Expanding health coverage could mean fewer cancer deaths in Oklahoma

Cancer has touched almost every family in the United States — nearly one in three people will be diagnosed with cancer in their lifetime. Despite the many advances in cancer treatment, Oklahoma is falling behind. While the national cancer death rate has steadily decreased, Oklahoma has one of the highest rates in the country, and it has been increasing over the past 10 years.

To combat this trend, Oklahoma should follow the path of 37 other states and expand health care coverage under the Affordable Care Act.  The Legislature had the opportunity to expand life-saving health care coverage this legislative session but chose to stall, likely leading to a ballot initiative that will allow voters to weigh in on Medicaid expansion in 2020. Expansion is critical to reversing trends on a number of health-related issues, including reducing the number of people in Oklahoma who are lost to cancer. Providing access to health care allows physicians to detect cancer earlier when chances of survival are higher and costs are lower, granting more Oklahomans the life-saving treatment they need.

Expansion states diagnose cancer when chances of survival are higher

Screenings for cancer are critical for reducing cancer deaths. Those who avoid seeing a doctor because they cannot afford it are not likely to be screened for cancer, so by the time they are diagnosed the consequences are dire. Think of cancer like a weed and just like a weed–the earlier cancer is caught and contained, the easier it is to remove. Survivability of cancer is measured in five-year increments. Patients who are diagnosed with early-stage cancer can be 3 to 10 times more likely to survive for five years than those with late-stage cancer. For instance, with colorectal cancer, 90 percent of people with early-stage will survive for five years compared to only 14 percent with late-stage. Early diagnosis is the difference between life and death for many people with cancer.

Early detection of cancer through screenings is critical and often only possible with health coverage. States that have expanded coverage have seen their screening rates improve. Following expansion in Kentucky, mammogram rates went up and the colonoscopy rate more than doubled among those with Medicaid, and death from colorectal cancer decreased 27 percent. Similarly, the state saw an increase in the diagnosis of early stage breast cancer as well as the quality of care. Consider another state, Louisiana, which has averted almost 12,000 cases of colorectal cancer since expanding coverage in 2014. As these states outcomes have improved as a result of expansion, Oklahomans have continued to unnecessarily suffer and die from treatable conditions because of the legislature’s resistance to expanding coverage.

Expanded coverage removes financial barriers to care for cancer patients

Coverage helps people afford and access care. On top of the emotional and physical costs, a cancer diagnosis carries a serious financial burden. Access to health insurance can ease financial concerns that families are carrying on top dealing with a cancer diagnosis. States with expanded coverage saw the number of survivors who could not afford to see a physician drop by almost two-thirds.

Expanding coverage provides financial relief and protections for those with a cancer diagnosis who are least likely to be able to afford the necessary treatment. The average cancer treatment costs $150,000 and people diagnosed with cancer are more than twice as likely to go bankrupt compared to those without a cancer diagnosis. The consequences of this are more than financial — cancer patients who declare bankruptcy have a 79 percent higher risk of dying compared to those who don’t declare bankruptcy. Survivors also need ongoing medical care even after they are in remission including costly scans to catch the cancer early in the event that it returns. Affordable health coverage can provide financial relief and protection for families that are already dealing with this devastating diagnosis.

Expanding coverage is critical in the fight against cancer deaths

There were more than 19,000 estimated cancer diagnoses in Oklahoma in 2018, and the lack of coverage has left Oklahoma in the bottom 10 states for cancer outcomes. We must do more to combat this problem. Expanding coverage has clear benefits that would help catch cancer earlier and prevent patients’ financial ruin. It is time to bring our tax dollars home and expand coverage for Oklahomans.


Daniel Huff is a Spring 2019 Public Policy Intern at OK Policy. He is currently pursuing an M.D. and a Masters in Public Health at the University of Oklahoma.

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