Congress has allowed ESRD patients to stay on private health plans, which provides an option for patients who can afford to stay on their private insurance. This option is particularly important given the lack of access to Medigap supplemental plans for ESRD patients under the age of 65 in nearly half the states. Many low-income individuals need assistance to exercise the option of staying on their private insurance.
Any proposed legislative or regulatory changes to the Affordable Care Act (ACA) should maintain patient protections that help people with chronic conditions such as kidney disease access the services they need to manage their conditions. AKF is fighting to protect the access of patients with chronic kidney disease and ESRD to affordable and high-quality health care. AKF has the following principles to guide our support:
- Access to comprehensive, affordable coverage – It is imperative that Congress and the administration ensure protections for people with preexisting conditions and maintain the integrity of the essential health benefit (EHB) standards established under the ACA. Doing so ensures that people in need of comprehensive and affordable coverage have access to it. We oppose the expansion of less comprehensive insurance options, such as association health plans and short-term limited duration plans, which are exempt from covering the essential health benefits or are able to deny or limit coverage for people with preexisting conditions. The expansion of these plan options will siphon healthier individuals from the risk pool, leading to higher premiums for individuals who purchase comprehensive ACA coverage. We also oppose proposed changes to states’ selection of EHB benchmark plans that could lead to less comprehensive categories of coverage and jeopardize access to life-saving services and treatments such as chronic kidney disease management, dialysis treatment, and kidney transplant.
- Market stabilization – AKF supports proposals that would help stabilize the ACA Marketplace, such as funding reinsurance programs, cost-sharing reduction payments, and ACA enrollment outreach and education activities. We also support proposals that would expand eligibility for cost-sharing reduction subsidies and advanced premium tax credits beyond the current income thresholds of 250 percent and 400 percent of the federal poverty level, respectively. By compensating insurers for high-cost patients, providing subsidies for a greater number of people to help them purchase coverage, and increasing enrollment through outreach efforts, these measures will help stabilize premiums in the ACA Marketplace and ensure access to comprehensive, affordable coverage options.