People of all backgrounds and demographic groups can get kidney disease, but people of color disproportionately reach kidney failure and end up on dialysis. Black people are at a notably higher risk, developing kidney failure at nearly four times the rate of white people.
A kidney transplant is considered the best treatment option for most people with kidney failure, but Black patients are less likely than white patients to be placed on the transplant waiting list. Additionally, once on the waitlist, Black patients are less likely to receive a transplant.
This reality is not acceptable. What can we do as a country to promote health equity so that every person has an opportunity for good kidney health?
Promoting health literacy
We can continue to develop disease prevention and management education programs, with accessibility and health literacy top of mind.
We can re-examine the way kidney function is measured to ensure equitable diagnosis and early treatment for everyone, regardless of race.
We can remain steadfast in supporting low-income individuals with financial assistance that helps them get the care they need to survive.
And we can advocate for new public policies that are centered in promoting health equity to make more kidney transplants possible, provide equitable access to health insurance, and drive innovation in research and treatment.
For example, the American Kidney Fund (AKF) worked with the rest of the kidney community for years to secure a landmark law that provides comprehensive anti-rejection drug coverage for the life of a patient’s transplant if they cannot afford these medicines. Before this bill was signed into law, Medicare coverage for these critical drugs ended 36 months post-transplant for patients under 65, which forced many kidney patients to return to dialysis when they could no longer afford the medicines they needed to prevent kidney rejection.
Pushing for change
Two other bills currently before Congress would improve health outcomes for patients, including those in underserved communities of color. The Living Donor Protection Act of 2021 would ultimately shorten the transplant waiting list by providing living organ donors job and insurance protections that would make it easier for them to donate kidneys.
Another bill, the Jack Reynolds Memorial Medigap Expansion Act, would make supplemental Medicare coverage — also known as Medigap — available in all 50 states to people with kidney failure who are under-65 Medicare beneficiaries. Medicare alone, without supplemental coverage, exposes dialysis patients to out-of-pocket costs of $10,000 per year or more, and Medicare alone is not considered sufficient health insurance coverage for the purposes of getting on the transplant waiting list.
These are two policy changes that can reduce the health disparities facing kidney patients. We must continue to work toward solutions that give all individuals an equitable chance at living a healthy life.
