Association for Public Policy Analysis & Management

Over the 2014-2016 time period the Affordable Care Act dramatically reduced the rate of uninsurance and underinsurance in the United states. In this study we estimate the effects of these coverage increases on cancer detection among the near-elderly. Using SEER data, we estimate that the Affordable Care Act increased cancer detection among the near-elderly by approximately 40%. We find large effects of the Affordable Care Act coverage expansions on both cancers with and without routine screening tests and that 66% of the newly detected cancers are early and middle stage cancers. Additionally, the empirical strategy used to identify the effects of the Affordable Care Act on cancer detection also functions as an implicit test of the coverage and underinsurance mechanisms to explain Medicare’s effects on health care utilization and health outcomes, in the prior literature. Our results highlight the importance of the Affordable Care Act and health insurance coverage generally for disease detection.