Medicaid Expansion and 1-Year Mortality Among Young Adults Initiating Dialysis

Was Medicaid expansion under the Affordable Care Act associated with lower 1-year mortality among young adults with kidney failure initiating dialysis?In this cohort study involving 7139 individuals comparing young adults affected by Medicaid expansion (ages 19-23 years) with adolescents whose eligibility was unchanged (ages 14-18 years), 1-year mortality among 19- to 23-year-olds initiating dialysis declined by a statistically significant 1.8 percentage points after expansion. Medicaid coverage increased and uninsurance decreased significantly among young adults, coinciding with improvements in predialysis care, length of hemodialysis sessions, and use of peritoneal dialysis.Medicaid expansion was associated with reductions in mortality among young adults with kidney failure, suggesting that expanded health insurance coverage may improve survival and care quality in this high-risk population.

Corresponding Author: Shailender Swaminathan, PhD, I96 TTK Rd, Chennai 600020, India (shailender_swaminathan@brown.edu).

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