Cramer-Matsui Letter Shows Strong Bipartisan Congressional Support for Charitable Premium Assistance

People with chronic illnesses who rely on charities like the American Kidney Fund to afford their health insurance premiums have been notified by an increasing number of insurance companies that the insurers won’t accept premium payments from nonprofits.

Patient advocacy organizations and advocates have rallied to fight back, urging the federal government to protect patients from this discriminatory behavior by insurers. And now, nearly 40 percent of the U.S. House of Representatives is asking the U.S. Department of Health and Human Services to step in.

On May 31, nearly 200 Congressional Democrats and Republicans sent a letter to HHS Secretary Tom Price to urge that HHS protect the right of Americans to receive help from charities like the American Kidney Fund to afford health insurance coverage.

On behalf of the patients we serve—low-income people who need dialysis to stay alive—we are grateful to Reps. Kevin Cramer (R-ND) and Doris Matsui (D-CA) for their leadership on this issue, and to each of the 182 members of Congress from 39 states who put patients ahead of politics by signing on to the letter.

The letter expresses concern over a 2014 rule issued by the Centers for Medicare & Medicaid Services (CMS) on the topic of charitable premium assistance for plans in the Affordable Care Act marketplace exchanges. The interim guidance is highly ambiguous and unclear, and some insurers have interpreted it as being a license to refuse all charitable premium payments for certain high-cost patients.  And many insurers are refusing charitable payments not just for exchange plans, but also for Medicare supplemental coverage (Medigap) and other insurance products. This is done with blatant disregard for the tens of thousands of Americans on dialysis who can’t afford health care because they are too sick to work.  The letter asks Secretary Price clarify that charitable premium assistance from bona fide nonprofits like AKF should be available for all types of insurance plans. 

“It’s hard to believe that – due to a 2014 CMS rule – a health plan is allowed to deny coverage to a chronically-sick patient just because they’re receiving donations from their local church or a nonprofit, but that’s what’s happening today in at least 41 states,” Rep. Cramer said in a statement. “The federal government should overturn this rule and let charities be charitable. By allowing nonprofit charities to provide premium assistance to those most in need, we are providing a free market safety net for the most vulnerable among us to stay on health insurance. This practice should be encouraged, not discouraged.”

The 182 cosigners all agree with Reps. Cramer and Matsui that CMS should let charities be charitable. Allowing people on dialysis to not have to worry about a health insurance bill lifts an immense amount of stress off their shoulders and provides them the opportunity to focus on their treatment and getting better. 

If you would like to join our Advocacy Network so you can have your voice heard on Capitol Hill, click here. If you have any questions about the Advocacy Network or would like more information please contact Ben Shlesinger, Associate Director of Government Relations, at or 301-984-6636.

Posted: | Author: Ben Shlesinger