Medicaid expansion was associated with lower 2- and 4-year all-cause mortality for adults less than 65 years old with resectable stage I to IIIA non-small cell lung cancer (NSCLC), based on a SEER-linked cohort (2006–2019) analyzed by expansion timing (pre, early, expansion, late) with difference-in-differences models. Post-expansion mortality fell overall (difference-in-difference HR≈0.94), with clearer reductions in late-expansion states (HR≈0.93) and during 2017 to 2019 (2-year HR≈0.85; 4-year HR≈0.86). Improvements persisted across both 2- and 4-year horizons after implementation, suggesting better access to effective care translated into survival gains.
Benefits were most evident among patients less than 55 years old, women, and non-Hispanic Asian/Native Hawaiian/Other Pacific Islander groups, and among those married/partnered. Rural residence and smaller metros were linked to higher mortality overall but did not show a unique expansion-related advantage. Early-stage diagnosis rates did not appear to shift with expansion. As a retrospective analysis limited to stages I to IIIA, with potential unmeasured confounding and only 4 years of follow-up, causal inference is constrained. Even so, the pattern supports that comprehensive, sustained coverage policy can enhance long-term survival in NSCLC.
Reference: Bonavitacola J. Medicaid Expansion Associated With Lower Mortality in NSCLC. AJMC. Published December 4, 2025. Accessed January 20, 2026. https://www.ajmc.com/view/medicaid-expansion-associated-with-lower-mortality-in-nsclc
Link: https://www.ajmc.com/view/medicaid-expansion-associated-with-lower-mortality-in-nsclc
