Dialysis patients breathe temporary sigh of relief knowing their medical financial assistance will not end on Dec 31

December 31, 2019

Court grants preliminary injunction to halt Assembly Bill 290 (Wood)

SACRAMENTO – Today, the Dialysis is Life Support coalition, a coalition of doctors, nurses, dialysis caregivers, veterans, community and business groups, expressed relief after a federal court in California granted a preliminary injunction preventing Assembly Bill 290 (Wood) from taking effect on Jan. 1, 2020.

“Considering both the likelihood that AB 290 will abridge plaintiffs’ constitutional rights and the extreme medical risks it poses to thousands of (end-stage renal disease) patients, the Court finds it obvious that the public interest favors a preliminary injunction, and that the balance of the hardships tilts strongly in plaintiffs’ favor,” the court said in its ruling released yesterday.

“The court’s ruling is very good news,” said Johnny Cooks, a dialysis patient from San Mateo. “The financial help I get from the nonprofit American Kidney Fund helps me pay for my Medicare supplemental insurance and for medical expenses and the treatments I need to stay alive. I can’t afford to pay that insurance on my own and without that supplemental coverage, my out-of-pocket costs will be in the thousands of dollars. I don’t have that kind of money.”

According to a statement released from AKF yesterday, the nonprofit plans to continue its medical financial assistance program in California including signing up new patients.

More than 3,700 low-income Californians on dialysis rely on medical financial assistance from the non-profit American Kidney Fund (AKF) which they use to pay for their health insurance coverage. AKF had repeatedly stated that AB 290, which was signed into law by Governor Newsom in October, contains provisions that conflict with the federal advisory opinion governing AKF’s premium assistance program, thereby forcing AKF to terminate the program in California.

As AB 290 was moving through the legislative process in 2019, AKF notified state legislators and patients that if the bill became law, the non-profit charity would be forced to leave California on Dec 31 this year. Despite hearing from dialysis patients, nurses, patient care technicians, physicians and many others, legislators passed the bill without coming up with a Plan B for dialysis patients who will lose insurance coverage without financial help from AKF.

In November, the American Kidney Fund, Dialysis Patient Citizens, and two patient plaintiffs filed a suit in federal court in California asserting numerous constitutional challenges against AB 290. Fresenius, DaVita, and U.S. Renal Care have separately filed suit in the same court also challenging AB 290’s constitutionality. The California Medical Association and the California State Conference of the NAACP filed amicus briefs in support of enjoining AB 290 as unconstitutional.

“We are truly grateful to the court for grating so many vulnerable dialysis patients this temporary reprieve,” said Hrant Jamgochian, Chief Executive Officer for Dialysis Patient Citizens, a national, nonprofit dialysis patient-led advocacy group and a member of Dialysis is Life Support. “We know that AB 290 still threatens more than 3,700 of the poorest and sickest dialysis patients in California. Health insurance coverage is absolutely critical for patients to continue their dialysis treatments, and if they can’t maintain it, their lives are literally on the line. That is why DPC joined as a plaintiff in this critical litigation, and why we hope this repugnant law never takes effect.”


More than 3,700 vulnerable dialysis patients in California rely on AKF’s charitable assistance grants to help pay for their health insurance – Medicare, Medigap supplemental, employer group health plans, COBRA, and other plans.

AKF beneficiaries are largely minority (68% are African American, Latino and Asian) and all are low-income (average less than $30K annually). Among other constitutional problems, AB 290 violates the First Amendment’s speech and association protections and conflicts with federal law, violating Congress’s efforts to protect ESRD patients’ access to health care and choice in insurance, and to spread dialysis costs among public and private insurers.

Dialysis patients must get dialysis three times a week, for three to four hours at a time, to stay alive. The process of dialysis, removing toxins and fluid build-up, is so critical that missing just one treatment increases patient risk of death by 30%.

Without AKF’s charitable premium assistance, many patients may find themselves unable to even afford their Medicare premiums.

And for many dialysis patients, AKF grants pay for the supplemental policies needed to cover the 20% of health care costs Medicare does not cover. Without a supplemental policy, out-of-pocket costs for dialysis patients average $9,000[1] annually.

Insurance companies sponsored AB 290 as a way to boost profits by pushing patients off private insurance and on to government-funded Medicare or Medi-Cal, which may be more costly, not offer as many benefits to patients and not provide coverage for their families.

For more information, go to ProtectPatients.com.

[1] https://www.kidney.org/blog/advocacy-action/medicare-beneficiaries-kidney-failure-have-highest-out-pocket-spending

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