A new study projects millions of Medicaid recipients could lose coverage under upcoming eligibility changes.
Researchers estimate the changes could lead to more than 1 million missed cancer screenings within two years.
The study suggests delayed screenings may result in more advanced cancer diagnoses and preventable deaths.
Proposed changes to Medicaid eligibility rules could have major ripple effects on cancer screening rates across the United States, according to new research from the University of Chicago published in JAMA Network.
The analysis looked at how new federal requirements — including work mandates and more frequent eligibility recertification — may affect access to preventive healthcare services like mammograms, colorectal screenings, and lung cancer screenings.
Researchers say these administrative changes could make it harder for some people to stay insured, even if they still qualify for Medicaid coverage.
“These new requirements introduce administrative barriers that often mean paperwork or technical errors determine whether someone gets screened for cancer,” researcher Sarah Shubeck, M.D., M.S., said in a news release.
“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.”
The study
The study focused on policy changes included in the 2025 federal budget legislation that are expected to take effect beginning in 2027.
Researchers used state-level Medicaid enrollment data and previous real-world examples — including Medicaid work requirements in Arkansas and pandemic-era eligibility verification changes — to estimate how many adults could lose coverage under the new rules.
They then modeled how those coverage losses might affect participation in routine cancer screenings recommended for breast, colorectal, and lung cancer. Using national screening statistics and cancer incidence data, the researchers projected potential downstream effects on diagnoses and mortality over a two-year period.
What the study found
Their projections suggest that roughly 7.5 million adults eligible for cancer screening could lose Medicaid coverage within two years of the new rules taking effect, with some estimates climbing above 10 million in more severe scenarios.
As a result, the researchers estimate the country could see more than 1 million missed cancer screenings, including approximately 406,000 missed mammograms, nearly 680,000 missed colorectal screenings, and more than 67,000 missed lung cancer screenings.
The study also projected that these missed screenings could lead to more than 2,300 undetected cancer cases nationwide. Some of those cancers may not be discovered until they have progressed to more advanced stages that are more difficult to treat.
Researchers estimated the changes could contribute to roughly 155 avoidable deaths tied to breast, colorectal, and lung cancers during the first two years after implementation.
“This analysis highlights how policy changes like Medicaid cuts and restrictions can have profound and preventable negative effects on public health,” researcher Adrian Diaz, M.D., said. “The hope is to inform policymakers and the public about the stakes before these changes take effect."