What's happening in the states: June 2021

Welcome to our What's happening in the states blog series, where we provide monthly legislative updates on what the American Kidney Fund (AKF) is working on across the country to improve the lives of those living with kidney disease and protect living organ donors.

Although many state legislative sessions have already ended for the year, AKF is still working on more than 105 bills in 33 states. A whopping 29 bills have already been signed into law, and 15 more are currently awaiting governors' signatures. While the pandemic may have slowed most things down, it certainly did not stop our progress fighting kidney disease!

Since our last monthly update

Maryland and Texas have signed into law protections for living organ donors, joining Kentucky, New Jersey, Pennsylvania and Washington earlier this year. Texas has also signed into law another bill to prevent discrimination against organ transplant recipients, joining Arkansas, Georgia, Wyoming and Oklahoma this year as well. These important laws ensure that people with mental and developmental disabilities do not experience discrimination in their ability to receive an organ transplant.

Nevada signed into law legislation to establish a kidney disease task force in the state, and similar bills have already passed in Colorado and Louisiana and are currently awaiting the governors' signatures. Other task force legislation is moving through the state legislatures in Connecticut, Massachusetts, New Jersey and Oregon.

Nevada

There are more than 5,000 Nevadans who rely on life-sustaining dialysis, and the majority of them are under the age of 65. So, when a bill was introduced to expand Medigap (Medicare supplemental insurance) to Nevadans under 65, we were initially thrilled. Unfortunately, we quickly discovered that Medicare beneficiaries who have kidney failure were deliberately excluded from this bill. Our government relations team and dedicated AKF Ambassadors worked tirelessly to get people with kidney failure included. But since health insurance companies, who do not want kidney failure patients on their plans because they are expensive to cover, refused to agree with this change, the bill sponsor ultimately pulled the bill from consideration.

An integral part of AKF's mission is to fight health disparities, which have been brought into sharp focus by the COVID-19 pandemic and its disproportionate impact on communities of color — the same communities most impacted by kidney failure. Compared to white Americans, Black Americans are 3.4 times more likely to develop kidney failure, Native Americans are 1.9 times more likely and Asian Americans are 1.3 times more likely. Additionally, people of Hispanic ethnicity are 1.5 times more likely to develop kidney failure than non-Hispanics. Access to affordable, high-quality health insurance is crucial for people with kidney failure so they can get the care they need need to survive. One way to address this growing inequality is by expanding Medigap coverage to all Medicare-eligible patients under 65, including those with kidney failure.

But there is good news in Nevada! The governor recently signed a bill that requires health insurers to offer an open enrollment period of 60 days to current Medigap enrollees beginning on a person's birthday. This bill will allow people who do have access to Medigap coverage to change to an equal or lesser Medigap plan if desired at that time. Another bill has been signed into law to create an advisory council to work with the Nevada Office of Minority and Health Equity for those who are interested in issues relating to kidney disease. The council will work to increase education and awareness of kidney disease in the state, and address racial and other health disparities in kidney disease.

Colorado, Oregon and Louisiana

We have been working on a bill in Colorado (HB21-1171) that is very similar to the bill that just passed in Nevada to create an advisory council. Colorado's bill would establish a kidney disease task force that would be vital in keeping patients healthy and expanding kidney disease education in the state to prevent people in the earlier stages of kidney disease from progressing to kidney failure. The purpose of the task force is to work with various entities, both public and private, to ultimately create policy proposals for lawmakers and regulators to consider that will help reduce the prevalence of kidney disease. We expect the task force's recommendations to be meaningful and to specifically address the underlying health determinants of kidney disease, the treatments available (including increasing living organ donor transplant availability and access to greater modality options for patients), and education and outreach (specifically to populations most affected by this disease).

Like Colorado, a task force bill (HB 2421) is moving through the Oregon Legislative Assembly, and we have been meeting with state lawmakers in both the House and Senate to ensure the bill makes its way to Governor Kate Brown's desk for her signature. Our efforts have led to more lawmakers in the state understanding the importance of kidney disease awareness and preventative measures. We will keep you updated on the bill's progress as the final weeks of Oregon's legislative session start to wind down.

Finally, a task force bill (HCR87) is moving swiftly through the Louisiana State Legislature and passed the legislature where it awaits signature. We are excited to see how much interest there is in Louisiana to create a kidney disease task force. Out of these three states, Louisiana has the highest number of residents living with kidney failure. The opportunity to engage more with local entities, lawmakers and doctors is crucial in curbing the rising rates of kidney disease among Louisianans.

How can you help?

All these bills have a better chance of moving through the legislative process with your help! If you would like to contact your state elected officials about these bills or help with written or live testimony during bill hearings, please reach out to me, Melanie Lendnal, AKF's Director of state policy & advocacy, at mlendnal@kidneyfund.org.