A large national study published in JAMA Network Open examined whether expanding Medicaid under the Affordable Care Act (ACA) was associated with survival among women diagnosed with breast cancer. Researchers analyzed data from nearly 1.6 million women aged 40–64 diagnosed between 2006 and 2021 using the National Cancer Database.
The study compared survival before and after the ACA in states that expanded Medicaid between 2010 and January 2014 (including early adopters) with states that did not expand Medicaid during the study period. States that expanded after 2014 were excluded. Analyses were adjusted for age, cancer stage, race and ethnicity, neighborhood income, and treatment.
The main finding: Women living in Medicaid expansion states experienced lower overall mortality compared with women in non-expansion states. Medicaid expansion was associated with about a 5% reduction in the risk of death and an absolute reduction in five-year mortality of 1.4 percentage points—equivalent to roughly 1,400 fewer deaths per 100,000 women with breast cancer.
These findings reinforce the National Breast Cancer Coalition’s (NBCC) long-standing advocacy to expand access to affordable, quality evidence-based health care. NBCC supports the ACA and policies that achieve that goal because access to coverage saves lives.
Importantly, these gains depend on stable coverage—policies that reduce Medicaid access risk reversing progress for people diagnosed with breast cancer.
On August 21, NBCC welcomed Drs. Oluwasegun Akinyemi, Miriam Michael, Robin Williams, and Shari Lawson for a discussion of their recent JAMA Network Open study examining whether expanding Medicaid under the Affordable Care Act was associated with better survival for women with breast cancer. The researchers analyzed nearly 1.6 million women ages 40–64 diagnosed with breast cancer between 2006 and 2021, comparing outcomes in states that expanded Medicaid with those that did not. They found that Medicaid expansion was associated with a 4.8% lower risk of death overall and an absolute 1.4 percentage-point reduction in mortality at five years—equivalent to about 1,400 fewer deaths for every 100,000 women with breast cancer. Missed it? Watch the webinar here.
