Medicaid Expansion Led to Melanoma Diagnosis at an Earlier Stage

Medicaid expansion and improved access to health care services can facilitate diagnosing melanoma at an early stage, according to a study being presented at the 2024 American Society of Clinical Oncology Annual Meeting.

Researchers sought to “evaluate the impact of the Affordable Care Act Medicaid expansion on melanoma stage at presentation.”

In the study, 12,667 nonelderly patients (40-64 years of age; 56% male; 95% White) who were newly diagnosed with melanoma and had known Medicaid expansion status were identified from the National Cancer Database. Exclusion criteria included any patients with private insurance, Medicare, or other government or unknown insurance.

The study time period spanned 2010 to 2020 and included pre- (2010-2013) and postexpansion (2014-2020) periods of Medicaid. The researchers performed year-to-year trend and difference-in-difference analyses to assess tumor staging between states with Medicaid expansion (MES) and those without (non-MES), both before and after the expansion.

The researchers observed that 41% of patients were uninsured and 59% had Medicaid during 2010 to 2020. The percentage of patients without insurance decreased significantly from 51% in 2010 to 16% in 2020, they noted. A total of 21% of patients had stage III melanoma and 18% had stage IV. Notably, the study found that stage IV melanoma at presentation decreased from 21% to 17% from 2010 to 2020 in MES. By contrast, stage IV melanoma at presentation increased from 20% to 23% over the same period in non-MES.

“The findings reveal the positive impact of Medicaid expansion on melanoma stage at presentation and suggest that improved access to health care services can facilitate diagnosing early-stage melanoma and decreasing the mortality rate. Despite these findings, there are still 16% of patients who did not have insurance in 2020, which indicates that continued effort is needed to improve the outcomes of these uninsured patients,” the researchers concluded.

Reference

Win S, Amini A, Modi B, et al. The positive impact of Medicaid expansion on melanoma stage at presentation. Abstract #1533. Published for the 2024 American Society of Clinical Oncology Annual Meeting; May 31-June 4, 2024; Chicago, Illinois.