ROCKVILLE, Md. (March 9, 2021) – The American Kidney Fund (AKF) applauds Reps. Cindy Axne (D-IA) and Jaime Herrera Beutler (R-WA) for introducing the Jack Reynolds Memorial Medigap Expansion Act, legislation that is vitally important to people with kidney failure, also known as end-stage renal disease or ESRD. The bill would expand Medigap coverage for ESRD patients under age 65, who currently cannot purchase Medigap in 20 states. Without Medigap supplemental coverage, these patients are exposed to unaffordable out-of-pocket expenses including copayments, deductibles and coinsurance.
"Where you live shouldn't determine whether your Medicare coverage is affordable — every state should make Medigap available to Medicare's ESRD beneficiaries under 65," said LaVarne A. Burton, president and CEO of the American Kidney Fund. "AKF is deeply grateful to Reps. Axne and Herrera Beutler for introducing this critical legislation. It has the power to make a real difference in the lives of the people we represent."
Kidney failure can strike at any age, and more than half of ESRD patients are younger than 65. Longstanding federal law makes most eligible for Medicare regardless of age, but Congress has left it up to the states to determine whether Medigap should be available to these younger patients. Medicare covers dialysis as an outpatient procedure and pays for 80% of treatment costs, but the patient must pay the other 20% with no annual out-of-pocket limit. For a dialysis patient without secondary insurance, this can mean medical expenses of $10,000 per year or more.
"Paying out of pocket $10,000 or more annually is an enormous burden on this patient population," said Burton. "More than 80% of people on dialysis are too sick to work. Medicare's out-of-pocket expenses are simply unaffordable for many patients."
Having Medigap is also critically important to patients who want to be added to the kidney transplant waiting list. Demonstrating an ability to pay Medicare's out-of-pocket expenses is usually a requirement to be accepted onto the transplant waiting list. "Without a Medigap plan, ESRD patients can be denied the life-saving procedure of a kidney transplant — the best treatment option for people with kidney failure," said Burton.
"This legislation would ensure that all ESRD patients, regardless of their age and where they live, will be able to purchase Medigap coverage. Introduction of this bill is just the first step. AKF is asking other Members of Congress to cosponsor this important legislation so that we can make 2021 the year Medigap becomes available to everyone with kidney failure," said Burton.
About the American Kidney Fund
The American Kidney Fund (AKF) fights kidney disease on all fronts as the nation’s leading kidney nonprofit. AKF works on behalf of the 37 million Americans living with kidney disease, and the millions more at risk, with an unmatched scope of programs that support people wherever they are in their fight against kidney disease—from prevention through transplant. With programs that address early detection, disease management, financial assistance, clinical research, innovation and advocacy, no kidney organization impacts more lives than AKF. One of the nation’s top-rated nonprofits, AKF invests 97 cents of every donated dollar in programs, earning the highest 4-Star rating from Charity Navigator for 20 years in a row as well as the Platinum Seal of Transparency from Candid, formerly GuideStar.