Medigap Expansion Bill Offers Fiscally Responsible Solution for Dialysis Patients

Posted: Feb 27, 2022 12:01 AM
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Medigap Expansion Bill Offers Fiscally Responsible Solution for Dialysis Patients

Source: AP Photo/Rogelio V. Solis

As of this March, it’s officially been two years since the COVID-19 pandemic upended our day-to-day lives. Mask-wearing, capacity limits, even broad shutdowns were enacted across the country as health experts worked to get a full grasp of the situation and understand the depth of the problem at hand, with a particular focus on protecting groups of patients with compromised immune systems. 

While things are thankfully on the upswing now – as vaccines and booster shots are widely available and the spike we saw in new cases at the start of the year has dropped dramatically – in many ways the full scope of just how much vulnerable groups of patients have been affected by the pandemic is only now coming into frame, for dialysis patients more than most other groups of patients.

Since kidney disease compromises a patient’s immune system, dialysis patients found it harder than ever to get the treatment they need. Finding reliable transportation to a clinic, ensuring they were safe from the virus while receiving treatment, and other factors contributed to something that the nation hasn’t seen before: the U.S. population of dialysis patients fell. And for many patients, the problem was only compounded by the fact that they didn’t have a reliable way to cover the costs of their treatments. 

While Medicare helps to cover some of the costs of dialysis treatment, it will only cover up to 80 percent of the total bill. The rest of the cost falls on patients and their families, unless they have access to Medigap insurance plans that prevent them from having to pay those significant out-of-pocket costs that Medicare doesn’t pay for. Right now, however, it is up to states to require insurers to offer those plans to dialysis patients, and many don’t. Even in cases where they do, those plans can be prohibitively expensive. 

Now, it’s important for lawmakers to find a smart, cost-effective solution that ensures dialysis patients across the country can access Medigap coverage. Thankfully, Representatives Jaime Herrera Beutler (R-WA-3) and Cindy Axne (D-IA-3) have introduced the Jack Reynolds Memorial Medigap Expansion Act to accomplish exactly that. The bill would guarantee that patients under 65 who suffer from End-Stage Renal Disease have access to Medigap plans that can help them pay for their dialysis treatments, and it would do it in a fiscally responsible way.

In fact, according to a study about the bill published last year, passing the Jack Reynolds Memorial Medigap Expansion Act would reduce federal spending on Medicare by $1.2 billion over the next ten years by extending the Medicare Secondary Payer period for dialysis patients who already receive coverage through an employer. 

This bill represents exactly the type of sound, responsible healthcare policy that the U.S. needs. I hope that Representatives Herrera Beutler and Axne receive the backing they need from their fellow members of Congress to ensure this bill makes it to the president’s desk and is signed into law. Dialysis patients across the country are counting on it. 

We’re still putting together the full picture of how dialysis patients and other vulnerable groups of patients were affected by the pandemic. However, we have a blueprint in front of us to combat one of the most significant challenges they’ve faced over the past two years, and we need Congress to do its part to help. This bill will benefit patients, benefit our country, and leave us better prepared to face whatever healthcare challenges may lie ahead. 

Matt Mackowiak is the President of Potomac Strategy Group and is a veteran of both the Bush administration and the Bush-Cheney re-election campaign.