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


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.


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



Affordable Care Act


Children’s Health Insurance Program


Confidence interval


Chronic kidney disease


Chronic Kidney Disease-Epidemiology Collaboration


Estimated glomerular filtration rate


Federal poverty level


National Health and Nutrition Examination Survey


Non-Hispanic black


Non-Hispanic white


United States



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.


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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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