Thousands of Californians in jeopardy with AB 290 signature by Governor Newsom

October 14, 2019

SACRAMENTO – The Dialysis is Life Support coalition, a coalition of doctors, nurses, hospitals, dialysis caregivers, veterans, community and business groups, and more than 4,000 dialysis patients, expressed dismay that Governor Newsom signed AB 290 (Wood) today. AB 290 is sponsored by insurance companies.

AB 290 will upend the lives of thousands of low-income, vulnerable dialysis patients by eliminating the charitable premium assistance provided by nonprofit organizations like the American Kidney Fund (AKF). Provisions in the bill conflict with federal guidelines under which AKF must function, forcing AKF to stop operating its patient premium assistance program in California altogether. AKF has said it will end premium assistance in California beginning January 1, 2020.

All who look to AKF for medical financial grants are low income. More than two-thirds are minorities.

“I don’t know what I’m going to do,” 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. I’m at a loss for why Governor Newsom would do this to patients like me.”

“By signing AB 290, Governor Newsom failed to protect the most vulnerable dialysis patients,” said Kelly Goss, California State Advocacy Manager, Dialysis Patient Citizens, a national, nonprofit dialysis patient-led advocacy group and a member of Dialysis is Life Support. “AB 290 will immediately harm more than 3,700 of the poorest and sickest dialysis patients in California. But it doesn’t stop there. Over the long-term, AB 290’s rate setting provisions will limit access to dialysis care for all dialysis patients in California.”


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, 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).

Provisions in AB 290 conflict with AKF’s federal governing regulations (HHS OIG 97-1). The bill risks the lives of the more than 3,700 patients who depend on AKF’s charitable premium assistance by forcing the organization to leave California.  

The California Legislature has no backup plan for these patients.

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 or not offer as many benefits to patients.


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