New York Medicaid expansion worsened racial disparities in surgical cancer care access

After New York expanded Medicaid in 2001, racial disparities in residents' access to surgical cancer care widened in the state, according to a study published in the Journal of the American College of Surgeons.  

For the study, researchers examined clinical care data on 67,685 nonelderly adult cancer surgery patients compiled in the state inpatient database. Fifteen percent of patients were either Medicaid beneficiaries or uninsured.

Twenty-one months after Medicaid was expanded in the state, racial disparities between blacks and whites regarding access to care at hospitals with the highest volume of cancer surgeries increased by 18 percent. Additionally, racial disparities at hospitals with low rates of patient mortality increased by 10 percent. Researchers did not attribute the increases in care disparities to insurance status since Medicaid beneficiaries experienced an overall increase in access to care at both hospital types.

"Pre-ACA Medicaid expansion reduced the disparity in access to surgical cancer care at high-volume hospitals by payer," wrote the study's authors. "However, it was associated with increased racial disparity in access to high-quality hospitals. Addressing racial barriers in access to high-quality hospitals should be prioritized."

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