non-Medicaid–expanded states saw a 1.3% decrease in Medicaid-insured patients, with a 0.5% increase in distant-stage disease diagnoses.

Overall, patients in Medicaid-expanded states had higher odds of receiving treatment compared with patients in non-Medicaid–expanded states. However, within Medicaid-expanded states, there was no significant impact of Medicaid expansion on treatment, and odds of treatment decreased. According to the authors, further study is necessary to investigate alternative factors for treatment within Medicaid-expanded states.

Disclosure: The study authors reported no conflicts of interest.

Journal of the American College of Surgeons

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