Researchers at Weston, Fla.-based Cleveland Clinic Weston Hospital found that states that expanded Medicaid saw a smaller rise in inflammatory bowel disease-related mortality than states that did not. The difference was not statistically significant. The team presented the findings at the American College of Gastroenterology’s 2026 meeting.
The researchers analyzed state-level IBD mortality data from 1999 to 2024 for all 50 states and Washington, D.C. They compared 32 expansion states with 19 non-expansion states, grouping each by whether it had adopted Medicaid expansion by Jan. 1, 2016. The team excluded 2014 through 2016 because states rolled out expansion at different times, according to an Oct. 12 Cleveland Clinic article.
After expansion, IBD mortality rose 8.3% in expansion states and 14.6% in non-expansion states. Maine, West Virginia and Oregon had the highest post-expansion mortality rates. Researchers are still investigating what drove those results.
“Having Medicaid coverage doesn’t actually mean that care was delivered,” said Leyla Maric, MD, associate medical director of the hospital’s Inflammatory Bowel Disease Center and a study author.
Dr. Maric said patients with coverage may still run into shortages of GI specialists, prior authorization delays and trouble accessing medications. The study relied on state-level rather than patient-level data. As a result, researchers could not track whether coverage led to timely diagnosis, treatment and follow-up.
The team may study prior authorization delays next. More than 3 million people have IBD, and Dr. Maric said future patient-level research should test whether coverage leads to timely specialty care and effective treatment.
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