Medicaid cuts under ‘One Big Beautiful Bill’ could result in over 1 million missed cancer screenings

Medicaid cuts under the “One Big Beautiful Bill” Act passed by Congress last year could result in over 1 million missed cancer screenings, according to new research. 

President Donald Trump signed his signature legislation last July, extending key tax cuts while raising the debt ceiling by $5 trillion and reducing Medicaid spending by 12%. Researchers with the University of Chicago recently aimed to assess the impact of the changes on cancer care, sharing their findings Jan. 8 in JAMA Oncology. 

Over the first two years of implementation, they estimate about 7.5 million Medicaid enrollees eligible for cancer screenings will lose coverage. This includes nearly 406,000 missed mammograms, 680,000 colorectal screening tests and 67,000 lung cancer screenings. 

“Estimates do not account for interruptions in ongoing cancer treatment, suggesting our findings are conservative,” Sarah P. Shubeck, MD, MS, and Adrian Diaz, MD, MPH, with UChicago’s Department of Surgery, wrote Thursday. “Overall, these findings highlight the substantial and preventable morbidity and mortality that could result from coverage retrenchment and underscores how national policy may result in divergent and costly public health consequences across states,” they added later. 

The study’s authors reached their conclusions by building a model to estimate the impact of the reconciliation bill’s two major Medicaid changes: work requirements and eligibility reverifications every six months. They utilized data both from Arkansas’ implementation of Medicaid work requirements in 2018, along with the results after reverification requirements were eased during the COVID-19 pandemic. 

UChicago researchers estimated that missed screenings would result in 1,055 undetected breast cancers in the first two years of implementing the reconciliation bill. That’s alongside another 748 undetected colorectal and 538 lung cancers. Among these, 156 breast, 105 colon and 65 lung cancers are expected to surface at advanced stages. Projected missed screenings and subsequent cancer outcomes varied substantially by state, the authors added. 

“Rates of missed screenings per enrollee were generally lower in states without expanded Medicaid and those with smaller screening gaps between Medicaid-insured and uninsured individuals,” Shubeck and Diaz wrote. 

The study is limited, among other factors, by its focus on only three cancer types, with “overall oncologic consequences likely larger.” Republicans have charged that the legislation will help to root out fraud and abuse in the Medicaid program while granting states more flexibility and encouraging able-bodied adults to work.