Roger Williams Medical Center in Providence, RI A fresh study shows that women with breast cancer living in Rhode Island and other states that expanded Medicaid eligibility were less likely to die from the disease. (Photo: Michael Salerno/Rhode Island Current)
Women with breast cancer living in states that expanded Medicaid eligibility were less likely to die from the disease, but not all received the same benefits, study finds recent study published in the medical journal JAMA Network Open.
Researchers from Howard University, the University of Alabama, Henry Ford Hospital in Michigan and others analyzed data on approximately 1.6 million women ages 40 to 64 who were diagnosed with breast cancer between 2006 and 2021.
They compared survival rates among women living in states that expanded Medicaid eligibility under the Affordable Care Act, commonly known as Obamacare, with rates in states that did not expand. About 58% of women lived in expansion states and about 42% lived in nonexpansion states. States began expanding Medicaid in 2014.
The researchers found that the expansion of Medicaid was associated with lower overall mortality rates – regardless of women’s disease stage, race, ethnicity or neighborhood income. Women in expansion states, whose cancer had spread to other organs – the most advanced stages of the disease – saw the most significant declines in deaths.
Among racial and ethnic groups, the largest relative increases were among Latina women, who were 19% less likely to die if they lived in an expansion state. Smaller increases were seen among non-Hispanic black women and residents of low-income areas. The smallest difference was among white women.
Dr. Oluwasegun Akinyemi, senior research fellow at the Clive O. Callender Outcomes Research Center at Howard University College of Medicine and co-author of the study, said Latina women’s huge gains may be due to the fact that many of them did not previously have insurance.
Black women have a higher mortality rate from breast cancer compared to white women, even though they have fewer cases, partly because they are often diagnosed with the disease at a later stage.
Overall, black women with breast cancer have benefited less from Medicaid expansion than other groups because they are disproportionately located in the South, where most states have not expanded, Akinyemi noted. States on hold on expansion include Alabama, Florida, Georgia, Mississippi, South Carolina, Tennessee and Texas.
The other three states not subject to expansion are Kansas, Wisconsin and Wyoming.
The researchers also compared death rates in low- and high-income neighborhoods. Women living in the highest-income neighborhoods, as well as those who received immunotherapy treatment, had lower mortality rates. Akinyemi said the result suggests that coverage provides greater access to treatment.
In July, President Donald Trump signed a sweeping tax and spending bill that would cut federal funding for Medicaid by more than $900 billion over the next decade. They say about 15 million people could lose their Medicaid coverage as a result estimates by the Center for Budget and Policy Priorities.
Editor’s Note: Due to incorrect information provided to Stateline, an earlier version of this story incorrectly represented the position of Dr. Oluwasegun Akinyemi. Stateline reporter Nada Hassanein can be reached at: nhassanein@stateline.org.
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