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Hi All,

At the risk of "opening a can of worms," I will be posting and seeking your opinion about the new American Health Care Act or "Trump Care" as it makes it's way through Congress.  This bill has passed through the House of Representatives yesterday, and now moves on to the Senate.  The full details of the plan have just been released and the National Kidney Fund has offered an opinion on it.  Other health organizations will surely chime in, as the details become more widely viewed.  The NKF press release is below;


The National Kidney Foundation opposes the American Health Care Act (AHCA) as amended.  The amendment to AHCA, offered by Representative Tom MacArthur (R-NJ), raises significant concerns for millions of Americans affected by chronic diseases.  If this bill passes, National Kidney Foundation is highly concerned that insurers in some states will be granted additional flexibility to charge higher premiums, and apply annual and lifetime limits on benefits without a limit on out-of-pocket costs for those with pre-existing conditions, including chronic kidney disease.  The bill also permits waivers on Federal protections regarding essential health benefits which could limit patient access to the medications and care they need to manage their conditions.  These limits could also include access to dialysis and transplantation.  For these reasons, we must oppose the legislation as amended.
In addition, National Kidney Foundation is concerned that the elimination of income based tax credits and cost sharing subsidies, combined with the reduction in funds to Medicaid, will reduce the number of people who will obtain coverage; many of whom have, or are at risk for, chronic kidney disease (CKD). 
Improvements in access to, and affordability of, healthcare are needed to address the many challenges kidney patients face today.  We urge Congress and the Administration to address the following challenges in their plans to improve access to affordable healthcare:
  • Access to healthcare is critical to detecting and managing chronic kidney disease (CKD) earlier.  Earlier detection and management of CKD can often delay or prevent progression of kidney disease and the need for dialysis treatment, improve outcomes for patients and lower healthcare expenditures.  NKF urges Congress to enact policies that maintain or increase the number of insured patients, which will enable earlier detection of CKD.
  • People with end stage renal disease (ESRD) require either a transplant or dialysis to survive.  Dialysis treatment becomes a lifelong physical, emotional and financial commitment.  As such, insurers should be prohibited from rejecting third party premium assistance payments provided by charitable organizations on behalf of ESRD patients and limiting coverage to people with ESRD who choose not to enroll in Medicare.
  • Most patients receive dialysis in outpatient clinics three times per week; four hours per treatment. Provider networks that significantly limit options for where patients are allowed to receive dialysis can result in patients traveling greater distances to receive care.  These limited options place a significant hardship on an extremely fragile patient population; network adequacy standards should take their fragility into consideration.  
  • Over 200,000 ESRD patients have received a life-saving kidney transplant and must take immunosuppressive drugs for the life of the transplant. 
    • The insurance practice of placing immunosuppressive medications, including generics, on high cost sharing tiers requiring coinsurance amounts of greater than 20% and up to 50%, while also excluding generic immunosuppressive medications from fixed copayment amounts, severely jeopardizes the long-term success of the transplant.  
    • Cutting back on, or skipping doses of, immunosuppressive medications can be detrimental to the transplant and the patient.
    • Each year Medicare spends $87,000 per dialysis patient; opposed to $32,500 for a transplant patient.  Transplantation is far more cost effective than a lifetime of dialysis. 
  • In addition, as a member of the National Health Council (NHC), NKF supports its domains and values for health care reform as these are essential to ensuring that people with chronic conditions are able to obtain and afford insurance. 
Kidney Disease Facts
1 in 3 American adults is at risk for kidney disease.  26 million American adults have kidney disease—and most aren’t aware of it.  Risk factors for kidney disease include diabetes, high blood pressure, family history, and age 60+.  People of African American; Hispanic; Native American; Asian; or Pacific Islander descent are at increased risk for developing the disease.  African Americans are 3 ½ times more likely, and Hispanics 1 ½ times more likely, to experience kidney failure.

The National Kidney Foundation (NKF) is the largest, most comprehensive and longstanding organization dedicated to the awareness, prevention and treatment of kidney disease.  For more information about the NKF visit

Publication Date: 

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  • Price of drugs and treatment cost are the primary concern, it these drugs are in reach of every body, then it would be a much better place to live in.  

  • Please sign and Share

    U.S. Senate: Senators Vote No for the ACHA
  • Medicaid funding to members make up only 5% of organ transplants performed, while Medicare members percentage is estimated at 90%.  Since the AHCA will cut Medicaid, I am hopeful the completed bill will include funding to those who need transplants outside the Medicare umbrella.

    Princeton .Edu pub.

    CMS statistics/requirements
  • I think to cost to produce meds will not change.  But what pharmacies charge certainly may change.  Best thing would be if we could order direclty and cut out the middle men.  

  • As I'm sure all of us are, I'm very concerned about this having even passed the House. Please, please please, if you live in the US: write, call, fax, and contact your senators! It's so imperative for so many reasons. Acne of all things is on the list of pre-existing conditions - who hasn't had acne at some point?! And a major concern is if you have on file that you were a victim of rape, it is also considered a pre-existing condition. There's just so much wrong with this bill it's painful. The best thing we can do is to make our voices heard and contact those who can make a difference! Praying for us all now.

    • I'm a nurse and a heart transplant ache shut the front door really! That's all I can say... my new heart can't afford to get upset over this act against humanity
    • My read of the Act is that pre-existing conditions are only an issue if you allow there to be a laps in coverage.  I think this is simple to avoid and proper as it is not fair to allow people to opt out of coverage and only seek coverage when they have a claim.  Can't have it both ways.  

      • That's not correct (putting aside the morality of letting someone die because he let his insurance lapse).  

        First, the House bill lets employers buy coverage for their employees with caps on what the insurer is required to pay out. As all of us know, transplants andrelated care are expensive. Second, the  House bill allows states to opt out of essential health benefits, including community rating, which is what stops insurers from charging people with pre-existing conditions more, and to force people into high risk pools.  The high risk pools are underfunded by the bill, and will result in substantial cost increases for sick people in the states that adopt them.  Third, the bill throws tens of millions of people off Medicaid, and a lot of these folks won't be able to afford coverage.   

        • No one "let" someone die.  That someone failed to keep his insurance current then it is not the fault of "they".  Personal responsbility is important.  Very.

          People with higher risk should pay more. It's how insurance and economics works.  Not sure how to fix that.  People who are at target weight and don't eat 10 lbs  of french fries a day should pay less.  

          • The underfunded high risk pools will include people who've had kidney transplants and need anti-rejection drugs, not to mention lots of other people with pre-existing conditions..  It's not just people who "eat 10 lbs of french fries."

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