Commentary: Assembly bill could make it harder for some dialysis patients to receive treatment

A patient undergoes dialysis at a clinic in Sacramento in 2018. The state Assembly is reviewing a bill on how such treatments are delivered.
(Photo by the Associated Press)

The California Assembly recently voted on a matter of life and death for me and thousands of other Californians living with failed kidneys.

If it sounds dramatic, it is because it is.

At age 50, I depend on a charitable financial grant from the nonprofit American Kidney Fund to help pay for my daily at-home dialysis. Without the grant, I cannot afford the treatment. Without the treatment, I will die. Assembly Bill 290, supported by California’s health insurance companies, will force AKF to cease operating its program in California, hurting me and the more than 3,700 Californians who rely on its financial assistance.

This is because provisions in AB 290 conflict with the strict federal guidelines under which AKF operates and, rather than risk its operations nationwide, AKF will simply stop offering assistance in California. The bill recently passed the Assembly and is headed to the Senate.

When I was 30 and first suffered kidney failure as a result of hypertension, my brother gave me one of his kidneys. I lived a healthy life for 19 years after the successful transplant, working in the mortgage business. But that kidney failed in 2017, forcing me back on dialysis. I lost 30 pounds and was so sick for six months I could not work. Even after returning to work, I soon got laid off because my illness prevented me from bringing in business.

Today the AKF’s charitable premium assistance, along with COBRA from my previous job, combine to pay for expensive dialysis treatment that cleans my blood and removes toxins from my body. This treatment keeps me alive.

AB 290, as the insurance companies designed it, means I will lose my financial assistance and I will be unable to pay my insurance premiums. I will be forced on to Medicare which I don’t want. It will not provide the medical coverage that is best for me.

I’m not alone. There are more than 3,700 dialysis patients in California who will lose financial assistance if AB 290 passes and AKF is forced to stop offering its services in California.

By forcing dialysis patients on to government-funded health care plans, AB 290 will threaten the long-term viability of dialysis clinics since government reimbursements don’t cover the cost of care. If dialysis clinics are forced to cut back services or close because they can’t cover their costs, patients will end up in emergency rooms where care is up to eight times more expensive. The health care system as a whole, and taxpayers, will bear the burden of higher costs.

Not surprisingly, AB 290 also allows insurance companies to pay less to dialysis providers as reimbursement for dialysis treatments. Of course that’s why the insurance industry is supporting the bill. But it doesn’t force insurers to pass any of their savings to consumers. A win-win for insurance companies, but not for patients.

I am trying to do my part to contribute to my health care; working part time and awaiting a kidney transplant on the UC Irvine Medical Center donor list. But it will be years, most likely, before I can get another kidney.

If AB 290 passes, it would cruelly revoke my insurance, right when I need it the most. Dialysis that keeps me alive might be pulled away from me before I even get a chance for my name to come up on the transplant list. I will be forced to either live so far in debt I won’t be able to afford food or shelter, or I will die.

This bill, quite literally, is targeting some of California’s poorest and sickest residents.

It is that simple, and that sad.

Duc Dang lives in Irvine.

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