Women diagnosed with breast cancer in states that expanded Medicaid eligibility have experienced significantly improved survival rates, according to a recent study published in the medical journal JAMA Network Open. Researchers from multiple institutions, including Howard University and the University of Alabama, analyzed data from approximately 1.6 million women aged 40 to 64 diagnosed with breast cancer between 2006 and 2021. Their findings suggest that Medicaid expansion under the Affordable Care Act, known colloquially as Obamacare, has had a positive impact on mortality rates.
The study found that women living in states that expanded Medicaid were less likely to die from breast cancer compared to those in non-expansion states. Specifically, about 58% of the participants resided in states that embraced the expansion, while 42% lived in states that did not. The expansion began in 2014, and the research indicates that it has led to lower overall mortality rates across various demographics, regardless of disease stage, race, ethnicity, or neighborhood income.
Key Findings on Survival Rates
Notably, women in expansion states whose cancer had metastasized to other organs—the most severe stage—saw the most significant reduction in mortality. Among different racial and ethnic groups, Hispanic women experienced the largest relative gains, with a 19% decrease in mortality rates when they lived in expansion states. The improvement among Hispanic women may be attributed to their historical lack of insurance coverage, according to Dr. Oluwasegun Akinyemi, director of the Clive O. Callender Outcomes Research Center at Howard University and a coauthor of the study.
In contrast, the study revealed that Black women, who typically face higher breast cancer death rates despite fewer diagnoses, benefitted less from Medicaid expansion. This disparity arises partly because Black women are often diagnosed at later stages of the disease. Dr. Akinyemi noted that this group is disproportionately located in the southern United States, where most states have opted not to expand Medicaid. States such as Alabama, Florida, Georgia, Mississippi, South Carolina, Tennessee, and Texas have not expanded their Medicaid programs, along with three others: Kansas, Wisconsin, and Wyoming.
Impact of Neighborhood Income and Treatment Access
The study also explored mortality rates in relation to neighborhood income. Women living in higher-income areas had lower mortality rates compared to those in lower-income neighborhoods. Additionally, those who received immunotherapy treatment benefited from improved survival outcomes. These results suggest that Medicaid expansion not only increases coverage but also enhances access to effective treatments, contributing to better health outcomes.
The findings come at a time when healthcare funding is under scrutiny. In July 2023, former President Donald Trump signed a tax and spending bill that is projected to reduce federal Medicaid funding by more than $900 billion over the next decade. This reduction may lead to approximately 15 million people losing Medicaid coverage, according to estimates from the Center on Budget and Policy Priorities.
This study underscores the critical role that Medicaid expansion plays in improving health outcomes for women with breast cancer, highlighting the need for continued support and policy advocacy to ensure equitable access to healthcare.
