Medicaid Expansion Ups Preemptive Listing for Kidney Transplant
From pre- to post-expansion period, 59% relative increase in Medicaid-covered preemptive listings.
(HealthDay News) -- The proportion of new preemptive listings for kidney transplantation with Medicaid coverage increased in states with Medicaid expansion in the post-expansion era, according to a study published online in the Clinical Journal of the American Society of Nephrology.
Meera N. Harhay, MD, from the Drexel University College of Medicine in Philadelphia, and colleagues performed a retrospective observational study of adults listed for kidney transplantation using the United Network of Organ Sharing database. Data were included for the pre-Medicaid expansion era (Jan. 1, 2011, to Dec. 31, 2013) and the post-Medicaid expansion era (Jan. 1, 2014, to Dec. 31, 2016).
The researchers observed a 59% relative increase in Medicaid-covered preemptive listings from the pre- to post-expansion period in the 24 states that fully implemented Medicaid expansion, compared with an 8.8% increase among 19 Medicaid non-expansion states. The adjusted proportion of listings with Medicaid coverage decreased by 0.3% (4.0 to 3.7%) among non-expansion states compared with a 3.0% increase (7 to 10%) among expansion states from the pre- to post-expansion period. Medicaid expansion correlated with absolute increases in Medicaid coverage by 1.4, 4.0, 5.9, and 5.3% among white, black, Hispanic, and other listings, respectively.
"Medicaid expansion was associated with an increase in the proportion of new preemptive listings for kidney transplantation with Medicaid coverage, with larger increases in Medicaid-coverage among racial and ethnic minority listings than among white listings," the authors write.
Harhay MN, McKenna RM, Boyle SM, et al. Association between Medicaid Expansion under the Affordable Care Act and Preemptive Listings for Kidney Transplantation. Clin J Am Soc Nephrol. doi: 10.2215/CJN.00100118 [Published online June 21, 2018]
The Affordable Care Act, Kidney Transplant Access, and Kidney Disease Care in the United States. Clin J Am Soc Nephrol. doi: 10.2215/CJN.06390518 [Published online June 21, 2018]