Medicaid Expansion Boosts Enrollment in Liver Transplant Recipients

Access to care improves among post liver transplant patients.

Expansion was found to increase Medicaid enrollment in post liver transplant recipients who had private health insurance at the time of the procedure.

Since liver transplant recipients in the United States have low rates of paid employment, many post-transplant patients are eligible for Medicaid public health insurance. In a study published in Liver Transplantation, researchers sought to determine whether recent Medicaid eligibility expansions increased Medicaid enrollment and insurance coverage in these individuals.

Researchers used data from the United Network for Organ Sharing registry to identify 12,837 patients between the ages of 18- and 59-years-old who received first-time liver transplants between 2009 and 2013. The results of the study showed that a total of 6554 patients (51%) lived in states that expanded Medicaid eligibility in 2014.

Participation in Medicaid post-transplantation was found to be more common in Medicaid expansion states (25%) compared with non-expansion states (19%). In 7279 transplant patients with private insurance at the time of the procedure, the likelihood of enrolling in Medicaid after expansion increased by 50% in the states that participated in the expansion.

However, there was no increase found in the states that opted out of the Medicaid expansion. Findings also revealed that Medicaid expansion had no effect on the use of post-transplant uninsured care, which was uncommon regardless of whether a patient had government or private insurance at the time of their procedure.

Although the findings indicate that Medicaid expansion increased post-transplant Medicaid enrollment in patients who had private insurance at the time of their liver transplantation, it did not seem to have an effect on the improvement of overall access to health insurance among these recipients.

“Our study presents the first evidence of how Medicaid expansion affected health insurance coverage of liver transplant recipients,” said researcher Dmitry Tumin, PhD. “Our findings indicate the need to understand how Medicaid expansion affected access to care, out-of-pocket expenditures, and clinical outcomes among liver transplant recipients, given the changes in their insurance status occurring due to this policy.”