[Skip to Content]
Access to paid content on this site is currently suspended due to excessive activity being detected from your IP address Please contact the publisher to request reinstatement.
[Skip to Content Landing]
Views 829
Citations 0
Research Letter
May 14, 2020

Association of Medicaid Expansion Under the Patient Protection and Affordable Care Act With Non–Small Cell Lung Cancer Survival

Author Affiliations
  • 1Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St Louis, Missouri
  • 2Alvin J. Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine, St Louis, Missouri
  • 3Center for Health Policy, University of Missouri, Columbia
  • 4Department of Health Management and Informatics, University of Missouri School of Medicine, Columbia
  • 5Division of General Medical Sciences, Department of Medicine, Washington University School of Medicine, St Louis, Missouri
JAMA Oncol. Published online May 14, 2020. doi:10.1001/jamaoncol.2020.1040

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).

Limit 200 characters
Limit 25 characters
Conflicts of Interest Disclosure

Identify all potential conflicts of interest that might be relevant to your comment.

Conflicts of interest comprise financial interests, activities, and relationships within the past 3 years including but not limited to employment, affiliation, grants or funding, consultancies, honoraria or payment, speaker's bureaus, stock ownership or options, expert testimony, royalties, donation of medical equipment, or patents planned, pending, or issued.

Err on the side of full disclosure.

If you have no conflicts of interest, check "No potential conflicts of interest" in the box below. The information will be posted with your response.

Not all submitted comments are published. Please see our commenting policy for details.

Limit 140 characters
Limit 3600 characters or approximately 600 words