Medicaid expansion states saw a significant decline in breast cancer mortality from 6.53 to 5.64 per 100,000 (p < 0.0005), notably in women aged 40-64.
Does Medicaid Expansion reduce breast cancer mortality in women in the United States?
Medicaid expansion is associated with a significant long-term reduction in breast cancer mortality, particularly among women aged 40-64.
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Abstract Background: Breast cancer remains one of the most commonly diagnosed cancers among women in the United States and is the leading cause of cancer-related deaths in women under 40. In 2010, the Affordable Care Act introduced Medicaid Expansion (ME) to improve healthcare access for low-income individuals, yet only some states adopted the policy. While earlier studies have shown short-term benefits of ME on cancer outcomes, there remains a need for long-term evaluation, especially in age-specific subgroups and across differing levels of healthcare access. Objective: This study investigates the effect of Medicaid Expansion on breast cancer mortality rates in the United States by: (1) comparing states that did and did not expand Medicaid before and after 2015, (2) analyzing differences in breast cancer mortality outcomes between patients under and over age 40, and (3) re-evaluating these trends after excluding states with the fewest oncologists per capita (Wyoming and Alaska). Methods: Using the CDC WONDER database, we analyzed breast cancer mortality data from 1999-2021 across all U.S. states and the District of Columbia. States were categorized based on Medicaid expansion status as of 2015. Breast cancer crude mortality rates (CMR) per 100,000 population were calculated and compared using t-tests and F-tests. Subgroup analyses were conducted for individuals under 40 and those aged 40-64. Additional analyses excluded states with minimal oncology resources. Results: Medicaid expansion was associated with a significantly larger decline in breast cancer CMR in expansion states (6.53 to 5.64, p .0005) compared to non-expansion states (6.75 to 6.02, p = 0.02). Among individuals aged 40-64, post-expansion breast cancer mortality was significantly lower in ME states compared to NME states (13.50 vs. 14.78, p = 0.01). For those under 40, breast cancer mortality declined in both ME and NME states, but no significant difference was found between the two after 2015 (p = 0.20). Excluding Wyoming and Alaska further strengthened the post-2015 difference between ME and NME states (p = 0.04). Conclusion: Medicaid expansion is associated with a significant long-term reduction in breast cancer mortality, especially among women aged 40-64 who benefit from routine screenings. While younger women also experienced improvements, the impact was less pronounced, suggesting that insurance alone may not eliminate barriers to care in this age group. These findings support the role of healthcare policy in improving cancer outcomes and highlight the need for targeted interventions for high-risk, underserved populations. Citation Format: I. Dwivedy, A. Jordan, K. J. Carnes. Long Term Impact of Medicaid Expansion on Breast Cancer Mortality abstract. In: Proceedings of the San Antonio Breast Cancer Symposium 2025; 2025 Dec 9-12; San Antonio, TX. Philadelphia (PA): AACR; Clin Cancer Res 2026;32(4 Suppl):Abstract nr PS5-11-20.
Dwivedy et al. (Tue,) reported a other. Medicaid expansion states saw a significant decline in breast cancer mortality from 6.53 to 5.64 per 100,000 (p < 0.0005), notably in women aged 40-64.