Kidney transplants jump under Medicaid expansion

By | August 21, 2019

Dive Brief:

  • Medicaid expansion helped more adults receive a preemptive kidney transplant, or a transplant before needing dialysis treatment, which can be grueling and time consuming, according to a new study from researchers at Drexel University published in the Journal of General Internal Medicine.
  • Transplants increased by 66% in expansion states and 37% in non-expansion states. Preemptive, living-donor kidney transplants covered by Medicaid increased by 2.2 percentage points in expansion states and 0.7 percentage points in non-expansion states.
  • This comes as both red and blue states become increasingly open to Medicaid expansion, though the Trump administration has taken steps to pare down program eligibility through controversial features such as work requirements. It’s not clear how the government’s new focus to expand the quality of kidney care in the U.S. conflicts with its efforts to constrict Medicaid expansion, especially in light of this new data.

Dive Insight:

The Affordable Care Act’s Medicaid expansion is responsible for ushering in coverage gains for millions of low-income Americans.

The program has greatly benefited low-income adults without children, who previously were cut off from coverage because they did not fit into eligibility categories such as having a child even though they were below the federal poverty line.

The study published Tuesday examined the rates of preemptive kidney transplants during the four years after Medicaid expansion and the four years leading up to expansion, which included 15,775 adults who received preemptive kidney transplants during that time.

Many adults with chronic kidney disease turn to dialysis to treat the effects of the disease as the kidneys can no longer effectively filter blood and remove toxins from the body. Patients use dialysis while waiting for a transplant.

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The study comes as President Donald Trump’s administration is working to revamp the way kidney care is delivered in this country. Part of that initiative includes increasing preemptive transplants to avoid patients progressing in the disease and reaching end-stage renal disease. The government wants to reduce the number of Americans with end-stage renal disease by 25% by 2030. 

The administration is introducing new payment models for kidney care in attempt to fix misaligned incentives. The push from the administration to move dialysis in the home also threatens some business in traditional dialysis chains. 

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