Abstract 80: Single Stage Direct-to-Implant Breast Reconstruction: A Comparison Between Sub-pectoral Versus Pre-pectoral Implant Placement

Abstract

BACKGROUND: Breast reconstruction is part of the complete care of the breast cancer patient, but insurance coverage remains a barrier to reconstruction, especially among those of lower socioeconomic status. Under the Affordable Care Act, states were given the option to expand Medicaid with federal assistance. As a result, 32 states (including DC) opted to expand Medicaid eligibility while 19 did not. Previous quasi-experimental studies took advantage of this unique state-specific policy implementation and found increased insurance coverage in expansion compared to nonexpansion states in the short-term. With longer-term data now available, we sought to study the effect of Medicaid expansion on changes in insurance coverage as well as specifically examine changes in breast reconstruction rates in expansion and nonexpansion states.