Precinct Reporter Group News

Main Menu

  • Home
  • About
  • Contact Us
  • Read Our E-Edition
  • ADVERTISE
Sign in / Join

Login

Welcome! Login in to your account
Lost your password?

Lost Password

Back to login

logo

Precinct Reporter Group News

  • Home
  • About
  • Contact Us
  • Read Our E-Edition
  • ADVERTISE
  • What Holds Up COVID Vaccines

  • Black Doctors Call for Urgent Action During COVID-19 Crisis

  • Blood Runs Low: Calls for Black Donors

  • LBUSD: Member Erik Miller Excited to Begin Work

  • Tustin Mayor Letitia Clark Discusses Goals

Latest PRGNews
Home›Latest PRGNews›Kidney Patients Fight SB 1156

Kidney Patients Fight SB 1156

By Precinct Reporter News
June 28, 2018
4491
0
Share:

By Dianne Anderson

If SB 1156 passes, local kidney transplant recipient Philip Silva fears that patients like himself, suffering kidney disease and over a decade on dialysis, risk getting pushed off their insurance or losing their homes in the process.

On the surface, he said SB 1156 (Connie Leyva, D-Chino) almost sounds good.

“But it has implications that nobody is aware of,” he said. “The attacking the kidney [disabled], they’re using us as pawns.”

Being under 65 years old, the only reason he qualified for Medicare was that he was an end-stage renal patient, but it wasn’t enough to cover his costs.

In the past, he received Medicare statements for his home-based peritoneal dialysis, with costs of $2,166.20 for one post-transplant drug, of which Medicare only picked up $187.52. His supplemental insurance also picked up only 20 percent.

His second job disqualified him from taking Medi-Cal, which is typical for end-stage renal patients to receive, but Medi-Cal came with strings attached.

He received Medi-Cal notices stating they would take his house if he died, and that his wife wouldn’t be able to get the house.

Silva, on dialysis, had lost his job, and unable to carry premiums not covered by Medicare. Through his social worker, he accessed a Medigap Plan in Tennessee, and he received his kidney last December.

Because he was unable to work consistently, the nonprofit American Kidney Fund picked up his Medicare and Medigap premium for eight years.

“I would’ve been completely broke without American Kidney Fund,” he said. “Especially when you get the transplant, it’s [costs are] outrageous.”

Silva, an adult education teacher, said through the ordeal, both he and his wife survived off his wife’s part-time income as a teacher, and AKF charitable donations.

It’s been rough.

Now he is looking for full-time work. He expects to return part-time as an adult education teacher in the coming weeks.

Opponents say the 90 day wait period to determine if the insurer will accept a charitable payment puts the patient at risk getting thrown off coverage without recourse.

Holly Bode, vice president of government relations at AKF, said they oppose the bill because it puts patients in the middle of SEIU’s efforts to organize dialysis clinics and the insurers’ battle with providers over reimbursement rates.

If longer waiting periods are established to receive financial help, she said that would harm patients and cause them to lose their coverage.

“What’s important to us is that patients have the ability to choose the insurance plan that is best for their individual and family situations, even if they need charitable help to pay their premiums, without undue administrative burdens or delays,” she said.

For patients like Silva who are under 65 years old, Medicare is often not the best choice. In California, patients can not access Medigap plans to cover the 20% co-insurance on all medical treatments. Medicare only covers 80 percent.

Mr. Silva is a good example of why options are important to dialysis and transplant patients, she said.

“AKF pays premiums for the full plan year and in many cases, like Mr. Silva’s, for many years. We are not a dialysis provider and we are not a financially interested third party. We are a nearly 50-year-old charitable organization that has received the highest ratings from charity watchdog groups like Charity Navigator,” she said.

Earlier this year, Sen. Leyva released a statement that requiring financially interested third parties to pay entire year premiums ensures that patients do not lose health coverage mid-year. She said the measure would require provider-funded organizations to follow disclosure requirements, and certify that consumers do not have better available options open to them.

“These providers have a right to make a profit, but not when those financial interests can hurt patients or even keep them from receiving the care they need,” she said.

She said the commonsense safeguard prevents patients from getting caught up in schemes where they may lose their health insurance, which could ultimately raise premiums for other Californians.

Under SB 1156, Sen. Leyva said that low-income patients that are eligible for Medi-Cal will continue to have their treatment covered by Medi-Cal, and that SB 1156 does not change any patient’s eligibility for any particular insurance or program.

“If an organization decides to stop paying the premiums of Medi-Cal eligible patients, those patients would be able to have their treatment covered promptly by Medi-Cal so that they would be able to continue to receive care. A financially interested third party would be able to continue making payments, but would receive the lower of the contracted rate or the Medicare rate,” Sen. Leyva said in an email.

TagsAmerican Kidney FunddialysislegislationMedi CalMedicareprecinct reporter
Previous Article

Children’s Fund Helps Nonprofits Service Community

Next Article

Rep. Maxine Waters Takes Strong Stand for ...

0
Shares
  • 0
  • +
  • 0
  • 0
  • 0
  • 0

Precinct Reporter News

Related articles More from author

  • Latest PRGNews

    Covered California Special-Enrollment Period

    June 14, 2018
    By Precinct Reporter News
  • COVID

    County Issues Order Mandating Patient Safety Measures

    April 7, 2020
    By Precinct Reporter News
  • Latest PRGNews

    Schools Offer Food Help and More for Students

    November 5, 2020
    By Precinct Reporter News
  • Latest PRGNews

    Congressman Elijah Cummings Dies at 68

    October 24, 2019
    By Precinct Reporter News
  • Latest PRGNews

    Backpack Giveaways For Students

    July 30, 2020
    By Precinct Reporter News
  • Latest PRGNews

    High Desert Education Candidates Seek Votes

    October 1, 2020
    By Precinct Reporter News

You might be interested

  • Breaking News

    A Hard Lesson in Democracy

  • Latest PRGNews

    Atatiana Jefferson Killed by Police in Her Own Home

  • Latest PRGNews

    Obamacare Enrollment Deadline Extended

Ads

Find us on Facebook

Precinct Reporter News Group

Your local news resource for 50 years in the Inland Empire, Orange County, Long Beach and surrounding areas!

To subscribe or advertise, call 909.889.0597

About us

  • Broadcasting & Media Production Company
    357 W. 2nd Street
    San Bernardino, California, CA 92401
  • mailto:sales@precinctreporter.com
  • Recent

  • Popular

  • What Holds Up COVID Vaccines

    By Precinct Reporter News
    January 14, 2021
  • Black Doctors Call for Urgent Action During COVID-19 Crisis

    By Precinct Reporter News
    January 14, 2021
  • Blood Runs Low: Calls for Black Donors

    By Precinct Reporter News
    January 14, 2021
  • IE/OC Prostate and Breast Cancer, Change the Menu

    By PRGNews
    July 16, 2015
  • Join our Recipe Competition!

    By PRGNews
    July 16, 2015
  • SB Budget Cuts CDBG

    SB CDBG Cuts Have Local Nonprofits Braced for the Worst

    By PRGNews
    July 16, 2015

Follow us

© Powered by Hotspotwebsites.net. All rights reserved.