I know, I know, I’m old.
Back when I was considering colleges, this place was called Drexel Tech. Even when I applied to grad/med schools, that’s what it was.
Now, it’s Drexel University- a hop, skip, and jump away from the University of Pennsylvania in Philadelphia. (Right next door to Union Station- the grand railroad depot- in Philly, too!) And, it even houses a medical school- and a school of public health now!
Both those colleges- Drexel Med and Dornslife School of Public Health were where this batch of good news was discerned. In concert with a guy from the University of Pennsylvania.
Dr. Meera Harhay (Drexel Med, Dornslife), Ryan McKenna, PhD (Dornslife), and Michael Harhay, PhD (Perelman Med, U of Penn) coauthored the results of this research in Nature. (It’s a preprint right now.)
These folks perused the medical data of 15775 adults (age 21 to 64) who received transplants- pre-emptively (that means the folks were NOT on dialysis when they received the transplant) over the years 2010 to 2017.
What makes these years important? That means we can see what was going on in the years just before Obamacare (officially this is known as PPACA, the Patient Protection and Affordable Care Act) kicked in- and what happened with the Medicaid expansion (or not- since not all states opted for the expansion). Yes, Obamacare passed in 2010, but Medicaid expansion (and the bulk of Obamacare benefits) didn’t become live until 2014.
Kidney disease is rampant in America. It trumps the incidence of breast cancer and prostate cancer- and more people die from renal failures. There are 37 million folks in the USA suffering from CKD (Chronic Kidney Disease). Yet, only 21167 transplants (59% of all organ transplants) were effected last year.
Only 34 jurisdictions (33 states and DC) opted for expanded Medicaid programs, covering those whose income is at or under 138% of the poverty levels. Most of those folks had no medical coverage before Obamacare and the expanded Medicaid program. (In 2015 and 2016, 30% of these lower-income folks- having CKD- were uninsured.)
In a nutshell, the data indicates that, for those states that opted for expanded Medicaid, there were 2/3 (66%) more kidney transplants. That compares to the 1/3 (37%) increase for those whose states did not elect to expand Medicaid. Living donor transplants (much less frequent at only 802 of the total) increased by 2.2% in the expanded Medicaid states compared to 0.7% for those who did not so opt. However, the raw numbers indicated a 20% increase in the ratio of the results- expanded Medicaid/opt out states- as a result of the expanded Medicaid program.
This bodes well for the new directive from the White House to have more folks undergo transplants, thereby decreasing the number of folks undergoing thrice weekly dialysis- which also meets the directive to reduce the number of folks with End Stage Renal Disease by 30% before 2030.
In a bit of irony, I wonder how many of the states that did not have the medicaid expansion have higher than average rates of CKD? I know, from living in the South for several years, there are a lot of unhealthy people down there.
Good point, Alana. TN, MI, AL have the highest incidence of CKD- and are not expanded Medicaid states. Nor are GA, NC, and SC- with the second highest incidence of CKD. SoCal is next (and California has expanded Medicaid). Followed by TX (no expanded Medicaid).