Kidney Care Partners (KCP) – the nation’s largest non-profit, non-partisan coalition of more than 30 organizations representing patients, professional care providers, and a wide range of kidney care stakeholders – sent a letter urging Congress to pass the bipartisan, bicameral Restore Protections for Dialysis Patients Act (
H.R. 8594/
S. 4750) to ensure our nation’s most vulnerable patient populations and their families retain access to important health care benefits provided by private plans as Congress intended, and individuals with kidney failure are not prematurely shifted off their private plans and into Medicare.
Earlier this year, KCP expressed concern that some private health plans were engaging in discriminatory activities against those with kidney failure, or end-stage renal disease (ESRD), by limiting coverage of life-sustaining dialysis treatment, ultimately forcing patients to pay more of that cost out of pocket or drop their private group coverage altogether, losing additional health benefits like dental and vision coverage and financial protections against out-of-pocket costs for both them and their families.
Unfortunately, a U.S. Supreme Court ruling issued this summer effectively eliminated crucial statutory protections Congress put in place 40 years ago to protect individuals with kidney disease from discrimination from their private plans. Fortunately, bipartisan members of the House and Senate have recognized this harmful decision and quickly introduced legislation to restore these vital statutory protections which – if not protected – would further hinder patient access to quality care, and unnecessarily burden U.S. taxpayers by putting additional pressure on our nation’s Medicare program.
The letter from KCP to House and Senate leadership explains, “While Medicare coverage is both a valuable option and important safety net for patients with ESRD, it can expose individuals with kidney failure to higher out-of-pocket costs and does not cover certain benefits, including those important to securing and maintaining a spot on a kidney transplant waitlist. It also could jeopardize the health coverage of dependent family members on private health plans. This straightforward, bipartisan, bicameral legislation will restore the status quo and clarify the statutory provisions for which both the majority and dissent recognized the need for this clarity.”
“KCP thanks Representatives Clarke, Arrington, Carter and Davis, and Senators Menendez and Cassidy for working together and acting quickly to address the troubling efforts of some private insurers to force individuals with kidney failure and their families out of their preferred plan,” said Michele Kimball, executive director of KCP. “This bipartisan legislation will prevent harm to these vulnerable individuals by eliminating any distinction among patients by insurers based on their need for renal dialysis care, which is the true intent of the Medicare Secondary Payer Act. Secondarily, the bill will also help to reinforce the Medicare Part A Trust Fund, which is increasingly underfunded.”
The language in the Restore Protections for Dialysis Patients Act intentionally includes a comparison to other chronic diseases to avoid any suggestion of a mandate. The legislation adds two sentences to the Medicare Secondary Payer Act to affirm Congress’s longstanding intent to ensure that individuals with chronic kidney failure do not receive lesser health benefits based on a diagnosis of kidney failure or a need for dialysis to keep them alive. The intent of the bill is to preserve the status quo before the Court’s decision and operationalize the MSPA provisions as they have been for decades.
Lori Hartwell, CEO of the national Renal Support Network – the leaders in engaging people with kidney disease – who has experienced both dialysis and kidney transplants, added, “Patient choice is important, and we should be able to decide if we want to keep our private insurance plan and Medicare. All healthcare sectors are a mix of private insurance and government-funded insurance. This MSP provision enacted 40 years ago protects people like me, who have experienced kidney failure, against private health plan’s unfair policies that deny meaningful, affordable coverage for themselves and their families. The actions by the Supreme Court, if not addressed by passing this critical legislation, set a dangerous precedent and will damage the kidney care community’s access to care at a catastrophic level.”
“At the end of the day, this is both a coverage and a cost issue – one that directly impacts patients’ ability to afford needed kidney care while further reducing equity among patients in accessing it,” concluded Kimball. “Passing bipartisan, bicameral legislation will once and for all prevent insurers from discriminating against dialysis patients by prematurely pushing them from private insurance plans into the Medicare program. This patient-centric, taxpayer-centric legislation is a win for individuals with kidney failure, their families, and the American taxpayer – and KCP urges Congress to act swiftly on this important measure.”
