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Wednesday, December 25, 2024

Callender, Sweeney Introduce Legislation to Expand Medigap Coverage to Terminal Patients

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State Rep. Jamie Callender | The Ohio House of Representatives

State Rep. Jamie Callender | The Ohio House of Representatives

State Representatives Jamie Callender (R-Concord) and Bride Rose Sweeney (D-Westlake) have introduced legislation in Ohio to address a critical issue in the state's Medigap insurance market. The proposed bill, known as HB 400, aims to expand access to Medigap plans for patients suffering from Amyotrophic Lateral Sclerosis (ALS) or end stage renal disease (ESRD), regardless of age.

Medigap Coverage, also known as Medicare Supplemental Insurance, provides additional coverage to individuals to help cover out-of-pocket costs that are not covered by Medicare Part A or B. Expanding access to Medigap plans would prevent families of ALS or ESRD patients from facing overwhelming medical bills or having to spend down their assets to qualify for Medicaid.

Kara Nett Hinkley, Vice President of State Policy at The ALS Association, expressed support for the legislation, stating, "No family impacted by ALS should be denied the ability to purchase an affordable Medigap plan." She emphasized the importance of Ohioans living with ALS having access to affordable coverage that guarantees the care they need and provides financial security for their families.

Hrant Jamgochian, CEO of Dialysis Patient Citizens, applauded the proposed legislation for its potential to improve the quality of life for dialysis patients. He stated, "We urge swift passage of this critically important legislation," highlighting the positive impact it could have on preventing bankruptcies and improving access to lifesaving kidney transplants while saving Ohio Medicaid dollars.

LaVarne A. Burton, CEO of the American Kidney Fund, also expressed gratitude to the legislators for their leadership on the bill. She emphasized the critical need for affordable access to Medigap insurance for ESRD patients in Ohio. Burton explained that ESRD patients on Medicare face high out-of-pocket costs, and most transplant centers require secondary insurance such as Medigap for Medicare beneficiaries to be eligible for kidney transplants.

HB 400 would require insurance companies offering Medigap policies to individuals over 65 years old to extend this coverage to qualifying individuals under 65. These insurance companies would not be allowed to charge a higher rate for individuals under 65 compared to those who are 65 years old. Sixteen other states, including Pennsylvania, Missouri, and Kentucky, have already adopted expanded Medigap access.

Representative Callender emphasized the importance of relieving families from the stress of crippling medical bills, allowing them to focus on their loved one's care and quality of life. Representative Sweeney echoed this sentiment, stating that no one should have to bankrupt their family to pay for basic medical care following an ALS or ESRD diagnosis. She highlighted the balanced and targeted approach of the legislation to address the unique circumstances faced by these families.

HB 400 is currently awaiting consideration by the House Insurance Committee.

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