Association of Medicaid Expansion Under the Patient Protection and Affordable Care Act With Non–Small Cell Lung Cancer Survival
Menée aux Etats-Unis, cette étude analyse l’association entre l’extension de la couverture Medicaid dans le cadre la loi sur la protection des patients et les soins abordables ("Obamacare") et la survie chez des patients atteints d’un cancer du poumon non à petites cellules
Advances in lung cancer care have improved survival,1 but this has not reached all socioeconomic groups.2,3 Insurance status affects access to early detection and stage-appropriate cancer treatments, which drive survival outcomes. The Patient Protection and Affordable Care Act (ACA) and Medicaid expansion provide health care access to individuals with incomes near federal poverty levels. Medicaid expansion under the ACA was implemented in 2014, substantially reduced the numbers of uninsured patients with cancer, and increased early-stage diagnoses of cancers.4-6 Analyses of lung cancer populations diagnosed in 2014 showed comparable increases in percentages of early-stage diagnoses between Medicaid expansion and nonexpansion states.4-6 However, it remains unknown if Medicaid expansion improved lung cancer survival. We hypothesized that Medicaid expansion was associated with improved population-level survival in patients with non–small cell lung cancer (NSCLC).