Georgia’s Kidney Care Community Praises Introduction of Legislation to Improve Patient Access to Quality Kidney Dialysis and Transplant Care

(BUSINESS WIRE)--Members of Georgia’s kidney care community – including patients, physicians, providers, and kidney transplant groups – today applauded State Senators Don Thomas (R-Dalton) and Ed Harbison (D-Columbus) for introducing bipartisan legislation to help approximately 2,000 Georgians suffering from kidney failure who are having difficulty accessing health insurance for their dialysis care or needed transplant medications. If enacted, this legislation could result in a positive fiscal impact of approximately $20 million over five years for Georgia’s Medicaid system. In addition to helping people with kidney failure, the legislation will also help any Georgia citizen who is under 65 and has Medicare as a result of a disability.

“I am proud to introduce legislation today that would provide thousands of Georgians with the financial assistance needed to access life-saving kidney care.”

Secondary coverage – known as Medigap insurance – is designed to help patients pay for medical expenses that Medicare does not cover, such as co-insurance, deductibles and co-pays. Under current federal law, only Medicare beneficiaries over the age of 65 are able to purchase this insurance as secondary coverage; however, patients under the age of 65 do not have this same option. This coverage provides patients with essential access to needed medical treatments, including kidney transplant, without cost being a barrier to care. Medigap coverage protects patients from having to “spend down” their income to become eligible for state Medicaid assistance. The legislation (S.B. 316) would provide Georgia end stage renal disease (ESRD) patients under the age of 65 and those deemed disabled access to Medigap coverage.

“I fully understand the vital role dialysis and transplant care play in the lives of individuals affected by this disease,” said Sen. Don Thomas. “I am proud to introduce legislation today that would provide thousands of Georgians with the financial assistance needed to access life-saving kidney care.”

Under current Medicare law, two populations qualify for coverage: individuals over the age of 65, and those under 65 who meet certain conditions, including the diagnosis of ESRD, also known as kidney failure. While Medicare covers most medical costs, it requires patients to pay deductibles and co-pays, which most patients pay for with the assistance of secondary insurance. However, more than 2,000 kidney patients in Georgia under age 65 have no secondary insurance coverage and cannot afford Medicare deductibles and co-pays. As a result, they often experience financial delays and roadblocks for critical medical services because of the upfront payments that are required and are forced to turn to the Medicaid program for support. To qualify for Medicaid, patients have to impoverish themselves, and often their families as well, to qualify. This, in turn, leads to severe health risks for patients who are unable to afford drugs or who forego treatment, which can result in emergency care and a higher cost to Georgia’s taxpayers.

In addition to granting coverage assistance to patients who are unable to pay expensive deductibles and co-pays, this legislation will lead to significant decreases in Medicaid spending for ESRD patients under the age of 65, resulting in approximately $20 million in Medicaid savings for Georgia taxpayers over five years.

“The ability to acquire Medigap insurance will significantly improve kidney care patients’ access to care across Georgia,” said Chad Lennox, executive director of Dialysis Patient Citizens, a national nonprofit patient organization. “No patient or family should have to jeopardize their financial future in order to receive the care they need, which is why we fully support this legislation. All dialysis and kidney transplant patients deserve the same level of access to care.”

If passed, Georgia will join 29 other states across the country that have already passed similar reforms. Most recently, the Florida Legislature unanimously passed the “The Alonzo Mourning Access to Care Act” – named for NBA All Star Alonzo Mourning who received a kidney transplant in 2003 – which will allow Florida’s ESRD patients and those disabled under age 65 to purchase Medigap insurance as secondary coverage for their kidney care.

“Access to quality dialysis and transplant care is absolutely critical to the more than 14,000 chronic kidney disease patients across the state of Georgia,” said Marlin R. Gottschalk, vice-president and legislative coordinator for the Georgia Association of Kidney Patients, a patient advocacy and support group. “Kidney disease knows no boundaries in terms of age, race or economic condition, so we must work together to ensure that policies are put in place that allow all patients, of every age, to access the coverage they need to receive quality medical care.”

To view the legislation, please visit http://www.legis.state.ga.us/legis/2009_10/sum/sb316.htm.

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