If you’re diagnosed with cancer, you have a better chance of long-term survival if you live in a state that has opted to expand Medicaid under the Affordable Care Act to include people with income levels slightly above the poverty line, according to results to be presented at the American Society of Clinical Oncology’s (ASCO) 2021 Annual Meeting.

The study authors conclude that if more states decide to expand income eligibility limits, survival rates for people with cancer would rise. Under a 2012 Supreme Court ruling, states can decide whether to expand these income limits. As a result, Medicaid income eligibility limits differ by state by a substantial amount.

In order to discern a correlation between eligibility limit and duration of survival after diagnosis, the researchers divided states into categories based on their respective caps: 50% or less of the federal poverty level (FPL), 51% to 137% of the FPL and 138% or more of the FPL. For reference, the FPL for a one-person household was set at $12,880 in 2021, according to the Department of Health and Human Services.

The researchers then used the National Cancer Database to identify nonelderly adults, defined as adults between ages 18 and 64, who had been diagnosed with any one of 17 common cancers between 2010 and 2013. Ultimately, they identified 1,426,657 such individuals. Of those, 22.0% resided in states in the first category, 43.5% in the second category and 34.5% in the third category. Even after controlling for confounding factors such as age, sex, race and ethnicity, the researchers observed a statistically significant association between the two variables.

In short, adults who resided in states that fell into the first and second categories tended to die sooner after diagnosis than adults who resided in states that fell into the third category, regardless of cancer stage.

The association was especially strong for women who had been diagnosed with early-stage breast cancer. Those in states with the lowest eligibility limits were 31% and 17% more likely to die during the study period than those in states with the highest eligibility limits, respectively, according to an ASCO press release.

“This study shows that states with expanded Medicaid income eligibility limits have improved cancer survival rates, consistent across cancer type and stage. Health insurance coverage is associated with improved access to cancer prevention, diagnosis and treatment, allowing us better opportunities to provide the right care to the right patient at the right time,” said Lori J. Pierce, MD, the president of ASCO, in the release.

Next, the researchers plan to investigate the relationship between Medicaid income eligibility limit and access to cancer treatment in the same or a similar patient population.

Click here to read the study abstract.
For more on the physical costs of poverty, read “Persistent Poverty Linked to Increased Risk of Dying From Cancer.” And for more on the benefits associated with Medicaid expansion, read “Medicaid Expansion Leads to Less Metastatic Cancer” and “Medicaid Expansion Improves Liver Transplant Waiting List Placement.”