Medicaid Expansion Linked to Improved Cancer Outcomes Among Older Adults Living in Low-Income Communities, Study Finds

• Medicaid expansion linked to earlier cancer diagnoses and improved survival
• Greatest benefits seen among older adults in low-income and underserved communities
• Benefits seen among older adults despite not being targeted by expansion
  

ATLANTA, September 15, 2026 - Medicaid expansion under the Affordable Care Act was designed to benefit adults younger than 65. However, a new study led by researchers at the American Cancer Society (ACS) suggests the policy may also benefit older adults with cancer. The findings, published today in JNCCN-Journal of the National Comprehensive Cancer Network, found Medicaid expansion increased Medicaid coverage, earlier-stage cancer diagnoses, and improved survival among adults age 65 and older living in low-income communities.

"Most research on Medicaid expansion has focused on younger adults, but many older adults with cancer still face financial barriers to care," said Kewei Sylvia Shi, MPH, associate scientist, health services research at the American Cancer Society, and lead author of the study. "Our findings suggest Medicaid expansion is helping improve access to coverage and cancer care for low-income older adults, even though they were not the primary population targeted by the policy."

While adults age 65 and older are generally covered through Medicare, some also qualify for Medicaid, which can help cover premiums, out-of-pocket expenses, transportation, long-term care, and other services not fully covered by Medicare.

Researchers analyzed National Cancer Database data from more than 1.46 million adults age 65 and older living in low-income communities who were newly diagnosed with cancer between 2010 and 2021. Investigators compared outcomes before and after Medicaid expansion among patients living in expansion and non-expansion states.

Researchers found patients in expansion states experienced greater increases in coverage and smaller declines in early-stage cancer diagnoses compared with patients in non-expansion states. In addition, two-year survival following diagnosis improved more in expansion states than in non-expansion states. The benefits were strongest among groups that often face greater barriers to care, including non-Hispanic Black patients, residents of non-metropolitan communities, patients with multiple chronic conditions, and those diagnosed with advanced-stage cancers.

The Medicaid expansion-associated improvements were particularly notable for earlier-stage diagnoses of lung cancer and head and neck cancer and for improved survival among patients with stage IV cancers, and for lung, kidney, and bladder cancers.

"While the improvements observed at the individual level were modest, they could translate into meaningful benefits across the large population of older adults diagnosed with cancer each year," added Shi. "The findings highlight how policies that expand access to health insurance coverage may help reduce barriers to care and improve outcomes among vulnerable older adults with cancer."

"This study is further evidence that Medicaid expansion saves lives," said Lisa Lacasse, president of the American Cancer Society Cancer Action Network (ACS CAN), the advocacy affiliate of ACS. "The cuts made to Medicaid by Congress are putting this lifesaving coverage at risk for cancer patients and survivors across the country. ACS CAN urges Congress, governors and state lawmakers to do all they can to protect eligible individuals' access to comprehensive, affordable health insurance coverage through Medicaid."

Other ACS researchers contributing to this study include Dr. Robin Yabroff and senior author Dr. Xuesong Han.

Additional ACS Resources:

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About the American Cancer Society
The American Cancer Society is a leading cancer-fighting organization with a vision to end cancer as we know it, for everyone. For more than 110 years, we have been improving the lives of people with cancer and their families as the only organization combating cancer through advocacy, research, and patient support. We are committed to ensuring everyone has an opportunity to prevent, detect, treat, and survive cancer. To learn more, visit cancer.org or call our 24/7 helpline at 1-800-227-2345. Connect with us on Facebook, X, and Instagram.