Children diagnosed with cancer at the time they are covered under Medicaid have similar survival rates to those who are privately insured, according to a new study. The article, “The Effect of Health Insurance on Childhood Cancer Survival in the United States,” published early online in CANCER, a peer-reviewed journal of the American Cancer Society, suggests that care under the government program may not be inferior.

However, the study also shows slight evidence for an increased risk of cancer death in children who are uninsured at diagnosis.

The research team, led by Kimberly Johnson of Washington University in St. Louis and Rohit Ojha of JPS Health Network in Fort Worth, examined 2007–2009 data on cancers diagnosed among children 15 and younger, contained in the Surveillance, Epidemiology, and End Results (SEER) cancer registry.

Among 8,219 individuals with childhood cancer (131 without insurance, 2,838 with Medicaid, and 4,297 with private insurance) who were followed for five years, average survival was 1.32 months shorter for uninsured children and 0.62 months shorter for children with Medicaid, when compared with those with private insurance. Children who were uninsured had a 26 percent higher risk of cancer death than those who were privately insured at diagnosis, whereas the risk for those with Medicaid was similar to those with private insurance at diagnosis.

“Overall, our results suggest largely similar survival for privately insured children and those with Medicaid at diagnosis, with slight evidence for an increased hazard of cancer death for children who were uninsured versus those who were privately insured at diagnosis,” the researchers write. “However, the number of uninsured children was very small, and thus this latter result may be due to chance and should be interpreted with caution.”

The researchers add that their finding is consistent with prior reports suggesting that children on Medicaid or their state’s Children’s Health Insurance Program (CHIP) have health care access comparable to that of children with private health insurance. Medicaid and CHIP provide a comprehensive set of benefits that include early and periodic screening, diagnostic and treatment; checkups; and physician and hospital visits.

Although one prior study reported worse health outcomes in some areas such as vision and dental health in children with Medicaid versus those with private insurance, Johnson and Ojha write that their data provides evidence showing that Medicaid coverage results in outcomes for childhood cancer similar to the outcomes resulting from private insurance.

“If our results are valid, then national or state health care policies that provide at least coverage with Medicaid for otherwise uninsured children may improve overall survival for children diagnosed with cancer,” they write.

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Effect of health insurance on child cancer prognosis

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