Regulatory Policy

Health Exchanges

KCP supports insurance parity and coverage of treatment for individuals with kidney failure who purchase insurance through the Health Insurance Exchanges. Parity should mean that individuals in the Exchanges have the ability to maintain their private coverage for thirty months after diagnosis with kidney failure, a diagnosis that makes them eligible for Medicare. The Department of Health and Human Services (HHS) clarified in the Final Rule on the Establishment of Exchanges and Qualified Health Plans (CMS-9989-F) that MSP rules apply in the small group market.

Parity also means that individuals with kidney failure have the same access to tax credits and subsidies as do other Americans within the Exchanges. It also means that individuals with kidney failure enrolled in these plans are not discriminated against when it comes to having access to the providers, services, and items they need.

Given the importance of private coverage to the dialysis patient population, the Center for Consumer Information and Insurance Oversight (CCIIO) should maintain the federal commitment to Americans living with kidney failure by ensuring that coverage for ESRD is expressly included as an essential health benefit. Americans with life-threatening kidney failure should have access to coverage for ESRD in plans offered through the Exchanges.

Issue Brief:

KCP Comment Letters:

KCP Patient Organizations Letter: