In a memo released on May 8th, Xavier Becerra, Secretary of Health and Human Services under President Biden, unveiled a new initiative aimed at addressing disparities based on race in the organ transplant field. The plan, which applies to 90 out of 257 transplant hospitals across the United States, introduces a scoring system to evaluate these hospitals.
According to this scoring system, a hospital is awarded one point for each successful kidney transplant, and 1.2 points for a transplant involving a recipient from a low-income background, as part of a “health equity performance adjustment.”
Although the system is said to be impartial to color, the Biden administration’s announcement acknowledges race as a key consideration: Becerra mentioned that the policy signifies the administration’s efforts towards eliminating racial biases from the transplant system. The announcement points out that 13.5% of kidney transplant recipients are African American, while this group constitutes 32% of individuals on the waitlist. On the other hand, white recipients make up 61.8% of the total recipients and only 35.8% of those on the waitlist. (It is noteworthy that these recipient percentages closely align with the latest census demographic data, where the U.S. population consists of 12.2% non-Hispanic black and 63.7% non-Hispanic white individuals.)
The Biden administration’s plan provides funding of up to $8,000 per transplant to hospitals meeting the transplant criteria, while hospitals failing to meet the requirements might face a penalty of up to $2,000 per transplant.
This action reflects measures taken during the Covid-19 pandemic, which involved point-based systems for distributing monoclonal antibodies. In these allotment strategies that considered race explicitly, minority status was often given a higher weight than or equal to factors like age or underlying health conditions: for example, Utah prioritized minority status over chronic pulmonary disease, and Minnesota rated minority status on par with diabetes or age over 65.
