Benefits of Medicaid Expansion on Lung Cancer Treatment Accessibility

A recent study published in The Annals of Thoracic Surgery reveals that the expansion of Medicaid under the Affordable Care Act has notably enhanced access to prompt treatment and high-volume medical facilities for patients diagnosed with early-stage non-small cell lung cancer (NSCLC). These findings highlight the significant impact that health care policies can have on the quality of oncologic care.

The research indicates that states that expanded Medicaid experienced an increase in lung cancer surgeries performed at high-volume hospitals, which are known for lower rates of postoperative complications and in-hospital mortality compared to facilities with lower surgical volumes. Moreover, patients residing in these expansion states were more likely to undergo surgery within 90 days following their diagnosis than those in non-expansion states.

While there has been a general decline in overall treatment rates within 30 and 90 days across the nation, the decrease has been less pronounced in states that opted for Medicaid expansion. This suggests that having insurance coverage plays a crucial role in reducing treatment delays.

According to the study's lead researcher, the availability of better insurance coverage and improved access to care may increasingly direct surgical cancer treatments from community hospitals to specialized institutions. However, the benefits of performing surgical resections for NSCLC at high-volume hospitals remain a subject of ongoing debate.

The research analyzed data from the National Cancer Database, focusing on 43,151 patients aged 40 to 64 who were diagnosed with stage I-II NSCLC between 2010 and 2016. Through adjusted difference-in-differences analyses, the study compared treatment trends before and after the 2014 Medicaid expansion. The results indicated a 2.8% increase in lung cancer surgeries and a 2.1% rise in surgeries completed within 90 days of diagnosis at high-volume hospitals following the expansion.

This increase in surgical procedures at high-volume hospitals implies that patients in states that expanded Medicaid had greater access to surgical care options compared to those in non-expansion states. With the rise in public awareness regarding hospital outcomes, the expansion of Medicaid may have allowed some patients to pursue care options that were previously inaccessible.

While this study demonstrates clear advantages of Medicaid expansion, further research is necessary to explore its effects on the overall quality of oncologic care. Policymakers and health care professionals can utilize this data to advocate for strategies that enhance access to timely and quality lung cancer treatment across the country.

The topic of Medicaid expansion remains contentious, with several states opting against accepting federal funding. Additionally, many states that have expanded Medicaid face potential challenges in maintaining coverage due to possible federal budget cuts. Thoracic surgeons are in a unique position to influence policy discussions and decisions related to this issue.