The Affordable Care Act (ACA), fully implemented in 2014, introduced reforms to Medicaid and the Children's Health Insurance Program (CHIP), aiming to enhance health care access for vulnerable populations. Key provisions that can influence health outcomes in adolescents and young adults (AYAs) with blood cancers include Medicaid expansion, which covers adults with income less than or equal to 138% of the federal poverty level based on modified adjusted gross income (MAGI), streamlined eligibility and enrollment processes, CHIP and Medicaid integration, and dependent coverage reform. Non-MAGI eligibility pathways based on age, disability, or waiver programs provide alternative routes for Medicaid coverage. By improving insurance coverage, providing affordable care and financial protection, and addressing health-related social needs such as transportation to care, Medicaid expansion has the potential to mitigate outcome disparities along the continuum of AYA blood cancer care. However, challenges persist due to coverage gaps in nonexpansion states, complexities in administrative processes to maintain continuous coverage, and barriers to accessing specialists for complex, AYA-focused multidisciplinary cancer care. The ending of the COVID-19 public health emergency's Medicaid Continuous Enrollment Provision has disrupted coverage for many AYAs. Given limited research evaluating the impact of the ACA on AYA blood cancer outcomes, more evidence is needed to guide future policies tailored to this vulnerable population. Despite encouraging progress following the ACA, continued collaborative efforts between policymakers, health care providers, patient advocates, and researchers are essential for identifying targeted strategies to ensure continuous and affordable coverage, access to specialized and coordinated care, and fewer disparities in AYA blood cancer outcomes.

1.
Corallo
B
,
Moreno
S.
Analysis of national trends in Medicaid and CHIP enrollment during the COVID-19 pandemic
.
KFF
. Accessed
2
April
2024
. https://www.kff.org/coronavirus-covid-19/issue-brief/analysis-of-recent-national-trends-in-medicaid-and-chip-enrollment/.
2.
KFF
. Health insurance coverage of children
0
-
18
. Accessed
10
July
2024
. https://www.kff.org/other/state-indicator/children-0-18/.
3.
Brooks
T
,
Roygardner
L
,
Artiga
S
,
Pham
O
,
Dolan
,
R.
Medicaid and CHIP eligibility, enrollment, and cost sharing policies as of January 2020: findings from a 50-state survey
. KFF. Accessed
2
April
2024
. https://www.kff.org/coronavirus-covid-19/report/medicaid-and-chip-eligibility-enrollment-and-cost-sharing-policies-as-of-january-2020-findings-from-a-50-state-survey/.
4.
MACPAC
. Medicaid expansion to the new adult group. Accessed
2
April
2024
. https://www.macpac.gov/subtopic/medicaid-expansion/.
5.
Ross
DC
,
Marks
C.
Challenges of providing health coverage for children and parents in a recession: a 50 state update on eligibility rules, enrollment and renewal procedures, and cost-sharing practices in Medicaid and SCHIP in 2009
. Kaiser Commission on Medicaid and the Uninsured. Accessed
10
July
2024
. https://www.kff.org/wp-content/uploads/2013/01/7855.pdf.
6.
KFF
. Medicaid and CHIP income eligibility limits for children as a percent of the federal poverty level. Accessed
3
April
2024
. https://www.kff.org/affordable-care-act/state-indicator/medicaid-and-chip-income-eligibility-limits-for-children-as-a-percent-of-the-federal-poverty-level/.
7.
Medicaid
. March 2024 Medicaid and CHIP enrollment data highlights. Accessed
6
July
2024
. https://www.medicaid.gov/medicaid/program-information/medicaid-and-chip-enrollment-data/report-highlights/index.html.
8.
Hudson
JL
,
Moriya
AS
.
The role of marketplace policy on welcome mat effects for children eligible for Medicaid or the Children's Health Insurance Program
.
Inquiry
. January-December
2020
;
57
:46958020952920.
9.
Ji
X
,
Castellino
SM
,
Mertens
AC
, et al.
Association of Medicaid expansion with cancer stage and disparities in newly diagnosed young adults
.
J Natl Cancer Inst
.
2021
;
113
(
12
):
1723
-
1732
.
10.
KFF
. Status of state Medicaid expansion decisions: interactive map. Accessed
18
April
2024
. https://www.kff.org/affordable-care-act/issue-brief/status-of-state-medicaid-expansion-decisions-interactive-map/.
11.
KFF
. Medicaid income eligibility limits for adults as a percent of the federal poverty level. Accessed
3
April
2024
. https://www.kff.org/affordable-care-act/state-indicator/medicaid-income-eligibility-limits-for-adults-as-a-percent-of-the-federal-poverty-level/.
12.
KFF
. State adoption of major optional pathways to full Medicaid eligibility based on old age or disability. Accessed
2
April
2024
. https://www.kff.org/other/state-indicator/state-adoption-of-major-optional-pathways-to-full-medicaid-eligibility-based-on-old-age-or-disability/.
13.
KFF
. Medicaid waiver tracker: approved and pending Section 1115 waivers by state. Accessed
2
April
2024
. https://www.kff.org/medicaid/issue-brief/medicaid-waiver-tracker-approved-and-pending-section-1115-waivers-by-state/.
14.
Special Needs Alliance
. The Katie Beckett difference. Accessed
7
July
2024
. https://www.specialneedsalliance.org/blog/the-katie-beckett-difference/.
15.
Medicaid
. Mandatory and optional Medicaid benefits. Accessed
24
April
2024
. https://www.medicaid.gov/medicaid/benefits/mandatory-optional-medicaid-benefits/index.html.
16.
MACPAC
. Overview of the Affordable Care Act and Medicaid. Accessed
3
April
2024
. https://www.macpac.gov/subtopic/overview-of-the-affordable-care-act-and-medicaid/.
17.
Ndumele
CD
,
Schpero
WL
,
Trivedi
AN
.
Medicaid expansion and health plan quality in Medicaid managed care
.
Health Serv Res
.
2018
;
53
(
suppl 1
):
2821
-
2838
.
18.
MACPAC
. Key CHIP design features. Accessed
3
April
2024
. https://www.macpac.gov/subtopic/key-design-features/.
19.
Ji
X
,
Hu
X
,
Castellino
SM
,
Mertens
AC
,
Yabroff
KR
,
Han
X.
Narrowing insurance disparities among children and adolescents with cancer following the Affordable Care Act
.
JNCI Cancer Spectr
.
2022
;
6
(
1
):
pkac006
.
20.
Guth
M
,
Ammula
M
,
Hinton
E.
Understanding the impact of Medicaid premiums and cost-sharing: updated evidence from the literature and Section 1115 waivers
.
KFF
. Accessed
24
April
2024
. https://www.kff.org/medicaid/issue-brief/understanding-the-impact-of-medicaid-premiums-cost-sharing-updated-evidence-from-the-literature-and-section-1115-waivers/.
21.
Janardan
SK
,
Miller
TP
.
Adolescents and young adults (AYAs) vs pediatric patients: survival, risks, and barriers to enrollment
.
Hematology Am Soc Hematol Educ Program
.
2023
;
2023
(
1
):
581
-
586
.
22.
Kahn
JM
,
Kelly
KM
,
Pei
Q
, et al.
Survival by race and ethnicity in pediatric and adolescent patients with Hodgkin lymphoma: a Children's Oncology Group Study
.
J Clin Oncol
.
2019
;
37
(
32
):
3009
-
3017
.
23.
Wolfson
JA
,
Kenzik
KM
,
Foxworthy
B
, et al.
Understanding causes of inferior outcomes in adolescents and young adults with cancer
.
J Natl Compr Canc Netw
.
2023
;
21
(
8
):
881
-
888
.
24.
Crotty
K
,
Lee
M
,
Treiman
K
, et al.
Health insurance, blood cancer, and outcomes: a literature review
.
Am J Manag Care
.
2021
;
27
(
6 spec no
):
SP241
-
SP244
.
25.
Zhao
J
,
Mao
Z
,
Fedewa
SA
, et al.
The Affordable Care Act and access to care across the cancer control continuum: a review at 10 years
.
CA Cancer J Clin
.
2020
;
70
(
3
):
165
-
181
.
26.
Hu
X
,
Yang
NN
,
Fan
Q
,
Yabroff
KR
,
Han
X.
Health insurance coverage among incident cancer cases from population-based cancer registries in 49 US states, 2010-2019
.
Health Affairs Scholar
.
2024
;
2
(
1
):
qxad083
.
27.
Han
X
,
Zhao
J
,
Yabroff
KR
,
Johnson
CJ
,
Jemal
A.
Association between Medicaid expansion under the Affordable Care Act and survival among newly diagnosed cancer patients
.
J Natl Cancer Inst
.
2022
;
114
(
8
):
1176
-
1185
.
28.
Barnes
JM
,
Barker
AR
,
King
AA
,
Johnson
KJ
.
Association of Medicaid expansion with insurance coverage among children with cancer
.
JAMA Pediatr
.
2020
;
174
(
6
):
581
-
591
.
29.
Ji
X
,
Shi
KS
,
Mertens
AC
, et al.
Survival in young adults with cancer is associated with Medicaid expansion through the Affordable Care Act
.
J Clin Oncol
.
2023
;
41
(
10
):
1909
-
1920
.
30.
Ji
X
,
Shi
KS
,
Ruddy
KJ
, et al.
Medicaid expansion is associated with treatment receipt, timeliness, and outcomes among young adults with breast cancer
.
JNCI Cancer Spectr
.
2023
;
7
(
5
):
pkad067
.
31.
Su
CT
,
Okullo
D
,
Hingtgen
S
,
Levine
DA
,
Goold
SD
.
Affordable Care Act and cancer survivors' financial barriers to care: analysis of the National Health Interview Survey, 2009-2018
.
JCO Oncol Pract
.
2021
;
17
(
10
):
e1603
-
e1613
.
32.
Himmelstein
G.
Effect of the Affordable Care Act's Medicaid expansions on food security, 2010-2016
.
Am J Public Health
.
2019
;
109
(
9
):
1243
-
1248
.
33.
Stewart
KA
,
Bradley
KWV
,
Zickafoose
JS
,
Hildrich
R
,
Ireys
HT
,
Brown
RS
.
Care coordination for children with special needs in Medicaid: lessons from Medicare
.
Am J Manag Care
.
2018
;
24
(
4
):
197
-
202
. Accessed
24
April
2024
. https://www.ajmc.com/view/care-coordination-for-children-with-special-needs-in-Medicaid-lessons-from-medicare.
34.
Barnes
JM
,
Yabroff
KR
,
Chino
F.
Unwinding of Medicaid continuous enrollment exposes millions to disrupted care—“Be Kind, Rewind
.”
JAMA Oncol
.
2024
;
10
(
2
):
157
-
158
.
35.
KFF
. Medicaid enrollment and unwinding tracker. Accessed
10
July
2024
. https://www.kff.org/medicaid/issue-brief/medicaid-enrollment-and-unwinding-tracker/.
36.
Yabroff
KR
,
Reeder-Hayes
K
,
Zhao
J
, et al.
Health insurance coverage disruptions and cancer care and outcomes: systematic review of published research
.
J Natl Cancer Inst
.
2020
;
112
(
7
):
671
-
687
.
37.
Ji
X
,
Zhang
EX
,
Bai
S
, et al.
Health insurance continuity and survival among children, adolescents, and young adults with blood cancer: an analysis based on SEER-Medicaid data
.
J Clin Oncol
.
2023
;
41
(
suppl 16
):
6504
.
38.
KFF
. Total Medicaid MCO enrollment. Accessed
18
April
2024
. https://www.kff.org/other/state-indicator/total-medicaid-mco-enrollment/.
39.
Leukemia and Lymphoma Society
. Managing your cancer. Accessed
16
May
2024
. https://www.lls.org/managing-your-cancer/finances-and-insurance-coverage/affordable-care-act-aca.
40.
Medicare Learning Network
. Health equity services in the 2024 physician fee schedule final rule. Accessed
3
September
2024
. https://www.cms.gov/files/document/mln9201074-health-equity-services-2024-physician-fee-schedule-final-rule.pdf-0.
You do not currently have access to this content.