Women in States with Medicaid Expansion More Likely to Have Mammography

Study finds adoption of Medicaid expansion could reduce disparities in breast cancer screening.

The expansion of Medicaid was found to improve breast cancer screening rates among low-income females in the United States, a recent study indicates.

The study, presented recently at the annual meeting of the Radiological Society of North America, found that low-income women were more likely to have a mammogram compared with women in states without Medicaid expansion.

The expansion fell under the Affordable Care Act, which offered states the option of providing coverage to people aged 65 years and under living at up to 133% of the federal poverty level.

"While increased use of screening mammography has significantly contributed to improved detection of breast cancer, substantial disparities in breast cancer screening exist among populations in the country," said lead author Soudabeh Fazeli Dehkordy, MD, MPH, of St. John Providence Hospital in Southfield, Mich. "We sought to determine whether increasing access to health insurance through Medicaid expansion has resulted in improved breast cancer screening adherence."

The researchers examined data from the 2008 and 2012 Behavioral Risk Factor Surveillance System with adjustments made for age, education, income, and race.

In 2008, rates of breast cancer screening among low-income women were similar throughout the United States regardless of whether their state had expanded Medicaid. In 2012, however, low-income women in states with expanded Medicaid were 25% more likely to have received a mammogram compared with 2008.

"Understanding the impact of Medicaid expansion on breast cancer screening rates in early expander states can provide valuable insights that can be very useful to both state and federal policymakers when considering key health policy," Dr. Fazeli Dehkordy said.

There are currently 23 states with expanded Medicaid coverage and 6 states that are implementing alternative options. The rest of the states have either elected not to expand coverage or are still evaluating the program.

"Adoption of Medicaid expansion by more states can result in considerable improvement of disparities in breast cancer screening, leading to better health outcomes for all women across the United States," Dr. Fazeli Dehkordy said.