Miami, FL, Friday, October 4, 2024 (By Bob Cortes *). Florida’s Kidney Patients Need Their Representative to Step Up One day, Jacksonville, Florida, resident Gloria Stephens’ body began to swell. She knew that swelling is a common first sign of kidney failure, a pressing concern given her history with diabetes. Shortly after, Gloria discovered she had End Stage Renal Disease (ESRD), commonly known as kidney failure. After that diagnosis, her life changed forever. Dialysis and kidney transplants are the only two available treatments for ESRD.
Gloria began dialysis, which filters the blood when the kidneys can’t. Dialysis is taxing on the body, but it vastly improves the health of its recipients who otherwise would have no means of removing deadly toxins from their bodies. Gloria drives herself to a dialysis clinic three times per week, for three hours per day. It’s difficult, but she remains determined not to let ESRD keep her down. Gloria isn’t alone. Over 50,000 Floridians currently live with kidney failure. Since only around one-third (https://www.kidneyfund.org/sites/default/files/media/documents/Florida-April-2021.pdf) of Floridians on the waiting list for a kidney transplant receive one in any given year, most rely on dialysis to survive.
Dialysis saves lives, which is why our elected officials must do everything in their power to expand access to quality treatment. However, the federal government has taken a back seat (https://www.ajmc.com/view/medicare-payment-rule-threatens-access-to-life-sustaining-kidney-care) in dialysis care, which is baffling considering the fact that Chronic Kidney Disease (CKD), the precursor to ESRD, is the fastest-growing (https://www.kidneyfund.org/all-about-kidneys/quick-kidney-disease-facts-and-stats#:~:text=Basic%20facts%20about%20kidney%20disease,symptoms%20until%20the%20late%20stages.) noncommunicable disease in the United States. Kidney disease will only become a bigger issue as more Americans are diagnosed with it, and our policymakers must take notice.
For many Americans on dialysis, private health insurance is imperative to receive quality care and avoid significant medical bills. Private insurance plans have traditionally provided (https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2789455) more comprehensive coverage for kidney patients, especially important given the unfortunate fact that better insurance often means receiving (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9891441/#:~:text=FIGURE%202.,LDKT%2C%20living%20donor%20kidney%20transplantation.) a transplant sooner. All of these benefits mean that private insurance is essential for patients.
However, the Supreme Court recently ruled in Marietta Memorial Hospital Employee Health Benefit Plan v. DaVita Inc. (https://www.naag.org/attorney-general-journal/supreme-court-report-marietta-memorial-hospital-employee-health-benefit-plan-v-davita-inc-20-1641-2/) that employer-sponsored health plans can limit coverage for dialysis patients, essentially requiring new patients to go onto Medicare just as they are beginning to confront a new serious health condition. Previously, federal law guaranteed that new dialysis patients with private plans could keep those plans for up to 30 months.
That buffer period gave patients time to plan for transitioning to Medicare, which is required by law. That time to plan is critical given the fact that Medicare only covers 80% of the costs for dialysis treatment, so patients need to figure out how they will pay for the remaining costs. In states without affordable supplemental insurance plans (including Florida (https://www.medicareresources.org/medicare-eligibility-and-enrollment/medigap-eligibility-for-americans-under-age-65-varies-by-state/)), many patients fall into debt or spend down their assets to qualify for Medicaid. With these new challenges, many ESRD patients are simply grateful to keep their jobs and continue working.
Patients’ need to maintain their income and insurance means that they usually don’t challenge their employers if the group plan discriminates against them. Dialysis patients should not have to choose between working with weak coverage or retiring for state-provided coverage, which is another reason why Congress must step in to protect them. Dialysis patients across Florida and the United States need our repre sentatives in Congress to champion their cause. The Restore Protections for Dialysis Patients Act (H.R. 6860) offers a crucial lifeline. The bill restores the 30-month protection that previously allowed dialysis patients to keep their private insurance, lending a hand to new dialysis patients in dire need. However, it’s vital that all Florida Representatives like Vern Buchanan (R-FL), Greg Steube (R-FL), Gus Bilirakis (R-FL), Kathy Castor (D-FL), Jared Moskowitz (D-FL), Kat Cammack (R-FL) and all others who have not signed on yet also lend their support and cosponsor this legislation.
Florida’s representatives on the U.S. House Committee on Ways and Means and the U.S. House Committee on Energy and Commerce can help push this bill through Congress. I commend Representatives Neal Dunn (R-FL) Cory Mills (R-FL) and Darren Soto (D-FL) for cosponsoring this important bill. Let’s hope all of Florida’s representatives come together to deliver for dialysis patients.
*Former state Representative.
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