Health & Spirit

With Obamacare, fewer Americans were uninsured when they were told they had cancer

Karen Kaplan, Los Angeles Times on

Published in Health & Fitness

As President Donald Trump and his allies in Congress keep pushing to get rid of Obamacare, new research shows that the contentious law has succeeded in expanding health insurance coverage for Americans with cancer.

But not everywhere. This upside of Obamacare -- known formally as the Patient Protection and Affordable Care Act, or ACA -- was seen primarily in states that participated in the Medicaid expansion that the law made possible.

By comparing states that expanded Medicaid to states that didn't, the researchers determined that the law reduced by about half the percentage of patients who did not have health insurance when they were diagnosed with cancer.

The findings, published Thursday in the journal JAMA Oncology, are based on five years of data from 13 states collected by the National Cancer Institute. The states in the NCI registry have a demographic profile that mirrors that of the country as a whole, and the cancer patients who are tracked are between the ages of 19 and 64.

Overall, the situation in the years 2010 to 2013 looked markedly different than the situation in 2014, the first year that Obamacare and the Medicaid expansion went into effect.

In the pre-Obamacare years, 5.73 percent of the patients who were newly diagnosed with cancer did not have health insurance to help them pay for their treatment, the researchers found. In 2014, that figure dropped by one-third, to 3.81 percent.

The percentage of uninsured patients fell for each type of cancer reported. Among patients who were told they had breast cancer, the proportion that lacked health insurance fell 26 percent in the first year of the Obamacare era. For patients with prostate cancer, the figure was 29 percent. It was just under 33 percent for those diagnosed with lung, bronchial or thyroid cancer.

When looking at cancers by stage at diagnosis, the law's benefits were spread pretty evenly among patients diagnosed with local, regional or metastatic disease that had spread to distant organs. In all three cases, the percentage of patients without health insurance fell by 33 percent to nearly 35 percent.

After the law went into effect, new cancer patients of all races and ethnicities were less likely to be uninsured. Among whites, the percentage without health insurance fell by 37 percent, compared with an 18 percent reduction for blacks. Among Latinos, the percentage of uninsured patients dropped by 40 percent. Declines were similar in counties with more poverty (33 percent) and those with less poverty (36 percent).

The biggest differences were between the states that chose to expand their Medicaid programs (California (where it's called Medi-Cal), Connecticut, Hawaii, Iowa, Kentucky, Michigan, New Mexico, New Jersey and Washington) and those that didn't (Alaska, Georgia, Louisiana and Utah).


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