Since its inception in 1965, Medicaid has included transportation to medical appointments as a mandated service. The benefit was confirmed in a 1974 U.S. District Court judgment in which the judge stated that transportation is needed because “…[left] untreated, the minor medical problem becomes the major medical problem.” The issue, however, is even more significant with end-stage renal disease (ESRD) patients on dialysis. For them, getting to the dialysis center can mean the difference between life and death.
On March 7, 2017, Representatives Susan Brooks (R-IN), Chris Collins (R-NY) and Brett Guthrie (R-KY) introduced legislation (H.R. 1394) that would give states the option of excluding non-emergency medical transportation (NEMT) from their Medicaid programs. The American Kidney Fund joined 41 other organizations in publicly opposing this legislation.
Many dialysis patients in the United States depend on this service because they are unable to drive and do not have reliable transportation to and from their treatments. Transportation is essential to ensure that dialysis patients who are covered by Medicaid are able to get access to lifesaving medical services. Seventeen percent of NEMT claims are for low-income dialysis patients, showing just how heavily dialysis patients depend on the service.
The cost of transportation can be prohibitively expensive for a low-income population. Indiana, Congresswoman Brooks’ home state, charges a $25 copay for Medicaid recipients for NEMT. For in-center dialysis patients, that would be $75 dollars a week and $300 a month—a significant cost that would be out of reach for many patients.
We continue to work to ensure that this legislation is not enacted so that dialysis patients covered by Medicaid can get to the dialysis center for their treatments.