Obamacare May Have Helped Extend Lives of Young Cancer Patients
Young adults with cancer, especially those who are Hispanic or Black, had better outcomes because of coverage available to them under the Affordable Care Act (ACA).
New research explored the impact of Medicaid coverage under the ACA, also known as Obamacare, linking it to with better survival for 18- to 39-year-olds. Young adults with breast cancer and stage 4 cancers also had striking improvements that could be linked to Medicaid expansion.
"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," lead author Xu Ji said in a news release from the Winship Cancer Institute of Emory University in Atlanta. She is a researcher at the institute.
Researchers from Winship and the American Cancer Society studied a nationwide sample of more than 345,000 young adults, particularly people of color, who were newly diagnosed with cancer.
Cancer is a leading cause of death in young adults. About 83,000 were newly diagnosed in 2020.
Young adults have not typically had the same survival improvements over time as pediatric and older cancer patients, and have worse prognoses for some cancers than younger or older groups.
Lack of health insurance is a major contributor to these poor outcomes, according to the study.
The Medicaid expansion under the ACA has been adopted in 39 of 50 states. South Dakota has adopted but not yet implemented it.
"The current study adds to accumulating evidence of the multiple health benefits of Medicaid expansion, reinforcing the importance of expanding Medicaid in all states," said senior author Xuesong Han, scientific director of health services research at the cancer society.
The ACA Medicaid expansion has the potential to improve access to care -- and by that, health outcomes -- by increasing insurance coverage for young adults, according to the study.
Researchers said information is lacking on young adults' experiences with cancer because they are not included in age-based screening guidelines for most cancers, and little evidence has been available on the ACA expansion for this group.
Expanding insurance coverage has a promising role in increasing access to early detection and quality cancer treatment and follow-up care, according to the study.
"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 co-author Dr. Sharon Castellino, an Emory University professor of pediatrics and director of the Leukemia and Lymphoma Program at the Aflac Cancer and Blood Disorders Center of Children's Healthcare of Atlanta.
"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 health care system," Castellino said in the release.
The findings were recently published in the Journal of Clinical Oncology.
The U.S. National Cancer Institute has more on adolescents and young adults with cancer.
SOURCE: Winship Cancer Institute of Emory University, news release, Dec. 19, 2022