Cancer patients who live in states that expanded their Medicaid programs under the Affordable Care Act (ACA) have a significantly better chance of survival compared to those living in states that did not expand Medicaid, a new study has found. The research shows that Medicaid expansion is associated with higher survival rates and improved cancer care, particularly for individuals in low-income communities.
The study, published on October 8, 2025, in the journal Cancer, highlights the positive impact that Medicaid expansion has had on the healthcare outcomes of cancer patients. According to the study’s lead researcher, Elizabeth Schafer, an associate scientist at the American Cancer Society, the evidence linking Medicaid expansion to improved survival rates for cancer patients is clear.
“Research has shown that Medicaid expansion can increase cancer screening prevalence, early-stage diagnosis, short-term survival and now — according to our own analysis — five-year survival,” Schafer said in a news release. “The evidence supporting Medicaid expansion in improving outcomes for cancer patients is clear.”
Medicaid Expansion and Its Impact on Cancer Survival Rates
The Affordable Care Act (ACA) provided states with the option to expand Medicaid eligibility, allowing nearly all adults with incomes up to 138% of the federal poverty level to qualify for Medicaid. This expansion aimed to reduce the number of uninsured Americans and improve access to healthcare services, including cancer screenings, preventive care, and necessary treatments.
According to the Kaiser Family Foundation (KFF), as of 2025, 38 states, including Washington D.C., have expanded Medicaid under the ACA, while 12 states have opted not to expand the program. The states that have not expanded Medicaid include Tennessee, Mississippi, Alabama, Georgia, South Carolina, Florida, Texas, Kansas, Wyoming, and Wisconsin. These states are mainly concentrated in the South, where the healthcare disparities and poverty rates are higher.
The study conducted by Schafer and her team compared cancer data from two periods: 2007 to 2008 (before Medicaid expansion) and 2014 to 2015 (after Medicaid expansion was implemented in many states). Researchers examined more than 1.4 million cancer cases in adults aged 18 to 59, comparing states that had expanded Medicaid (26 states) with states that had not expanded Medicaid (12 states).
The results were striking. The study found that in states that expanded Medicaid, five-year survival rates for cancer patients improved by more than 2.5 percentage points. Additionally, overall survival rates were more than 3 percentage points better in Medicaid expansion states compared to non-expansion states. These improvements in survival rates are particularly important for cancer patients, who often face significant challenges in accessing timely and appropriate care.
Positive Impact for Low-Income and High-Poverty Communities
One of the key findings of the study was that patients living in high-poverty areas experienced significant improvements in cancer survival if they lived in a Medicaid expansion state. For these patients, five-year survival rates improved by 1.5 percentage points, and overall survival rates improved by 1.7 percentage points. This shows that Medicaid expansion is particularly beneficial for those in low-income communities who may otherwise struggle to afford cancer screenings, treatment, and follow-up care.
Prior research has already linked Medicaid expansion to better access to insurance coverage and increased use of cancer screening services. Both of these factors can help improve the odds of early diagnosis, which is critical for effective treatment and improved survival outcomes. Early-stage cancer detection allows doctors to intervene with less aggressive treatments, which can have better long-term outcomes for patients.
The Importance of Medicaid Expansion for Cancer Patients
The findings from this study underscore the importance of expanding Medicaid in the remaining states that have not yet adopted the expansion. According to Schafer, expanding Medicaid is a crucial step in improving cancer care for all Americans, particularly those who are most vulnerable to the financial and health burdens of cancer.
“These findings underscore the importance of protecting and expanding Medicaid in the remaining 10 non-expansion states to improve outcomes for all individuals,” Schafer said. “Medicaid expansion is an essential tool in the fight against cancer, and it is critical that we continue to advocate for its expansion to ensure all patients have the best chance at survival.”
The study emphasizes that Medicaid expansion not only helps provide better healthcare access but also helps reduce health disparities among low-income communities and minority populations. It allows individuals to access cancer screenings, treatments, and follow-up care that might otherwise be out of reach due to cost barriers. For people with cancer, having reliable access to these services can be the difference between life and death.
Challenges and Future Directions
Despite the significant benefits of Medicaid expansion, the debate over its expansion continues in certain parts of the United States. In July 2025, the Republican-led Congress approved a series of Medicaid cuts that included higher co-pays, stricter work requirements, and more eligibility checks. These cuts have the potential to hinder access to Medicaid for millions of low-income Americans, making it even more difficult for them to receive the care they need.
Moreover, some states that have not expanded Medicaid are reluctant to do so, citing concerns over state budgets and the long-term financial implications of expansion. However, advocates for Medicaid expansion argue that the long-term benefits, such as improved public health outcomes and reduced healthcare costs in the future, far outweigh the initial costs.
The study’s findings should serve as a wake-up call for policymakers in non-expansion states. By refusing to expand Medicaid, these states are depriving cancer patients of life-saving care and hindering their chances of survival. Medicaid expansion is not just a financial issue; it is a moral imperative for the well-being of all Americans, especially those battling cancer.
Conclusion: A Vital Step for Cancer Patients
The evidence is clear: Medicaid expansion leads to better outcomes for cancer patients, improving both survival rates and quality of life. For cancer patients, Medicaid expansion is a life-saving intervention that should be considered an essential part of comprehensive cancer care. It’s time for the remaining states to act and ensure that all individuals have access to the healthcare they need to fight cancer.
As researchers continue to explore the benefits of Medicaid expansion, it is essential for policymakers, healthcare providers, and advocates to push for expanded access to this critical program. By doing so, we can help ensure that every cancer patient has the opportunity to survive and thrive, regardless of where they live.
