Protect Charitable Premium Assistance, Protect Patients with Chronic Conditions

The Centers for Medicare & Medicaid Services (CMS) recently announced it is looking into claims by health insurance carriers about charitable financial assistance programs used by chronic disease patients.

Specifically, health insurance companies are concerned about patients with chronic conditions – who have ongoing needs/more costs associated with their treatment – choosing private health plans over public programs. Similar to before the Affordable Care Act was put in place, insurance companies are trying to get rid of patients who could cost more because of pre-existing and chronic health conditions.

While the public comment period ended at 5 p.m. on September 22, 2016, CMS has not yet issued a final decision on this issue.

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Additional facts:

  • While insurance companies have started this campaign against kidney dialysis, there’s no telling who who they’ll target next as they look to shift patients with chronic health conditions off of their plans.
  • The next targets could be patients with other health issues requiring ongoing or expensive treatments such as those used by people with lung disease, cancer, coronary artery disease or hemophilia.
  • We’ve already seen evidence of this with insurers refusing co-pay assistance programs for certain drugs, such as those required following surgery for cancer – discriminating against patients based on their disease.
  • Charitable assistance programs provide a lifeline to many patients struggling with co-pays and premium payments to treat a chronic illness.
  • A majority of patients relying on charitable assistance to pay premiums related to kidney disease treatment are racial minorities, and many live below the poverty line. Discrimination against patients using charitable financial assistance because they have end-stage renal disease has a disproportionate impact on racial minorities and the poor.
  • Join the Chronic Disease Coalition