In a memo published on May 8th, Xavier Becerra, Biden’s Secretary of Health and Human Services, announced a new plan to address “racial inequities” in the organ transplant industry. The plan, which covers 90 of the 257 transplant hospitals in the U.S., proposes a points system to grade the included hospitals.
Under this points system, a hospital earns a point for any successful kidney transplant, but 1.2 points for a kidney transplant with a low-income recipient as part of a “health equity performance adjustment.”
While the system is ostensibly colorblind, the Biden administration’s announcement gives race as a motivating factor: Becerra stated that the policy represents the Biden administration “taking concrete steps to remove racial bias” from the transplant system. The announcement cites that 13.5 percent of kidney transplant recipients are African American, compared to 32 percent of waitlisted individuals, while whites make up 61.8 percent of recipients and only 35.8 percent of the waitlist. (The memo does not mention that these percentages of recipients roughly align with the most recent census demographic data: The U.S. population is 12.2 percent non-Hispanic black and 63.7 percent non-Hispanic white.)
The Biden administration’s plan allocates up to $8,000 per transplant to each hospital that meets the transplant quota, while hospitals that do not meet the quota may have to pay up to $2,000 per transplant.
This move mirrors Covid-era measures that included point-based systems for the allocation of monoclonal antibodies. In these explicitly race-based allocation schemes, minority status was oftentimes weighted higher or as highly as age or comorbidities: Utah rated minority status above chronic pulmonary disease, and Minnesota rated minority status as equivalent to diabetes or age above 65.
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