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首页> 外文期刊>Journal of the advanced practitioner in oncology >Issues in Oncology: 2021 ASCO Annual Meeting Highlights for the Advanced Practitioner: The Advanced Practitioner Perspective: Study Finds Income Eligibility Limits for Medicaid May Be Associated With Worse Long-Term Survival Among Newly Diagnosed Patients With Cancer, By Jo Cavallo
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Issues in Oncology: 2021 ASCO Annual Meeting Highlights for the Advanced Practitioner: The Advanced Practitioner Perspective: Study Finds Income Eligibility Limits for Medicaid May Be Associated With Worse Long-Term Survival Among Newly Diagnosed Patients With Cancer, By Jo Cavallo

机译：Issues in Oncology: 2021 ASCO Annual Meeting Highlights for the Advanced Practitioner: The Advanced Practitioner Perspective: Study Finds Income Eligibility Limits for Medicaid May Be Associated With Worse Long-Term Survival Among Newly Diagnosed Patients With Cancer, By Jo Cavallo

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Reshma Jagsi, MD, DPhil, of the University of Michigan, and Narjust Duma, MD, of the University of Wisconsin Carbone Cancer Center, discuss the state of diversity in the hematology-oncology workforce, mechanisms that lead to inequities, promising interventions, and where the field should go next (Abstract 11000). The Advanced Practitioner Perspective: Before addressing the advanced practitioner perspective on this abstract, this piece will begin with a very brief review of Medicaid and how access varies by state. If you already have a good understanding of Medicaid, please skip the following section. Overview of Medicaid: All state Medicaid programs are not created equal. Medicaid is a health insurance program that is funded through a combination of federal and state dollars. It was originally developed in 1965 to provide health care for Americans who were unable to work. States don't have to participate, but they all do. Each state must meet the guidelines of the Centers for Medicare and Medicaid Services to qualify for federal funding, but they have significant leeway to implement restrictions as they see fit once they have met the federal requirements. In each state, access to the resources varies based on a host of factors, including income, age, number of household members, pregnancy, and presence of reduced abilities. With the passage of the Affordable Care Act (ACA), an attempt was made to make Medicaid requirements consistent between states. The benchmark for access to Medicaid through the ACA was 133% above the federal poverty level (FPL). Of note, the FPL varies by size of family. For example, under the ACA, an individual earning less than $17,130 would have access to Medicaid via the ACA's initial calculations. (The FPL for an individual earning an adjusted taxable income is approximately $12,880. FPL × 1.33.) This provision of the ACA was overturned by the Supreme Court, and the percentage above the poverty line providing access to Medicaid was left to individual states. For example, an individual in Alabama, which did not expand Medicaid to cover low-income adults outside certain parameters, is not eligible for Medicaid insurance if they make 0% over FPL—a low Medicaid income eligibility limit. In contrast, Arizona expanded access to Medicaid, for those who don't qualify for other programs, to people making less than 138% of FPL—a high Medicaid income eligibility limit. Advanced Practitioner Roles: This abstract presented at the ASCO Annual Meeting reports that more generous availability of Medicaid insurance translates into improved survival for cancer patients. What part do advanced practitioners play in improving these outcomes? One of the answers comes down to the difference between availability and access. In states that have an FPL criteria of 138%, there is greater availability to insurance and care.

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