Effect of the Affordable Care Act on breast cancer presentation at a safety net hospital

2019 
Abstract Introduction The Affordable Care Act (ACA) mandated the expansion of Medicaid in order to increase access to health care services. We examined the effect of the ACA on breast cancer screening and diagnosis at a Los Angeles safety net hospital. Methods We performed a retrospective review of breast cancer patients treated at our institution. We compared two cohorts: patients diagnosed with breast cancer in the years 2011–2012 (pre-ACA) vs. 2015–2016 (post-ACA). Results There were no differences in number of screening mammograms performed, age at diagnosis, mammography-detected cancers, or clinical stage at diagnosis. There was a significant decrease in the number of patients who reported as self-pay (34% vs. 6%, p Conclusion In the 2-year period following ACA implementation, there was limited impact on breast cancer presentation at a safety-net hospital. Long-term follow-up across different healthcare systems is necessary to fully evaluate the global impact of the ACA on breast cancer care.
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