The Corner

Health Care

CA Bill Could Restrict Access to Kidney Dialysis

A California kidney patient writes to warn that AB 290 could make kidney dialysis more difficult to access for thousands of patients that obtain charitable assistance to help pay for their care. From the column by Duc Dang:

I depend on a charitable financial grant from the nonprofit American Kidney Fund to help pay for my daily at-home dialysis. Without the grant, I cannot afford the treatment. Without the treatment, I will die. Assembly Bill 290, supported by California’s health insurance companies, will force AKF to cease operating its program in California, hurting me and the more than 3,700 Californians who rely on its financial assistance.


This is because provisions in AB 290 conflict with the strict federal guidelines under which AKF operates and, rather than risk its operations nationwide, AKF will simply stop offering assistance in California.

The bill has already passed the assembly and is heading for the Senate, which approved a nearly identical bill last year, eventually vetoed by Jerry Brown.

If the bill becomes law, it would force Dang onto Medicare, which doesn’t provide an equivalent benefit:

By forcing dialysis patients on to government-funded health care plans, AB 290 will threaten the long-term viability of dialysis clinics since government reimbursements don’t cover the cost of care. If dialysis clinics are forced to cut back services or close because they can’t cover their costs, patients will end up in emergency rooms where care is up to eight times more expensive. The health care system as a whole, and taxpayers, will bear the burden of higher costs.

Not surprisingly, AB 290 also allows insurance companies to pay less to dialysis providers as reimbursement for dialysis treatments. Of course that’s why the insurance industry is supporting the bill. But it doesn’t force insurers to pass any of their savings to consumers. A win-win for insurance companies, but not for patients.

If Dang is correct — and his position is echoed by patient advocacy groups — then the bill would make people with potential terminal kidney conditions less able to access care, effectively corroding hope — this in a state where many of these patients would also qualify legally for assisted suicide.

Now, that’s a real way to reduce healthcare costs! Good grief.

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