JAMA 9 2026 Medicare Advantage Enrollment and Access to Kidney Transplant After the 21st Century Cures Act

This retrospective study evaluates whether the expansion of Medicare Advantage eligibility for patients with end-stage kidney disease has impacted their ability to receive life-saving treatments. By comparing data from 2021 through 2023, researchers discovered that those enrolled in private Medicare Advantage plans faced significantly lower rates of kidney transplantation and new wait-listing compared to those in traditional Medicare. These disparities were most pronounced among younger beneficiaries, suggesting that private plan structures may inadvertently create barriers to high-value surgical care. Ultimately, the text serves as a call for increased policy oversight to ensure that the growing number of patients in these managed care plans do not lose access to the most effective treatments for kidney failure.