Get Full Government Meeting Transcripts, Videos, & Alerts Forever!
Get email alerts on the Medicare Supplement topic
No spam. Unsubscribe anytime.
Senate committee hears bill to require Medigap availability for Medicare beneficiaries under 65 with ESRD or disability
Summary
Senate Bill 292 would require insurers to offer Medicare supplemental (Medigap) policies to beneficiaries under 65 who qualify for Medicare because of end‑stage renal disease or disability, at the same premiums and terms available to 65‑year‑olds; patient advocates and kidney organizations urged passage while insurers warned of premium impacts.
Senate Bill 292, sponsored by Sen. Roberta Lang, would require insurers that offer Medicare supplement (Medigap) policies to make those plans available to eligible Medicare beneficiaries younger than 65 who qualify because of end‑stage renal disease (ESRD) or qualifying disabilities.
“Most of you know Medicare is a federal health insurance program for seniors who are 65 years and older… a less known fact is that millions of individuals younger than 65 can also enroll in Medicare because they suffer from end stage renal disease or certain qualifying disabilities,” Lang told the committee.
Pamela Zielske of Dialysis Patient Citizens told the panel, “For dialysis patients, these costs can be as high as $16,000 per year.” She and other witnesses said states that require Medigap availability for the under‑65 Medicare population reduce financial strain and improve transplant access.
Stakeholders from the American Kidney Fund, Nevada Kidney organizations, transplant surgeons and patient advocates testified in support. Josie Gammes of the American Kidney Fund said Medigap is “a key requirement in the transplant evaluation process” and that without supplemental coverage many patients cannot meet transplant centers’ financial criteria.
An actuarial analysis in the record (Health Management Associates) was cited by supporters as estimating that offering Medigap to the under‑65 ESRD population at the same premium as a 65‑year‑old would increase the overall pool cost by about 0.9 percent (roughly $2 per month) and could save the state in Medicaid spending by preventing some patients from “spending down” to qualify for Medicaid.
Opposition testimony came from America’s Health Insurance Plans (AHIP), which warned insurers would bear disproportionately high costs for younger ESRD beneficiaries and said forcing Medigap rate parity could raise premiums for older, fixed‑income Medigap enrollees. AHIP noted ESRD beneficiaries typically have much higher per‑person costs than a standard 65+ enrollee.
No committee vote was recorded during the hearing. Sponsor Lang described an effective implementation timeline in the bill: an open enrollment period commencing Oct. 1, 2025, and running through April 1, 2026, and said the bill would adopt a standard premium‑setting method used successfully in other states.
Witnesses emphasized the bill’s limited scope: actuarial evidence shows the population affected in Nevada is small—supporters cited roughly 1,547 ESRD patients under age 65 with about 991 not eligible for Medicaid—while potential fiscal impacts on the broader Medigap pool were characterized as modest.
