Fewer Dialysis Patients Die When States Expand Medicaid



Brown University research has found that in the first three (3) years of Medicaid expansion due to the Affordable Care Act, the number of Dialysis patients who died decreased in states that expanded Medicaid compared to non-expansion states.

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Lead researcher, Dr. Amal Trivedi (Brown University, School of Public Health) said, “To my knowledge, this is the first study to find an association between Medicaid expansion under the ACA and lower death rates in adults.” The link to expansion and lower death rates may be related to the fact that prior studies have generally found that expanding the Medicaid Program has been associated with substantial gains in coverage, access to care, use of services to limit side-effects, and better self-rated health among patients.

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In Medicaid expansion states, the number of patients who died decreased from 6.9 percent prior to expansion to 6.1 percent after expansion - a total reduction of 0.8 percentage points. While the numbers may seem meager (lacking in quantity), since we are talking about our fellow Dialysis patients' lives, this could be as many as 48,000 patients saved as a result of expanding Medicaid.

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In January 2014, 25 states and the District of Columbia extended Medicaid to non-elderly residents with incomes at or below 138 percent of the poverty level, while 25 states did not -- though eight more have expanded Medicaid since then.

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While the authors caution that more research is needed to determine exactly what caused the decrease in deaths, the study suggests expanded insurance coverage, which provides better access to care, is a key factor in reducing mortality among Dialysis patients. Medicaid expansion reduced the rate of end-stage renal disease patients without insurance, by 4.2 percentage points.

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