Reject AB 290
July 7, 2019
By Ricky Gossette
Editor’s note: The author is a dialysis patient.
Five years ago, I received the life-changing news that my kidneys were failing and I would need dialysis three times a week to survive. Just this last February, I was laid off from my job as an IT employee for a law firm.
And now, I face perhaps the most devastating news of all. The California Legislature is considering a bill that would end a charitable assistance program for dialysis patients that I rely upon to stay alive.
Assembly Bill 290 would force the nonprofit American Kidney Fund to stop a program in California that provides insurance premium assistance to thousands of low-income dialysis patients like me. It is sponsored by profit-hungry insurance companies seeking to shave the amount they reimburse dialysis clinics to below what it even costs to provide. In the process, insurance company profits would go up.
Without this assistance, which helps me pay for health insurance premiums as I wait on a transplant list, I would lose insurance and the peace of mind it brings to me that I will have access to regular dialysis treatments and I will stay on the transplant list. AKF’s program is literally saving my life.
Think about that. Insurance companies would see their profits rise at the expense of people’s lives.
In 2018, more than 3,700 Californians on dialysis, or about 5 percent of all dialysis patients, received financial assistance from the American Kidney Fund.
AB 290 requires AKF and other charities to disclose confidential patient information in violation of federal regulations governing how AKF must operate. So rather than risk its operations and the patients it serves nationwide, AKF has said it would be forced to leave California if AB 290 is passed.
Even in the unlikely event that AKF is able to continue providing premium assistance to low-income patients, AB 290 would allow 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 percent below the actual cost of providing dialysis care.
AB 290 does not even require insurers to pass these savings to consumers, but rather allows them to keep them as profit.
This would be devastating for dialysis clinics, many of which rely on privately-insured patients to make ends meet. Some might even be forced to close their doors, reducing access to dialysis at a time when the need is growing. Where will patients like me get dialysis if outpatient clinics close? The only option would be hospital emergency rooms where the cost of care is much higher.
For me, it took a while to adjust to the drastic lifestyle change that comes with going to a dialysis clinic three times a week for three to four hours at a time. On dialysis, you must structure your life around these life-sustaining treatments, change your diet, and budget wisely. But I just had to make it a part of my life.
This bill, quite simply, will harm a lot of people. I urge the Legislature to save lives and defeat this insurance-company cash grab that discriminates against vulnerable, low-income Californians. Please vote no on AB 290.
— Ricky Gossette/Vallejo