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Journal of General Internal Medicine

, Volume 34, Issue 3, pp 351–353 | Cite as

The Affordable Care Act and Trends in Insurance Coverage and Disease Awareness Among Non-elderly Individuals with Kidney Disease

  • Meera Nair HarhayEmail author
  • Ryan M. McKenna
Concise Research Reports

INTRODUCTION

Kidney disease afflicts approximately 10% of the United States (US) population and is its’ ninth leading cause death.1 Though US individuals with kidney disease can receive Medicare if they qualify by age or require maintenance dialysis, younger individuals with earlier-stage disease are not afforded this coverage. Uninsured US individuals with kidney disease are more likely to be low-income and non-white,2 less likely to receive preventative care,2 and more likely to die or become dialysis dependent.3 Since 2010, minorities and low-income US individuals experienced substantial gains in insurance coverage under Patient Protection and Affordable Care Act (ACA) policies, particularly Medicaid expansion.4 The goal of this study was to examine whether similar trends were evident in insurance coverage and disease awareness among non-elderly US individuals with kidney disease.

METHODS

We analyzed eight waves of the National Health and Nutrition Examination Survey ([NHANES]...

Abbreviations

ACA

Affordable Care Act

CHIP

Children’s Health Insurance Program

CI

Confidence interval

CKD

Chronic kidney disease

CKD-EPI

Chronic Kidney Disease-Epidemiology Collaboration

eGFR

Estimated glomerular filtration rate

FPL

Federal poverty level

NHANES

National Health and Nutrition Examination Survey

NHB

Non-Hispanic black

NHW

Non-Hispanic white

US

United States

Notes

Acknowledgments

MNH is supported by a grant (K23DK105207) from the National Institutes of Health (NIH)/National Institutes of Diabetes and Digestive and Kidney Diseases (NIDDK). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Author Contributions

MNH and RMM designed the study, analyzed the data, interpreted the data and drafted and revised the manuscript; both authors approved the final version of the manuscript.

Compliance with Ethical Standards

Conflicts of Interest

The authors of this manuscript have no conflicts of interest to disclose.

References

  1. 1.
    National Institute of Diabetic and Digestive and Kidney Diseases. Kidney Disease Statistics for the United States;Pages. Accessed at U.S. Department of Health and Human Services at https://www.niddk.nih.gov/health-information/health-statistics/kidney-disease on September 12 2018.
  2. 2.
    Hall YN, Rodriguez RA, Boyko EJ, Chertow GM, O’Hare AM. Characteristics of uninsured Americans with chronic kidney disease. J Gen Intern Med. 2009;24(8):917–22.CrossRefGoogle Scholar
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    Jurkovitz CT, Li S, Norris KC, Saab G, Bomback AS, Whaley-Connell AT, et al. Association between lack of health insurance and risk of death and ESRD: results from the Kidney Early Evaluation Program (KEEP). Am J Kidney Dis. 2013;61(4 Suppl 2):S24–32.Google Scholar
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    Lipton BJ, Decker SL, Sommers BD. The Affordable Care Act Appears to Have Narrowed Racial and Ethnic Disparities in Insurance Coverage and Access to Care Among Young Adults. Med Care Res Rev. 2017:1077558717706575.Google Scholar
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Copyright information

© Society of General Internal Medicine 2018

Authors and Affiliations

  1. 1.Department of Medicine, Division of Nephrology and HypertensionDrexel University College of MedicinePhiladelphiaUSA
  2. 2.Department of Epidemiology and BiostatisticsDrexel University Dornsife School of Public HealthPhiladelphiaUSA
  3. 3.Department of Health Management and PolicyDrexel University Dornsife School of Public HealthPhiladelphiaUSA

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