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WASHINGTON, Sept. 22, 2021 /PRNewswire/ — Immediately Dialysis Patient Citizens (DPC) launched a report by Well being Administration Associates (HMA) detailing the prices related to the passage of the Jack Reynolds Memorial Medigap Growth Act (H.R. 1676), which might require insurers to make Medigap plans out there to Finish-Stage Renal Illness (ESRD) sufferers below the age of 65.
Beneath present federal regulation, insurers will not be required to supply Medicare Supplemental Insurance coverage (additionally known as Medigap) plans to sufferers below 65 years of age. Whereas Medicare pays for 80 p.c of a person’s healthcare prices, sufferers are required to cowl the remaining 20 p.c out-of-pocket. Consequently, Medicare beneficiaries who stay in states with out added affected person protections for people below the age of 65 usually wrestle to cowl their well being care prices. The shortage of supplemental insurance coverage additionally stays a major barrier for a lot of dialysis sufferers attempting to safe a kidney transplant, as they’re usually required to reveal they possess the remaining funds to cowl a probably life-saving transplant surgical procedure with a purpose to stay “lively” on the transplant ready checklist.
Well being coverage specialists usually criticize Medigap’s reduction from price sharing as including to Medicare expenditures. Nonetheless, utilizing Medicare price knowledge from 2017-2019, HMA estimated that extending Medigap protection to all ESRD sufferers below the age of 65 would solely add about $50 million in federal expenditures over the subsequent 10 years. HMA actuaries in contrast the utilization of companies by twin eligible dialysis sufferers vs. Medicare-only dialysis beneficiaries, and located that the one related enhance in price was in drug spend. HMA suspects that by increasing entry to Medigap protection, extra dialysis sufferers may have the cash to pay for all of their prescribed medicines, as their supplemental insurance coverage would now cowl their different well being care associated bills. Subsequently, HMA projected a de minimis price enhance to Medicare on account of elevated utilization below Half D following the growth of Medigap entry to sufferers below 65 years of age. On the similar time, the potential enhance in medicine adherence might result in higher well being outcomes and decreased problems. The total report by HMA is accessible at: https://www.dialysispatients.org/wp-content/uploads/2021/09/DPC-Est-Impact-Jack-Reynolds-Memory-Medigap-Exp-Act.pdf.
“For states that do not have protections for ESRD sufferers below 65, like my residence state of Alabama, many sufferers do not have anyplace to show,” mentioned DPC Board President Andrew Conkling. “In lots of instances the place insurers do provide Medigap protection for ESRD sufferers below 65, the plans are nonetheless not reasonably priced. With out that protection, the prices may be overwhelming, and it may be tougher to obtain a kidney transplant.”
DPC is calling on Congress to enact the Jack Reynolds Memorial Medigap Growth Act, which was introduced earlier this yr by Representatives Cindy Axne (D-IA) and Jaime Herrera Beutler (R-WA), to assist present ESRD sufferers with the supplemental insurance coverage they should stay financially safe. DPC just lately launched an interactive State Report Card on Medigap Entry and Affordability for ESRD sufferers below 65 out there at: www.DialysisPatients.org/Medigap
“At the moment, it is as much as every state to find out whether or not Medigap plans are bought to folks youthful than 65 years outdated who might qualify due to their kidney diseases,” Rep. Axne mentioned. “The difficulty that bothered Jack Reynolds – for whom this invoice is called – and what bothers me is that these Medigap plans have an pointless age cap regardless of solely being open to these with critical diseases. Kidney points can occur at any age. For Jack, he was solely 4 years outdated when he was injured, and 22 when his kidneys started to fail. The bipartisan laws I am main with Congresswoman Herrera Beutler would make this commonsense repair to allow sufferers of all ages to get the protection and care they want.”
“People dwelling with finish stage renal illness ought to have entry to life-saving medicines, dialysis, and kidney transplants wanted to deal with their sickness,” Rep. Herrera Beutler mentioned. “Sadly, hundreds of People below the age of 65 dwelling with ESRD are barred from acquiring a Medigap plan that would assist cowl the price of these therapies. I am proud to accomplice with my colleague, Congresswoman Axne, on this vital laws to place Medigap plans inside attain and thereby guarantee sufferers – no matter their age – can entry the care they want.”
With greater than 30,000 affected person members, Dialysis Affected person Residents (DPC) is a patient-led, non-profit group working to enhance the standard of life for all dialysis sufferers via training and advocacy. Study extra right here: https://www.dialysispatients.org/
CONTACT: Hannah Bracamonte, firstname.lastname@example.org
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SOURCE Dialysis Affected person Residents