Chicago (AFP) – A pair of studies have found that Obamacare led to an increase in early-stage ovarian cancer detections and helped nearly erase racial differences in the timely treatment of a range of cancers.
The findings were presented Sunday and come as the administration of President Donald Trump is renewing its efforts to strike down the Affordable Care Act signed into law by his predecessor Barack Obama.
Both papers were presented the annual meeting of the American Society of Clinical Oncology in Chicago.
The study on ovarian cancer screening was led by Anna Jo Smith at the Johns Hopkins Department of Gynecology and Obstetrics in Baltimore.
“Having health insurance plays a major role in whether or not a woman has access to care providers who can monitor symptoms and act on those symptoms if necessary,” she said in a statement.
The five-year survival rate for women diagnosed with early-stage ovarian cancer is 75 percent, but the figure drops dramatically to 30 percent for those diagnosed at a later stage.
The ACA was signed into law on March 2010, and by 2016-17, some 12.7 million people were covered under the law.
The percentage of Americans who were uninsured dropped from 16 percent in 2010 to less than 12 percent by 2016.
The researchers used data from the National Cancer Database to look at the years before (2004-2009) and after (2011-2014) the passing of the ACA.
They looked at the stage of the diagnosis and the time to treatment for the 21 to 64 age group, and compared it to those 65 and older, which was used as a control group because they had access to publicly funded Medicare before and after.
They found that there was a relative gain of 1.7 percent in early-stage diagnosis and a 1.6 percent improvement in receiving treatment within 30 days.
While the difference may not sound very large, “For the 22,000 women diagnosed with ovarian cancer in the United States annually, it means that close to 400 more women could be diagnosed at an early, treatable stage,” the team said.
– Racial differences erased –
The second paper on Obamacare found that differences between whites and blacks in timely care “practically disappeared” following the passage of the law.
Two key provisions of the ACA were granting states permission to expand public funded Medicaid coverage to low-income citizens starting in 2014, and providing subsidies to those who could not afford to buy private insurance if they did not qualify for Medicaid.
The study looked at the records of 2.2 million people diagnosed with advanced cancers including non-small cell lung cancer, breast, urothelial, gastric and esophageal, colorectal, renal cell, prostate, and melanoma cancers.
It compared states which expanded Medicaid against those that did not as well as outcomes before and after in states which did expand.
“This gave us the opportunity to design a natural experiment,” quantitative scientist and co-author Blythe Adamson from Flatiron Health, which funded the study, told AFP.
Prior to Medicaid expansion, African American patients were 4.8 percentage points less likely to receive timely treatment as compared with white patients, the researchers wrote.
After the ACA was passed, 6.1 percent more blacks received timely treatment as well as 2.1 percent of whites, making the differences between the races statistically insignificant.
“To see such a strong effect that really eliminated this disparity in this particular setting among this group of patients was surprising, and we’re very excited to see this,” Amy J. Davidoff at the Yale School of Public Health told AFP.
Trump’s Justice Department announced in March an abrupt escalation in the administration’s push against Obamacare by siding with a Texas federal court ruling that declared the health care law unconstitutional.
That ruling is currently being appealed and the resulting impasse looks increasingly likely to end up in the Supreme Court — putting a politically radioactive issue center stage as the country moves towards the 2020 presidential election.