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Journal of Cancer Survivorship

, Volume 10, Issue 3, pp 583–592 | Cite as

Medicaid expansion and access to care among cancer survivors: a baseline overview

  • Wafa W. TaraziEmail author
  • Cathy J. Bradley
  • David W. Harless
  • Harry D. Bear
  • Lindsay M. Sabik
Article

Abstract

Purpose

Medicaid expansion under the Affordable Care Act facilitates access to care among vulnerable populations, but 21 states have not yet expanded the program. Medicaid expansions may provide increased access to care for cancer survivors, a growing population with chronic conditions. We compare access to health care services among cancer survivors living in non-expansion states to those living in expansion states, prior to Medicaid expansion under the Affordable Care Act.

Methods

We use the 2012 and 2013 Behavioral Risk Factor Surveillance System to estimate multiple logistic regression models to compare inability to see a doctor because of cost, having a personal doctor, and receiving an annual checkup in the past year between cancer survivors who lived in non-expansion states and survivors who lived in expansion states.

Results

Cancer survivors in non-expansion states had statistically significantly lower odds of having a personal doctor (adjusted odds ratio [AOR] 0.76, 95 % confidence interval [CI] 0.63–0.92, p < 0.05) and higher odds of being unable to see a doctor because of cost (AOR 1.14, 95 % CI 0.98–1.31, p < 0.10). Statistically significant differences were not found for annual checkups.

Conclusions

Prior to the passage of the Affordable Care Act, cancer survivors living in expansion states had better access to care than survivors living in non-expansion states. Failure to expand Medicaid could potentially leave many cancer survivors with limited access to routine care.

Implications for Cancer Survivors

Existing disparities in access to care are likely to widen between cancer survivors in Medicaid non-expansion and expansion states.

Keywords

Medicaid expansion Cancer survivors Access to care Disparities 

Notes

Acknowledgments

This study was supported under a graduate training fellowship in disparities research from the Susan G. Komen Breast Cancer Foundation (GTDR14302086, PI Sabik). The research was also supported by the Massey Cancer Center.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

This article does not contain any studies with human participants or animals performed by any of the authors.

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Copyright information

© Springer Science+Business Media New York 2015

Authors and Affiliations

  • Wafa W. Tarazi
    • 1
    Email author
  • Cathy J. Bradley
    • 2
  • David W. Harless
    • 3
  • Harry D. Bear
    • 4
  • Lindsay M. Sabik
    • 1
  1. 1.Department of Health Behavior and Policy, School of MedicineVirginia Commonwealth UniversityRichmondUSA
  2. 2.University of Colorado Cancer CenterAuroraUSA
  3. 3.School of BusinessVirginia Commonwealth UniversityRichmondUSA
  4. 4.School of MedicineVirginia Commonwealth UniversityRichmondUSA

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