Medicaid Expansion Can Improve 5-Year Survival Outcomes in Patients With Cancer

Medicaid expansion improved 5-year survival rates in patients with cancer in rural and high-poverty areas, according to data published in Cancer Discovery.

The findings underscore and reveal that the impact of financial support for patients goes beyond the price of care and leads to better health outcomes.¹

In the United States, the American Cancer Society reports that over 2 million people will be diagnosed with cancer in 2025. As rates continue to rise, access to care becomes increasingly more crucial. Care disparities exist across disease states, impacted greatly by location, economic status, sex or gender, race or ethnicity, age, and insurance coverage—understood broadly as social determinants of health. Thus, financial assistance becomes a critical component of ensuring access to care and optimizing survival outcomes.²

Elizabeth J. Schafer, MPH, of the American Cancer Society in Atlanta, and colleagues aimed to identify how Medicaid expansion affected access to screening and treatment in patients from rural and high-poverty areas of the United States. They assessed data from 1,423,983 patients with cancer (ages 18-59 years) diagnosed between 2007 and 2008 and 2014 and 2015 residing in 26 states with Medicaid expansion (n = 813,684) and 12 without (n = 610,299).^1,3

"The evidence supporting Medicaid expansion in improving outcomes for cancer patients is clear," Schafer told MedPage Today. "Research has shown that Medicaid expansion can increase cancer screening prevalence, early-stage diagnosis, short-term survival, and now—according to our own analysis—5-year survival. These findings underscore the importance of protecting and expanding Medicaid in the remaining 10 non-expansion states to improve outcomes for all individuals."³

Schafer’s team found that Medicaid expansion was associated with improved access to early cancer screening and treatment in patients from rural areas, resulting in a 2.55–percentage point (ppt) increase in 5-year cause-specific survival rates (95% confidence interval [CI], 0.23–4.86). In patients from high-poverty areas in Medicaid expansion states, they observed a 1.54 ppt improvement (95% CI, 0.30–2.77).^1,3

“Improvements in 5-year cause-specific survival and OS were greater in Medicaid expansion than non-expansion states among individuals residing in rural and high-poverty communities and among individuals diagnosed with cancers that generally have a worse prognosis, emphasizing the importance of Medicaid expansion in mitigating disparities in survival outcomes,” Schafer wrote in the study.^1,3

Gains were also observed among non-Hispanic White individuals (difference-in-differences [DD]: 0.37 ppt; 95% CI, 0.05–0.70) and for patients with pancreatic (DD: 2.60 ppt; 95% CI, 0.86–4.34), lung (DD: 1.32 ppt; 95% CI, 0.30–2.34), and colorectal cancers (DD: 1.31 ppt; 95% CI, 0.26–2.37).^1,3

Similar results were observed for overall survival (OS). Over a 5-year period, cancer deaths occurred in 170,409 people living in Medicaid expansion states and 143,598 in non-expansion states. Cause-specific survival improved in both groups over time, rising from 77.7% to 79.5% in expansion states and from 75.1% to 77.0% in non-expansion states, but the difference between the 2 was not statistically significant.^1,3

The timing of these findings highlights the potential risk of Medicaid cuts pose to patient access and survival outcomes. Congress voted to substantially cut Medicaid earlier this year as part of the Trump agenda, though these cuts have not yet taken effect.⁴ As health care professionals and patients try to navigate in this period of uncertainty, protecting patient access to cancer screening and therapies is critical.

REFERENCES

1. Schafer E, Johnson C, Moraes F, et al. Association between Medicaid expansion and 5-year survival among individuals diagnosed with cancer. Cancer Discov. October 8, 2025. doi:10.1158/2159-8290.CD-25-1244

2. American Cancer Society. Cancer Facts and Figures 2025. 2025. https://www.cancer.org/content/dam/cancer-org/research/cancer-facts-and-statistics/annual-cancer-facts-and-figures/2025/2025-cancer-facts-and-figures-acs.pdf

3. Bankhead C. Medicaid Expansion Linked to Better Cancer Survival at 5 Years. MedPage Today. October 8, 2025. Accessed October 8, 2025. https://www.medpagetoday.com/hematologyoncology/othercancers/117844

4. American Medical Association. Changes to Medicaid, the ACA and other key provisions of the One Big Beautiful Bill Act. American Medical Association. September 11, 2025. Accessed October 8, 2025. https://www.ama-assn.org/health-care-advocacy/federal-advocacy/changes-medicaid-aca-and-other-key-provisions-one-big