Dialysis Patient Citizens and American Kidney Fund explain why premium assistance bans discriminate against patients

4.22.16

Jackson Williams and Deborah Darcy, government affairs directors of Dialysis Patient Citizens and the American Kidney Fund, recently spoke to the National Association of Insurance Commissioners on the importance of charitable assistance for insurance premiums.

They addressed the association, made up of the chief health insurance regulators from each of the fifty states, at its annual meeting in April in New Orleans. The NAIC is an incredibly important body. While a state’s insurance commissioner might not be a household name, the decisions he or she reaches can have huge impact on the lives of patients dealing with chronic health conditions and chronic disease.

Insurance carriers are increasingly refusing to accept charitable assistance on behalf of patients. In as many as 38 states, patients have been told that their premium payments are no good because they have been getting help from a nonprofit. While it is insurers that are implementing these policies, the final decision on whether to permit this type of behavior rests with each state’s insurance commissioner.

“… insurance carriers are now using ‘an insincere interpretation of the CMS guideline to dis-enroll patients … erroneously claiming the guideline requires them to not accept the third-party payment and having enrollees sign a declaration saying the patient does not receive aid from charity assistance.”

Given how ambiguous federal regulatory guidelines on health insurance can be, these commissioners often have broad discretion in which type of policies they allow. Preventing insurance companies from rejecting charitable assistance to patients for instance is something these commissioners could do.

Darcy and Williams urged the commissioners to prioritize patients’ needs and to stop the purging of kidney patients from health insurance companies’ rolls.

Low-income dialysis patients have received financial assistance from nonprofit organizations for decades to help them maintain their private insurance or Medigap coverage.

Darcy noted that insurance carriers are now using “an insincere interpretation of the CMS guideline to dis-enroll patients … erroneously claiming the guideline requires them to not accept the third-party payment and having enrollees sign a declaration saying the patient does not receive aid from charity assistance,” according to Dialysis Patient Citizens.

The Chronic Disease Coalition is hopeful that insurance commissioners will hear this message and protect patients. Refusing to do so will only allow discriminatory policies to spread, putting more and more lives at risk.