Increase in Early-Stage Cancer Diagnoses Tied to ACA’s Medicaid Expansion, Pitt Study Finds

PITTSBURGH, Nov. 12, 2020 – In an analysis published today in the American Journal of Preventive Medicine, researchers from the University of Pittsburgh Graduate School of Public Health demonstrate positive effects of the Affordable Care Act (ACA) Medicaid expansion on rates of early cancer diagnosis. 

The study showed that health insurance expansions increased early-stage cancer diagnoses, while rates of late-stage cancer decreased. 

“We used cancer diagnosis rates as a marker of access to care,” explained lead author Lauren Lin, B.S., a medical student at Pitt School of Medicine. “An increase in early-stage cancer diagnoses means that people who didn’t have health care before the Medicaid expansion got a chance to see a primary care physician and get screened.” 

As the U.S. Supreme Court hears arguments this week that could decide the future of the ACA, results presented in the manuscript make a strong case that striking down the law would hurt the nation’s health. 

“Our study adds to the literature demonstrating the positive health effects of Medicaid expansion,” said senior author Coleman Drake, Ph.D., assistant professor in Pitt Public Health’s Department of Health Policy and Management. “This is another case where, depending on the Supreme Court’s ruling, the beneficial effects of preventive care provided by Medicaid expansion could disappear.” 

The scientists used data collected from cancer registries to track cancer diagnoses pre- and post- Medicaid expansion across different states. They found an immediate increase in early-stage cancer diagnoses within a year of ACA expansion, and a slight reduction in late-stage cancer diagnoses after three years. 

“It is important to remember that while the ACA was passed 10 years ago, the key provisions weren’t implemented until 2014,” said co-author Lindsay Sabik, Ph.D., associate professor of health policy and management at Pitt Public Health, and member of the UPMC Hillman Cancer Center. “Because we often don’t see the effects immediately, it’s important for us to keep studying the long-term consequences of health care reform.” 

Aparna Soni, Ph.D., of the American University in Washington, D.C., co-authored the paper. 

This research was supported by National Center for Advancing Translational Sciences grant  5KL2TR001856, National Cancer Institute Cancer Center Support grant P30CA047904, the Horowitz Foundation for Social Policy and the University of Pittsburgh School of Medicine Dean’s Summer Research Program. 

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