The Affordable Care Act: Mammography and Socioeconomic Disparity

The likelihood of a Medicare beneficiary’s foregoing mammography for socioeconomic reasons is lower than before the Affordable Care Act (ACA) was implemented, according to an article published in Cancer.¹

To determine whether ACA implementation affected mammography and colonoscopy disparity by socioeconomic status, researchers compared the rates of these procedures in the 2-year period preceding ACA implementation with the 2-year period thereafter. Medicare beneficiaries were grouped into 2 sets of 4 quartiles: the first by income, and the second by education.

Of 862,267 women included in the mammography sample, income- and education- based disparity decreased in every measured category in the 2-year period after the ACA was implemented. Compared to the first quartile, individuals in the fourth quartile for income had an odds ratio increase of 0.87 to 0.94; for education, 0.76 to 0.86.

No significant changes were found for colonoscopy between the measured time points; the authors speculated, however, that factors other than cost, such as perceived discomfort, may explain this finding.

The authors concluded, despite the expected repeal of the ACA in 2017, that future studies should “examine the ACA’s impact in other populations, including newly insured individuals.”

Reference

1. Cooper GS, Kou TD, Dor A, Koroukian SM, Schluchter MD. Cancer preventive services, socioeconomic status, and the Affordable Care Act. Cancer. 2017 Jan 9. doi: 10.1002/cncr.30476 [Epub ahead of print]