Our Policy Priorities

There are longstanding health disparities in the U.S. — differences in health outcomes and health care among groups of people related to their race, ethnicity, age, disability, gender, geographic location, socioeconomic status and sexual orientation.

People with ESRD have experienced a disproportionate impact from COVID-19. Data from the Centers for Medicare and Medicaid Services (CMS) showed that at the end of 2020, Medicare beneficiaries with ESRD had the highest rate of hospitalization among all Medicare beneficiaries — a rate six times higher than the hospitalization rate for Medicare beneficiaries generally.

Although 37 million Americans are living with chronic kidney disease (CKD), most of them do not know it because it has no symptoms in the early stages. Millions more individuals are at risk of developing kidney disease and are not aware of their risks.

Health insurers systematically discriminate against low-income ESRD patients who rely on charitable assistance to afford their health insurance premiums and access the health care they need to stay alive. Over the years, many insurance carriers have refused charitable premium assistance payments from AKF on behalf of ESRD patients.

Kidney disease affects 37 million Americans — far more than many other diseases. Yet federally funded research for kidney disease has lagged compared with many other diseases. 

A kidney transplant is considered the best treatment option for many people facing kidney failure because it can increase their chances of living a longer, healthier life. However, the number of people on the organ transplant waiting list is great — about 108,000 Americans are on the list, with nearly 85 percent of those in need of a kidney.

Most ESRD patients are eligible for Medicare even if they are under 65. But 20 states do not require health insurers to offer private supplemental Medigap plans to these younger Medicare beneficiaries. 

As the Medicare benefit continues to evolve for ESRD beneficiaries and people with earlier stages of chronic kidney disease, and as policymakers examine ways to improve quality and lower costs, access to coverage options, supporting patient choice in treatment options, and improving care quality and patient education must be at the center.

The elimination of preexisting condition exclusions for health insurance under the Affordable Care Act (ACA) has enabled patients with chronic diseases, including kidney disease, to enroll in private commercial health plans that provide comprehensive coverage.

Access to medically appropriate prescription drugs for kidney patients must be preserved amid federal efforts to address the rising cost of prescription drugs. Patients with chronic kidney disease, kidney failure and kidney transplants rely on prescription drugs to manage their kidney disease and comorbidities.

Dietary interventions have been shown to be successful in managing and improving symptoms of chronic diseases such as heart disease, diabetes, and kidney disease.

Several important pieces of legislation have been introduced in the current Congress, and we are actively working to enact these bills that would affect kidney patients and their access to life-sustaining health care.