Cohort study of association of statewide Medicaid expansion with survival in resectable non-small cell lung cancer

Medicaid expansion under the Affordable Care Act broadened eligibility for government-funded health coverage. A retrospective cohort study using SEER data evaluated the association between timing of Medicaid expansion status of patients’ state of residence at diagnosis of resectable non-small cell lung cancer with survival: nonexpansion, early expansion (2011), 2014 expansion, or late expansion (after 2014). In this cohort study of 53,842 patients with NSCLC, Medicaid expansion status was associated with increased 2-year survival in states that expanded coverage in 2014 or earlier, and increased 4-year survival for all Medicaid expansion groups. A time lag for mortality differences was observed after policy implementation, but there was no corresponding increase in early-stage diagnoses after Medicaid expansion. The authors conclude that these findings suggest that Medicaid expansion was associated with decreased mortality hazards for patients diagnosed with resectable NSCLC