Obamacare Gave More Breast Cancer Survivors Access to Breast Reconstruction

A new study was presented at an online meeting of the American Society of Breast Surgeons on April 29 found that breast reconstruction disparities improved dramatically with Medicaid expansion under the Affordable Care Act. Findings also revealed that there were significant increases in breast reconstruction among non-Hispanic Black women, sometimes even achieving higher rates than surgeries of non-Hispanic white women. According to the meeting, the study also found significant growth in reconstruction rates among women with lower income and education levels, during the same time period.

“The timeline for broadening Medicaid qualification criteria, providing coverage to those who had previously been uninsured, corresponded directly with the timeline for mitigation of breast reconstruction disparities in race, income and education,” Sharon Lum, MD, Loma Linda University Health, lead researcher of the study said in a news release.

Lum also stated that the rate of breast reconstruction following a mastectomy (breast removal), and interventions consistent with high-quality care, had been consistently lower among Black women than white women, in previous years. According to the study, 1,196,859 breast cancer patients, age 40 and older, in the National Cancer Database who underwent a mastectomy with or without reconstruction from 2010 to 2017 were examined. Lum noted that convergence of reconstruction utilization for the lowest education and income groups similarly coincided with Medicaid expansion in some states.

Health Day News pointed out that research presented at meetings is typically considered preliminary until it is published in a peer-reviewed journal. Additionally, the American Cancer Society provides additional insight about breast reconstruction, beyond insurance coverage concerns.

Medical history and overall health, which could affect healing, were just two other mentioned factors. However, the size and location of the cancer, breast size, extent of the breast cancer surgery, treatment needs, tissue available of the breast cancer survivor, desired recovery time, and willingness to undergo more than one surgery are all variables when breast reconstruction is considered.