Key Points Question What is the association between the Patient Protection and Affordable Care Act’s state-specific Medicaid expansion and the use of autologous breast reconstruction? Findings In this national cross-sectional study of 45 850 patients who underwent mastectomy and 9215 patients who received autologous breast reconstruction, although the proportion of patients undergoing autologous breast reconstruction increased from 18.1% to 23.0% over the study period, Medicaid expansion was associated with significantly decreased odds of undergoing reconstruction for African American, Hispanic, Asian, and Native American patients. Meaning Medicaid expansion was associated with decreased odds of autologous reconstruction for African American, Hispanic, and other patients with minority race/ethnicity.

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