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New Report Reiterates Importance of Passing Medigap Expansion for Kidney Patients


Every year, there seems to be a new hot topic that lawmakers on Capitol Hill turn their attention to. From infrastructure overhauls, tax reform, social spending, and everything in between, lawmakers always find a new launching point for the next legislative debate.

Some issues, however, persist throughout every new session of Congress, such as how to make healthcare coverage more accessible and affordable to the individuals who need it most. That is in part because right now, massive numbers of Americans are unsure whether they would be able to afford the level and quality of care they need if they were hit with a massive new medical bill today.

It’s an experience that patients suffering from End-Stage Renal Disease (ESRD) know all too well. Medicare, which supplies coverage to ESRD patients, only covers 80 percent of the costs of the dialysis treatments and medications that kidney patients need to stay alive. Since dialysis patients often need treatment several times each week, those remaining costs can overwhelm patients and their families quickly. Complicating matters further is that many ESRD patients don’t just have kidney disease. They also have diabetes, heart conditions, or other medical complications that pile on their own costs.

Despite this, current federal law doesn’t require insurers to offer supplemental Medigap plans that cover the costs that aren’t otherwise paid for by Medicare to patients under 65 years old.

That means unless an ESRD patient who is under 65 lives in a state that individually requires insurers to offer that coverage, they may not have any options to pay for the treatment. And, even in many states that do require insurers to offer that coverage, it is still too expensive for ESRD patients to realistically afford.

Congress needs to intervene and provide relief for the thousands of ESRD patients across the nation who don’t know how they’ll be able to afford the very treatments and medications that keep them alive. It can do just that by passing the Jack Reynolds Memorial Medigap Expansion Act, which is a bipartisan bill introduced by Representatives Cindy Axne (D-IA-3) and Jaime Herrera Beutler (R-WA-3) that would ensure ESRD patients can affordably access Medigap plans no matter where in the country they live.

One noteworthy aspect of the bill is that it would extend the Medicare Secondary Payer (MSP) period for patients with ESRD who already receive coverage through their employer. What this would do is require employers to continue offering that coverage for 12 months beyond what is currently required, meaning fewer ESRD patients would need to rely on Medicare as their primary form of coverage.

This would have important implications for how much our nation spends on Medicare. In fact, a recent study conducted by Health Management Associates showed that the MSP extension included in the bill alone would lower federal Medicare spending by $1.2 billion over the next ten years. The message from this report is clear: passing this bill is right for dialysis patients, and will provide important reductions in federal spending on Medicare.

Thankfully, dozens of lawmakers are already on board with this bill, and I sincerely hope their colleagues in Congress from every state across the nation join them in working to pass this bill.

As our lawmakers debate infrastructure spending, social programs, and whatever else may be the focus of the latest news cycle, it’s important we keep in mind the other legislative priorities we need to address, including the Jack Reynolds Memorial Medigap Expansion Act. Kidney patients across the nation are counting on them.

Andrew Lara is a critical care nurse and city councilman in Pico Rivera, CA.