ArticleJACC. Heart failure2017
The Affordable Care Act Medicaid Expansion Correlated With Increased Heart Transplant Listings in African-Americans But Not Hispanics or Caucasians.
Article in JACC. Heart failure, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 41 papers.
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Who cites it
41 citing papers in PubMed.
- Transforming Advanced Heart Failure Programs: Addressing Institutional and Systemic Drivers of Racial and Ethnic Disparities in Care.Circulation. Heart failure · 2026Review
- Racial Disparities in Heart Transplantation: Long-Term Graft Survival and Nonmortality Outcomes.Journal of the American Heart Association · 2025Article
- Changes in Heart Transplant Listings by Insurance and Race During the COVID Public Health Emergency.Circulation. Heart failure · 2025Observational
- The application of neighborhood area deprivation index to improve health equity across the spectrum of heart failure: a review.Heart failure reviews · 2025Review
- Challenges Related to Out-of-Pocket Costs in Heart Failure Management.Circulation. Heart failure · 2025Review
- Breaking Barriers: Advancing the Mission of The Equity in Heart Transplant Project.JACC. Case reports · 2024Article
- Disparities by Sex, Race, and Ethnicity in Use of Left Ventricular Assist Devices and Heart Transplants Among Patients With Heart Failure With Reduced Ejection Fraction.Journal of the American Heart Association · 2024Article
- Heart Failure with Reduced Ejection Fraction and COVID-19, when the Sick Get Sicker: Unmasking Racial and Ethnic Inequities During a Pandemic.Cardiology clinics · 2023Review
- Racial, Ethnic, and Gender Disparities in Valvular Heart Failure Management.Heart failure clinics · 2023Review
- Brief Review: Racial and Ethnic Disparities in Cardiovascular Care with a Focus on Congenital Heart Disease and Precision Medicine.Current atherosclerosis reports · 2023Review
- Temporal trends in primary payers in pediatric heart transplant and association with long-term survival.Pediatric transplantation · 2023Article
- Remote Patient Monitoring for Patients with Heart Failure: Sex- and Race-based Disparities and Opportunities.Cardiac failure review · 2023Review
- Racial Inequities in Access to Ventricular Assist Device and Transplant Persist After Consideration for Preferences for Care: A Report From the REVIVAL Study.Circulation. Heart failure · 2023Observational
- Toward equitable utilization of durable left ventricular assist device therapy in advanced heart failure-Raising the veil of health disparities.Journal of cardiac surgery · 2022Article
- Association Between the Affordable Care Act Medicaid Expansion and Receipt of Cardiac Resynchronization Therapy by Race and Ethnicity.Journal of the American Heart Association · 2022Article
- Assessment of U.S. heart transplantation equity as a function of race: Observational analyses of the OPTN database.Lancet regional health. Americas · 2022Article
- Estimating the causal effect of the Medicaid expansion on heart transplant volume with a differences-in-differences model.JTCVS open · 2022Article
- Relationships between 2018 UNOS heart policy and transplant outcomes in metropolitan, micropolitan, and rural settings.The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation · 2022Article
- Operational and Ethical Considerations for a National Adult Congenital Heart Disease Database.Journal of the American Heart Association · 2022Article
- A scoping review of inequities in access to organ transplant in the United States.International journal for equity in health · 2022Article
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Authors and funding
8 authors.
Funding
Abstract
objectivesThe aim of this study was to determine if the Affordable Care Act (ACA) Medicaid Expansion was associated with increased census-adjusted heart transplant listing rates for racial/ethnic minorities.
backgroundUnderinsurance limits access to transplants, especially among racial/ethnic minorities. Changes in racial/ethnic listing rates post-ACA Medicaid Expansion are unknown.
methodsUsing the Scientific Registry of Transplant Recipients, we analyzed 5,651 patients from early adopter states (implemented the ACA Medicaid Expansion by January 2014) and 4,769 patients from non-adopter states (no implementation during the study period) from 2012 to 2015. Piecewise linear models, stratified according to race/ethnicity, were fit to monthly census-adjusted rates of heart transplant listings before and after January 2014.
resultsA significant 30% increase in the rate of heart transplant listings for African-American patients in early adopter states occurred immediately after the ACA Medicaid Expansion on January 1, 2014 (before 0.15 to after 0.20/100,000; increase 0.05/100,000; 95% confidence interval [CI]: 0.01 to 0.08); in contrast, the rates for African-American patients in non-adopter states remained constant (before and after 0.15/100,000; increase 0.006/100,000; 95% CI: -0.03 to 0.04). Hispanic patients experienced an opposite trend, with no significant change in early adopter states (before 0.03 to after 0.04/100,000; increase 0.01/100,000; 95% CI: -0.004 to 0.02) and a significant increase in non-adopter states (before 0.03 to after 0.05/100,000; increase 0.02/100,000; 95% CI: 0.002 to 0.03). There were no significant changes in listing rates among Caucasian patients in either early adopter states or non-adopter states.
conclusionsImplementation of the ACA Medicaid Expansion was associated with increased heart transplant listings in African-American patients but not in Hispanic or Caucasian patients. Broadening of the ACA in states with large African-American populations may reduce disparities in heart transplant listings.
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