Del. Bagnall: Medigap Bill Would Provide Much-Needed Choice to Md. Dialysis Patients

By Del. Heather Bagnall

The writer, a Democrat, represents Anne Arundel County’s District 33 in the Maryland House of Delegates. 

For years, as a full-time performer I experienced first-hand the challenge of lack of access to affordable, comprehensive health care; the fear of an illness or injury which could have a catastrophic impact on my livelihood and financial health.

The Affordable Care Act was a game changer for so many, providing access to the peace of mind which comes with health coverage, and having the right coverage makes a world of difference for people. However, with the passage of the Affordable Care Act, the gaps in coverage, the challenges of ensuring affordability became more and more clear, and medical bills can quickly mount and create serious problems for patients and their families.

Unfortunately, for many patients younger than 65 who have End-Stage Renal Disease (ESRD), that is exactly the case. Since many have to rely on Medicare to cover large portions of their treatments, any costs that Medicare doesn’t cover on its own need to come out of their pockets unless they live in a state that offers protections guaranteeing them access to Medigap coverage.

Even in Maryland this is a problem, because access is not the same as choice, and while state law does require a plan to be available to ESRD patients younger than 65, choice is limited.

Because there is no one-size-fits-all solution when it comes to a patient’s coverage, expanding the options that are open to ESRD patients would help to make sure every patient has exactly what they need to be able to afford their care.

A new bill in Congress could help to do that by expanding the options available to ESRD patients.

Del. Heather Bagnall (D-Anne Arundel).

The Jack Reynolds Memorial Medigap Expansion Act, introduced earlier this year, would make Medigap plans easier for dialysis patients under 65 to access, ensuring that they can get coverage that meets their needs, rather than having to meet the costs traditional Medicare doesn’t cover on its own or trying to work within the coverage offered by the limited options in their state.

Having that coverage is life-changing for patients. It offers an enormous and welcome sense of financial security since they won’t have to pay for up to 20% of their dialysis treatments, which many patients need three or more times every week.

Without Medigap coverage to pay for the portions of the treatments that Medicare doesn’t on its own, those bills add up quickly and can leave patients unable to afford the very treatments that they need to stay alive.

The benefits of having coverage go beyond financial security and peace of mind, too.

Having Medigap coverage can keep patients eligible to eventually receive a kidney transplant and get off of dialysis treatments altogether. Making this coverage more widely available is smart, common-sense and fiscally responsible policy that will make an immense difference in patients’ lives.

For the sake not just of Maryland’s more than 15,000 dialysis patients, but for every ESRD patient across the country, Congress needs to make passing the Jack Reynolds Memorial Medigap Expansion Act a priority.

Thankfully, one of Maryland’s members in the House of Representatives could help to make that happen.

Rep. Steny Hoyer (D-MD-5) is House majority leader, and in his position can help to get this over the finish line. With his support, this bill can pass, and I hope both he and Maryland’s other elected officials in Washington give the bill the support it needs to finally pass into law and provide dialysis patients with the peace of mind they deserve.

Maryland has long been a leader in health care innovation for our state, and now we can be a leader for the nation.

Living with kidney disease already presents a range of challenges. Simply affording the care it requires shouldn’t be one of them.

Unfortunately, that’s the reality for too many dialysis patients across the U.S., who are unsure of exactly how they will be able to cover the costs of their treatments.

Congress has an opportunity to solve that problem by passing the Jack Reynolds Memorial Medigap Expansion Act, and it’s one patients are counting on them to take.

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