To the editor:

Every day, thousands of Ohioans with kidney disease inspire others through their perseverance. Kidney failure, or End Stage Renal Disease (ESRD), is fatal without a kidney transplant or dialysis, a regular treatment needed to perform the kidney’s function. Like Charlene J. Smith — a dialysis patient and ordained pastor in east Cleveland, Charlene manages her ESRD with dialysis and lives an active lifestyle. The last thing she needs to worry about is covering her expenses. Unfortunately, that’s a reality many patients in Ohio like Charlene face.

A recent Supreme Court ruling could create financial pitfalls upending dialysis patients’ lives and preventing them from receiving a transplant. It’s time for Ohio’s congressional delegation, especially U.S. House Committee on Ways and Means members Brad Wenstrup (R-OH) and Mike Carey (R-OH), to step in and protect them.

They should help pass the Restore Protections for Dialysis Patients Act (H.R. 6860), which would prevent new dialysis patients from losing private insurance coverage and falling into debt. Fortunately, Congressman Wenstrup is a cosponsor of the bill, and I hope Congressman Carey will cosponsor it too. Congressmen Wenstrup and Carey care deeply about Ohioans’ access to healthcare. Wenstrup is fighting to expand hospital-grade healthcare access at home, and Carey is fighting to extend patient access to innovative treatments and emergency services. They can continue their fight to extend healthcare access to Ohio’s most vulnerable by ensuring that Ohio’s kidney patients do not continue losing their private coverage.

A little-known Supreme Court decision, Marietta Memorial Hospital v. Davita, opened the door for private insurance companies to discriminate against dialysis patients. The court’s decision could leave them with little choice but to switch to Medicare before they are ready to pay the 20% that Medicare doesn’t cover.

Before the court’s decision, a patient diagnosed with ESRD on an employer-provided insurance plan could keep that plan for 30 months before transitioning to Medicare. However, the court wrongfully protected an insurer that limited its dialysis coverage. This breakdown in precedent has led many new dialysis patients to drop their insurance plans and prematurely transition to Medicare. Prematurely shifting patients onto Medicare could impose lasting damage on the over 17,000 ESRD patients in Ohio.

Private plans often provide more comprehensive coverage, drastically improving a patient’s chances of receiving a kidney transplant. For better or worse, ESRD patients lacking coverage often remain ineligible for kidney transplants. The Court’s ruling could, therefore, exacerbate existing disparities in kidney transplant outcomes.

For instance, Black Americans are four times more likely to suffer from ESRD but remain much less likely to receive a kidney transplant. Wealthier Americans also enjoy far better transplant outcomes than lower-income Americans. Weakening coverage will only worsen these socioeconomic and racial disparities.

The Supreme Court’s ruling also prevents patients from living productive lives. Medicare only covers 80% of dialysis patients’ healthcare expenses, and dialysis patients either rely on Medicaid, Medicare supplemental insurance (Medigap) plans, or employer-provided private insurance to cover the remaining 20%. Those middle-class Americans with incomes above the Medicaid threshold rely either on Medigap or on their employers. While Ohio does offer Medigap, the plans are not affordable for ESRD patients under 65. And since dialysis patients are just grateful if their employers will let them keep their job, they often won’t challenge them if their private insurance policies are discriminatory or inadequate. Thus, many patients will be forced to stop working to qualify for Medicaid. We should not force Ohioans to stop working just to receive coverage for life-saving treatment.

We need Congressmen Wenstrup and Carey to make it a priority to protect dialysis patients in Ohio and work together to continue to build support for the Restore Protections for Dialysis Patients Act. This legislation would restore protections for the dialysis patients’ first 30 months of care, significantly increasing their chances of receiving a kidney transplant while protecting coverage for their dependents.

John R. Morrow,

Liverpool Township