On March 23, Senate bill (SB) 1156 was introduced in the California state senate that would limit the ability of nonprofit charitable organizations like AKF to provide financial assistance to California dialysis patients who are unable to afford their health coverage. Most notably, as a condition of being allowed to make a third-party premium payment, the bill would require organizations like AKF to submit an annual statement to the insurer and the Department of Insurance (DOI) attesting that each recipient of premium assistance has applied and been determined ineligible for Medicare coverage and ineligible for financial assistance from California’s Medicaid (Medi-Cal) and ACA Marketplace (Covered California) programs. The bill is supported by the Service International Employees Union (SEIU) and Blue Shield of California.

This legislation would encourage discrimination against low-income ESRD patients based merely on their disability. The bill is a thinly-veiled attempt by insurance companies to kick kidney disease patients, who are disproportionately low-income and minority, off their insurance plans. Although the bill is poorly written and confusing, it would give insurance companies enormous power to determine which patients they would accept AKF premium support from and make it extremely difficult for ESRD patients to choose the coverage that best suits their needs. This is especially concerning for ESRD patients under the age of 65, because California law prohibits them from enrolling in Medigap supplemental coverage. For those patients, a private commercial plan with an out-of-pocket maximum may be the best plan for them and their families, since they cannot access Medigap coverage that would help them cover the 20 percent of medical expenses (with no out-of-pocket cap) that Medicare Part B does not.   

AKF issued a press release, issued an action alert to our advocates that urges lawmakers to vote no, and launched a landing page on our website informing people how this bill discriminates against ESRD patients and jeopardizes the coverage and care of many of the 67,000 Californians who rely on dialysis to stay alive. AKF staff has had several meetings with members of the California Senate Health Committee in Sacramento to educate them on AKF programs and how this bill will harm kidney disease patients. The Senate Health Committee held a hearing on the bill on April 18, and AKF staff and AKF advocate Lori Noyes provided testimony.

If you live in California, please contact your state lawmakers and urge them to vote no on SB 1156 by using our action alert and calling their offices. You can look up your state lawmakers here.