Association of Medicaid expansion with diagnosis, treatment, and survival among patients with non-small cell lung cancer

Analysis of National Cancer Database data examined the association between Medicaid expansion and stage at diagnosis, timely initiation and receipt of guideline-concordant treatment, and 5-year overall survival (OS) among people with stage I to IV non-small cell lung cancer (NSCLC) at age 18-64 years between 2004 and 2023. Compared with people in nonexpansion states (n=164,228), people in expansion states (n=350,290) were more likely to be female, non-Hispanic White, or living in areas with higher family income or in nonmetropolitan areas. Medicaid expansion was associated with increases in early-stage NSCLC diagnosis, timely treatment initiation, and higher 5-year OS. In stratified analyses, people living in areas with lower household income were more likely to benefit from Medicaid expansion. The authors conclude that Medicaid expansion was associated with improvements in early detection, timeliness of guideline-concordant treatment, and survival for people with NSCLC. Anticipated Medicaid coverage losses may jeopardize these gains.