Marysville Appeal-Democrat

Insurers keep going after dialysis patients

- By Thomas D. Elias

The relief California’s 66,000 kidney dialysis patients felt last fall after two serious threats to their survival were beaten back has turned out to be short-lived.

Not only are labor unions contemplat­ing a second attempt to pass something like last year’s failed Propositio­n 8, but there’s also an attempt to revive a legislativ­e proposal that could throw thousands of patients who require dialysis to stay alive off the expensive treatment.

Because labor interests like the Service Employees Internatio­nal Union, which sponsored Propositio­n 8, lost by a solid 62-38 percent margin last year, that possible revival looks like the less threatenin­g of this dangerous pair.

Propositio­n 8 aimed to put more union workers

in hundreds of dialysis clinics, where patients with end-stage kidney disease sit for at least three hours, three times a week while their blood runs through filtering machines that cleanse it of toxins normally removed by healthy kidneys. It would have forced closure of an unknown number of clinics by demanding they withhold payment from key workers and officials.

(Full disclosure: The writer underwent six months of dialysis before receiving a kidney transplant.)

The other threat last year came from a legislativ­e bill carried by Democratic state Sen. Connie Leyva of San Bernardino County. Her measure could have thrown dialysis patients off their health insurance plans if they accept third-party aid in paying premiums.

For some dialysis patients, such aid is critically important. Many are so exhausted and weakened by the constant blood interchang­es they endure that they cannot work, living on fixed disability payments and other forms of welfare. Premium assistance can be the means for staying alive.

But Leyva’s bill, known as SB1156, quickly moved through several legislativ­e committees, eventually passing handily in part due to support from unions that saw it as somewhat similar in impact to their ballot initiative, which eventually failed. Fortunatel­y for dialysis patients, then-gov. Jerry Brown vetoed that bill.

But it is back, a near clone sponsored this time by Democratic Assemblyma­n Jim Wood of Healdsburg, whose district includes much of the state’s North Coast. It would require organizati­ons providing charitable financial aid to dialysis patients to disclose their identities to insurance companies. This bill is part of a national effort by insurers to force such patients off their books and onto public coverage like Medi-cal. Essentiall­y, the insurance companies seek to transfer their expense to taxpayers.

Dialysis does cost a lot, often running more than $6,000 per month and sometimes above $50,000. So the new measure can have two major effects: Limiting some people’s ability to get dialysis and increasing insurance company profits.

No one yet knows how Wood’s new bill, known this time as AB 290, will eventually fare. But there are few new faces in the Legislatur­e, and there’s little new about the identity of their financial backers. Which will likely place the fate of thousands of dialysis patients in the hands of Gov. Gavin Newsom, who has said nothing about this bill.

There are ironies here. One comes in the brief bio posted on Woods’ official website, where the longtime dentist brags that he’s “been successful in passing legislatio­n to protect and expand (access to) medical, dental and mental health care…”

His new bill would have the opposite effect. Because it allows insurance companies to reimburse dialysis clinics at rates below the

 ??  ?? Thomas D. Elias writes on California politics and other issues.
Thomas D. Elias writes on California politics and other issues.

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