Statewide Medicaid Expansion and Survival in Resectable Non-Small Cell Lung Cancer

Area of Science:

• Oncology
• Health Services Research
• Public Health Policy

Background:

• Medicaid expansion under the Affordable Care Act increased health coverage eligibility.
• Non-small cell lung cancer (NSCLC) is a leading cause of cancer death in the US.
• Improved access to care may impact survival rates for resectable NSCLC.

Purpose of the Study:

• To evaluate the association between state-level Medicaid expansion and all-cause mortality in patients with resectable NSCLC.
• To determine if expanded insurance coverage influences survival outcomes for NSCLC patients.

Main Methods:

• Cohort study using Surveillance, Epidemiology, and End Results (SEER) data (2006-2019).
• Included patients aged 20-64 diagnosed with stage I-IIIA NSCLC.
• Used difference-in-differences analysis with Cox proportional hazards regression to assess mortality.

Main Results:

• Medicaid expansion was associated with lower 2- and 4-year all-cause mortality.
• Early and 2014 expansion states showed significant mortality reductions compared to non-expansion states.
• Mortality decreases were observed post-expansion and persisted; early-stage diagnosis rates did not change.

Conclusions:

• Medicaid expansion is associated with improved survival in patients with resectable NSCLC.
• Expanded insurance coverage may improve access to timely and effective cancer care.
• Findings highlight the potential of health policy in improving cancer patient outcomes.