Insurance Type, Race Linked to Liver Care Gaps
Four studies presented at The Liver Meeting 2026 in Denver connect insurance coverage and race to disparities in liver disease care.
Updated on Nov. 7, 2026 in Healthcare
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Four studies presented at The Liver Meeting 2026, the annual meeting of the American Association for the Study of Liver Diseases, found that insurance type and race are linked to disparities in liver disease care. Researchers reported that Medicaid-insured patients made up 23.6% of liver transplant listings in Medicaid expansion states compared with 10.0% in nonexpansion states.
Why it matters
The findings point to gaps in how patients with cirrhosis and other liver conditions are monitored and treated depending on their coverage and background. Understanding these gaps can help health systems identify where patients may be falling out of care.
Among 114,778 adults listed for liver transplant at 142 centers in 33 states from 2014 to 2024, waitlist mortality was lower among privately insured patients in both expansion and nonexpansion states. Black patients accounted for 5% of resmetirom users compared with 9% of comparators (P = .0008).
The players
American Association for the Study of Liver Diseases
A professional medical society focused on research and care for liver diseases, which hosts The Liver Meeting each year.
The details
Researchers enrolled patients with cirrhosis from 4 US health systems and surveyed them about education, income, insurance, health literacy, housing, and barriers to liver care. Medicaid insurance was associated with lower odds of semiannual hepatocellular carcinoma surveillance (OR, 0.55; 95% CI, 0.34-0.86), while a college education was associated with higher odds (OR, 1.50; 95% CI, 1.15-1.96).
Timeline
2014: Start of the transplant listing analysis period, the year Medicaid expansion took effect
2014-2024: Period covering 114,778 adult liver transplant listings analyzed
November 5-9, 2026: The Liver Meeting 2026 is held in Denver, Colorado
Health Landscape
The disparities reported in these studies are measured against the coverage changes introduced by Medicaid expansion under the Affordable Care Act, which has shaped who gets listed for liver transplant across states. The findings add liver care data to the ongoing national debate over how coverage type relates to access to specialized treatment.
Patients with cirrhosis who are covered by Medicaid may be less likely to receive semiannual liver cancer surveillance, according to these findings. Patients and families can ask their care teams whether they are scheduled for regular imaging and what coverage options apply to their treatment.
The takeaway
Insurance coverage and background appear to influence whether patients with liver disease receive consistent monitoring and transplant access. Patients who are unsure whether they are getting recommended surveillance can ask their clinicians directly about the schedule.
Further reading
For broader context on access to specialized care, explore Healthcare coverage across the business section.
Source note: This article includes information reported by Ajmc.
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