ACA Medicaid expansion eliminated racial disparities in timely cancer treatment

A summary about press coverage of results from a research study from Flatiron Health and Yale, presented at the ASCO 2019 Plenary Session.

I led a research study learning that the Affordable Care Act (ACA) Medicaid expansion was associated with reduction in racial disparity in timely treatment of advanced cancer.

Results were reported in the The Washington Post, Wall Street Journal, New York Times, Associated Press, CNN, US News and World Report, Newsweek, Financial Times, Essence Magazine, Agence France-Presse, The Post and Courier, Journalists Resource, The Root, Yale News, Washington Post PowerPost, The Skimm, The Week, and NPR News.

Health and oncology-specific press coverage included STAT, The Cancer Letter, Nature Reviews Clinical Oncology, news@JAMA, MedPage Today, Medscape, OncLive, AJMC Newsroom, Kaiser Health Network, Becker’s Hospital Review, The ASCO Post, ASCO News Release, Pink Sheet, SurvivorNet, Cancer.Net, Targeted Oncology, Healio, Cancer Therapy Advisor, Cancer Health, California Health Care Foundation, National Coalition for Cancer Survivorship, FierceHealthcare, AXIOS Vitals, GenomeWeb, Health Payer Intelligence, and Physicians Weekly.

The Plenary Session

Of more than 7,000 abstracts submitted to the ASCO 2019 Annual Meeting, my first-author study was selected for the number one podium presentation in the largest and most influential session, called the Plenary. Tens of thousands of oncologists and cancer researchers attended the Plenary session and watched the live stream from overflow rooms.

Our research team sat in the center of the front row before the Plenary session began. Dr. Amy Davidoff from Yale presented the results on behalf of our team.

It was an honor for me to lead this @flatironhealth @YaleCOPPER research study, have Dr. Amy Davidoff present on my behalf at #ASC019, and have @yzafar bring many of 40k people to tears in his discussion of its impact. https://t.co/Zbri6lyoyN pic.twitter.com/eILd9QVDGt

— Dr. Blythe Adamson (@DrBlytheAdamson) June 2, 2019

#ASCO19 audience members live tweeted reactions to each slide.

Sitting in this room with nearly 10,000 people, who are all prioritizing attending #ASCO19 with the single goal of improving #cancercare to be truly moving.#plenarysession pic.twitter.com/FR5kr3RghJ

— Dr. Miriam Knoll (@MKnoll_MD) June 2, 2019

Tanya Elshahawi Taffurelli designed beautiful visualizations to tell a story with the data.

Dear President @BarackObama
Today marks the plenary session of the largest cancer meeting of the year.

40000 attendees join me in celebrating the erasure of racial disparities in timely access to treatment through the Affordable Care Act.

Thank you, sir.#asco19 pic.twitter.com/UtkPHuA4VC

— Mark Lewis, MD, FASCO (@marklewismd) June 2, 2019

No better way to understand the size and scope of #asco19 than to watch the plenary session exit. pic.twitter.com/e0lyaehn7v

— Mandy Davis Aitken (@davisa20) June 2, 2019

After a press briefing, Dr. Davidoff and I recorded this video with Medscape describing a few elements of the study.

News reached government leaders who can use the evidence to design healthcare policy

The news blew up on Twitter. It started with a Washington Post tweet to 13 million followers.

Andy Slavitt, who ran the Center for Medicare and Medicaid Services (CMS) from 2015-2017, tweeted the Washington Post article. Then Senator Dianne Feinstein tweeted the STAT article. Former FDA Commissioner Robert Califf said “Not surprising. Hopefully, more states will catch on & act on behalf of their people.”

Andy Slavitt

BREAKING: Great news. Since the ACA, African American disparity in advanced cancer diagnosis & treatment has almost entirely caught up to whites where Medicaid has expanded, a near 5% improvement.

There is a right direction. Support those pushing for it. https://t.co/IaJfWHknll

— Andy Slavitt 🇺🇦 (@ASlavitt) June 2, 2019

The news soon reached government leaders, who tweeted it to their constituents.

Senator Feinstein

Thanks to the Affordable Care Act, the disparity in access to cancer care for white and African-American patients has almost been eliminated. Further proof that the ACA is saving lives and improving care for millions of Americans. https://t.co/EeZ0qzjWwQ

— Senator Dianne Feinstein (@SenFeinstein) June 3, 2019

U.S. Representatives

New research shows that fewer Americans, especially women and people of color, are dying of cancer because of expanded health coverage through the ACA.

Healthcare saves lives.

That’s why we’re fighting so hard to make sure every American has access to quality care. https://t.co/rSelu2fEBO

— Adam Schiff (@AdamSchiff) June 3, 2019

The Affordable Care Act helped reduce inequity within our country.

But the Trump admin and the GOP have continuously worked to undermine the law and take away health coverage from American families.

Democrats will not stop fighting to #ProtectOurCare. https://t.co/ZkGwJCG4oU

— Senate Democrats (@SenateDems) June 3, 2019

Study Team

This study was only possible because of a strong and dedicated research team. The abstract was coauthored with investigators from Flatiron Health Aaron Cohen, Melissa Estevez, Kelly Magee, Erin Williams, and Neal Meropol. Our team also included investigators Cary Gross and Amy Davidoff from the Yale COPPER Center.

Citation

Adamson BJS, Cohen A, Estevez M, Magee K, Williams E, Gross C, Meropol N, Davidoff A. ACA and Medicaid Expansion Impact on Racial Disparity in Time to Cancer Treatment. Journal of Clinical Oncology 37, 2019 (suppl; abstr LBA1).

Acknowledgements

I must thank David Cirilli, Tanya Elshahawi Taffurelli, Samantha Azaria, Julia Saiz-Shimosato, Pooja Shaw, Sharon Moon, Mariana Hernandez, Laini Talcott, Lesley Plotkin, Somnath Sarkar, Carrie Bennette, Melisa Tucker, Aracelis Torres, Brian Segal, Ken Carson, Jenny Edelson, and Kara Kubarych for help preparing for this ASCO 2019 Plenary Session.

Header image credit: Tanya Elshahawi Taffurelli, Flatiron Health