The potential impact of the Affordable Care Act and Medicaid expansion on reducing colorectal cancer screening disparities in African American males

Few investigations have explored the potential impact of the Affordable Care Act on health disparity outcomes in states that chose to forgo Medicaid expansion. Filling this evidence gap is pressing as Congress grapples with controversial healthcare legislation that could phase out Medicaid expansion...

Full description

Saved in:
Bibliographic Details
Published in:PloS one 2020-01, Vol.15 (1), p.e0226942-e0226942
Main Authors: Powell, Wizdom, Frerichs, Leah, Townsley, Rachel, Mayorga, Maria, Richmond, Jennifer, Corbie-Smith, Giselle, Wheeler, Stephanie, Hassmiller Lich, Kristen
Format: Article
Language:English
Subjects:
African Americans
Age
Aged
Cancer
Cancer screening
Colonoscopy
Colorectal cancer
Colorectal carcinoma
Colorectal Neoplasms - diagnosis
Colorectal Neoplasms - economics
Computer simulation
Costs
Early Detection of Cancer - economics
Early Detection of Cancer - ethics
Economic aspects
Economic impact
Evaluation
Expansion
Gender
Government programs
Health care
Health care policy
Health care reform
Health disparities
Health insurance
Health surveillance
Healthcare Disparities - economics
Healthcare Disparities - trends
Hispanic Americans
Humans
Insurance
Insurance coverage
Insurance law
Legislation
Male
Males
Medicaid
Medicaid - economics
Medicaid - trends
Medical law
Medical screening
Medicine and Health Sciences
Methods
Middle Aged
Mortality
North Carolina
Patient Protection and Affordable Care Act - economics
Patient Protection and Affordable Care Act - trends
People and places
Political activity
Political aspects
Population
Public health
Race
Race Factors - economics
Research and Analysis Methods
Social Sciences
Sociodemographics
Studies
Tumors
United States
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Few investigations have explored the potential impact of the Affordable Care Act on health disparity outcomes in states that chose to forgo Medicaid expansion. Filling this evidence gap is pressing as Congress grapples with controversial healthcare legislation that could phase out Medicaid expansion. Colorectal cancer (CRC) is a commonly diagnosed, preventable cancer in the US that disproportionately burdens African American men and has substantial potential to be impacted by improved healthcare insurance coverage. Our objective was to estimate the impact of the Affordable Care Act (increasing insurance through health exchanges alone or with Medicaid expansion) on colorectal cancer outcomes and economic costs among African American and White males in North Carolina (NC), a state that did not expand Medicaid. We used an individual-based simulation model to estimate the impact of ACA (increasing insurance through health exchanges alone or with Medicaid expansion) on three CRC outcomes (screening, stage-specific incidence, and deaths) and economic costs among African American and White males in NC who were age-eligible for screening (between ages 50 and 75) during the study period, years of 2013-2023. Health exchanges and Medicaid expansion improved simulated CRC outcomes overall, though the impact was more substantial among AAs. Relative to health exchanges alone, Medicaid expansion would prevent between 7.1 to 25.5 CRC cases and 4.1 to 16.4 per 100,000 CRC cases among AA and White males, respectively. Our findings suggest policies that expanding affordable, quality healthcare coverage could have a demonstrable, cost-saving impact while reducing cancer disparities.
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0226942