ASO Author Reflections: The Challenge of Achieving High-Quality, Equitable Care for Pancreatic Cancer: Might Medicaid Expansion Be a Piece of the Puzzle?

Abstract

It has been widely documented that sociodemographicbased disparities in cancer outcomes are largely driven by inequitable access to healthcare. Socioeconomic deprivation is estimated to be responsible for 22% of excess allcancer mortality, with widening education and income inequalities in mortality and lower survival in more deprived neighborhoods and among most ethnic-minority groups. Disparities in access to care for pancreatic cancer have been noted across the cancer care continuum, including diagnosis at a later stage, decreased referrals to specialized oncologic care, and inequitable recommendation and receipt of therapies, including curative-intent surgical resection. Health equity was one of the main goals of the Affordable Care Act. Medicaid Expansion, which allows for expanded Medicaid eligibility to adults with incomes at or below 138% of the federal poverty limit, has been implemented by 36 states. Medicaid expansion has been shown to be associated with improved cancer screening and utilization of surgery in some cancers; however, its impact on the delivery of pancreatic cancer care was not yet known and this was the focus of our study. PRESENT