Medicaid Expansion Associated with Better Mortality Outcomes for Lung Cancer Surgery, Study Finds

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Lung cancer is the leading cause of cancer-related mortality and the second most diagnosed cancer in the United States. About 80% to 85% of these cases are non–small cell lung cancer (NSCLC), according to the American Cancer Society. Forty percent of patients also experience complications within 30 days of surgery.

To find out if patients with Medicaid have the same complications, a research team led by Leticia M. Nogueira, Ph.D., used the National Cancer Database to identify 14,984 adults ages 45 to 64 who underwent NSCLC surgery between 2008 and 2019. This age range was chosen because it is before individuals are eligible for Medicare and the time most associated with lung cancer diagnosis. The mean age of the subjects was 56.3 years and 54.6% were women. In addition, 62.1% lived in Medicaid expansion states.

The study took place from March 2021 to September 2023 and was published today in JAMA Network Open.

During the study, researchers found that for people covered by Medicaid in expansion states, there was a 30-day post-operative mortality decrease from 0.97% before the ACA to 0.26% after the ACA. Similarly, 90-day postoperative mortality decreased from 2.63% before the ACA to 1.32% after the ACA. There was no difference detected in non-Medicaid expansion states.

“Our findings suggest the importance of Medicaid expansion in improving access to care following hospital discharge,” the researchers write. “As policymakers consider whether to expand Medicaid or change different ACA provisions, these findings provide important evidence of the positive health consequences associated with coverage expansion.”