Advocating for the kidney community in 2025

In 2025, a year in which the health care policy environment shifted and brought uncertainty, the American Kidney Fund's government affairs team continued to work on legislation and policies that help improve the lives of those living with and at-risk for kidney disease as well as living organ donors. As we settle into 2026, we want to look back at the progress we made last year thanks to the support and dedication of our expansive network of nearly 50,000 Ambassadors. 

Here is an overview of AKF's advocacy efforts in 2025. 

AKF Ambassadors

• Had more than 960 meetings with Congressional and state legislative offices
• Sent almost 44,000 action alerts to state and federal legislators. In June, 21,000 action alerts were sent to urge members of Congress to protect Medicaid and Affordable Care Act subsidies.
• Held 110 virtual in-district meetings with the local offices of their members of Congress.
• Had 410 meetings with state lawmakers and their staffs in 48 states.

AKF's government affairs team

• Sent 6 comment letters to federal agencies such as the Centers for Medicare and Medicaid Services (CMS) on issues that are important to the kidney community. The letters provided AKF's perspective on behalf of the kidney community on a number of critical topics, including:
  • The End-Stage Renal Disease (ESRD) Prospective Payment System (PPS) rule, which determines how dialysis clinics are paid through Medicare
  • The Affordable Care Act, Medicare Advantage and Part D programs, all of which play a vital role in health care coverage for people with kidney failure
  • Medicare coverage for molecular testing for solid organ allograft rejection, which allows transplant patients to get non-invasive testing to monitor for organ rejection. 

AKF advocacy events

AKF hosted several important advocacy-related events in 2025, including:

• Our first annual West Coast fly-in, which was hosted in Denver, Colorado. Attendees participated in advocacy training, including how to tell your story and social media training.

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• APOL1-Mediated Kidney Disease (AMKD) Townhall discussion with Congressman Glenn Ivey, which highlighted patients with AMKD and spread awareness of this rapidly progressive form of genetic kidney disease that impacts people of west and central African ancestry. AKF also hosted a session about AMKD at the Congressional Black Caucus Foundation's Annual Legislative Conference.
• Two advocacy days on Capitol Hill, connecting AKF Ambassadors with their elected officials to discuss important kidney disease legislation.
• The third Patient Access Initiative Summit, which is part of AKF's ongoing work to address health care access and issues faced by people with and at-risk for kidney disease. 

Bills and policy updates

In 2025, AKF was involved in the passage of 9 bills on the state level, including 3 living donor related bills, 3 Medigap bills, 2 biomarker bills and 1 bill that prevents life and disability insurers from discriminating against people who have received genetic testing. 

On the federal level, our advocacy efforts also increased support and cosponsors for AKF's priority federal bills. We hope for additional support and passage in 2026.

• The Living Donor Protection Act (H.R. 4582/4583 and S. 1552) would ensure living organ donors are protected from insurance discrimination and can take time off from work after organ donation surgery. By the end of 2025, the bill added 37 cosponsors in the Senate and 112 cosponsors in the House.
• The New Era for Preventing End-Stage Kidney Disease Act of 2025 (H.R. 1518). The bill aims to improve the understanding and timely and accurate diagnosis of rare kidney diseases. H.R. 1518 had 45 cosponsors.
• The Kidney Care Access and Protection Act (H.R. 6214/S. 2730) takes steps to improve and protect kidney dialysis patients' access to innovative therapies and high-quality kidney health care.  By the end of 2025, the bill added 1 cosponsor in the Senate and 2 in the House.
• Access to Genetic Counselors Act (H.R. 6280/S. 3607) would change Medicare law so the program would recognize genetic counselors as practitioners and give them the ability to bill Medicare directly. This would give Medicare beneficiaries greater access to their services. This bill had 3 cosponsors at the end of 2025. The Senate bill was introduced the first week in January 2026.
• Extending the Affordable Care Act enhanced advanced premium tax credits. The enhanced advanced premium tax credits were set to expire at the end of 2025. Unfortunately, Congress did not expand them before the deadline. AKF's government affairs team is continuing to meet with congressional offices on this issue in hopes that a solution will be passed early 2026. 

Get involved in 2026

Interested in helping fight for positive change for the kidney community? There are several ways you can get involved. 

Join our Mobile Advocacy Network! This is a quick and easy way to stay up to date about advocacy opportunities in your state and at the federal level so you can take action on important issues. Through this tool, you can send emails and engage with your lawmakers on X and other social media platforms. Sign-up for the Mobile Advocacy Network here, or by texting "KIDNEY" to 52886.

• If you have friends and family who are interested in becoming AKF Ambassadors, please encourage them to sign up.
• If you are already an AKF Ambassador and are interested in participating in this year's Kidney Action Summit, which will be held May 4-6 in Washington, D.C., be sure to keep an eye on your Ambassador e-newsletter and the Facebook group for when applications are open.
• AKF is tracking kidney-related legislation across all 50 states so that AKF Ambassadors and advocates know exactly where to step in. To find out what is happening in your state and how you can help, check out our advocacy map.

Thank you to all the AKF Ambassadors who worked with us in 2025 to advocate for the kidney community and helped to achieve these accomplishments. We look forward to continuing our advocacy efforts with you this year!