For 2 years, the American Kidney Fund has engaged with a broad coalition of patient and disease groups, community organizations, minority advocates, veteran and taxpayer groups and medical associations in fighting legislation, like California’s A.B. 290, that harms low-income, mostly minority patients by threatening their access to health care.
A.B. 290 — supported by health insurers and labor unions — guts protections at the heart of the federal advisory opinion governing our Health Insurance Premium Program (HIPP). It would require us to disclose to insurers the identity of poor and largely minority grant recipients treated by certain dialysis providers — solely because they need charitable help to pay their bills. This disclosure plays fast and loose with the federal anti-disclosure requirements for our program, for all programs like it nationwide, and with the underlying law. We simply cannot comply with a state law that forces us to violate federal law; it would endanger the essential safety net we provide to 75,000 patients nationwide.
A.B. 290 would require AKF to ask the federal HHS Office of Inspector General (OIG) to approve this disclosure, which can be done only by seeking a new advisory opinion that would govern our program nationally. The OIG approved our program because it is a blind donation system. We don’t disclose donors, nor do we disclose patient information. This way, provider donations are not likely to influence a patient’s selection of a provider and indeed, about half the providers with patients in our program do not contribute. The OIG drew this conclusion in large part because we certified that patients would not be informed of whether a provider donated to AKF.
There is precedent that leads to our concern. The OIG has revoked at least one nonprofit advisory opinion — one containing the same safeguards against disclosure — for making the same type of disclosures that A.B. 290 requires.
The legislature has forced a decision we never wanted to make If signed by the governor, we must stop providing financial assistance to California dialysis and transplant patients. AKF is not giving up. We continue to fight for the ability to help needy patients in California. But for now, we have no choice.
- LaVarne Burton
American Kidney Fund