Blog post

What's Happening in the States: April 2023

Welcome to our What's happening in the states blog series, where we provide monthly legislative updates on what AKF is working on across the country to improve the lives of those living with kidney disease and protect living organ donors.
Map of US - what's happening in the states

Welcome back to our What's Happening in the States series, where we provide quarterly legislative updates on what the American Kidney Fund (AKF) is working on across the country to improve the lives of those living with kidney disease and protect living organ donors.

  • Landscape
    • This could be a productive year for the states. All 50, plus the District of Columbia, will be in session at some point during the year. Over the first three months of 2023, we have already seen progress in key areas like living donor protection, Medigap coverage and biomarker testing. It is an exciting time, and we expect even more movement on important bills as we move into spring.
    • 2022 was a successful year for AKF advocates, with 14 laws passed across the country.  We had victories on behalf of living donors and people seeking Medigap coverage, and we were able to pass legislation that started kidney disease task forces to look at future legislation that could help people suffering from kidney disease.
  • State Progress
    • So far, Wyoming and New York have enacted new laws to protect living donors. The Wyoming legislation will stop insurance companies from reducing or denying someone's coverage simply because they are a donor, and the New York bill extends financial support to living donors.
    • In Medigap coverage expansion, Virginia will require insurers to offer plans to end-stage renal disease patients at the same prices as similar plans available for people 65 and older as of July 1. Kentucky passed its own law extending Medigap coverage to people under 65 who qualify for Medicare, including people with end-stage renal disease beginning next year.
    • Interest in biomarker testing coverage is growing, and AKF is tracking more than 20 bills across the states that would expand insurance coverage of biomarker testing for people with kidney disease or other serious conditions. Just last week, Kentucky Gov. Andy Beshear signed a bill that ensures biomarker testing coverage under health plans and Medicaid, beginning in 2024.
  • Legislation to Watch
    • AKF is tracking a wide range of bills across the states this year, especially since so many states are or will be in session in 2023. As usual, we are closely monitoring efforts to expand living donor protections and Medigap coverage, in addition to biomarker and genetic testing coverage and legislation focused on building awareness of kidney disease and its impacts.
    • We expect movement across the country in the coming months and are paying close attention to legislative activity in Rhode Island, Texas, North Carolina and South Carolina.
      • Rhode Island lawmakers have filed language to expand living donor protections, as well as a bill to establish a tax credit of up to $10,000 for people who have donated a kidney.
      • In Texas, we are tracking legislation on biomarker testing coverage, living donor awareness, and Medigap and Medicaid expansion.
      • By summer, we hope that North Carolina and South Carolina will advance their respective bills extending living donor protections.
    • We will follow these bills and legislatures closely, but this is just a snapshot of the issues AFK is tracking. If you do not see your state here, that does not mean there are no important measures before the legislative body. We will have more updates to come as sessions progress, but we are also happy to discuss with you directly! Please feel free to reach out to us.
  • Get Involved
    • If you would like to join in these efforts, be sure to sign up for our AKF Ambassador Network. Once you are part of the network, you will receive emails or text messages that alert you to opportunities to contact your legislators at the state and federal levels on potential legislation. You will also get invited to monthly webinars with AKF Government Affairs staff, giving you the latest information and opportunities to engage. AKF staff will also help you share your powerful stories so our elected officials can grasp why these issues are so vitally important.
    • All these bills have a better chance of moving through the legislative process with your help! If you would like to contact your state lawmakers about these bills or help with written or live testimony during bill hearings, please reach out to Ari Holland-Baldwin at  
    • Also please follow @akf_advocacy on Twitter, where we provide real time updates on state activity and other important advocacy information.
    • And of course, don't forget to join us right from your cell phone by texting "KIDNEY" to 52886 or clicking here. We look forward to working with you!


Ari Holland-Baldwin

Ari Holland-Baldwin is the Associate Director of State Policy and Advocacy at AKF