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From the Appalachian Mountains to our Gulf Coast beaches, Alabama is filled with outdoor adventure and scenic wonder. Our cultural heritage is celebrated through music, art, and food, with deep ties to jazz, blues, and Southern cuisine. With strong educational institutions and a growing economy, Alabama is a place where tradition meets progress, making it a wonderful place to live and visit. With all of our good, we do face some unique challenges.
From the 1950s to 2016, our state’s health was on the rise, but since then, we’ve been struggling. The mortality rate in Alabama shot up in 2020 and remains high today, largely driven by the rise of chronic illness in our state. Despite the current public health trends, if we work together, we can put Alabama on the right path.
We can do so by addressing one of the leading causes of death in Alabama: kidney failure, medically known as End Stage Renal Disease (ESRD). Alabama’s kidney failure rates are rising, and many new Alabamians remain financially ill-equipped to confront this or any serious medical condition. To add insult to injury, a recent Supreme Court ruling imposed significant financial challenges for kidney patients, and we need Congress to step in to prevent current trends from becoming even worse.
Over 10,000 Alabamians receive dialysis, the physically taxing treatment typically done three times per week that filters patients’ blood in place of the kidneys. Yet it’s become even more difficult for many working Alabamians to access and pay for dialysis care due to a Supreme Court decision that allowed employer-provided insurance plans to discriminate against new dialysis patients by denying basic coverage for dialysis. In response, Alabama’s members of Congress must help pass the Restore Protections for Dialysis Patients Act (H.R. 6860), which would restore legal protections to these vulnerable patients.
In Marietta Memorial Hospital Employee Health Benefit Plan v. DaVita Inc., the Supreme Court ruled that employer-provided insurance plans can refuse to provide adequate coverage for new dialysis patients’ treatment, essentially pushing them onto Medicare before they’re ready. Previously, new dialysis patients with employer-provided health insurance could keep that insurance for the first 30 months of care. That “coordination period” allowed new dialysis patients to enjoy better coverage, removing financial worries in the crucial beginning months of care. Now, dialysis patients no longer can rely on this legal protection.
The Restore Protections for Dialysis Patients Act is premised on the notion that hard-working dialysis patients deserve coverage for life-saving care. I come across hard-working people in our great state daily who somehow balance careers and family with medical treatment. It’s exhausting, especially for dialysis patients in a rural state with a shrinking number of dialysis clinics and vast racial disparities in care. These Alabamians need protection from financial and medical injustice.
Consistent dialysis treatment costs over $100,000 per year, which is why virtually all dialysis patients rely on insurance of some kind. For most families, private insurance remains essential to covering the costs of treatment. Even when working dialysis patients eventually transition to Medicare, which is required by law, they still rely on private insurance to cover the remaining 20 percent of costs that Medicare doesn’t cover. They work for their coverage, an admirable fact that must be encouraged, not inhibited.
Instead, patients who don’t qualify for Medicaid now must either pay out-of-pocket for 20 percent of the costs or, for the over 50 percent of Alabama’s dialysis patients under 65, pay extremely high premiums for Medicare supplemental insurance plans. Adding this immense financial stress on top of the existing stress of dialysis treatment only makes health outcomes worse.
Patients who worked their whole lives shouldn’t lose the coverage they deserve. Luckily, Congresswoman Terri A. Sewell, D-AL, and Congressman Gary Palmer, R-AL, have the power to help push H.R. 6860 to the floor of the House of Representatives to stop this injustice. Rep. Sewell has already cosponsored this bipartisan bill, and Rep. Palmer can follow suit. Together, they can work across party lines to advance H.R. 6860 for Alabama’s kidney patient community.
