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Kentucky and Arkansan residents proved to be the big surprise winners in the Affordable Care Act, with both states taking Medicaid expansion and seeing the largest decrease in their uninsured populations among the states. And in Kentucky, that coverage expansion improved breast cancer care, and by extension health care in general, according to new research.
More evidence is in for the effectiveness of the Affordable Care Act in improving certain types of care, with new data showing that women with breast cancer, ages 20 to 64, in Kentucky, have better outcomes and lower utilization of invasive operations.
[…] In Kentucky, one of the Medicaid expansion states, a University of Louisville study of breast cancer care has found a connection between Medicaid expansion and improved quality of breast cancer care, including an increase in the diagnosis of an early stage in the disease and greater utilization of breast-conserving surgery, instead of more invasive operations such as mastectomy. […]
The researchers chose breast cancer as a measure of Medicaid expansion's impact because, along with colon cancer, it's common. The data showed that from 2011 to 2013, 635,547 screening mammograms were performed in the state; that number increased to 680,418 from 2014 to 2016. In 2011 alone, 208,600 screening mammograms were performed versus 234,315 in 2016. The number of screening mammograms covered by Medicaid increased from 5.6 percent before expansion to 14.7 percent afterward, and the number of women who had screening mammograms and were uninsured declined almost tenfold, from 0.53 percent before to 0.05 percent after expansion.
Along with that screening came early detection. "Early stage (Stage I-II) breast cancers accounted for 64.5 percent of the diagnoses in 2011-2013, as opposed to 66.7 percent in 2014-2016. Late-stage (III-IV) cancers comprised 15 percent versus 12.9 percent in the same time frame." That's enough to be statistically significant, and the early detection allowed for early, less drastic interventions. That helps account for the 6 percent decline—from 50.5 to 44.5 percent—in mastectomies. Which is great for Kentucky.
Or was, until Republican Matt Bevin hit the governor's chair and started systematically dismantling the state's Obamacare program, KYnect. That destruction includes imposing work requirements on Medicaid recipients specifically designed to reduce the Medicaid enrolled population by 100,000. Like, that is his goal: kick 100,000 people out of care. Because health care doesn't matter, science doesn't matter, and women's lives really don't matter. He's a Republican, after all.