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Early Medicaid Expansion and Cancer Mortality.

Publication ,  Journal Article
Barnes, JM; Johnson, KJ; Adjei Boakye, E; Schapira, L; Akinyemiju, T; Park, EM; Graboyes, EM; Osazuwa-Peters, N
Published in: J Natl Cancer Inst
November 29, 2021

BACKGROUND: Although Medicaid expansion is associated with decreased uninsured rates and earlier cancer diagnoses, no study has demonstrated an association between Medicaid expansion and cancer mortality. Our primary objective was to quantify the relationship between early Medicaid expansion and changes in cancer mortality rates. METHODS: We obtained county-level data from the National Center for Health Statistics for adults aged 20-64 years who died from cancer from 2007 to 2009 (preexpansion) and 2012 to 2016 (postexpansion). We compared changes in cancer mortality rates in early Medicaid expansion states (CA, CT, DC, MN, NJ, and WA) vs nonexpansion states through a difference-in-differences analysis using hierarchical Bayesian regression. An exploratory analysis of cancer mortality changes associated with the larger-scale 2014 Medicaid expansions was also performed. RESULTS: In adjusted difference-in-differences analyses, we observed a statistically significant decrease of 3.07 (95% credible interval = 2.19 to 3.95) cancer deaths per 100 000 in early expansion vs nonexpansion states, which translates to an estimated decrease of 5276 cancer deaths in the early expansion states during the study period. Expansion-associated decreases in cancer mortality were observed for pancreatic cancer. Exploratory analyses of the 2014 Medicaid expansions showed a decrease in pancreatic cancer mortality (-0.18 deaths per 100 000, 95% confidence interval = -0.32 to -0.05) in states that expanded Medicaid by 2014 compared with nonexpansion states. CONCLUSIONS: Early Medicaid expansion was associated with reduced cancer mortality rates, especially for pancreatic cancer, a cancer with short median survival where changes in prognosis would be most visible with limited follow-up.

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Published In

J Natl Cancer Inst

DOI

EISSN

1460-2105

Publication Date

November 29, 2021

Volume

113

Issue

12

Start / End Page

1714 / 1722

Location

United States

Related Subject Headings

  • United States
  • Patient Protection and Affordable Care Act
  • Pancreatic Neoplasms
  • Oncology & Carcinogenesis
  • Medicaid
  • Insurance Coverage
  • Humans
  • Bayes Theorem
  • Adult
  • 3211 Oncology and carcinogenesis
 

Citation

APA
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Barnes, J. M., Johnson, K. J., Adjei Boakye, E., Schapira, L., Akinyemiju, T., Park, E. M., … Osazuwa-Peters, N. (2021). Early Medicaid Expansion and Cancer Mortality. J Natl Cancer Inst, 113(12), 1714–1722. https://doi.org/10.1093/jnci/djab135
Barnes, Justin M., Kimberly J. Johnson, Eric Adjei Boakye, Lidia Schapira, Tomi Akinyemiju, Eliza M. Park, Evan M. Graboyes, and Nosayaba Osazuwa-Peters. “Early Medicaid Expansion and Cancer Mortality.J Natl Cancer Inst 113, no. 12 (November 29, 2021): 1714–22. https://doi.org/10.1093/jnci/djab135.
Barnes JM, Johnson KJ, Adjei Boakye E, Schapira L, Akinyemiju T, Park EM, et al. Early Medicaid Expansion and Cancer Mortality. J Natl Cancer Inst. 2021 Nov 29;113(12):1714–22.
Barnes, Justin M., et al. “Early Medicaid Expansion and Cancer Mortality.J Natl Cancer Inst, vol. 113, no. 12, Nov. 2021, pp. 1714–22. Pubmed, doi:10.1093/jnci/djab135.
Barnes JM, Johnson KJ, Adjei Boakye E, Schapira L, Akinyemiju T, Park EM, Graboyes EM, Osazuwa-Peters N. Early Medicaid Expansion and Cancer Mortality. J Natl Cancer Inst. 2021 Nov 29;113(12):1714–1722.

Published In

J Natl Cancer Inst

DOI

EISSN

1460-2105

Publication Date

November 29, 2021

Volume

113

Issue

12

Start / End Page

1714 / 1722

Location

United States

Related Subject Headings

  • United States
  • Patient Protection and Affordable Care Act
  • Pancreatic Neoplasms
  • Oncology & Carcinogenesis
  • Medicaid
  • Insurance Coverage
  • Humans
  • Bayes Theorem
  • Adult
  • 3211 Oncology and carcinogenesis