Medicaid Expansion Led to Higher Rates of Mammography and Insurance Coverage

May 4, 2020

Medicaid expansion under the Affordable Care Act (ACA), has increased access to mammograms - a key part of early breast cancer detection - for lower-income women, a new study suggests.

The team, led by senior study author Christine H. Rohde, MD, MPH, FACS, member of the Cancer Population Science program at the Herbert Irving Comprehensive Cancer Center (HICCC), published their findings in the Journal of the American College of Surgeons last week.

“The ACA created a natural experiment in which some states expanded Medicaid and other ones did not,” Dr. Rohde, who is also an associate professor of surgery at Columbia University Irving Medical Center, said said in a press release. “This research shows that Medicaid expansion through the ACA does have a significant impact on patients, specifically in terms of insurance coverage and mammography.”

Dr. Rohde and her team analyzed the impact of Medicaid expansion between 2011 to 2016 and preventative breast cancer screening rates from 2010 to 2018, comparing data from seven states that expanded Medicaid coverage to six states that did not. The team found that mammogram rates were higher among 50- to 74-year old women from lower-income households in states with expanded Medicaid coverage. Among women 50-74 years old making less than $15,000 in states with expanded Medicaid coverage, mammogram rates increased from 63% in 2010 to 74% in 2018. In states that did not expand coverage, rates went from 68% in 2010 to 69% in 2018.

“These results demonstrate that when given the opportunity, people take advantage and enroll in available insurance and that this expanded eligibility may more preferentially benefit historically underprivileged groups such as those of lower socioeconomic status,” the researchers concluded.

Read the full press release on the American College of Surgeons website.

 

The study team includes Dr. Rohde’s coauthors are Yoshiko Toyoda, MD, and Ishani D Premaratne, BA, of Columbia University Irving Medical Center/NewYork-Presbyterian Hospital, division of plastic and reconstructive surgery, department of surgery; and Eun Jeong Oh, MA, and Codruta Chiuzan, PhD, of Columbia University Mailman School of Public Health, department of biostatistics.

The study is titled "Affordable Care Act State-Specific Medicaid Expansion: Impact on Health Insurance Coverage and Breast Cancer Screening Rates."

This research was supported in part by the Weill Cornell Medicine Dean’s Diversity and Healthcare Disparity Research Award.