The following article features coverage from the 2021 American Society of Clinical Oncology (ASCO) Annual Meeting. Click here to read more of Cancer Therapy Advisor‘s conference coverage.

Increased Medicaid eligibility is associated with a higher cancer survival rate, according to research being presented at the 2021 American Society of Clinical Oncology (ASCO) Annual Meeting.1

Medicaid income eligibility limits vary by state, investigator Jingxuan Zhao, MPH, an associate scientist at the American Cancer Society in Atlanta, Georgia, explained in a press presentation.

The 2014 Affordable Care Act allowed states to increase eligibility limits for non-elderly adults by up to 138% of the Federal Poverty Level (FPL), but not all states have expanded Medicaid eligibility to this degree.

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To determine whether Medicaid eligibility expansion predicts survival outcomes in the oncology setting, Zhao and colleagues analyzed data from 1,426,657 patients in the National Cancer Database. The patients, aged 18 to 64 years, were diagnosed with 1 of 17 common cancers between 2010 and 2013.

Medicaid eligibility by state was divided into 3 categories: 50% of the FPL or less, 51% to 137% of the FPL, and 138% of the FPL or greater. Follow-up was conducted for up to 8 years, and survival time was measured through the end of 2017.

In the overall cohort, 22% of patients were in the 50% or less group, 43.5% were in the 51% to 137% group, and 34.5% were in the 138% or higher group.

Patients living in states with lower eligibility limits had worse survival rates. This was true regardless of whether their cancer was diagnosed at a late or early stage.

As an example, among female patients with stage I-II breast cancer, the hazard ratios for death were 1.31 (95% CI, 1.18-1.46) in the 50% or less group and 1.17 (95% CI, 1.06-1.30) in the 51% to 137% group. Among female patients with stage III-IV breast cancer, the hazard ratios for death were 1.21 (95% CI, 1.10-1.33) in the 50% or less group and 1.13 (95% CI, 1.03-1.23) in the 51% to 137% group.

“To date, little has been known about the effects of Medicaid income eligibility limits on cancer outcomes,” Zhao said in a press release.2 “Our research provides strong evidence that state expansion of Medicaid is associated with better long-term survival among newly diagnosed cancer patients.”

Disclosures: One study author declared affiliations with a pharmaceutical company. Please see the original reference for a full list of authors’ disclosures. 

Read more of Cancer Therapy Advisor’s coverage of the 2021 ASCO Annual Meeting by visiting the conference page.


  1. Zhao J, Han X, Nogueira L, Jemal A, Yabroff K. Association of state Medicaid income eligibility limits and long-term survival after cancer diagnosis in the United States. J Clin Oncol 2021; 39(suppl 15; abstr 6512). doi:10.1200/JCO.2021.39.15_suppl.6512
  2. Patients with newly diagnosed cancer live longer in states with higher Medicaid income limits [press release]. Alexandria, VA: American Society of Clinical Oncology; May 19, 2021.