Citizens of Dialysis Patients Release Health Management Associates Report:

WASHINGTON, September 22, 2021 / PRNewswire / – Today, Dialysis Patient Citizens (DPC) released a report from Health Management Associates (HMA) detailing the costs associated with switching to Jack reynolds Memorial Medigap Expansion Act (HR 1676), which would require insurers to make Medigap plans available to patients with end-stage renal disease (ESRD) under the age of 65.

Under current federal law, insurers are not required to offer Medicare supplemental insurance plans (also known as Medigap) to patients under the age of 65. While Medicare pays 80 percent of an individual’s health care costs, patients are required to cover the remaining 20 percent out of pocket. As a result, Medicare beneficiaries who live in states without additional patient protection for those under 65 often find it difficult to cover their health care costs. The lack of supplemental insurance also remains a significant barrier for many dialysis patients who attempt to obtain a kidney transplant, as they are often required to demonstrate that they have the remaining funds to cover a potentially life-saving transplant operation in order to remain “active” on the transplant waiting list.

Health policy experts often criticize Medigap’s cost-sharing relief as adding to Medicare spending. However, using Medicare cost data from 2017 to 2019, HMA estimated that extending Medigap coverage to all ESRD patients under 65 would only add about $ 50 million in federal spending. over the next 10 years. HMA actuaries compared service utilization by dual-eligible dialysis patients versus Medicare-only dialysis recipients, and found that the only relevant increase in costs was in drug spending. HMA suspects that by expanding access to Medigap coverage, more dialysis patients will have the money to pay for all of their prescribed medications, as their supplemental insurance would now cover their other healthcare-related expenses. Therefore, HMA has forecast an increase in de minimis costs for Medicare due to increased use under Part D following the expansion of Medigap access to patients under 65 years of age. At the same time, the potential increase in treatment adherence could lead to better health outcomes and reduced complications. HMA’s full report is available at:

“For states that do not have protections for ESRD patients under 65, such as my home state Alabama, many patients have nowhere to turn “, said the chairman of the board of directors of DPC Andre Conkling. “In many cases where insurers offer Medigap coverage for ESRD patients under 65, the plans are still not affordable. Without this coverage, the costs can be huge and it can be more difficult to receive a transplant. kidney.”

The DPC calls on Congress to adopt the Jack reynolds Memorial Medigap Expansion Act, which was introduced earlier this year by officials Cindy axne (D-IA) and Jaime Herrera Beutler (R-WA), to help provide patients with ESRD the extra confidence they need to stay financially secure. The DPC recently published an interactive report card on Access and Accessibility to Medigap for ESRD Patients Under 65, available at:

“Currently, it is up to each state to determine whether Medigap plans are sold to people under the age of 65 who may be eligible because of their kidney disease. ” Representative Axne said. “The problem that bothered Jack reynolds – who this bill is named for – and what bothers me is that these Medigap plans have an unnecessary age limit although they are only open to people with serious illnesses. Kidney problems can occur at any age. For Jack, he was only four when he was injured and 22 when his kidneys started to fail. The bipartisan legislation that I run with the congresswoman Herrera Beutler would make this common sense solution to enable patients of all ages to get the coverage and care they need. “

“People living with end-stage kidney disease should have access to life-saving drugs, dialysis and kidney transplants needed to treat their disease” representing Herrera Beutler noted. “Unfortunately, thousands of Americans under 65 living with ESRD are not eligible for a Medigap plan that could help cover the cost of these treatments. I am proud to be associated with my colleague, Congresswoman Axne, on this important legislation to be put in place The Medigap plans are within reach and thus ensure that patients, regardless of their age, can access the care they need. ”


With more than 30,000 patient members, Dialysis Patient Citizens (DPC) is a nonprofit, patient-led organization that strives to improve the quality of life for all dialysis patients through education and advocacy. Learn more here:

CONTACT: Hannah bracamonte, [email protected]

SOURCE Dialysis patients Citizens

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