Iowans deserve stability in kidney care

Iowans take pride in resilience. From farmers weathering storms to small-town families coming together in hard times, our state is built on neighbors looking out for one another. For thousands of Iowans living with kidney failure, that resilience is tested every single week by the reality of dialysis.

Dialysis is the only treatment outside of a transplant for end-stage renal disease (ERSD). It requires patients to spend hours at a clinic multiple times each week just to stay alive. That burden alone would push anyone to their limits. But because of a recent U.S. Supreme Court ruling, Iowa families coping with kidney failure now face another threat: the possibility of losing their private health insurance coverage far earlier than expected.

Historically, patients starting dialysis could count on their employer or private health plan to remain their primary coverage for 30 months before transitioning to Medicare. That window was critical. It gave patients time to adjust to their new reality, protect their finances, and explore supplemental coverage options to fill the gaps that Medicare leaves behind.

The Supreme Court’s decision opened the door for private insurers to scale back or deny dialysis coverage, essentially forcing patients onto Medicare prematurely. And Medicare only covers 80% of dialysis costs. The rest, often thousands of dollars every month, falls on patients and their families. Many end up draining their savings or spending down their assets to qualify for Medicaid, placing strain on families and state resources alike.

For Iowa’s dialysis community, the consequences are serious. More than 5,400 Iowans are living with kidney failure, including nearly 3,000 currently on dialysis, while only about one in three patients on the state’s transplant waiting list received a kidney in 2023. Patients who lose private insurance too soon face reduced access to physicians and medications, and they have a harder time getting a transplant. This isn’t just about paperwork or billing codes, it’s about survival and dignity.

There is a solution. Congress can fix this problem by passing the Restore Protections for Dialysis Patients Act (S.1173). This bipartisan bill would reinstate the long-standing 30-month protection and ensure that patients get the coverage they were promised when they paid into their insurance plans. It doesn't expand government spending or create new programs. It simply restores fairness and stability.

Sen. Chuck Grassley has long championed Iowa seniors and families. As a senior member of the Senate Finance Committee, he is uniquely positioned to help dialysis patients here at home and across the country by supporting this critical legislation.

Iowa families shouldn’t be forced into medical debt or denied a fair chance at a kidney transplant because of an insurance loophole. They deserve security during one of the hardest chapters of their lives.

By backing the Restore Protections for Dialysis Patients Act, Sen. Grassley can help ensure that dignity, stability, and fairness remain within reach for Iowans fighting kidney disease.

Deann Lagrange lives in Iowa City.