Blog post

What's happening in the states: February 2022

Welcome to our "What's happening in the states" blog series, where we provide monthly 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.
Map of Rhode Island with blog title on top

Welcome to our What's happening in the states blog series, where we provide monthly 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.

Welcome to the 2022 state legislative sessions

The state legislative sessions are in full swing this year. Nearly all 50 states are in session right now, which means there is a lot of legislative activity across the country. In January, more than 33,000 state bills were introduced. That is almost 1,100 new bills each day! With so much activity, we are actively monitoring legislation that impacts those living with or at risk for kidney disease.

Some of our policy priorities include expanding protections for living organ donors, increasing access to Medigap, establishing chronic kidney disease task forces and passing resolutions to support Kidney Disease Awareness Month throughout March. Right now, AKF is working on more than 60 bills in over half of the states. So far this year, we have testified in Georgia, Kentucky, Virginia, Rhode Island and Nebraska.

Living donor protections

Living donor protection legislation is currently pending in 13 states. It is extremely important for lawmakers in those states to hear from their constituents (people who live in their districts) about the importance of living organ donation. Direct communication from constituents allows lawmakers to understand why these protections are needed and helps to ensure that these bills become laws. Living donor protection legislation prevents insurance companies from discriminating against living organ donors by charging higher premiums or refusing to insure them altogether, provides financial incentives and removes financial burdens for living donors. These protections can lead to an increase in organ donations and save lives by getting more people off the kidney transplant waiting list.

If you live in Delaware, Florida, Kentucky, Indiana, Massachusetts, Michigan, Ohio, North Carolina, Georgia, South Carolina, Virginia, West Virginia or Nebraska, please get in touch with your state representative or senator through the action center on our new website.


Another type of legislation that is critical to making health care affordable for people living with kidney disease involves expanding their access to Medigap. Medigap is private, supplemental Medicare insurance. Most people with kidney failure are eligible for Medicare, regardless of age, and most of them choose to enroll in the program as their primary health insurance coverage. However, Medicare plans typically cover only 80% of the costs of medical care and have no cap on out-of-pocket expenses. Medigap insurance plans help people afford their copays.

Medigap coverage is also vitally important for people trying to get on the kidney transplant waiting list. At most transplant centers across the country, kidney transplant candidates must demonstrate an ability to pay Medicare's out-of-pocket expenses to be accepted onto the waiting list. Without a Medigap plan, someone with kidney failure can be denied the lifesaving procedure of a kidney transplant.

Unfortunately, not all Medicare beneficiaries have access to supplemental coverage. In 20 states, including Rhode Island, where a Medigap bill is being considered, insurers are not required to offer Medigap to people with kidney failure who are under the age of 65. In advocating for Medigap legislation, AKF is working to ensure that people with kidney failure can access these important, supplemental insurance plans, regardless of their age.

Be sure to visit our new action center to stay updated on the Rhode Island bill's progress and how you can take action in your state.

How can you help?

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 Melanie Lendnal, AKF's senior director of state policy & advocacy, or Lindsay Gill, AKF's associate director of state policy & advocacy.

Also, please follow us on Twitter at @AKF_Advocacyfor real-time updates on state activity and other important advocacy information.

And of course, join us right from your phone by texting "KIDNEY" to 52886 or clicking here. We look forward to working with you!


Melanie Lendnal

Melanie Lendnal is the senior director of state policy and advocacy at AKF.

Lindsay Gill

Lindsay Gill is the associate director of state policy & advocacy at AKF.