The Hill | February 22, 2017
Franklin W. Maddux, M.D. | Opinion Contributor
As lawmakers consider different ways to repeal and replace the Affordable Care Act, one thing remains certain: when the dust settles, millions of Americans will be watching, waiting, and expecting policies that improve their health, access to healthcare, and how they receive it.
More than half a million of these Americans are living with End Stage Renal Disease (ESRD) – also known as kidney failure – and have a tremendous stake in the sustainability and effectiveness of our healthcare delivery system. So too do the approximately 17 percent of Americans living with the earliest form of the condition, Chronic Kidney Disease (CKD). These Americans living with ESRD and CKD require complex and multifaceted care plans involving multiple medications, physicians and care settings to manage their conditions with therapies like dialysis and kidney transplantation. Preserving and protecting their ability to access high quality healthcare is critical, and should be without burdensome obstacles.
While Congress does its part to plan what the future of healthcare will look like, Kidney Care Partners (KCP) is working diligently to put forth ideas and solutions that will help. Not only are we focused on ensuring dialysis care is readily accessible to anyone who needs it, we are committed to providing care that improves patients’ quality of life. We are moving ahead with new research initiatives to develop enhanced therapies and innovative devices to further advance the care of these disorders.
Time is of the essence. While the kidney community has worked constructively with policymakers and key stakeholders to demonstrate sustained quality improvement in key areas, the Medicare coverage upon which most Americans with kidney failure rely upon is at a critical crossroads. Congress and the administration must ensure the integrity of these coverage options now and into the future, lest we see a reversal or a slowing of this positive trend.
This year, the kidney community is working with lawmakers to assure stability of the ESRD program by protecting access to commercial insurance options. During the last few years, health plan issuers have been able to discriminate against patients in need of dialysis, despite the federal requirements stipulating that they cannot take pre-exiting conditions into account when making coverage decisions. For example, some insurers have prohibited patients from using charitable assistance to help pay premiums – making those plans too costly for patients who rely on those payments to retain their coverage. Others have essentially forced dialysis patients to enroll in Medicare, ignoring their right to remain on a commercial insurance plan if they desire the additional coverage. These discriminatory practices must be stopped. Patients must be afforded options to enroll in the insurance plan of their choice so they can access critical therapies like kidney transplantation, home dialysis, and in-center dialysis therapy.