American Kidney Fund supports injunction to halt CMS interim final rule


Statement from LaVarne A. Burton, President and Chief Executive Officer, American Kidney Fund

ROCKVILLE, Maryland (January 6, 2017) -- The American Kidney Fund (AKF) supports the Emergency Motion for Temporary Restraining Order and Preliminary Injunction filed today by Dialysis Patient Citizens et al. We have maintained that the interim final rule (IFR) released by the Centers for Medicare & Medicaid Services (CMS) on December 14, 2016 and scheduled to go into effect on January 13, 2017 was hastily promulgated, is discriminatory, contains serious factual errors, and, most egregiously, threatens to turn back the clock to a time when patients with pre-existing conditions could not get private health care coverage. We have filed an affidavit in support of the motion.

We will submit a comment letter to CMS next week detailing our opposition to the interim final rule and the flawed process through which it was promulgated. The IFR effectively gives insurers veto power over covering patients with kidney failure who need financial assistance to afford their insurance premiums—relegating an entire class of disabled individuals who are poor and disproportionately minority to dependence on taxpayer-funded health care—even if they have determined it is not the best choice for them.

The American Kidney Fund has been the safety net for low-income dialysis patients for 45 years, and we have assisted patients in paying their health insurance premiums for 20 years under our federally approved Health Insurance Premium Program (HIPP). AKF has provided premium assistance for private commercial individual health care plans (as well as private COBRA plans and EGHPs) since 1997, long before the passage of the Affordable Care Act (ACA). We have operated this program under the guardrails provided by the U.S. Department of Health and Human Services. 

HIPP exists to preserve each eligible low-income ESRD patient’s ability to choose and maintain the coverage that is best for them, no matter what that coverage option is and no matter who their health care provider is. AKF strongly supports the rights of patients to choose their own insurance plans and health care providers. By providing assistance for the full range of insurance options and otherwise staying independent from patients’ choices regarding provider and coverage, we ensure that our grant decisions cannot steer patients toward any particular type of coverage. We have reached out on numerous occasions to the Centers for Medicare and Medicaid Services and offered to work with them to ensure that patient rights continue to be protected even as our health insurance Marketplace has changed.

We are already seeing insurers emboldened by the IFR and moving to refuse third-party premium assistance for other coverage plans such as COBRA. We expect that insurers will continue to invoke the IFR as providing authority to discriminate against ESRD patients seeking assistance for Medigap, COBRA and EGHPs. Tens of thousands of low-income individuals living with ESRD will have no option but the most basic Medicare or Medicaid coverage, funded 100 percent by taxpayers, with no way to pay for the thousands of dollars in additional, uncovered costs for their care. Tragically, thousands more may find themselves unable to afford even the modest premiums required by government programs, endangering their access to the very treatments that keep them alive.