No On AB 290

What is AB 290?

  • Increases insurance company profits while harming dialysis patients.
  • Attacks vulnerable, low-income dialysis patients by eliminating charitable premium assistance (CPA) in California.
  • Slashes what private insurers pay for the care of dialysis patients – below the actual cost of care.
  • Jeopardizes access to care for ALL dialysis patients who need dialysis three days a week, four hours at a time, to survive.
  • Opposed by patients, doctors and dialysis providers.
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Learn More about AB 290 See Who Opposes AB 290

Reject AB 290: Bill Eliminates Financial Assistance for more than 3,700 Low-Income California Dialysis Patients

Bill increases insurance company profits while harming dialysis patients and jeopardizing access to care.

AB 290 attacks vulnerable, low-income dialysis patients by eliminating charitable premium assistance (CPA) in California.

  • In 2018, more than 3,700 Californians on dialysis (about 5% of all dialysis patients) received financial assistance from the American Kidney Fund (AKF), an independent, non-profit charitable organization which helps pay health insurance premiums for dialysis patients enrolled in Medicare Part B, Medigap, Medicare Advantage, employer group health, COBRA and commercial health insurance plans. These patients are largely minority (68% Latino, African-American and Asian) and low-income (average income less than $30,000/yr).
  • AKF warns: “If AB 290 is passed, it will quickly force AKF to stop helping low-income Californians living with kidney failure.” AB 290 requires AKF and other charities to disclose confidential patient information to insurance companies in violation of federal regulations governing charitable premium assistance. AKF states that these provisions would violate the program’s federal regulations and force it to stop helping California patients.
  • AB 290 discriminates against low-income dialysis patients. The only patients affected by AB 290 are low-income dialysis patients who need charitable premium assistance to help pay their insurance premiums.

AB 290 jeopardizes access to care for ALL dialysis patients who need treatment three days a week, four hours at a time, to survive.

  • When AKF is forced to discontinue premium assistance in California, thousands of dialysis patients will lose their private insurance coverage and be forced onto government programs (Medicare/Medi-Cal). This likely will result in a significant increase in what patients have to pay for their own care, since Medicare only covers 80% of treatment costs. And as collateral damage, many other California patients will lose assistance with their Medicare and Medigap premiums.
  • AB 290 also jeopardizes the financial viability of dialysis clinics. Shifting even a few patients from private insurance to government programs, or slashing what private insurers pay for the care of commercial patients, upsets the delicate dialysis ecosystem. Throughout health care, reimbursements from private insurance help subsidize the losses from government payors – whose payments do not cover the cost of care. With dialysis, this necessary cross-subsidization is even more acute. 90% of dialysis patients rely on government coverage and only 10% of patients have private insurance.
  • As funding for dialysis clinics is dramatically reduced, California patients will experience long-term access to care issues (fewer clinics built, fewer treatment times available). This, at a time when demand for dialysis is growing at a rate of 5% per year statewide and California must build an additional 350 clinics over the next 10 years to meet demand.
  • If California can’t meet future demand for dialysis treatment facilities, patients will end up dialyzing in hospital emergency rooms at a much higher cost. This will raise health care and taxpayer costs for all Californians.

AB 290 slashes what private insurers pay for the care of dialysis patients – below the actual cost of care.

  • In the unlikely event that charities are somehow able to continue providing premium assistance to low-income patients, AB 290 adds another provision to pad insurance company profits.
  • AB 290 allows insurance companies to slash reimbursements to Medicare rates for patients who receive charitable premium assistance. According to a January 2019 report by the payment advisory committee for the federal government (MedPAC), Medicare reimbursement levels are 1.1% below the actual cost of providing dialysis care.

AB 290 does nothing to lower overall health care costs.

  • The bill does not contain any language requiring insurers to pass any savings on to consumers. AB 290, sponsored by insurance companies, increases insurance company profits.

AB 290 sets a dangerous precedent that threatens charitable assistance for patients with other life-threatening diseases.

  • Many charitable premium assistance programs serving patients coping with other financially-crippling, catastrophic diseases--like cancer, rare blood disorders, multiple sclerosis and rheumatoid arthritis--operate under the same guidelines as the American Kidney Fund (OIG 97-1).
  • Provisions in AB 290 that prevent AKF from operating in California could potentially jeopardize these other non-profits as well. Patients who rely on those programs will be left with nowhere to turn.

AB 290 is opposed by doctors, caregivers, patients, business and taxpayer groups, and dialysis providers. This dangerous bill will jeopardize patient access to life-saving dialysis care.

Reject insurance company profiteering. Protect patient access to life-saving dialysis care. No on AB 290.

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Who Opposes AB 290


  • California Medical Association
  • California Hospital Association
  • Renal Physicians Association
  • National Hispanic Medical Association
  • National Medical Association
  • Chronic Disease Coalition
  • Dialysis Patient Citizens
  • Minority Health Institute
  • California Hepatitis C Task Force
  • American Kidney Fund
  • National Renal Administrators Association
  • Alameda-Contra Costa Medical Association
  • Fresno Madera Medical Society
  • Imperial County Medical Society
  • Kern County Medical Society
  • Los Angeles County Medical Association
  • Merced-Mariposa County Medical Society
  • Monterey County Medical Association
  • Napa County Medical Society
  • North Valley Medical Association
  • Orange County Medical Association
  • Placer-Nevada County Medical Society
  • Riverside County Medical Association
  • San Bernardino County Medical Society
  • San Francisco Marin Medical Society
  • San Joaquin Medical Society
  • San Mateo County Medical Association
  • Santa Clara County Medical Association
  • Sierra Sacramento Valley Medical Society
  • Solano County Medical Society
  • Stanislaus County Medical Society
  • Tuolumne County Medical Society
  • Yuba-Sutter-Colusa Medical Society
  • Ventura County Medical Association
  • Los Angeles Wellness Station
  • FAIR Foundation
  • California Dialysis Council
  • Satellite Healthcare
  • DaVita Kidney Care
  • Fresenius Medical Care
  • U.S. Renal Care
  • Dialysis Clinic, Inc.


  • California State Conference NAACP
  • Desert AIDS Project
  • Community Health Action Network
  • Black Women Organized for Political Action – Political Action Committee
  • Sacramento Valley Section-National Council of Negro Women, Inc.
  • Equity Alliance Group, Inc.


  • California State Commanders Veterans Council
  • American Legion, Department of California
  • American GI Forum of California
  • AMVETS Department of California
  • Women Veterans Alliance
  • California Association of County Veterans Services Officers
  • National Guard Association of California
  • ROA Department of the Golden West
  • Scottish American Military Society
  • Jewish War Veterans, Department of California
  • United Veterans Council of San Joaquin County
  • National Veterans Foundation
  • California Council of Military Officers Association of America
  • Vietnam Veterans of America, California State Council
  • Association of the United States Army, Northern California Chapter
  • Association of the United States Army, Southern California Chapter


  • Los Angeles County Business Federation (BizFed)
  • Valley Industry & Commerce Association
  • California Black Chamber of Commerce
  • Latin Business Association
  • Orange County Business Council
  • Southwest California Legislative Council
  • Chambers of Commerce Alliance of Ventura and Santa Barbara Counties
  • Long Beach Area Chamber of Commerce
  • Silicon Valley Black Chamber of Commerce
  • Elk Grove Chamber of Commerce
  • Oxnard Chamber of Commerce
  • Greater Bakersfield Chamber of Commerce
  • Filipino-American Chamber of Commerce Business Network
  • Greater Coachella Valley Chamber of Commerce


  • California Taxpayer Protection Committee
  • Contra Costa Taxpayers Association
  • Placer County Taxpayers Association
  • Fullerton Association of Concerned Taxpayers

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