Effect of Medicaid Expansion on Colorectal Cancer Screening Rates

Area of Science:

• Public Health
• Health Services Research
• Health Policy

Background:

• Colorectal cancer screening significantly reduces cancer incidence and mortality.
• Minority and low-income populations experience lower screening rates.
• The Affordable Care Act expanded insurance coverage, but not all states adopted Medicaid expansion.

Purpose of the Study:

• To evaluate the impact of Medicaid expansion on colorectal cancer screening rates.
• To assess disparities in screening among minority and low-income populations post-Medicaid expansion.

Main Methods:

• Utilized the Behavior Risk Factor Surveillance System (BRFSS) data from 2012-2016.
• Employed a difference-in-difference analysis comparing expansion and non-expansion states.
• Focused on respondents aged 50-64, stratified by income and race/ethnicity.

Main Results:

• Overall screening rates increased in expansion states compared to non-expansion states.
• Early Medicaid expansion states saw significant increases in screening for low-income (+5.7%) and Black (+8.1%) respondents.
• No significant changes in screening rates were observed for Hispanic respondents in expansion states.

Conclusions:

• Medicaid expansion accelerated colorectal cancer screening increases in early expansion states, especially for low-income and Black populations.
• The study highlights the differential impact of Medicaid expansion across demographic groups.
• Continued monitoring of Medicaid expansion's effects on cancer care outcomes is crucial.