Last week, to kick off National Kidney Month, American Kidney Fund (AKF) patient-advocates from around the country came to Washington to educate their elected officials about the financial challenges kidney patients experience, and to urge lawmakers to put an end to discriminatory practices among some health insurers.
The advocates first had a day of training, where they heard presentations on federal lawmaking, the current political climate on Capitol Hill, and the growing practice of health insurers refusing insurance premium payments from the American Kidney Fund, a refusal that jeopardizes the health coverage of people with kidney failure.
The next day, advocates spoke at a congressional briefing entitled Misconceptions, myths and realities: Dialysis patient access to insurance. Patients told congressional offices how living with kidney failure depleted their savings and left them in great financial hardship. Their stories underscored the importance of AKF’s Health Insurance Premium Program, which helps kidney failure patients with all types of insurance plans, including Medigap, which helps patients pay many of the health care costs that Medicare doesn’t cover.
After the briefing, advocates talked to their members of Congress about the problem of insurance companies rejecting health insurance premium payments made by nonprofit charitable organizations like AKF on behalf of people with chronic illnesses like kidney failure. Under a 2014 Centers for Medicare and Medicaid Services (CMS) rule, insurance carriers are required to accept third party payments for Marketplace exchange plans only from federal and state programs; tribal organizations; and the Ryan White HIV/AIDS program.
CMS’s guidance on nonprofits like AKF making such payments has been open to a wide range of interpretations, and as a result, some insurance carriers are refusing to accept payments from AKF. Some carriers have erroneously applied the guidance to non-Marketplace insurance types, like Medigap. Some carriers have gone so far as to refuse coverage to anyone who is applying for health insurance but indicates on their application that they need charitable assistance to afford the plan. CMS recently stated that it intends to address in a future rule the issue of nonprofits making such payments. Along with other patient advocacy organizations, AKF has been asking CMS for two years to issue clear guidance that will protect the patients AKF assists.
The advocates asked their members of Congress to urge CMS to quickly issue new guidance that requires insurers to accept third-party premium payments from nonprofit charitable organizations, and to cosponsor H.R. 3742, the Access to Marketplace Insurance Act. Advocates told congressional offices that through rulemaking or legislation, the federal government can require insurance companies to accept health insurance payments from nonprofits like AKF, and thereby protect the health coverage of individuals who rely on charitable assistance.
To contact your U.S. Senators and U.S. Representative about this important issue, please visit the American Kidney Fund’s Action Center.
AKF’s Advocacy Day on Capitol Hill was made possible thanks to generous support from the following sponsors:
- Akebia Therapeutics
- Otsuka America Pharmaceutical, Inc.