TY - JOUR
T1 - Implications of the initial Braidwood v. Becerra ruling for colorectal cancer outcomes
T2 - a modeling study
AU - van den Puttelaar, Rosita
AU - Shi, Kewei Sylvia
AU - Smith, Robert
AU - Zhao, Jingxuan
AU - Ogongo, Margaret Katana
AU - Harlass, Matthias
AU - Hahn, Anne
AU - Zauber, Ann G.
AU - Yabroff, K. Robin
AU - Lansdorp-Vogelaar, Iris
N1 - Publisher Copyright:
© The Author(s) 2024. Published by Oxford University Press.
PY - 2025/4
Y1 - 2025/4
N2 - The Affordable Care Act (ACA) eliminated patient cost-sharing for United States Preventive Service Task Force (USPSTF) recommended services. However, if the US Court of Appeals for the Fifth Circuit fully upheld a US District Court ruling in Braidwood Management v. Becerra, 666 F. Supp. 3d 613 (N.D. Tex 2023), cost-sharing for USPSTF recommendations made after ACA passage would have been reinstated for more than 150 million people. The case would have reinstated cost-sharing for colorectal cancer (CRC) screening for ages 45-49 years and for polyp removal during (diagnostic) colonoscopy across all ages. Using the MISCAN-Colon model, we simulated the potential impact on CRC outcomes, assuming early-onset CRC trends and lower screening participation. An 8-percentage-point decline in screening participation could increase CRC incidence by 5.1% and CRC mortality by 9.1%, with slightly lower costs due to increased cost-sharing. Larger decreases in screening participation can result in higher costs from increased incidence and delayed diagnoses.
AB - The Affordable Care Act (ACA) eliminated patient cost-sharing for United States Preventive Service Task Force (USPSTF) recommended services. However, if the US Court of Appeals for the Fifth Circuit fully upheld a US District Court ruling in Braidwood Management v. Becerra, 666 F. Supp. 3d 613 (N.D. Tex 2023), cost-sharing for USPSTF recommendations made after ACA passage would have been reinstated for more than 150 million people. The case would have reinstated cost-sharing for colorectal cancer (CRC) screening for ages 45-49 years and for polyp removal during (diagnostic) colonoscopy across all ages. Using the MISCAN-Colon model, we simulated the potential impact on CRC outcomes, assuming early-onset CRC trends and lower screening participation. An 8-percentage-point decline in screening participation could increase CRC incidence by 5.1% and CRC mortality by 9.1%, with slightly lower costs due to increased cost-sharing. Larger decreases in screening participation can result in higher costs from increased incidence and delayed diagnoses.
UR - https://www.webofscience.com/api/gateway?GWVersion=2&SrcApp=eur_pure&SrcAuth=WosAPI&KeyUT=WOS:001349222400001&DestLinkType=FullRecord&DestApp=WOS_CPL
U2 - 10.1093/jnci/djae244
DO - 10.1093/jnci/djae244
M3 - Article
C2 - 39361402
SN - 0027-8874
VL - 117
SP - 790
EP - 794
JO - Journal of the National Cancer Institute
JF - Journal of the National Cancer Institute
IS - 4
M1 - djae244
ER -
