The model for the Affordable Care Act, the 2006 Massachusetts health care reform, was associated with increased resection rates and a reduced risk for emergency resection in patients with colorectal cancer, a study published in the Journal of Clinical Oncology has shown.1

Lack of insurance coverage has previously been linked to more advanced disease at presentation, more emergency admissions at time of colectomy, and reduced survival compared with patients with private insurance.

In 2006, Massachusetts enacted health care reform that provided health insurance to nearly all of its residents. Therefore, researchers sought to evaluate the impact of health insurance expansion on colorectal cancer care.

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For the study, investigators analyzed data from 17,499 patients with colorectal cancer with government-subsidized or self-pay (GSSP) or private insurance admitted to a hospital between 2001 and 2011 in Massachusetts and 144,253 from 3 control states.

Researchers found that the Massachusetts health care expansion was associated with 44% increased rate of resection of colorectal cancer compared with control states (odds ratio [OR], 1.44; 95% CI, 1.23-1.68; P <.001).

In addition, results showed that insurance expansion reduced the probability of emergency admission by 6.21 percentage points (95% CI, –11.88-–0.54; P =.032) and lower the probability of an elective admission by 8.13 percentage points (95% CI, 1.34-14.91; P =.019) vs control states.

The findings ultimately suggest that health insurance expansion may aid to improve access to care for patients with colorectal cancer.


1. Loehrer AP, Song Z, Haynes AB, Chang DC, Hutter MM, Mullen JT. Impact of health insurance expansion on the treatment of colorectal cancer. J Clin Oncol. 2016 Oct 3. doi: 10.1200/JCO.2016.68.5701. [Epub ahead of print]