Expanding Medicaid coverage may have led to better cancer survival rates among young adults, according to new research published in the Journal of Clinical Oncology.
The study finds that states that expanded Medicaid to cover most adults making up to 138% of the Federal Poverty Level saw increased two-year cancer survival rates compared with states that did not expand Medicaid. Forty states, including the District of Columbia, have expanded Medicaid.
Cancer is a leading cause of death among 18- to 39-year-olds. More than 80,000 people in this age group were newly diagnosed in 2020.
“Historically, young adults have not experienced the same survival improvements as pediatric or older cancer patients,” says Xu Ji, a researcher at Winship Cancer Institute of Emory University, assistant professor of pediatrics, and lead author of the study.
One reason for the disparity is a lack of health insurance coverage, says Ji, who is also a professor at the Emory University School of Medicine. That’s why expanding Medicaid has the potential to improve outcomes for cancer patients.
Most young adults aren’t regularly screened for most cancers. For example, doctors don’t recommend regular colonoscopies until you turn 45.
“This population doesn’t have any kind of screening regularity,” says Dr. Sharon Castellino, a pediatric hematologist/oncologist, professor of pediatrics, and researcher at Winship. “They also are young and mobile and working or early in parenthood years and transient, and may not seek regular health coverage, because in general, they should be a healthy population.”
Because of this, when young adults are diagnosed with cancer, it tends to be at a more advanced stage. More advanced cancers have lower survival rates.
Expanding Medicaid had particularly strong benefits for minorities, especially Black and Hispanic patients. These groups were more likely to not have health insurance coverage before expansion and had worse cancer outcomes to begin with.
“Because of the disparities among minority patients, there’s more opportunity for them to improve when a policy like this comes into effect,” Ji says.
Aside from giving people access to cancer treatment, expanding Medicaid also gives young adults better access to regular preventive care, which may lead to cancers being detected earlier, Castellino says. The study is evidence that young adults and their families should make every effort to enroll in health insurance, even if they don’t currently have health problems, the authors say.
“Our study provides more data showing that Medicaid expansion is effective in saving lives and improving overall survival among these young patient populations with cancer,” Ji says.
Expanding Medicaid has also been linked to reduced hospitalizations among pregnant women, according to a study published in Health Affairs.
“Our findings indicate that expanding Medicaid coverage led to improved postpartum health for low-income birthing people,” said Maria Steenland, an assistant professor at Brown University and a co-author of the study.
Each state runs its own Medicaid program, so eligibility varies, especially in the 11 states that haven’t expanded Medicaid to cover all adults making below a certain income threshold. Your age, disability status, pregnancy status, household size, and other factors can also qualify you for Medicaid.
As of September, more than 90 million Americans were enrolled in Medicaid or Children’s Health Insurance Programs, thanks in part to loosened eligibility rules during the COVID-19 pandemic. But millions of people could lose coverage in April when pre-pandemic enrollment rules return. 
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