{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,19]],"date-time":"2026-05-19T20:08:58Z","timestamp":1779221338854,"version":"3.51.4"},"reference-count":42,"publisher":"Elsevier BV","issue":"2","license":[{"start":{"date-parts":[[2026,2,1]],"date-time":"2026-02-01T00:00:00Z","timestamp":1769904000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2026,2,1]],"date-time":"2026-02-01T00:00:00Z","timestamp":1769904000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2027,1,22]],"date-time":"2027-01-22T00:00:00Z","timestamp":1800576000000},"content-version":"am","delay-in-days":355,"URL":"http:\/\/www.elsevier.com\/open-access\/userlicense\/1.0\/"}],"funder":[{"DOI":"10.13039\/100006545","name":"NIMHD","doi-asserted-by":"publisher","award":["1K23MD018090-01"],"award-info":[{"award-number":["1K23MD018090-01"]}],"id":[{"id":"10.13039\/100006545","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000062","name":"National Institute of Diabetes and Digestive and Kidney Diseases","doi-asserted-by":"publisher","award":["5K08-DK120902"],"award-info":[{"award-number":["5K08-DK120902"]}],"id":[{"id":"10.13039\/100000062","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["cghjournal.org","clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Clinical Gastroenterology and Hepatology"],"published-print":{"date-parts":[[2026,2]]},"DOI":"10.1016\/j.cgh.2025.04.032","type":"journal-article","created":{"date-parts":[[2025,7,7]],"date-time":"2025-07-07T19:31:57Z","timestamp":1751916717000},"page":"312-327.e1","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":0,"title":["The Affordable Care Act Improves Access, Survival, and Racial Disparities of Patients With Liver Disease: A Systematic Review"],"prefix":"10.1016","volume":"24","author":[{"given":"Tiana L.","family":"Walker","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tarek G.","family":"Aridi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Meera","family":"Iyengar","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shazia Mehmood","family":"Siddique","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lisa","family":"Philpotts","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nneka N.","family":"Ufere","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0837-0746","authenticated-orcid":false,"given":"Lauren D.","family":"Nephew","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"78","reference":[{"key":"10.1016\/j.cgh.2025.04.032_bib2","doi-asserted-by":"crossref","first-page":"2650","DOI":"10.1016\/j.cgh.2019.07.060","article-title":"Contemporary epidemiology of chronic liver disease and cirrhosis","volume":"18","author":"Moon","year":"2020","journal-title":"Clin Gastroenterol Hepatol"},{"key":"10.1016\/j.cgh.2025.04.032_bib3","doi-asserted-by":"crossref","first-page":"1382","DOI":"10.1002\/hep.32743","article-title":"Health disparities in chronic liver disease","volume":"77","author":"Kardashian","year":"2023","journal-title":"Hepatology"},{"key":"10.1016\/j.cgh.2025.04.032_bib4","doi-asserted-by":"crossref","first-page":"1162","DOI":"10.14309\/ajg.0000000000001712","article-title":"Rural-urban disparities in mortality from cirrhosis in the United States from 1999 to 2019","volume":"117","author":"Ufere","year":"2022","journal-title":"Am J Gastroenterol"},{"key":"10.1016\/j.cgh.2025.04.032_bib5","doi-asserted-by":"crossref","DOI":"10.1001\/jamanetworkopen.2020.22942","article-title":"Changes in adult alcohol use and consequences during the COVID-19 pandemic in the US","volume":"3","author":"Pollard","year":"2020","journal-title":"JAMA Netw Open"},{"key":"10.1016\/j.cgh.2025.04.032_bib6","doi-asserted-by":"crossref","first-page":"185","DOI":"10.1097\/MCG.0000000000001665","article-title":"Increasing prevalence and racial disparity of alcohol-related gastrointestinal and liver disease during the COVID-19 pandemic: a population-based national study","volume":"57","author":"Damjanovska","year":"2023","journal-title":"J Clin Gastroenterol"},{"key":"10.1016\/j.cgh.2025.04.032_bib10","author":"Tolbert"},{"key":"10.1016\/j.cgh.2025.04.032_bib11","author":"Corallo"},{"key":"10.1016\/j.cgh.2025.04.032_bib12","doi-asserted-by":"crossref","first-page":"108S","DOI":"10.1097\/01.AOG.0000514996.69681.e0","article-title":"The impact of the Affordable Care Act on U.S. maternal mortality [21J]","volume":"129","author":"Hope","year":"2017","journal-title":"Obstet Gynecol"},{"key":"10.1016\/j.cgh.2025.04.032_bib13","doi-asserted-by":"crossref","first-page":"596","DOI":"10.1016\/j.amepre.2019.11.018","article-title":"Impact of the Affordable Care Act on colorectal cancer outcomes: a systematic review","volume":"58","author":"Xu","year":"2020","journal-title":"Am J Prev Med"},{"key":"10.1016\/j.cgh.2025.04.032_bib14","doi-asserted-by":"crossref","first-page":"178","DOI":"10.1016\/j.jclinepi.2021.03.001","article-title":"The PRISMA 2020 statement: an updated guideline for reporting systematic reviews","volume":"134","author":"Page","year":"2021","journal-title":"J Clin Epidemiol"},{"key":"10.1016\/j.cgh.2025.04.032_bib17","article-title":"ROBINS-I: a tool for assessing risk of bias in non-randomised studies of interventions","volume":"355","author":"Sterne","year":"2016","journal-title":"BMJ"},{"key":"10.1016\/j.cgh.2025.04.032_bib18","doi-asserted-by":"crossref","first-page":"1618","DOI":"10.1093\/cid\/cix1062","article-title":"State Medicaid hepatitis c treatment eligibility criteria and use of direct-acting antivirals","volume":"66","author":"Kapadia","year":"2018","journal-title":"Clin Infect Dis"},{"key":"10.1016\/j.cgh.2025.04.032_bib19","doi-asserted-by":"crossref","DOI":"10.1001\/jamanetworkopen.2024.22406","article-title":"Medicaid expansion and restriction policies for hepatitis C treatment","volume":"7","author":"Furukawa","year":"2024","journal-title":"JAMA Netw Open"},{"key":"10.1016\/j.cgh.2025.04.032_bib20","doi-asserted-by":"crossref","first-page":"692","DOI":"10.1016\/j.jval.2017.09.011","article-title":"State Medicaid reimbursement for medications for chronic hepatitis C infection from 2012 through 2015","volume":"21","author":"Lu","year":"2018","journal-title":"Value Health"},{"key":"10.1016\/j.cgh.2025.04.032_bib21","doi-asserted-by":"crossref","first-page":"366","DOI":"10.1111\/jvh.13661","article-title":"Removal of medicaid restrictions were associated with increased hepatitis C virus treatment rates, but disparities persist","volume":"29","author":"Nephew","year":"2022","journal-title":"J Viral Hepat"},{"key":"10.1016\/j.cgh.2025.04.032_bib22","doi-asserted-by":"crossref","first-page":"20","DOI":"10.1097\/LVT.0000000000000221","article-title":"Affordable Care Act Medicaid expansion associated with increased liver transplant waitlist access without worsening mortality","volume":"30","author":"Wahid","year":"2024","journal-title":"Liver Transpl"},{"key":"10.1016\/j.cgh.2025.04.032_bib23","doi-asserted-by":"crossref","first-page":"737","DOI":"10.1001\/jamacardio.2016.2067","article-title":"Implementation of the Affordable Care Act and solid-organ transplantation listings in the United States","volume":"1","author":"Oliveira","year":"2016","journal-title":"JAMA Cardiol"},{"key":"10.1016\/j.cgh.2025.04.032_bib24","doi-asserted-by":"crossref","first-page":"173","DOI":"10.1016\/j.jamcollsurg.2017.05.004","article-title":"Medicaid participation among liver transplant candidates after the Affordable Care Act Medicaid expansion","volume":"225","author":"Tumin","year":"2017","journal-title":"J Am Coll Surg"},{"key":"10.1016\/j.cgh.2025.04.032_bib25","doi-asserted-by":"crossref","first-page":"1894","DOI":"10.1177\/000313481808401234","article-title":"Solid-organ transplantation and the Affordable Care Act: accessibility and outcomes","volume":"84","author":"Trivedi","year":"2018","journal-title":"Am Surg"},{"key":"10.1016\/j.cgh.2025.04.032_bib26","doi-asserted-by":"crossref","first-page":"56","DOI":"10.1016\/j.transproceed.2022.12.008","article-title":"Association of the Affordable Care Act on access to and outcomes after kidney or liver transplant: a transplant registry study","volume":"55","author":"Katz-Greenberg","year":"2023","journal-title":"Transplant Proc"},{"key":"10.1016\/j.cgh.2025.04.032_bib27","doi-asserted-by":"crossref","first-page":"1723","DOI":"10.1002\/lt.26209","article-title":"Medicaid expansion association with end-stage liver disease mortality depends on leniency of Medicaid hepatitis C virus coverage","volume":"27","author":"Wahid","year":"2021","journal-title":"Liver Transplant"},{"key":"10.1016\/j.cgh.2025.04.032_bib28","doi-asserted-by":"crossref","DOI":"10.1001\/jamanetworkopen.2020.19869","article-title":"Association of state Medicaid expansion with racial\/ethnic disparities in liver transplant wait-listing in the United States","volume":"3","author":"Nephew","year":"2020","journal-title":"JAMA Netw Open"},{"key":"10.1016\/j.cgh.2025.04.032_bib29","doi-asserted-by":"crossref","first-page":"1482","DOI":"10.1016\/j.hpb.2022.03.003","article-title":"Medicaid expansion is associated with a higher likelihood of early diagnosis, resection, transplantation, and overall survival in patients with hepatocellular carcinoma","volume":"24","author":"Elshami","year":"2022","journal-title":"HPB (Oxford)"},{"key":"10.1016\/j.cgh.2025.04.032_bib30","doi-asserted-by":"crossref","DOI":"10.1016\/j.jamcollsurg.2021.07.289","article-title":"Beyond insurance status: impact of Medicaid expansion on the diagnosis of hepatocellular carcinoma","volume":"233","author":"Papageorge","year":"2021","journal-title":"J Am Coll Surg"},{"key":"10.1016\/j.cgh.2025.04.032_bib31","doi-asserted-by":"crossref","first-page":"4589","DOI":"10.1245\/s10434-023-13562-9","article-title":"The impact of Medicaid expansion on early-stage hepatocellular carcinoma care","volume":"30","author":"Lima","year":"2023","journal-title":"Ann Surg Oncol"},{"key":"10.1016\/j.cgh.2025.04.032_bib32","doi-asserted-by":"crossref","first-page":"328","DOI":"10.1016\/j.amjsurg.2022.09.004","article-title":"Medicaid expansion and surgery for HPB\/gastrointestinal cancers: NCDB difference-in-difference analysis","volume":"225","author":"Kaelberer","year":"2023","journal-title":"Am J Surg"},{"key":"10.1016\/j.cgh.2025.04.032_bib33","doi-asserted-by":"crossref","DOI":"10.1158\/1538-7755.DISP20-PO-206","article-title":"Influence of social determinants of health on timeliness to treatment for metastatic HCC and the impact of Affordable Care Act","volume":"29","author":"Jayakrishnan","year":"2020","journal-title":"Cancer Epidemiol Biomarkers Prev"},{"key":"10.1016\/j.cgh.2025.04.032_bib34","doi-asserted-by":"crossref","first-page":"1176","DOI":"10.1093\/jnci\/djac077","article-title":"Association between Medicaid Expansion under the Affordable Care Act and survival among newly diagnosed cancer patients","volume":"114","author":"Han","year":"2022","journal-title":"J Natl Cancer Inst"},{"key":"10.1016\/j.cgh.2025.04.032_bib35","doi-asserted-by":"crossref","first-page":"291","DOI":"10.1016\/j.mayocpiqo.2022.05.002","article-title":"Patients hospitalized for complications of cirrhosis may have benefited from Medicaid expansion under the Affordable Care Act","volume":"6","author":"Wang","year":"2022","journal-title":"Mayo Clin Proc Innov Qual Outcomes"},{"key":"10.1016\/j.cgh.2025.04.032_bib36","doi-asserted-by":"crossref","first-page":"e21","DOI":"10.1097\/MCG.0000000000001102","article-title":"Recent trends and the impact of the Affordable Care Act on emergency department visits and hospitalizations for gastrointestinal, pancreatic and liver diseases","volume":"54","author":"Barakat","year":"2020","journal-title":"J Clin Gastroenterol"},{"key":"10.1016\/j.cgh.2025.04.032_bib37","doi-asserted-by":"crossref","first-page":"2873","DOI":"10.1007\/s11606-021-07185-7","article-title":"Differences in cause-specific premature mortality by Medicaid expansion status, 2010\u20132018","volume":"37","author":"Khan","year":"2022","journal-title":"J Gen Intern Med"},{"key":"10.1016\/j.cgh.2025.04.032_bib38","doi-asserted-by":"crossref","first-page":"419","DOI":"10.1016\/j.cgh.2020.11.042","article-title":"Impact of Medicaid expansion on liver-related mortality","volume":"20","author":"Kumar","year":"2022","journal-title":"Clin Gastroenterol Hepatol"},{"key":"10.1016\/j.cgh.2025.04.032_bib39","doi-asserted-by":"crossref","first-page":"2725","DOI":"10.3390\/healthcare11202725","article-title":"Care for vulnerable populations with chronic liver disease: a safety-net perspective","volume":"11","author":"Wang","year":"2023","journal-title":"Healthcare (Basel)"},{"key":"10.1016\/j.cgh.2025.04.032_bib41","author":"Artiga"},{"key":"10.1016\/j.cgh.2025.04.032_bib42","author":"Cervantes"},{"key":"10.1016\/j.cgh.2025.04.032_bib44","doi-asserted-by":"crossref","DOI":"10.1001\/jamanetworkopen.2022.3991","article-title":"Rates of diabetes-related major amputations among racial and ethnic minority adults following Medicaid expansion under the Patient Protection and Affordable Care Act","volume":"5","author":"Tan","year":"2022","journal-title":"JAMA Netw Open"},{"key":"10.1016\/j.cgh.2025.04.032_bib45","doi-asserted-by":"crossref","DOI":"10.1111\/ctr.14418","article-title":"Potential association between public medical insurance, waitlist mortality, and utilization of living donor liver transplantation: an analysis of the Scientific Registry of Transplant Recipients","volume":"35","author":"Emamaullee","year":"2021","journal-title":"Clin Transplant"},{"key":"10.1016\/j.cgh.2025.04.032_bib46","doi-asserted-by":"crossref","DOI":"10.1111\/ctr.14784","article-title":"Associations between social determinants of health and abdominal solid organ transplant wait-lists in the United States","volume":"36","author":"Johnson","year":"2022","journal-title":"Clin Transplant"},{"key":"10.1016\/j.cgh.2025.04.032_bib47","doi-asserted-by":"crossref","first-page":"1075","DOI":"10.1002\/lt.24480","article-title":"Medicaid enrollment after liver transplantation: effects of Medicaid expansion","volume":"22","author":"Tumin","year":"2016","journal-title":"Liver Transplant"},{"key":"10.1016\/j.cgh.2025.04.032_bib48","doi-asserted-by":"crossref","first-page":"962","DOI":"10.1093\/jnci\/djad094","article-title":"Changes in cancer mortality after Medicaid expansion and the role of stage at diagnosis","volume":"115","author":"Barnes","year":"2023","journal-title":"J Natl Cancer Inst"},{"key":"10.1016\/j.cgh.2025.04.032_bib49","doi-asserted-by":"crossref","first-page":"956","DOI":"10.1377\/hlthaff.2023.00035","article-title":"Medicaid expansion associated with increase in palliative care for people with advanced-stage cancers","volume":"42","author":"Han","year":"2023","journal-title":"Health Aff (Millwood)"},{"key":"10.1016\/j.cgh.2025.04.032_bib50","doi-asserted-by":"crossref","first-page":"434","DOI":"10.1016\/j.gassur.2024.01.042","article-title":"Medicaid expansion and palliative care for advanced-stage liver cancer","volume":"28","author":"Lima","year":"2024","journal-title":"J Gastrointest Surg"}],"container-title":["Clinical Gastroenterology and Hepatology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S1542356525005671?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S1542356525005671?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2026,5,19]],"date-time":"2026-05-19T19:44:11Z","timestamp":1779219851000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S1542356525005671"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2]]},"references-count":42,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2026,2]]}},"alternative-id":["S1542356525005671"],"URL":"https:\/\/doi.org\/10.1016\/j.cgh.2025.04.032","relation":{},"ISSN":["1542-3565"],"issn-type":[{"value":"1542-3565","type":"print"}],"subject":[],"published":{"date-parts":[[2026,2]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"The Affordable Care Act Improves Access, Survival, and Racial Disparities of Patients With Liver Disease: A Systematic Review","name":"articletitle","label":"Article Title"},{"value":"Clinical Gastroenterology and Hepatology","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.cgh.2025.04.032","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2026 by the AGA Institute","name":"copyright","label":"Copyright"}]}}