Overview
- JAMA Pediatrics, which published the study Monday, reports a 1.8 percentage-point drop in one-year mortality for 19–23-year-olds starting dialysis after Medicaid expanded.
- Deaths in that group fell from 3.6% before expansion to 2.1% after, while a comparison group of adolescents with unchanged eligibility rose from 0.7% to 1.1%.
- Insurance coverage shifted for young adults starting dialysis as uninsurance fell from 19.4% to 7.8% and Medicaid enrollment rose from 37.1% to 48.5% after the ACA broadened eligibility.
- Access and care quality improved for the young adult group with predialysis nephrology care increasing to 66.1% and with longer hemodialysis sessions and greater use of peritoneal dialysis.
- Researchers analyzed 7,139 patients in expansion states from 2010 to 2019, and an editorial warned that cuts tied to July 2025’s H.R.1 law, which could drop 5–10 million from Medicaid by 2028, may reverse these gains.