ACA Medicaid Expansion Has Increased Access to Cancer Trials

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Proportion of SWOG trial participants who had Medicaid insurance increased by 20 percent per year after ACA Medicaid expansion

HealthDay News — Implementation of Affordable Care Act (ACA) Medicaid Expansion (ME) was associated with an increase in the proportion of patients using Medicaid in cancer clinical trials, according to a study presented at the annual meeting of the American Society of Clinical Oncology, held from June 3 to 7 in Chicago.

Joseph M. Unger, PhD, from the Fred Hutchinson Cancer Research Center in Seattle, and colleagues used data from the SWOG Cancer Research Network to examine the number and proportion of patients insured by Medicaid at enrollment over time. All 47,042 patients aged 18 to 64 years enrolled to treatment trials between April 1, 1992, and February 28, 2020, using Medicaid vs private insurance were examined.

The researchers found that following the ACA ME, there was a 20% increase per year in the odds of patients using Medicaid. Noting that the proportion of patients using Medicaid decreased during periods of economic growth and low unemployment, the model-based estimate of the proportion of patients with Medicaid insurance was 7.4% at the end of the study period when national unemployment was low, had the ACA ME not occurred. However, the actual rate was 20.8%. Patterns were consistent by age, but the annual increase in the proportion of Medicaid use was higher for female than male patients (29 vs 7%).

“These findings suggest that the recently enacted Cancer Treatment Act, which mandates that state Medicaid programs cover the routine care costs of clinical trial participation, may continue to improve access to clinical trials for those with Medicaid insurance,” the authors write.

One author disclosed financial ties to AIM Specialty Health.


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