ArticleJournal of clinical oncology : official journal of the American Society of Clinical Oncology2023
Survival in Young Adults With Cancer Is Associated With Medicaid Expansion Through the Affordable Care Act.
Article in Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 29 papers, 2 of them syntheses that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
29 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Systematic Review of Health Insurance and Survival Among Adolescent and Young Adult Cancer Patients.Journal of adolescent and young adult oncology · 2026Pooled it
- The Impact of Social Determinants on Healthcare Transition Readiness Among Adolescent and Young Adult Childhood Cancer Survivors: A Mixed Methods Systematic Review.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2026Pooled it
- Changes in Medicaid Enrollment Among Adult Survivors of Childhood Cancer After Medicaid Expansion: A Report From the Childhood Cancer Survivor Study.JCO oncology practice · 2026Article
- Sociodemographic disparities and reasons for delayed healthcare among U.S. cancer survivors: an All of Us study.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2026Article
- "Nothing Is as Great a Learning Experience as Getting a $15,000 Bill": A Mixed-Methods Study of Young Adult Cancer Survivors' Experience With Insurance Coverage.JCO oncology practice · 2026Article
- Social Risk Burden among US Cancer Survivors across Adulthood: Evidence from the 2022-2023 BRFSS.Cancer research communications · 2026Article
- Sociodemographic Disparities and Reasons for Delayed Healthcare Among U.S. Cancer Survivors: An All of Us Study.Research square · 2025Article
- Medicaid Expansion Is Associated with Lower Mortality in Patients with Locally Advanced Breast Cancer.Annals of surgical oncology · 2025Article
- Association of Medicaid expansion with colon cancer care: treatment patterns and survival in non-metastatic cases from state registry-claims data.Cancer causes & control : CCC · 2025Article
- Survival Determinants and Sociodemographic Disparities in Early-Onset Non-Small Cell Lung Cancer.JAMA network open · 2025Article
- Cardiomyopathy Screening Adherence Among Medicaid-Enrolled Long-Term Survivors of Childhood Cancer.Cancer medicine · 2025Article
- Immune Checkpoint Inhibitors and Survival Disparities by Health Insurance Coverage Among Patients With Metastatic Cancer.JAMA network open · 2025Article
- Association Between Medicaid Coverage Continuity and Survival in Patients With Newly Diagnosed Pediatric and Adolescent Cancers.JCO oncology practice · 2025Article
- Medicaid coverage continuity is associated with lymphoma stage among children and adolescents/young adults.Blood advances · 2025Article
- Article
- The lasting impact of the ACA: how Medicaid expansion reduces outcome disparities in AYAs with leukemia and lymphoma.Hematology. American Society of Hematology. Education Program · 2024Article
- Social vulnerability is associated with advanced breast cancer presentation and all-cause mortality: a retrospective cohort study.Breast cancer research : BCR · 2024Article
- Association of Medicaid Expansion With Timely Receipt of Treatment and Survival Among Patients With HR-Negative, HER2-Positive Breast Cancer.Journal of the National Comprehensive Cancer Network : JNCCN · 2024Article
- Survivorship after adolescent and young adult cancer: models of care, disparities, and opportunities.Journal of the National Cancer Institute · 2024Article
- Medical financial hardship between young adult cancer survivors and matched individuals without cancer in the United States.JNCI cancer spectrum · 2024Article
Corrections and comments
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Authors and funding
7 authors.
Funding
Abstract
purposeMedicaid expansion through the Affordable Care Act (ACA) has been shown to improve insurance coverage and early diagnosis of cancer in young adults (YAs); whether these improvements translate to survival benefits remains unknown. We examined the association between Medicaid expansion under the ACA and 2-year overall survival among YAs with cancer.
methodsUsing the National Cancer Database, we identified 345,413 YAs (age 18-39 years) diagnosed with cancer in 2010-2017. We applied the difference-in-differences (DD) method to estimate changes in 2-year overall survival after versus before Medicaid expansion in expansion versus nonexpansion states.
resultsAmong all YAs, 2-year overall survival increased more in expansion states (90.39% pre-expansion to 91.85% postexpansion) than in nonexpansion states (88.98% pre-expansion to 90.07% postexpansion), resulting in a net increase of 0.55 percentage points (ppt; 95% CI, 0.13 to 0.96). The expansion-associated survival benefit was concentrated in patients with female breast cancer (DD, 1.20 ppt; 95%CI, 0.27 to 2.12) when stratifying by cancer type and in patients with stage IV disease (DD, 2.56; 95%CI, 0.36 to 4.77) when stratifying by stage. In addition, greater survival benefit associated with Medicaid expansion was observed among racial and ethnic minoritized groups (DD, 1.01 ppt; 95% CI, 0.14 to 1.87) as compared with non-Hispanic White peers (DD, 0.41 ppt; 95% CI, -0.06 to 0.87) and among patients with a Charlson comorbidity score of ≥ 2 (DD, 6.48 ppt; 95% CI, 0.81 to 12.16) than those with a comorbidity score of 0 (DD, 0.44 ppt; 95% CI, 0.005 to 0.87).
conclusionMedicaid expansion under the ACA was associated with an improvement in overall survival among YAs with cancer, with survival benefits most pronounced among patients of under-represented race and ethnicity and patients with high-risk diseases.
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