Introduction
The purpose of this study is to determine the association between Medicaid expansion
in Louisiana and cancer mortality by race and sex.
Methods
Data from the National Vital Statistics System mortality files were used to quantify
deaths from cancer between 2010 and 2019 for Louisiana and a sample of states that
had yet to adopt the Affordable Care Act's Medicaid expansion as of December 2019.
A series of population-weighted comparative interrupted time series models were estimated
to determine whether Louisiana's Medicaid expansion was associated with reduced cancer
mortality. Analyses were conducted in May 2021–August 2021.
Results
Medicaid expansion was associated with an average of 3.3 (95% CI= −6.4, −0.1; p=0.045) fewer quarterly cancer deaths per 100,000 Black female Louisiana residents
and an average of 5.8 (95% CI= −10.4, −1.1; p=0.015) fewer quarterly cancer deaths per 100,000 Black male residents. There were
no statistically significant changes in cancer mortality for White people in Louisiana
associated with Medicaid expansion. Following expansion, the Black–White mortality
gap in cancer deaths declined by approximately 57% for female individuals (4.6–2.0)
and 49% for male individuals (10.1–5.2).
Conclusions
Medicaid expansion in Louisiana was associated with a reduction in cancer mortality
for Black female and male adults. Estimates of the association between Medicaid expansion
and cancer mortality in Louisiana directly relate to the potential impacts for states
that have yet to adopt Medicaid expansion under the Affordable Care Act, which are
primarily located in the Southern U.S.
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Article info
Publication history
Published online: November 13, 2021
Identification
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© 2021 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.
