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Reps. Sweeney, Callender Provide Sponsor Testimony to Expand Medigap Coverage

HB 400 aims to provide access to medigap coverage for patients diagnosed with ALS and ESRD
April 10, 2024
Bride Rose Sweeney News

COLUMBUS – State Reps. Bride Rose Sweeney (D-Westlake) and Jamie Callender (R-Concord) today provided sponsor testimony on House Bill (HB) 400 to the House Insurance Committee. HB 400 aims to extend Medigap coverage to patients in Ohio diagnosed with End Stage Renal Disease (ESRD) and Amyotrophic Lateral Sclerosis (ALS). While ESRD and ALS patients are federally eligible to receive Medicare Coverage, Ohio does not allow them to purchase Medigap coverage.

This bill has the potential to impact 2,672 individuals under age 65 living with end stage renal disease on Medicare and another 1,200 individuals living with ALS in Ohio. According to the ALS Association, it costs nearly $90K in out-of-pocket expenses to cover the cost of caring for a person with ALS. ESRD patients need dialysis treatments three times a week to stay alive, which can cost up to $18K a year in out-of-pocket costs.

“People living with ALS shouldn't have to spend their limited time focused on fighting insurance and losing sleep worrying about the medical debt they’re going to leave behind,” said Kara Nett Hinkley, Vice President of State Policy at The ALS Association. “Instead, they should be able to focus their last months and days on family, their friends, the things that really matter. Policymakers can make Ohio the 18th state to enact similar protections so that no Ohioan living with ALS is left without affordable Medigap options when facing this devastating terminal illness.”

By extending Medigap coverage to ESRD and ALS patients, it would eliminate the often-crippling financial burden these diseases place on families. Medigap coverage, also known as a Medicare supplement insurance plan, is an additional insurance plan that can be purchased to assist with covering expenses not paid by Medicare. This can include things like co-payments, co-insurance costs, and deductibles.

“This critically important bipartisan legislation will help around 2,600 under-age 65 Ohioans with End Stage Renal Disease who are covered by Medicare, but not on the state’s Medicaid program,” said Hrant Jamgochian, J.D., LL.M, CEO of Dialysis Patient Citizens.  “Dialysis patients deserve to be treated equitably -- no matter their age -- with access to affordable Medigap coverage, which provides access to life-saving kidney transplantation and helps families struggling with ESRD to avoid medical bankruptcy in order to afford their medical care. We urge the swift passage of HB 400.”

Nationally, 12% of all Medicare enrollees are eligible due to a long-term disability rather than age. 17 other states have already adopted similar legislation to extend Medigap Coverage to ESRD and ALS patients. Actuarial analysis from the Health Management Associates indicates that expanding Medigap coverage to ESRD and ALS patients in Ohio would only lead to a 0.5% increase in premiums, taking the monthly payment from $188 to $189.

HB 400 doesn’t just make sense for the patients and families impacted by these heartbreaking diagnoses, it makes sense for Ohio taxpayers too,” said Rep. Sweeney. “This bill takes a measured, fiscally-sound approach by which we can offer support to terminally ill patients and families in need, without forcing people to join the Medicaid rolls or overburdening the private insurance system.”

“Every year, hundreds of families here in Ohio receive the crushing news that their loved one has been diagnosed with a terminal disease,” said Rep. Callender. “By removing the additional burden of potentially crippling medical debt, friends and family will be able to focus on the things that matter, spending time with their loved one and ensuring quality of care”

HB 400 now awaits proponent testimony in the House Insurance Committee. 

EDITOR’S NOTE: A picture of Rep. Sweeney delivering sponsor testimony is attached to this press release.