Medicaid is a lifeline for millions of people who live with chronic kidney disease or are at risk of developing it, and who cannot afford to pay for health care on their own. At Northwest Kidney Centers, we see every day how vital this program is for our patients.
Right now, the U.S. Senate is considering a House-approved bill that would cut Medicaid by an estimated $715 billion. If passed, these cuts could leave 8.6 million more Americans without health insurance over the next decade, according to the nonpartisan Congressional Budget Office.
This isn’t just a budget issue. It’s a matter of life and death for thousands of kidney patients here in Washington and across the country.
Medicaid is a crucial safety net for people with low incomes or disabilities, helping them get the care they need. That includes preventive care to stop kidney disease before it starts, dialysis treatments to stay alive and access to kidney transplants. When people lose access to Medicaid, they may lose access to these services. Furthermore, almost every safety-net health care provider is already operating at a financial loss or close to break-even. Cutting funding for organizations already on the brink endangers the entire fabric of providers that work together to care for everyone. There is real risk for not only patients currently receiving Medicaid but for all patients that are served by health care providers operating in a fragile and underfunded ecosystem.
Preserving Medicaid funding is the right moral, humane and financial decision. We’ve already seen the difference Medicaid expansion made. Since 2010, 41 states and Washington, D.C., have expanded their programs to cover more people. According to a study published in the Journal of the American Medical Association, in those states, people have better blood pressure, better blood sugar control and better outcomes when kidney disease strikes. Nearly 75% of new kidney failure cases are caused by diabetes and high blood pressure/heart disease. Treating those early can prevent kidney failure altogether.
Further published data shows that in states that expanded Medicaid, fewer people died during their first year on dialysis. More patients were also added to the kidney transplant list early, meaning they could spend less time on dialysis and more time living their lives.
Here in Washington, Medicaid helps pay for dialysis treatments for low-income and disabled patients. But that’s only possible because the federal government helps cover the cost. If federal lawmakers change that to a fixed amount per state, through block grants or per-person spending caps, Washington could be forced to cut important services. That might mean that some of the services our patients depend on — rides to dialysis appointments, support for home dialysis or care coordinators to help patients manage their health, for example — would be deemed “optional” and would likely be cut.
Another part of the proposal would require all “able-bodied” adults ages 19-64 who receive Medicaid to work, volunteer, or go to school for at least 80 hours a month. That sounds simple, but for dialysis patients, it’s anything but.
Dialysis is not just a medical treatment; it’s a part-time job. Patients often sit through three treatments a week, four hours at a time and are often exhausted after these sessions. Studies show about 80% of dialysis patients are unable to work. The current proposal uses a vague definition of “able-bodied,” putting thousands of patients in danger of losing coverage they rely on to survive.
At Northwest Kidney Centers, we believe that every person deserves access to dialysis. We’re the largest nonprofit dialysis organization in the state. But Medicaid already pays us less than what it costs to provide dialysis. We make up the difference through private insurance and generous community donations. If federal reimbursements drop further, we may not be able to serve everyone who needs us.
Lawmakers must consider the real-world impact of these cuts. Dialysis care isn’t optional. It’s not elective. It’s essential.
We urge lawmakers to protect Medicaid, and the people whose lives depend on it.
If you would like to share your thoughts, please submit a Letter to the Editor of no more than 200 words to be considered for publication in our Opinion section. Send to: letters@seattletimes.com
