TennCare’s Big Cuts In 2005 May Have Delayed Breast Cancer Diagnoses, Study Suggests

A major cut in TennCare enrollment more than a decade ago has been linked to delays in diagnosing breast cancer, according to findings published this week in the journal Cancer. 

In the study, researchers compared breast cancer data in Tennessee before and after 2005 — the year when the state’s government-subsidized health care program, TennCare, decided to address serious financial problems by dropping 170,000 people. 

They found that for women across Tennessee, the percentage of breast cancer cases diagnosed at a late stage, rather than early, went up after 2005. But it increased even more for women who lived in low-income zip codes, where people were more likely to have lost health insurance. 

To be clear on the limitations of the study: It only identifies a correlation between time of diagnosis and zip code, which is not the same as looking at what happened to individual patients after they lost Medicaid. An analysis of the study notes that, with this method, “it is impossible to assess the direct effects of Medicaid disenrollment on individual patients; instead, the analysis uses ecological data to infer negative effects.”

Still, researchers say their work provides evidence of the potential downsides of shrinking state Medicaid programs like TennCare.

“These negative health consequences should be considered by policymakers who weigh the costs and benefits of implementing or discontinuing expanded Medicaid coverage under the Patient Protection and Affordable Care Act,” they write.