Changes in Insurance Coverage Among Cancer Patients Under the Affordable Care Act

Abstract

This analysis uses SEER Medicaid data to quantify changes in health insurance coverage under the Affordable Care Act among nonelderly patients newly diagnosed with cancer.

Figure.. Changes in Percentage of Uninsured Patients With Newly Diagnosed Cancer Based on State Medicaid Expansion Status, 2010-2014

Calculations are based on Surveillance, Epidemiology, and End Results data from 2010 to 2014. The sample is restricted to first-time cancer diagnoses for adults aged 19 to 64 years. The 2014 expansion states in the SEER database are California, Connecticut, Hawaii, Iowa, Kentucky, Michigan, New Mexico, New Jersey, and Washington. The nonexpansion states are Alaska, Georgia, Louisiana, and Utah. The difference-in-differences estimate for Medicaid expansion was −2.38 (95% CI, −3.97 to −0.79; P = .007). Standard errors were clustered at the state level. The model adjusted for patient’s age, marital status, sex, race/ethnicity, state of residence, year of diagnosis, county unemployment rate, and county median income. Trends in coverage did not differ significantly based on expansion status before 2014 (β = −0.15, 95% CI, −0.42 to 0.13; P = .26).