ASO Author Reflections: Despite Medicaid Expansion, Large Disparities in Breast Reconstruction Persist

Abstract

It has been recognized for many years that disparities in the use of breast reconstruction exist based on race, income, education, health insurance, geographic region, and whether the patient is treated at an academic medical center. The Affordable Care Act (ACA) sought to address some of these disparities by expanding Medicaid coverage to patients at or below 138% of the federal poverty limit. This has led to markedly reduced numbers of uninsured patients in the states that participated in the program, and also has resulted in better access to screening and prevention practices, reduced infant mortality, better trauma care, and reduced late-stage presentation of breast cancer. It has not been known, however, whether this has led to a decrease in the disparities regarding breast reconstruction.