A new study from University of Chicago Medicine projects that upcoming federal Medicaid changes could result in more than 1 million missed cancer screenings within two years of taking effect.
In a research letter published in JAMA Oncology, surgical oncologist Sarah Shubeck and Adrian Diaz, a surgical oncology fellow, used recent data and statistical modeling to project the downstream effects of proposed Medicaid work requirements and more frequent recertification rules outlined in the One Big Beautiful Bill from the administration of President Donald Trump.
Starting in January 2027, new federal rules will require many Medicaid recipients to prove they are working and recertify their eligibility more often. In practice, these new hurdles will make it more difficult for people to remain insured.
“These new requirements introduce administrative barriers that often mean paperwork or technical errors determine whether someone gets screened for cancer,” Shubeck said. “A particularly concerning aspect is that people who are disproportionately likely to lose coverage are exactly the people most likely to benefit from early cancer detection: younger adults and people from vulnerable social groups.”
Shubeck and Diaz estimate that within two years of the new rules taking effect, roughly 7.5 million adult Medicaid enrollees eligible for cancer screening would lose coverage, with the number rising above 10 million under the most drastic scenario modeled.
The researchers analyzed real-world data from across the United States, such as the previous work requirements in Arkansas and pandemic-era changes in Medicaid verification. The results showed that more than 1 million mammograms and screenings for colorectal and lung cancers may be missed nationwide within the first two years of the new restrictions. This could result in over 2,300 undetected cases of breast, colorectal and lung cancer—hundreds of which may be at more advanced and difficult-to-treat stages when finally discovered.
Even without accounting for potential treatment interruptions for already-diagnosed cancer patients, the model projects approximately 155 avoidable deaths from only these three types of cancer within two years of policy implementation.
“Early screening saves lives, and lost coverage means lost opportunities for detection,” Diaz said. “The consequences aren’t just numbers—they represent real families affected by avoidable disease and loss.”
The authors emphasized that the impact will vary widely across states, depending on factors like whether states expanded Medicaid under the Affordable Care Act, populations of screening-eligible adults, and differences in state safety net programs that help support cancer screening and treatment for people without insurance.
“This analysis highlights how policy changes like Medicaid cuts and restrictions can have profound and preventable negative effects on public health,” Diaz said. “The hope is to inform policymakers and the public about the stakes before these changes take effect.”
—This article was originally published on the Biological Sciences Division website.
